Ambiguous Loss Research Articles

The Ambiguities of Out‐of‐Home Care: Children With Severe or Profound Disabilities*

Abstract: Ambiguous loss and boundary ambiguity experienced by families during the process of placing their child in out‐of‐home care was described by parents in 20 families raising a child with severe or profound developmental disabilities. In retrospective interviews, parents discussed their experiences before and after placing their child and how they experienced ambiguous loss as they raised a child that was psychologically absent but physically present. Parents faced ambiguities related to the nature and diagnosis of the disability, support services, and placement. A second situation of ambiguous loss was created when the child was placed. Parents experienced two forms of boundary ambiguity (role and membership ambiguity) and ambivalence regarding placement decisions. Research and clinical implications for working with families are presented.

Ambiguous Loss After Lesbian Couples With Children Break Up: A Case for Same‐Gender Divorce*

Abstract: The theory of ambiguous loss is applied to structural ambiguity and personal transcendence in the parent‐child relationship following a same‐gender relational ending. Working recursively through the six guidelines of ambiguous loss (finding meaning, tempering mastery, reconstructing identity, normalizing ambivalence, revising attachment, and discovering hope), I use reflexive personal narrative to describe the impact of a child’s psychological presence but physical absence on a nonbiological parent. Three themes are identified: (a) naming the problem—the loss of our family unit, (b) the paradox of presence and absence—fractured parent‐child ties, and (c) recursive discovery of meaning and hope. Implications for practice include the following: (a) applying ambiguous loss to nonlegal relational loss, (b) public policy—the right to same‐gender divorce, and (c) telling our stories as transformative practice.

Ambiguous Loss Theory: Challenges for Scholars and Practitioners

Introduction On the occasion of my retirement from the University of Minnesota, a symposium was held to encourage the continuation of research about loss and boundary ambiguity. This special issue continues that goal. The papers herein illustrate how a new generation of scientists and practitioners applies loss theory to understand previously unstudied situations and populations. Their work generates new questions and hypotheses and, hopefully, stimulates others to join the ongoing process of research, practice, and theorizing. Why Do We Need Theorizing? In these times of crises and terror, we need new theories to guide our work in safeguarding the natural resiliency of families. To assess both diversities and commonalities in how families stay strong, we need more inclusive theory to analyze data and guide interventions for easing the family stress and trauma. I began with a universal family experience-lossand studied it in the context of an additional stressor-ambiguity. Indeed, as Dilworth-Anderson (2005) writes, intuition begins this process. Observing family therapy in the early 1970s, I noticed physically present fathers were often psychologically absent (Boss, 1972). Soon, I realized that psychological absence was not only just about fathers but also about any loved one in the family who was there, but not there. Out of observation and intuition emerged a more inclusive term, ambiguous and a model of the two types: physical absence with psychological presence, psychological absence with physical presence (Boss, 1999, 2004, 2006). Family members have described the first type of loss as Leaving without good-bye, and the second type as Good-bye without leaving. Both are distressing and may traumatize. Today, the stress- and resiliency-focused theory of loss includes linkages to meaning, mastery, ambivalence, identity, attachment, and hope (Boss, 2006). Although many practitioners report anecdotally that the theory is useful, more research-based evidence is needed. This special issue serves as a beginning for more research to continue integrating theory, research, and application. What Is Ambiguous Loss? Ambiguous loss is a loss that remains unclear. The premise of the loss theory is that uncertainty or a lack of information about the whereabouts or status of a loved one as absent or present, as dead or alive, is traumatizing for most individuals, couples, and families. The ambiguity freezes the grief process (Boss, 1999) and prevents cognition, thus blocking coping and decision-making processes. Closure is impossible. Family members have no other option but to construct their own truth about the status of the person absent in mind or body. Without information to clarify their loss, family members have no choice but to live with the paradox of absence and presence (Boss, 2006). For example, when families are separated by military deployment, they of course hope to be reunited again but also know that they will never be the same as they were before the separation. I propose that both/and thinking strengthens adults' and children's resiliency despite the ambiguity of a family member's absence or presence. That is, it is useful for a family member to think dialectically about thesis, antithesis, and synthesis in a practical way: my loved one is gone, but s/he is also here; I can learn to tolerate the stress of the ambiguity (Boss, 1999, 2004, 2006). When relationships are unclear and closure is impossible, the human need for finality can distress or traumatize families. Whether it is caring for a mate in the grip of dementia from Alzheimer's, or waiting to learn the fate of a child gone missing, the ambiguity in such losses immobilizes and traumatizes. Bereft of rituals to support them (because the loss is unverified), families are left on their own. Because of the ambiguity, relationships dissipate as friends and neighbors do not know what to do or say to families with unclear losses. …

