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URMC / BHP / BHP Blog / December 2023 / Ambiguous Loss: The Grief is Real

Ambiguous Loss: The Grief is Real

Author: Jennifer Mooney, LMHC

The death of a friend, colleague, or family member is a clearly identifiable loss that is likely accompanied by grief. Other losses are less clear, such as loss resulting from divorce, infertility, immigration, incarceration, or missing person cases. Ambiguous loss is a term coined by Pauline Boss, PhD in the 1970s to describe losses that are unclear or unconfirmed. There are two types of ambiguous loss: physical and psychological.

With physical ambiguous loss, a person is physically absent but psychologically present. Loved ones may be physically absent due to incarceration or military deployment but remain close psychologically. Missing person cases may be a result of natural disasters, plane crashes, kidnapping, or other crimes. Family members may have no information about whether the person is alive or well, yet no confirmation of their death. In other words, they are “gone but not for sure”.

With psychological ambiguous loss, a person is psychologically absent but physically present. Family members may be diagnosed with dementia, addicted to alcohol, obsessed with video games, or impacted by a traumatic brain injury. In these cases, the person is there in body but disconnected emotionally or cognitively. In other words, they are “here but not here”.

In some cases such as psychological abuse and cults, loved ones may be absent and unreachable both physically and psychologically, even though they are still alive.

The experience of ambiguous loss can bring unrelenting confusion and unending torment as the mind tries to make sense of the nonsensical. Paradox and contradictions abound. The goal of grief shifts from achieving closure to learning to live with grief by finding meaning.

The following assumptions which underlie the theory of ambiguous loss provide some guidance:

  • With ambiguous loss, closure is a myth. Grief may continue indefinitely, for years or a lifetime.
  • With ambiguous loss, we assume truth is not attainable and ask how people manage to live well despite the absence of truth.
  • People cannot cope with a problem until they know what it is. Naming the problem as “ambiguous loss” allows the coping process to begin.
  • It is possible to find some kind of meaning, no matter how baffling the loss is.
  • Resilience means increasing one’s tolerance for ambiguity.

When coping with ambiguous loss, begin to recognize absolute and binary thinking (“either-or”) and work toward dialectic, paradoxical thinking (“both-and”) instead. Some examples of paradoxical thinking are:

            “They are both here, and also gone.”
             “I am both my mother’s child, and now a mother to her.”
             “I am both married, and a widow.”

The way in which you understand your loss and describe your loss can make it easier to communicate about what you’re experiencing.  It may also make it easier for you to reach out for help.  If you are experiencing stress, depression, or anxiety symptoms as a result of a loss or other life circumstances, Behavioral Health Partners is here to help through Well-U, your employee wellness team. To make a confidential appointment, call (585) 276-6900.


Betz, G., Thorngren, J. M. (2006). Ambiguous loss and the family grieving process. The Family Journal: Counseling and Therapy for Couples and Families, 14(4), 359-365.

Boss, P. (2016). The context and process of theory development: The story of ambiguous loss. Journal of Family Theory & Review, 8(3), 269-286.

Boss, P., Carnes, D. (2012). The myth of closure. Family Process, 51(4), 456-469.


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