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Ambiguous Loss
Supporting families with
missing loved ones
Presented by:
Maureen Trask
For: Volunteers of Victim
Services Wellington
Tues. Nov. 7, 2017
1
Learning Objectives
 Understand ambiguous loss
 Support the families left behind
 Reflect on family experiences
 Recap and Q&A
2
3
Daniel Trask
Missing Nov. 3, 2011 Found May 24, 2015
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 Fdn,
discuss Ambiguous Loss at the annual Association of Death Education
and Counseling (ADEC) Conference, 2011.
http://www.youtube.com/watch?v=C2vYyefAgZ0
4
Types of Ambiguous Loss
1. Physically Absent-
Psychologically Present
2. Psychologically Absent-
Physically Present
 Adoption
 Migration
 Missing people
 Miscarriage and stillborn loss
 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
5
How to ease its effects
6
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)
Manage the contradictions
Take two opposing ideas, make into one
 I am both sad - and still happy
 I am both alone - and still connected
 I am both powerless - and still empowered
 I am both frozen - and still transforming
 I am both doubtful - and still hopeful
 I am both burdened - and still grateful
 My loved one is both gone - and still here
7
Effects of Ambiguous Loss
 Emotional rollercoaster and physical stress
 Changes families, relationships, roles and identity
 Can change spiritual beliefs
 Tend to withdraw/isolate self or be angry
Goal:
Learn to live with the emotional tidal waves.
Learn to live with and adapt to the changes that
come with the loss AND learn to live with the
ambiguity by developing meaning. (Boss, 1999)
Boss, P. (1999). Ambiguous loss: learning to live with unresolved grief. Cambridge, MA: Harvard University Press 8
Why does it matter?
9
Ambiguous loss:
 Freezes the grief process
 Paralyzes couple and family functioning
 Prevents “closure”
 Families can name it
(Ambiguous Loss)
 Families need support
(I’m not crazy, it’s the situation)
AFP Supporting those who
are left behind
10
© Commonwealth of Australia 2014 AFP Australian Federal Police,
National Missing Persons Coordination Centre, Project Officer Sarah Wayland
* Framework – Working
with those left behind
5 themes for working specifically with families
of missing persons:
1. Reanimation: move past “frozen”
2. A celebration so far: respond to loss
3. The trauma timeline: explore the impact
4. A protected place: safe place of pain
5. Opportunities for growth: living with loss
© Commonwealth of Australia 2014 AFP Australian Federal Police,
National Missing Persons Coordination Centre, Project Officer Sarah Wayland 11
Framework
1. Reanimation
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‘.
12
Framework
2. A celebration so far
Respond to the loss
 Acknowledge 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.
13
Framework
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.
14
Triggers and Trauma
 “Having a missing loved one is the most painful
loss of all.” (Dr. Pauline Boss, 1999)
 The *Trauma Timeline is an important aspect when
assessing the implications of the loss
 Triggers can affect the emotional ups and down
- Possible Sightings
- Remains Found
- News, tips and leads
- Some item(s) found, but no physical evidence
*Supporting those who are left behind, Australian Federal Police (Sarah Wayland), 2007
15
The Trauma Timeline
16© Commonwealth of Australia 2014 AFP Australian Federal Police,
National Missing Persons Coordination Centre, Project Officer Sarah Wayland
Framework
4. A protected place
Safe place of pain
 Co-construct a space where families can
acknowledge the
pain of not knowing
while still finding
ways to live life.
17
Framework
5. Opportunities for growth
Living with ambiguous loss
 Explore ways in which families can live
with their loss,
rather than being
consumed by it.
18
Services (Support)
Support looks different to everyone
19
* Someone to really listen
* Being present
* Just being there
were by far the most popular
ways to support someone.
How You Can Help
 Be the needed point of referral for families
 Offer peace of mind for families that you are
there for them, especially when new triggers
 Help enable families to navigate through
their journey of uncertainty
 Support families, but don’t try to advise on
investigation or searches on behalf of Police
 Listen - Empathize - Empower - Be Present 26
Challenges with Police
(from a Family Perspective)
 Not being taken serious by police in the
first instance
 Making sense of the entire situation -
understand the process and options
 Lifestyle bias and assumptions of the
disappearance
 Lack of communications - not being kept
up to date, short or long term 25
Living and Learning on my
Ambiguous Loss Journey
 “Loss of a missing loved one is often a
lonely and an untrodden path for each of
us who has to walk it.” *
 Can I learn to live with
this loss?
 How do I get closure?
 How do I get support?
22* Living in Limbo: Five Years On, Missing People UK, 2013
Recap and Q & A
 Ambiguous Loss is an uncertain loss
 Triggers can impact the journey (traumatic)
 Each situation is unique and individual
 Families need support and resources
 It’s about finding meaning and hope
 “Closure” is a myth, families want answers
and resolution
Any moments or thoughts? Questions?