Another Kind of Ambiguous Loss: Seventh‐day Adventist Women in Mixed‐Orientation Marriages

Abstract: Narratives of five Seventh‐day Adventist heterosexual women whose mixed‐orientation marriages ended were analyzed through the lens of ambiguous loss. Thematic coding identified a wave‐like process of changing emotional foci that emerged from their experience during marital dissolution. Elements of ambiguous loss included boundary ambiguity, retrospective interpretation and grieving, secrecy, and renegotiation of spiritual beliefs. A process model is introduced and elucidated through participant narratives. Treatment suggestions and implications for further study are provided.

Dimensions of Ambiguous Loss in Couples Coping With Mild Cognitive Impairment*

Abstract: We applied the theory of ambiguous loss to couples with mild cognitive impairment (MCI), an age‐related decline in memory and other cognitive processes assumed not to interfere with daily activities or the maintenance of personal relationships. Face‐to‐face interviews with 67 older married couples revealed that lack of understanding about the behavioral manifestations of MCI resulted in much ambiguity in their lives. Fluctuations in the elders’ functioning required spouses to alter their daily activities and responsibilities. As a result, couples often experienced distress that affected their emotional involvement with one another. Findings advance theoretical implications of ambiguous loss and provide educators and practitioners with suggestions for working with couples experiencing mild memory loss.

Loss, Trauma, and Resilience: Therapeutic Work With Ambiguous Loss

Back to table of contents Previous article Next article Book ReviewFull AccessLoss, Trauma, and Resilience: Therapeutic Work With Ambiguous LossSandra L. Bloom M.D.Sandra L. Bloom M.D.Search for more papers by this authorPublished Online:1 Mar 2007https://doi.org/10.1176/ps.2007.58.3.419AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail I was driving in the car with two friends of mine, who are both psychiatrists, last weekend. One of my friends was discussing a particularly challenging problem she was confronting, and what came to my mind was Pauline Boss's book, Loss, Trauma, and Resilience , which I had just finished reading. Dr. Boss has covered important territory, because she has focused on the neglected subject of loss, particularly as it applies to situations in which the person is physically gone but not dead. Into this category fall experiences as traumatic as having a family member who is kidnapped or a prisoner of war or whose body is never found after a disaster. Other circumstances are so unfortunately common that they are not generally classified as "traumatic," such as being a part of a family in which someone suffers from Alzheimer's disease, chronic mental illness, or addiction.What these situations have in common, according to Dr. Boss, is the condition of ambiguous loss—situations in which it is not known if a loved one is dead or alive, is absent or present, or is in or out of your family or relationship. In some cases, the ambiguously lost person is physically absent but remains uncomfortably psychologically present. In other cases the lost person is physically present, but the person he or she once was is gone in some fundamental ways. In such cases, the classical notion of "closure" becomes impossible. The actual experience of ambiguous loss is so universal that Dr. Boss questions the viability of closure as a useful concept. She asserts that in fact "closure is a myth" and that "perhaps the reason we talk so much about closure is that we can't stand the pain."Although Boss spends a great deal of time in the book discussing her theoretical premises and the therapeutic frameworks that inform her work, she is obviously an experienced family therapist, and the meat of this book for clinicians comes from the therapeutic guidelines that clearly derive from a wealth of practical, hands-on experience with suffering individuals and families. She does not deny the traumatic losses she has encountered, but her experiences have taught her about the resilience that often lies in the background of families who brush up against, or are hit with the full force of, tragedy.The book has some redundancy, which can be forgiven in service of the value of repetition. The chapter on trauma and stress is weakened by the lack of reference to other people in the field of traumatic stress studies who have been carefully enumerating the connections between trauma and loss.This decidedly is a book worth reading, especially for new therapists in the field, because it reminds us all that both psychodynamic and family systems principles are as relevant today as they were in previous decades. For human beings, attachment and loss remain central to our existence on this planet.Dr. Bloom is affiliated with Community Works, Philadelphia. FiguresReferencesCited byDetailsCited by‘That's got me to where I am today’: examining the role of social capital in rural recovery4 January 2022 | Addiction Research & Theory, Vol. 30, No. 4ONE STEP TOWARDS RECONCILIATION IN CYPRUS: PERCEPTIONS OF THE ‘OTHER’ FOR THE FAMILIES OF MISSING PERSONS14 May 2020 | All Azimuth: A Journal of Foreign Policy and Peace Volume 58Issue 3 March, 2007Pages 419-420PSYCHIATRIC SERVICES March 2007 Volume 58 Number 3 Metrics PDF download History Published online 1 March 2007 Published in print 1 March 2007

