Missing Persons and Ambiguous Loss - Supporting Families Apr 17 2019
1. Missing Persons and
Ambiguous Loss –
Supporting Families
Presented by: Maureen Trask
For: Volunteers and Staff at
Victim Assistance Services of
Oxford County (VASOC)
On: Wed. April 17, 2019
1
2. Learning Objectives
Know What Families Need
Understand Ambiguous Loss
Learn How You Can Help Families
Recap and Q&A
2
7. Needs of Families
Be heard and believed
Know what to expect of self and others
Understand the systems and resources
Stop the roller coaster and reduce stress
Take care of self first, find balance
Feel safe and connected, with trust
Cope and maintain Hope
7
8. Services for Families
Information
Crisis intervention
Trauma informed approach
Culturally respectful service offerings
Short and long-term emotional support
Referrals and/or community connections
Advocacy
8
9. 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
9
10. 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
10
11. Effects of Ambiguous Loss
Emotional rollercoaster and physical stress
Changes families, relationships, roles and identity
Can change spiritual beliefs and values
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 11
12. How to ease its effects
12
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)
13. 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
13
14. Why does it matter?
14
Ambiguous Loss:
Freezes the grief process
Paralyzes couple and family functioning
Prevents “closure” but,
“closure” is a myth
Families can name it
(Ambiguous Loss)
Families need support
(I’m not crazy, it’s the situation)
15. Services (Support)
Support looks different to everyone
15
* Someone to really listen
* Being present
* Just being there
were by far the most popular
ways to support someone.
16. Your 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, the systems
Support families, but don’t try to advise on
investigation or searches on behalf of Police
Listen - Empathize - Empower - Be Present 16
17. Your Skills and Role
Crisis Intervention and Trauma Informed
Help with urgent practical matters
Arrange and link to other services/resources
Demonstrate Compassion, Kindness,
Genuine Listening, Empathy
Navigate the system(s) and resources
Emotional Support and Safe Place
Understand Ambiguous Loss
17
20. 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‘.
20
21. 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.
21
22. 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.
22
23. 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
23
25. 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.
25
26. 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.
26
27. Challenges with Police
(from a Family Perspective)
Not being taken seriously by Police in the first
instance – Families know their loved one
Lifestyle bias and assumptions about the
disappearance – Investigate all cases
Lack of communications, not kept up to date –
Agree on frequency of contact
Making sense of the entire situation –
Information on police process and options
25
28. 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 answers?
How do I get support?
28* Living in Limbo: Five Years On, Missing People UK, 2013
29. Recap and Q & A
Ambiguous Loss is an uncertain loss
Triggers can impact the journey (traumatic)
Each situation is unique and individual
It’s about finding meaning and hope
“Closure” is a myth, families want equal treatment
to find answers and get resolution
Victim Services can provide the outreach support
and resources that families need
Any moments or thoughts? Questions?
29
30. From me to each of you:
30
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
Introductions
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)
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.
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.
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
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)