23
From me to each of you:
24
Maureen Trask: trasker@rogers.com
Support for Us – Families with
Missing Loved Ones (FB page)
Links to the Presentation and
Resource Materials will be emailed.

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Ambiguous Loss Supporting families with missing loved ones

  • 1. Ambiguous Loss Supporting families with missing loved ones Presented by: Maureen Trask For: Volunteers of Victim Services Wellington Tues. Nov. 7, 2017 1
  • 2. Learning Objectives  Understand ambiguous loss  Support the families left behind  Reflect on family experiences  Recap and Q&A 2
  • 3. 3 Daniel Trask Missing Nov. 3, 2011 Found May 24, 2015
  • 4. 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 Fdn, discuss Ambiguous Loss at the annual Association of Death Education and Counseling (ADEC) Conference, 2011. http://www.youtube.com/watch?v=C2vYyefAgZ0 4
  • 5. Types of Ambiguous Loss 1. Physically Absent- Psychologically Present 2. Psychologically Absent- Physically Present  Adoption  Migration  Missing people  Miscarriage and stillborn loss  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 5
  • 6. How to ease its effects 6 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)
  • 7. Manage the contradictions Take two opposing ideas, make into one  I am both sad - and still happy  I am both alone - and still connected  I am both powerless - and still empowered  I am both frozen - and still transforming  I am both doubtful - and still hopeful  I am both burdened - and still grateful  My loved one is both gone - and still here 7
  • 8. Effects of Ambiguous Loss  Emotional rollercoaster and physical stress  Changes families, relationships, roles and identity  Can change spiritual beliefs  Tend to withdraw/isolate self or be angry Goal: Learn to live with the emotional tidal waves. Learn to live with and adapt to the changes that come with the loss AND learn to live with the ambiguity by developing meaning. (Boss, 1999) Boss, P. (1999). Ambiguous loss: learning to live with unresolved grief. Cambridge, MA: Harvard University Press 8
  • 9. Why does it matter? 9 Ambiguous loss:  Freezes the grief process  Paralyzes couple and family functioning  Prevents “closure”  Families can name it (Ambiguous Loss)  Families need support (I’m not crazy, it’s the situation)
  • 10. AFP Supporting those who are left behind 10 © Commonwealth of Australia 2014 AFP Australian Federal Police, National Missing Persons Coordination Centre, Project Officer Sarah Wayland
  • 11. * Framework – Working with those left behind 5 themes for working specifically with families of missing persons: 1. Reanimation: move past “frozen” 2. A celebration so far: respond to loss 3. The trauma timeline: explore the impact 4. A protected place: safe place of pain 5. Opportunities for growth: living with loss © Commonwealth of Australia 2014 AFP Australian Federal Police, National Missing Persons Coordination Centre, Project Officer Sarah Wayland 11
  • 12. Framework 1. Reanimation 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‘. 12
  • 13. Framework 2. A celebration so far Respond to the loss  Acknowledge 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. 13
  • 14. Framework 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. 14
  • 15. Triggers and Trauma  “Having a missing loved one is the most painful loss of all.” (Dr. Pauline Boss, 1999)  The *Trauma Timeline is an important aspect when assessing the implications of the loss  Triggers can affect the emotional ups and down - Possible Sightings - Remains Found - News, tips and leads - Some item(s) found, but no physical evidence *Supporting those who are left behind, Australian Federal Police (Sarah Wayland), 2007 15
  • 16. The Trauma Timeline 16© Commonwealth of Australia 2014 AFP Australian Federal Police, National Missing Persons Coordination Centre, Project Officer Sarah Wayland
  • 17. Framework 4. A protected place Safe place of pain  Co-construct a space where families can acknowledge the pain of not knowing while still finding ways to live life. 17
  • 18. Framework 5. Opportunities for growth Living with ambiguous loss  Explore ways in which families can live with their loss, rather than being consumed by it. 18
  • 19. Services (Support) Support looks different to everyone 19 * Someone to really listen * Being present * Just being there were by far the most popular ways to support someone.