Loss, Trauma, and Resilience: Therapeutic Work With Ambiguous Loss

Loss, Trauma, and Resilience: Therapeutic Work With Ambiguous Loss

A Rational Decision Rule with Extreme Events

Risks induced by extreme events are characterized by small or ambiguous probabilities, catastrophic losses, or windfall gains. Through a new functional, that mimics the restricted Bayes-Hurwicz criterion within the Choquet expected utility approach, it is possible to represent the decisionmaker behavior facing both risky (large and reliable probability) and extreme (small or ambiguous probability) events. A new formalization of the precautionary principle (PP) is shown and a new functional, which encompasses both extreme outcomes and expectation of all the possible results for every act, is claimed.

Ambiguous Loss and the Family Grieving Process

Ambiguous losses are physical or psychological experiences of families that are not as concrete or identifiable as traditional losses such as death. Ambiguous loss could include anything from miscarriage to losing one's spouse to Alzheimer's disease while he or she is still living. Ambiguous loss may include not knowing whether or not a loved one is living or dead, such as cases of child abduction or military personnel who are missing in action. Ambiguous loss is inherently characterized by lack of closure or clear understanding. This article defines types of ambiguous losses and details some of their characteristics. A model for counseling families who are experiencing ambiguous loss is described. Specifically, the model combines family stress theory with narrative therapy techniques to help families define their losses, assess their resources, and develop meaningful narratives about the loss.

REVIEWS

Boss, P. (2006). Loss, trauma and resilience: Therapeutic work with ambiguous loss. Lebow, J. L. (Ed.). (2005). Handbook of clinical family therapy. Selekman, M. (2005). Pathways to change: Brief therapy with difficult adolescents.

Writing Beyond the Wall: Translation, Cross-cultural Exchange, and Chen Ran's 'A Private Life'

