Ambiguous Loss

By Rev. Thomas Taylor, LCSW-R, Ph.D., LCC Pastoral Counselor

A funny thing happened on the way to telling people I was ill. By ill, I mean, cancer. Prostate cancer. The funny thing that happened was how many colleagues, friends, and family shared stories of being ill themselves – stories I had not heard. A colleague with breast cancer, a church leader with prostate cancer, a friend who recently lost a parent to cancer, and so on. All of a sudden, I find myself on this well-trod path with many fellow travelers on a similar journey – a journey that is, for many, a long one. While I am reassured by the stories shared by fellow prostate cancer survivors, I’m am still in an odd place. An in-between place – one including both fear and hope.

Pauline Boss*, the family therapist who created the concept “ambiguous loss”, suggests paradoxical thinking helps us face ambiguous and in-between places. For me, I have to hold two opposing ideas in my mind at the same time: I am ill and I feel healthy. I have cancer and it’s treatable. Paradoxical thinking challenges our preference for either / or, black or white thinking such as “I have terminal cancer” or “I don’t have cancer”. Binary thinking, according to Ms Boss, involves some denial and lack of truth at each end of the paradox. Moreover, we don’t like in-between places or states of mind that require waiting and not knowing. We want closure. We want our loved ones as well as ourselves to get over our losses so we can move on with our lives.

“Here’s the crux”, Ms Boss says, “Now and then, there’s a problem that has no solution. It could be an illness. It could be a lost person. It could be something like more everyday ambiguous losses such as adoption, divorce, immigration. Now and then, there are problems that don’t have a perfect fix. And then this idea of holding two opposing ideas in your mind at the same time is very useful for stress reduction”.

Life is full of in-between states, of situations involving “ambiguous loss”, in which our expectation for closure doesn’t fit. Situations, according to Ms Boss, of complicated grief that include illness, divorce, addiction, aging, and, of course, death. “You love somebody. And when they’re lost, you still care about them. You can’t just turn it off.” Another example is caring for someone with dementia – they are physically present, but may no longer be psychologically / emotionally present. We expect to grieve in stages, you know, like Kubler-Ross taught. Wrong. Kubler-Ross’s stages of grief described, according to Ms Boss, what a dying person goes through but not what their caregivers go through. Instead, Ms Boss suggests, a caregiver’s grief is “more oscillations of up and down. These ups and downs get farther apart over time, but they never completely go away, the downs, of feeling blue, of feeling sad”.

Those of us who are heirs to Luther’s paradoxical view of Christian life – for example, that we are simultaneously saint and sinner – are grounded in living with ambiguity and holding two opposing ideas in our hearts and minds at the same time. Being grounded in this paradox is, among many things, good for our stress reduction. Moreover, it deepens our empathy for others living with an “ambiguous loss” that has no clear resolution or closure. It is one way in which we share with others we are on a similarly well-trod path and that none of us is alone.

* Boss, Pauline. “The Myth of Closure.” On Being, Krista Tippett, PBS. December 13, 2018, Original Air Date June 23, 2016.

The Rev. Thomas S. Taylor, STM, LCSW-R, PhD, is counselor-in-residence at Advent Lutheran Church in New York, NY, and at LCC’s Bronxville site, helping individuals, couples and families with a variety of mental health issues
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