  • 20. How You Can Help  Be the needed point of referral for families  Offer peace of mind for families that you are there for them, especially when new triggers  Help enable families to navigate through their journey of uncertainty  Support families, but don’t try to advise on investigation or searches on behalf of Police  Listen - Empathize - Empower - Be Present 26
  • 21. Challenges with Police (from a Family Perspective)  Not being taken serious by police in the first instance  Making sense of the entire situation - understand the process and options  Lifestyle bias and assumptions of the disappearance  Lack of communications - not being kept up to date, short or long term 25
  • 22. Living and Learning on my Ambiguous Loss Journey  “Loss of a missing loved one is often a lonely and an untrodden path for each of us who has to walk it.” *  Can I learn to live with this loss?  How do I get closure?  How do I get support? 22* Living in Limbo: Five Years On, Missing People UK, 2013
  • 23. Recap and Q & A  Ambiguous Loss is an uncertain loss  Triggers can impact the journey (traumatic)  Each situation is unique and individual  Families need support and resources  It’s about finding meaning and hope  “Closure” is a myth, families want answers and resolution Any moments or thoughts? Questions? 23
  • 24. From me to each of you: 24 Maureen Trask: trasker@rogers.com Support for Us – Families with Missing Loved Ones (FB page) Links to the Presentation and Resource Materials will be emailed.

Editor's Notes

  1. Introductions
  2. I’m here to share my journey of ambiguous loss, with having had a missing son for 3 ½ years. Daniel had set me on this path, which was new to me, but I am learning lots about strength, resiliency, never giving up. As a parent, no one prepares you for this type of loss.. Through this presentation, I will share what ambiguous loss is, what you can do to help support families and how to relate to their experience of uncertainty. So, as a Mom left behind, living in limbo, frozen in grief, not knowing what I was grieving or how to deal with this loss. More questions than answers. My journey was 3 ½ years. Many have endured this path on their own, for far to many years. This poem “When Someone you love goes missing”, by Tom M. Brown, speaks to this journey. (read poem)
  3. Dr. Pauline Boss presented the theory of ambiguous loss in 1999 (book). She has also applied her theory by facilitating support for families in numerous disasters including 9/11, Thailand tsunami, and Malaysian air crash. When I learned of her work, I read her books and immediately connected with what I was experiencing, it made sense. It wasn’t me, it was the situation. I contacted her to learn more and determine if support material or services were available for families such as mine, very little in Canada. This short clip is an excellent introduction to ambiguous loss. Pauline has written subsequent books on Loss, Trauma and Resilience (2006) and Dementia (2011), building on research and clinical experience of ambiguous loss. In Loss, Trauma, and Resilience, Boss provides the therapeutic insight and wisdom that aids mental health professionals in not "going for closure," but rather building strength and acceptance of ambiguity. What readers will find is a concrete therapeutic approach that is at once directive and open to the complex contexts in which people find meaning and discover hope in the face of ambiguous losses. In Loving Someone Who Has Dementia, Boss builds on research and clinical experience, yet the material is presented as a conversation. She shows you a way to embrace rather than resist the ambiguity in your relationship with someone who has dementia.
  4. Two types of ambiguous loss… Psychologically absent- Physically present The loved one is physically present however; they are cognitively and emotionally absent. Physically absent- Psychologically present The loved one is physically absent but remains psychologically present. Missing People (for example disappeared, kidnapped, missing in action, or mass disasters such as 9/11) It is also possible to be experiencing both at the same time as I am with a missing son and a mother with dementia. As you can see with all of these examples there is no real goodbye to the relationship and roles, no farewell ritual, and yet someone is lost and something remains creating ambiguity.
  5. 1. Find meaning Look at values, beliefs, and traditions Remove blame 2. Accept Uncertainty Change the way think of loved one by taking two opposing ideas and make them into one: they are both here and not here. Balance need for control with acceptance of ambiguity Externalize blame 3. Reconstruct identity- inevitable for roles within relationship/ families to change. Therefore forced to change roles and identity. 4. Learn to live with ambivalence as a new norm- experience conflicting feelings/thoughts (I.e. wishing for answers even if death itself). Here accept the emotional rollercoaster and develop strategies to help with the waves of mixed and overwhelming emotions. 5. Revisit attachment-most difficult as you accept ambiguity and the uncertainty as part of life. Part of this task is to celebrate the missing and mourn the changes. 6. Discover hope- look at strengths and see how you have made it to this point with pain. Discover hope in different ways (i.e. nature, volunteering, etc.). *Use a Narrative Therapy approach- identify what has been lost, discuss the effects of the loss, normalizing the experience, assess coping resources, lay to rest guilt and blame, and develop rituals to allow to move on while still remembering. Overall, the goal is to take authorship of a new and more meaningful of story of loss. ** Common to do family therapy
  6. Ambiguous loss inherently creates complicated grief. But the pathology lies in the ambiguity, not in the person whose grief is frozen. Therapeutic challenge then is not closure, but a paradoxical search for meaning in meaninglessness. Understanding is key – providers must understand ambiguous loss to understand my experience. Let me live my experience, understanding that the type of loss I’m experiencing will influence the type of grief I experience. (the type of loss shapes the type of grief – and the support challenge)