The past decade has witnessed an unprecedented rise in the global flow of knowledge, nowhere more apparent in the exchange of ideas between China and modern western democracies. Our interest concerns one aspect of this global flow— the translation of Chinese women’s autobiographical writing into English. Taking Chen Ran’s A Private Life (English edition, 2004) as a point of departure, the paper explores issues of translingual practice and cross-cultural exchange. It considers what escapes or is lost in translation as well as the additive potential of the host text. It is sometimes the case that the translation can deliberately make certain ambiguities visible—whether from pragmatic, market-driven motivations or from more complex political, historical and cultural considerations. These negotiations of meaning that occur in the translation process can reverberate on the critical reception of texts in both the ‘guest’ and ‘host’ languages (Liu 1995), with open-ended, incomplete and indeterminate effects. 
 The paper examines the effects of the omission of a brief parenthetical section of three paragraphs from one chapter of the Chinese edition of A Private Life. Yet, even that small emendation changes the original text as a cultural object and alters potential modes of its reception. In this case, the translation results in a loss of ambiguity, irony, philosophic and rhetorical sophistication while also offering additive potentials that enhance the generation of new meanings in the translingual exchange, here with reference Tiananmen and contemporary feminism in China. The translation process provides new channels for readers, writers and theorists to dialogue and communicate across gaps of difference, despite inhibiting factors like the imposition of local restraints, the universalising pressures of western modernity, and asymmetrical relations of power between guest and host language contexts.

OPLS methodology for analysis of pre-processing effects on spectroscopic data

Pre-processing of spectroscopic data is commonly applied to remove unwanted systematic variation. Possible loss of information and ambiguity regarding discarded variation are issues that complicate pre-treatment of data. In this paper, OPLS methodology is applied to evaluate different techniques for pre-processing of spectroscopic data gathered from a batch process. The objective is to present a rational scheme for analysis of pre-processing in order to understand the influence and effect of pre-treatment. O2PLS uses linear regression to divide the systematic variation in X and Y into three parts; one part with joint X– Y covariation, i.e. related to both X and Y, one part of X with Y-orthogonal variation and one part of Y with X-orthogonal variation. All of the investigated pre-treatment methods removed an additive baseline as expected. In the analysis of raw and differentiated data variation associated with the baseline was found in the Y-orthogonal part of X. Orthogonal information was also found in Y, which suggests that this pre-processing procedure not only removed variation. This would have been more difficult to detect without the O2PLS model since both raw and differentiated data must be analysed simultaneously. Development of a knowledge based strategy with OPLS methodology is an important step towards eliminating trial and error approaches to pre-processing.

Life in the Trading Zone: Structuring Coordination Across Boundaries in Postbureaucratic Organizations

In our study of an interactive marketing organization, we examine how members of different communities perform boundary-spanning coordination work in conditions of high speed, uncertainty, and rapid change. We find that members engage in a number of cross-boundary coordination practices that make their work visible and legible to each other, and that enable ongoing revision and alignment. Drawing on the notion of a “trading zone,” we suggest that by engaging in these practices, members enact a coordination structure that affords cross-boundary coordination while facilitating adaptability, speed, and learning. We also find that these coordination practices do not eliminate jurisdictional conflicts, and often generate problematic consequences such as the privileging of speed over quality, suppression of difference, loss of comprehension, misinterpretation and ambiguity, rework, and temporal pressure. After discussing our empirical findings, we explore their implications for organizations attempting to operate in the uncertain and rapidly changing contexts of postbureaucratic work.

Surviving and Thriving After Trauma and Loss

Individuals and their communities experience trauma and loss during times of natural disaster. Using Hurricane Katrina as a context, the authors provide an overview of the phases of disaster coping and discuss the ambiguous losses that can occur during these traumatic and life-changing times. The use of rituals as a creative intervention is introduced to help individuals and families facilitate their grief processes.

If I Didn’t Have HIV, I’d Be Dead Now: Illness Narratives of Drug Users Living With HIV/AIDS

The purpose of this study is to illuminate the experiences of lower income, urban, HIV-positive drug users. The authors asked 60 participants about HIV risk behaviors, the impact of HIV on their lives, religious beliefs, life plans, relationships, and work-related issues both prior to and since diagnosis. They developed a theoretical framework based on illness narratives and ambiguous loss theories. Themes pertaining to both physical and emotional or spiritual dimensions were located within Benefit, Loss, or Status Quo orientations. The findings contribute to researchers' understanding of the HIV/AIDS illness experiences among the very marginalized and have important implications for physical and mental health care professionals working with HIV-positive drug users.

