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Book Review:
Ambiguous Loss: Learning to Live with Unresolved Grief
by Pauline Boss. ISBN: 0-674-01738-2
Publisher: Harvard University Press, 1999
Book
Review by Sandra Pace
 Many
people deal with unresolved and ambiguous losses in their lives.
Ironically, these ambiguous losses are often more difficult to
deal with than "definitive" losses such as death or
divorce, where one has a period of grieving and then can move
on in life. This slim volume describes ambiguous losses in a way
that makes them comprehensible. The book also points to ways to
deal with them.
Pauline
Boss describes ambiguous losses as those where a family member
is physically absent, but psychologically present because it’s
unclear whether they are dead or alive. She gives examples of
soldiers missing in action or kidnapped children, and those where
children are lost to adoption.
The
second type of ambiguous loss is where the person is physically
present, but psychologically absent, such as with Alzheimer’s
or other diseases, or in the grip of addictions or chronic mental
illnesses. The results of both of these types of loss are the
same, however, in that the grief is not resolved because the ambiguous
loss is in the situation, outside the person. The outside force
that freezes the grief is the uncertainty and ambiguity of the
loss, she says.
Ambiguous
loss is the most stressful loss people can face, Boss’s research
shows. When people suffering these losses are evaluated in the
traditional way, she argues they often look dysfunctional, exhibiting
anxiety, depression and somatic illnesses. They feel incompetent,
as it destroys one’s sense of mastery. Ambiguous losses can
freeze people in place so that they can’t move on with their
lives. These losses can traumatize, leading to Post-Traumatic
Stress Disorder, and ambiguous losses typically are a long-term
situation that traumatize and immobilize, rather than a single
event that has flashback effects. People feel helpless, and no
longer act, because they cannot have their hopes raised and dashed
so many times.
Though
not the focus of the book, Boss makes specific reference to
the losses in adoption, and the effects on the mother who loses
her child to adoption. She indicates that for the mother and
for many of the adopted people, knowing each other is necessary
to resolve the loss, even if their search yields news that is
less than ideal. She feels that adoptive families should recognize
that their boundaries are fluid and include the children’s
first parents, and that leaving unspoken ambiguity about the
family structure is unhealthy for the children.
Pauline
Boss indicates that with ambiguous losses, there is no right answer
for resolving them. Each person must create the best possible
answer for the moment, and understand that the answer will need
to be revised in the face of changing circumstances. Complicated
losses may seem hopeless and irresolvable, but the power to change
can never be taken from us, she says. . The confusion we feel
is due to the ambiguity rather than to anything we did or didn’t
do. She describes denial as an adaptation that can be useful,
but over time becomes less function. It is neither something to
avoid nor to advocate. What assists the most is a combination
of optimism and realistic thinking. People can manage this with
support from their own community and the professional community.
Of course, for those who have lost their children or their first
parents to adoption, this understanding is sometimes more difficult
to find.
It
is in reunion that I personally can relate to Pauline Boss’
explanation that we must temper our hunger for mastery and learn
to redefine our relationship to the person we’ve lost. The
pain of losing my child and the joy of him finding me again led
me to want to regain what had been lost: I wanted to be a mother
to my son. However, as I came to know him, I realized that I had
to constantly redefine what I hoped for in the situation. In the
end, the relationship I have built with my son is deep and loving,
but it is not entirely a mother/son relationship. There is ambiguity
in it. This ambiguity is not my fault, and it is not his fault.
It is inherent in the flawed institution of closed adoption. The
situation is wrong; we are not. We are damaged by it, and learning
to heal from it.
Boss
recommends that seeking information is an initial step to resolving
ambiguous loss, thus giving support to first parents and those
adopted to search for and find each other. She recommends that
therapists help people to understand what ambiguous loss is, and
that it’s normal to feel ‘stuck’ in the grip of
it. It is the situation, not the person, that is sick, she says.
A strength of the book is Boss’ understanding that individuals
are unique and that each person needs to find their own way to
resolve the loss. She sees that people need time for respite as
well as time to engage the loss.
Finally,
Boss echoes Franklin “Man’s Search for Meaning,”
saying we must make meaning of our losses. She has found four
factors which affect how we find meaning in our losses:
-
Our
family of origin and early social experiences affect what
meaning we see in situations. This is where we develop rules,
roles, and rituals for making sense out of loss.
-
One’s
spirituality influences how we make sense of losses.
-
Our
own optimism or pessimism affects our thinking about our losses.
-
Our
view of the world also affects how we make meaning of our
losses. Is we see the world logically, as a fair and just
place, we find it hard to tolerate ambiguous loss, because
we see it as what we deserve. On the other hand, if we see
that bad things can happen to good people, and that an external
force caused the loss, it is still tragic, but this frees
the person to act again. Hence, understanding the greed of
society for the children of unwed mothers, and the lack of
protection and support for these mothers, means that they
can stop seeing themselves as wholly to blame for losing their
children.
I
would highly recommend this book for all parents who have lost
children to adoption, and those adopted also. Though the book
deals with many types of ambiguous losses, and only in a small
way specifically with adoption losses, the applicability of the
information is clear and helpful to those of us who’ve lost
by adoption.
"Contrary
to popular belief, mothers don't go on in this world after "giving
up" a child, enjoying their lives and forgetting the child
ever existed. Even though people would love to think this
is true, its not the reality of the situation for most of us.
Our lives are colored by the tramatic event and we are never the
same afterwards. Most of us grieve for years ....
Losing a child to adoption in many ways is worse than losing a
child to death. With death we have closure to some degree,
with adoption we know that we have a child out there in the world
somewhere. ... and we know we love them sight unseen."
- Jaymie Frederick, first mother, professional searcher and licensed
PI
Note: The terms "unwed" mother, "birthmother", "birthmom", "birthmoms",
"dear birthparent", "birthparent", "birthparents", "birthfather"
"biological" make a parent appear to be less than the mother or
father they are. These terms dehumanize and limit the parent's role
to that of an incubator. Using the honest terms "mother",
"single mother" or "natural mother" help the
public to understand why real family members must not be separated
to obtain babies for adoption.
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