What is ambiguous grief?

Grief is hard. It’s an experience of deep sorrow after loss and can involve many varying emotions and psychological responses. These might include anger, guilt, shame, regret, fear, shock, anxiety, depression, disconnection, loneliness, confusion, yearning, obsessive thoughts, among many others.

Most people associate the term ‘grief’ with losing someone who has died. But another type of grief is called ‘ambiguous grief’. It’s the kind of grief that happens when there’s a loss that isn’t clear and, well, ambiguous.

Family therapist and researcher Dr. Pauline Boss coined the term ‘ambiguous grief’ in the 1970s to describe grief when there's “no verification of death or no certainty that the person will come back or return to the way they used to be.” Other therapists have expanded the term to include deaths without closure.

Here are some examples of situations that may be associated with ambiguous grief:

• A loved one has gone missing but the body was not found. For example, from a natural disaster, a kidnapping, being lost at sea, or as a result of war or forced migration.

• Death of someone who was estranged and no longer in their life. For example, an ex-spouse or partner, former friend, or family member.

• A loved one who is physically alive but may be psychologically absent. For example, a loved one living with dementia, brain injury, mental illness, struggling with addiction.

• Children in foster care because their parents are unable to care for them.

• Placing a child for adoption.

• Experience of miscarriage, stillbirth or termination of a pregnancy.

• A loved one who is incarcerated.

These kinds of losses can complicate the process of grieving and result in unresolved grief. When there’s uncertainty or added confusion, a person with ambiguous grief can feel frozen in time and may prevent healing and recovery from the loss.

Coping with Ambiguous Grief

Here are a few tips that may help with the journey through ambiguous grief.

1. Acknowledge your grief

   Remember there isn’t a right way or wrong way to move through grief. And there certainly are not any stages of grief (more about this in another post) that get you from start to finish line. The goal isn’t “How do I stop feeling sad, angry and confused?” but to accept that you are feeling sad, angry and confused – and how can you still live in a meaningful way while giving space for these feelings.

2. Consider ceremony
   In some cases of ambiguous grief, creating a ritual to remember the lost loved one can provide therapeutic benefits. Other actions might be donating money to a charity that may have meaning to the loved one. Ceremony could look like planting a tree in honour of the loved one, or gathering with family on their birthday to pay tribute to them.

3. Make room for Self

   The experience of grief is mentally consuming and distressing. It’s important to make room for Self, and take self-care breaks. This might look like letting a friend cook a meal for you and watching a movie together. It might mean creating reminders for yourself to drink water, eat meals regularly, and go for walks for some fresh air. It might mean cuddling a soft blanket or stuffie when emotions hit harder. It might mean taking 5 minutes outdoors for mindfulness – being present in the moment to examine the trees, to notice the temperature of the air, or sounds that can be heard. It might mean making time for your hobbies or interests.

4. Get support
   Whether through a support group, friends, family members or mental health professional, it’s essential to work through your feelings with people you feel safe sharing your grief with. Carrying your emotions alone can lead to feelings of loneliness and further despair. Allow room for the complicated feelings to breathe and process.

5. Be patient with yourself

   There may be a desire to just “get over it” — getting impatient and even frustrated with yourself for having feelings about the loss. When there’s been a deep cut to the physical body, it takes time to heal, right? The same is true for the emotional self. You can’t rush the process of healing whether it’s physical or emotional. You can simply help it along by acknowledging your grief, accepting the complicated emotions, taking time for self-care, and getting good support through connections.

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Art as Therapy Invitation: Creating Space for Self-Care

It should be noted that art therapy for grief differs from “art as therapy” (meaning, art-making as being therapeutic). This art invitation is intentionally art as therapy. This is because in processing grief through the arts, it’s recommended to work with an art psychotherapist so they can help manage the overwhelming feeling that may arise with grief.

1. In a notebook or on a piece of paper, start by completing the journal prompt:
   Today, I support myself by

2. Using any art materials of your choosing, create a visual representation of your journal reflection.