April 21, 2015: A presentation to local service agencies regarding "Ambiguous Loss" * and the needs of families with missing loved ones. Group discussion followed to identify the gaps in services. (Hosted by Canadian Mental Health Association Waterloo, Wellington, Dufferin (Ontario Canada). * by Dr. Pauline Boss

1. Supporting Those
Experiencing
Ambiguous Loss
Presented by:
Maureen Trask
Vicki MacDonald
Danuta Seasons
Deborah Gauthier
Community Discussion Session
Wed. April 22, 2015
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2. AGENDA
 Welcome and Introductions
 The Unique Needs of those
experiencing Ambiguous Loss
 Gaps in the System
 Possible Solutions
 Considerations and Contributions
 Next Steps
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3. 3Missing since Nov. 3, 2011
Daniel Trask

4. Journey to Date
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 Bringing Families Together
Music for the Missing, Dec. 2011
 Calling on Grief and Loss Experts
Bereaved Families of Ontario (BFO), Nov. 2012
Bereavement Ontario Network (BON), Jan. 2013
BON Conf, Ambiguous Loss presentation, Oct. 2013
BFO Breakfast Networking Group, Oct. 2013
Community Counselling Agencies, Sept. 2013
 Offering 8 Month Support Group
Cardinal Counselling, Nov. 13, 2012 – June 11, 2013

5. Journey to Date Continued
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Joint Planning Group: Families, Police, Media, Apr. 2013
 The Record, Missing Series, Nov. 2013 – Mar. 2014
 CTV Kitchener, Cold Case Series, Mar. 2014
 Rogers TV, Families/Police Speak Out, Apr. 2014
 Ontario Needs Missing Persons Legislation, Oct. 2014
 Victim Services Waterloo., May/Sept. 2014
 Victim Services, Volunteer Training, Nov. 2014/Feb. 2015
Connecting with Other Community Partners
 Cardinal Counselling, Sept. 2012
 Crime Prevention Council, Dec. 2013
 Trauma Informed Initiative, July 2014
 Canadian Mental Health WWD, Dec. 2014

6. Missing Incidents in
Waterloo Region
Vicki MacDonald, Staff Sergeant, Homicide Branch,
Waterloo Region Police Service (WRPS)
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 Who is a Missing Person?
 Local Missing Person Incidents

7. So what is Ambiguous Loss?
Danuta Seasons, 1st Step Family Counsellor, CMHA WWD
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 A loss that occurs without closure or understanding
 Leaves a person searching for answers
 thus complicates and delays the process of grieving
 Often results in unresolved grief, frozen in grief,
living in limbo.

8. Let’s hear from
Dr. Pauline Boss
http://www.youtube.com/watch?v=C2vYyefAgZ0
Dr. Pauline Boss and Dr. Gloria Horsley
discuss Ambiguous Loss at the annual
ADEC (Association of Death Education
and Counseling) conference, 2011.
Dr. Pauline Boss, principal theorist of the concept of Ambiguous Loss
Dr. Gloria Horsley, Open to Hope Foundation, founder and president
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9. 1. How does it differ from
ordinary loss?
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 There is no verification of death.
 There is no certainty that the person will come
back or return to the way they used to be.

10. 2. Why does it matter?
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Ambiguous loss:
 Freezes the grief process
 Paralyzes couple and family functioning
 Prevents closure
 Families can name it
 Families need support

11. 3. How does one ease its
effects?
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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)

12. 4. What are the types of
Ambiguous Loss?
Physically Absent-
Psychologically Present
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
 Autism
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13. To Accept the Uncertainty,
manage the contradictions
Take two opposing ideas (both – and),
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
 Daniel is both gone - and still here
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14. Effects of Ambiguous Loss
 Emotional rollercoaster
 Changes families, relationships, roles and identity
 Can change spiritual beliefs
 Tend to withdraw/isolate self
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)
12Boss, P. (1999). Ambiguous loss: learning to live with unresolved grief. Cambridge, MA: Harvard University Press

15. As a 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
 “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 guidelines
Boss, P., & Carnes, D. (2012). The myth of closure. Family Processes, x(x), doi: 10.1111/famp.12005
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16. Ambiguous Loss Recap
 Traumatic Loss (Boss, 2009)
 Externally Caused (Boss, 2009)
 Unclear Loss (Boss, 1999)
 Senseless Loss (Boss, 2009)
 Lacks Closure
 Frozen Grief/being Stuck in Limbo (Boss, 1999)
 An Individual Journey
Boss, P. (2009). The trauma and complicated grief of ambiguous loss. Pastoral Psych, 59(2), 137-145. doi:
10.1007/s11089-009-0264-0
Boss, P. (1999). Ambiguous loss: Learning to live with unresolved grief. Cambridge, MA. Harvard University Press
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17. AFP Supporting those who
are left behind - Framework
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© Commonwealth of Australia 2014 AFP Australian Federal Police,
National Missing Persons Coordination Centre, Project Officer Sarah Wayland
5 Themes in Supporting Families
1. Re-animation – Move past frozen
2. A Celebration So Far – Respond to the loss
3. The Trauma Timeline – Explore the impact
4. A Protected Place – Safe place of pain
5. Opportunities for Growth – Living with
Ambiguous Loss

18. The Trauma Timeline
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© Commonwealth of Australia 2014 AFP Australian Federal Police,
National Missing Persons Coordination Centre, Project Officer Sarah Wayland

19. 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?
19* Living in Limbo: Five Years On, Missing People UK, 2013

20. Services (Support)
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.

21. The Unique Needs of Those
Experiencing Ambiguous Loss
 Point of referral/contact for families
 Initial support (Emotional, Missing Persons Report)
 Practical support (Media, Search, Property, Finances)
 Counselling (group, family, peer, individual)
 Cope with triggers
 Community tribute
Need someone who will:
 Listen, Empathize
 Communicate, Connect
 Be Present, Be Supportive 26

22. Group Discussion
 Gaps in the System
 Possible Solutions
 Considerations and Contributions
 Next Steps
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23. Anything More?
 Any questions?
 Any moments or thoughts?
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24. Thank You !
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Support for Us – Families with
Missing Loved Ones (FB page)