oct 26 2016 ambiguous loss for bbn group

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www.cmhagrb.on.c a Title CMHA Waterloo Wellington Dufferin Presentation April 3, 2013 www.cmhawwd.ca Sharing with Bereavement Breakfast Network Group Ambiguous Loss: Supporting families with missing loved ones Presented by: Maureen Trask Wed. Oct. 26, 2016 Assistance by CMHA Waterloo Wellington Dufferin www.cmhawwd.ca

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Page 1: Oct 26 2016 Ambiguous Loss for BBN Group

www.cmhagrb.on.ca

Title

CMHA Waterloo Wellington Dufferin

• Presentation

• April 3, 2013

www.cmhawwd.ca

Sharing with Bereavement Breakfast Network Group

Ambiguous Loss: Supporting families with

missing loved ones Presented by: Maureen Trask Wed. Oct. 26, 2016

Assistance by CMHA Waterloo Wellington Dufferin

www.cmhawwd.ca

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Topics

What is Ambiguous Loss?

The Experience of Those Left Behind (Families with Missing Loved Ones)

A Framework for Support

Recap and Q & A

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Daniel Trask

Missing Nov. 3, 2011 Found May 24, 2015

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What is Ambiguous Loss?

Dr. Pauline Boss, principal theorist of the concept of Ambiguous Loss and Dr. Gloria Horsley, founder and president of Open to Hope Foundation, discuss Ambiguous Loss at the annual Association of Death Education and Counseling (ADEC) Conference, 2011.

http://www.youtube.com/watch?v=C2vYyefAgZ0

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Ambiguous Loss Recap

Unclear Loss Senseless Loss Traumatic Loss Externally Caused Lacks Closure / Understanding Frozen Grief / Being Stuck in Limbo A Unique Individual Journey

Boss, P. (2009). The trauma and complicated grief of ambiguous loss. Pastoral Psych, 59(2), 137-145. Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA. Harvard University Press

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Types of Ambiguous Loss

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1. Physically Absent- Psychologically Present

2. Psychologically Absent- Physically Present

Adoption Migration Miscarriage and stillborn loss Missing people Natural disaster and catastrophic tragedy

Addictions Dementia and Alzheimer’s Mental health issues Separation/Divorce Traumatic brain injury or coma

There is no verification of death. There is no certainty that the person will come back

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Ambiguous Loss differs from traditional loss

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Traditional Loss Ambiguous Loss

Some knowledge and understanding from society and western culture

Lack of knowledge about what ambiguous loss is and its effects

Some services/supports available- grief counsellors/professionals

Tremendous lack of services and supports – lack of professionals that specialize or educated on this

Seen as “normal” because everyone at some point in their life has a loved one that dies

Seen as “not normal”, “complicated grief”, and not affecting the mass majority

Spiritual/belief teachings exist that speak to death and mourning

No spiritual/belief teachings discuss ambiguous loss

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Ambiguous Loss differs from traditional loss continued

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Traditional Loss Ambiguous Loss

Mourn the loss after the death Cannot mourn because no defined death to mourn

Customary rituals that allow for closure

Symbolic rituals that ordinarily support a loss do not exist. (Boss, 1999)

Some tolerance to the loss that results from a death.

Co-workers, peers, and society are less likely to tolerate ambiguity.

The loss as a result of a death is legitimized by society.

Ambiguous loss is not legitimized by society.

Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA: Harvard University Press.

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Why does it matter?

Freezes the grief process Paralyzes couple and family functioning Prevents “closure”

Families can name it, “Ambiguous Loss” Families need help Families need support

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What Families need to do…

•File Missing Person Report•Contact family, friends, last know locations•Handle jurisdiction changes•Deal with property (Home, Bills, MTO, Medical)•Manage triggers (Sightings, Remains, Psychics)•Maintain relationship with Police and searchers•Live with the ambiguity and uncertainty•Hopefully, find meaning10/25/2016 10 10

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How does one learn to ease the effects? Guidelines for resiliency while having to live with ambiguous loss: (Boss, 1999)

1. Find Meaning (look at values, beliefs, traditions)

2. Accept Uncertainty (make 2 opposing ideas into 1)

3. Reconstruct Identity (forced to change roles)

4. Normalize Ambivalence (as the new norm)

5. Revisit Attachment (celebrate the missing and mourn the changes)

6. Discover Hope (look at strengths, making it with the pain) 

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AFP Framework: 5 themes for working with families of missing persons

1. Reanimation: move past “frozen”2. A celebration so far: respond to loss3. The trauma timeline: explore the impact4. A protected place: safe place of pain5. Opportunities for growth: living with loss

© Commonwealth of Australia 2014 AFP Australian Federal Police, National Missing Persons Coordination Centre, Project Officer Sarah Wayland

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1. Re-animation

Move past “frozen” Help families with their

sense of being frozen to the time of their loved one's disappearance.

Assist families to move from their sense of feeling ‘stuck‘.

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2. A celebration so far

Respond to lossAcknowledge and honour the family's relationship

with the missing person.Facilitate families to find

an opportunity to respond to the current loss of their loved one.

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3. The trauma timeline

Explore the impact of the disappearance, as well as the accumulated traumas, families may have faced prior to their loved one going missing.

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3. The trauma timeline – example

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4. A protected place

A safe place of painCo-construct with families a space where they can

acknowledge the pain of not knowing while still finding ways to live life.

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5. Opportunities for growth

Living with loss Explore ways in which families can live with their loss, rather than being consumed by it.

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Support:Looks different to everyone

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“Someone to really listen…”

“Being present…”

“Just being there …”

…were by far the most popular ways to support someone

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First Nations Experiential Knowledge Circle / Learning Cycle

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Experiencing - Engagement in "Real life" learning experience Reflecting - Internalization of the Experience

Making Meaning - Analysis of the Experience

Acting - Application of Experience to other Real Life Situations

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As a Support and Helper(Facilitator)

Educate that grief is not a linear process Encourage to share story, call loved one by name and

educate on importance of this Help build strategies to cope with tidal waves of emotion Help cope with the tough questions: the ‘why’, ‘what if’

and ‘should of’ Help to recognize and build resilience Help externalize the loss to release blame and guilt Help find meaning in their experience of loss

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As a Support and Helper (Facilitator) continued Help embrace the paradox & move forward with the

“good enough” (Boss & Carnes, 2012)

Listen more and do less Empower to see loss in a new way Hold multiple truths about the missing person Normalize the experience, feelings, and thoughts Work collaboratively with the client(s) with a lowered

hierarchy Help build “… a new narrative that is less burdened with

negative attributions, which invoke guilt, shame, remorse, or desire for retribution” (Boss & Carnes, 2012)

Use tasks as guidelines10/25/2016 2222

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Recap and Q & A

Ambiguous Loss is an uncertain loss Triggers can impact the journey I’m not “crazy”, it’s the situation Each situation is unique and individual Families need support It’s about finding meaning and hope “Closure” is a myth, families want answers

Questions?10/25/2016 2323

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From me to each of you:

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Maureen Trask: [email protected]

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“Thanks”