Lunch & Learn for Carizon Family and Community Services, Kitchener, ON, Canada Explaining ambiguous loss (Dr. Pauline Boss) and the support needs of families with missing loved ones.

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Title
CMHA Waterloo Wellington Dufferin
• Presentation
• April 3, 2013
www.cmhawwd.ca
Lunch & Learn
For Carizon Family and Community Services
Ambiguous Loss:
Supporting families with
missing loved ones
Presented by: Maureen Trask
Tues. Nov. 24, 2015 www.cmhawwd.ca

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Topics
 What is Ambiguous Loss?
 The Experience of Those Left Behind
(Families with Missing Loved Ones)
 How You Can Help?
 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 Fdn,
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
 Traumatic Loss (Boss, 2009)
 Externally Caused (Boss, 2009)
 Unclear Loss (Boss, 1999)
 Senseless Loss (Boss, 2009)
 Lacks Closure / Understanding
 Frozen Grief / being Stuck in Limbo (Boss, 1999)
 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
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

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Ambiguous Loss differs from
traditional loss
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
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’t name it
 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)
• Live with the ambiguity and uncertainty
• Hopefully, find meaning

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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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APF Framework:
5 themes for working 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

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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 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.

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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 pain
 Co-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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Services / Support:
Support looks different to everyone
“Someone to really listen…”
“Being present…”
“Just being there …”
…were by far the most popular
ways to support someone

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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

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As a 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 guidelines

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Resources
 Dr. Pauline Boss www.ambiguousloss.com
 Australian Federal Police (AFP)
National Counselling Framework www.missingpersons.gov.au/education--
training/working-with-families/supporting-those-who-are-left-behind.aspx
 Full Version AFP Support Workbook
www.missingpersons.gov.au/~/media/MP/Files/PDFs/Supporting%20those%20
who%20are%20left%20behind.ashx
www.afp.gov.au/~/media/afp/pdf/2/24-25-new-national-counselling-
framework.ashx
 Presentation and Reference Materials
 Networking with Police and Agencies
 Support for Us - Families with Missing Loved Ones FB page

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Recap and Q & A
 Ambiguous Loss is an uncertain loss
 Triggers can impact the journey
 Each situation is unique and individual
 Families need support
 It’s about finding meaning and hope
 “Closure” is a myth, families want answers
Questions?

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Thank You!
Maureen Trask: trasker@rogers.com