Uncertainty management and adoptees’ ambiguous loss of their birth parents

According to the National Adoption Information Clearing House (2000; http://www.calib.com/naic/statistics.htm) 120,000 children each year are adopted in or into the US. Much has been written about the attachment and adjustment issues adoptees experience, yet there has been no comprehensive study on the loss felt by adoptees as they reach adulthood. This study of 54 adult adoptees extends the literature on uncertainty management and ambiguous loss by examining how these forces inform one another in the context of adoption. More specifically, it builds upon the uncertainty management literature by investigating the multiple ways in which adoptees experience uncertainty and loss and how these experiences, and the management responses that result from them, are shaped by the familial, perceptual, and situational factors that comprise them.

Ambiguous Loss Research, Theory, and Practice: Reflections After 9/11

This article contains an overview of three decades of research, theory development, and clinical application about ambiguous loss. Although the work includes both physical and psychological types of ambiguous loss, the focus is the aftermath of 9/11 (September 11, 2001), when the World Trade Center collapsed following terrorist attacks. On the basis of her previous work, the author was asked to design an intervention for families of the missing. She reflects on what she learned from this unexpected test and presents new propositions and hypotheses to stimulate further research and theory that is more inclusive of diversity. She suggests that scholars should focus more on universal family experience. Ambiguous loss is just one example. Encouraging researchers and practitioners to collaborate in theory development, she concludes that research‐based theory is essential to inform interventions in unexpected times of terror, and in everyday life.

Unconscious Communication and the Transmission of Loss

In this paper, I examine the sense of loss that some adoptive parents experience in being unable to conceive and how this interfaces with the “ambiguous loss” of the birth mother for the adoptee. I outline an interpersonal-relational perspective on adoption using current thinking on the concept of projective identification. I propose that the adoptive parents and their own attachment histories, including their representations of the adoptive child, partially determine the meaning (s) of the adoption transmitted to the adoptee. The multiple losses associated with infertility interact with the young child's understanding of his origins, his self-representation, his fantasies of where babies come from, and the conscious and unconscious meanings of adoption within the family constellation.

A Risk and Resiliency Modelof Ambiguous Loss inPostdivorce Stepfamilies

This study examined the role of ambiguous loss in postdivorce stepfamilies, developing a grounded theory of individual, familial, and environmental risk and resiliency factors that mediate it. Qualitative interviews with 81 stepfamily members provided the foundation for the theoretical framework. More specifically, the interviews revealed three types of ambiguous loss: (a) the loss of one's previous family form and traditional nuclear family ideal, (b) the loss of a single-parent bond, and (c) the loss of a noncustodial parent-child bond. Taken together, the severity of the ambiguous loss, individuals' perceptions of control over it, the communication among family members, and the contextual factors surrounding divorce and remarriage, were combined to develop a conceptual model of family members' communicative responses to the loss that can guide future research.

Remaking family life: strategies for re-establishing continuity among Congolese refugees during the family reunification process

The restrictive immigration and refugee policies of many Western countries force most refugee families to remain separated for long periods. Although there is much discussion among professionals in the community and the clinical milieu about the problems families encounter after reunification, the strategies employed by refugees to restore family life have not been paid much attention. This longitudinal study documents the pre- and post-reunification experiences of 12 refugee families from the Democratic Republic of Congo in Montreal. Our results suggest that family separation can be understood as an ambiguous loss, in that the temporary absence of other family members cannot be fully acknowledged because of the perpetual uncertainty and permanent risk to them. Memory work, in the form of shared family memories, attenuates the pain of the absence. Once reunited, family members must re-establish continuity in spite of the many denied rifts between them. The capacity to recall a personal, familial or collective history of previous separation and loss appears to be protective, as if the memory of life's discontinuities provides an opportunity to recreate a partial sense of continuity out of repeating experiences of chaos.