A woman whose son is diagnosed with psychosis. A man living with pain syndrome (CRPS). A woman who wants children but who can’t have them. A loved one living with dementia who doesn’t recognize you anymore. Someone missing after being swept away by a hurricane and you don’t know whether they are alive or dead. Divorce. Losing a job you love. A pet who gets lost. Being ghosted. Family who won’t talk to you anymore. These are examples of ambiguous losses, which are often accompanied by grief. Here is what Dr. Pauline Boss had to say at our Mental Health Forum, in her own words.

“The underlying criterion for ambiguous loss is that you have to love what you lost. You have to be attached to it…but there’s not a fix. That’s the problem with ambiguous loss, you have to learn to live with it. Ambiguous loss leads to helplessness. That is, if you have a loved one who is not the way they used to be, or they’re sick and you don’t know what the diagnosis is, or you’ve got something in your own body that can’t be fixed, then you need to seek information in order not to be helpless or hopeless. Action is a helpful way of coping, it’s better than just thinking about it all the time and it also gives you power. But it’s a process, so when that comes to an end, you have to move on to accept that you may have to live with the ambiguity for the rest of your life.

“Binary thinking doesn’t work, where you either win or you lose. You’re either absent or present. You’re either sick or you’re healthy. Any of those kinds of ways of thinking are not helpful here so we move from binary thinking to more dialectical thinking where, for example, with a mental illness of a child, you would say ‘He’s both here and sometimes gone if he has an episode’ or somebody with dementia, they’re both here and gone.

“(Sometimes ambiguous loss) depends on context. If somebody wants a divorce, they probably don’t have an ambiguous loss; they may think they have a gain. It’s like in families where someone is transitioning gender. The parents and the siblings may have an ambiguous loss but the person who’s transitioning is glad and likely has no feeling of loss or grief. Many divorces are not wanted by one of the parties, or maybe both, and probably not by the children either, so a lot of people are affected by it and I think it’s good for them to have a name for what is distressing.

“The current idea is to find meaning in your loss. That’s true for ambiguous loss too but it is harder to find meaning in a loss that is unclear. Oftentimes the meaning people find with a missing person either psychologically or physically is that they honour that person somehow by living a good life themselves, or by finishing a project that the absent person had started, or by memorializing. I highly encourage memorializing a person who has died, or ambiguously lost persons. (And then sometimes) loss is meaningless and it will never make sense, so then hopefully you find something else in your life to balance that so it can make sense.

“Sometimes the things we feel guilty about aren’t our faults, so allow yourself to feel those feelings and talk to yourself or talk with others…normalize the guilt. Don’t push it down because it’ll come up more if you do. Talk about it, laugh at it, see that it is not true.

“You don’t have to get over it, don’t let anybody tell you that. It’s cruel if they do.”

On October 17^th, we held our Annual Mental Health Forum (formerly the Low-Beer Memorial Lecture). We were joined by Dr. Pauline Boss, who coined the term “ambiguous loss”, and by Lori Tyrrell and Jonathan Borenstein, who shared their experiences with ambiguous loss. The event was moderated by CBC’s Sonali Karnick.

From Share&Care Winter 2025