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Book Review:
Ambiguous Loss: Learning to Live with Unresolved Grief

by Pauline Boss. ISBN: 0-674-01738-2
Publisher: Harvard University Press, 1999
Book Review by Sandra Pace

Many people deal with unresolved and ambiguous losses in their lives. Ironically, these ambiguous losses are often more difficult to deal with than "definitive" losses such as death or divorce, where one has a period of grieving and then can move on in life. This slim volume describes ambiguous losses in a way that makes them comprehensible. The book also points to ways to deal with them.

Pauline Boss describes ambiguous losses as those where a family member is physically absent, but psychologically present because it’s unclear whether they are dead or alive. She gives examples of soldiers missing in action or kidnapped children, and those where children are lost to adoption.

The second type of ambiguous loss is where the person is physically present, but psychologically absent, such as with Alzheimer’s or other diseases, or in the grip of addictions or chronic mental illnesses. The results of both of these types of loss are the same, however, in that the grief is not resolved because the ambiguous loss is in the situation, outside the person. The outside force that freezes the grief is the uncertainty and ambiguity of the loss, she says.

Ambiguous loss is the most stressful loss people can face, Boss’s research shows. When people suffering these losses are evaluated in the traditional way, she argues they often look dysfunctional, exhibiting anxiety, depression and somatic illnesses. They feel incompetent, as it destroys one’s sense of mastery. Ambiguous losses can freeze people in place so that they can’t move on with their lives. These losses can traumatize, leading to Post-Traumatic Stress Disorder, and ambiguous losses typically are a long-term situation that traumatize and immobilize, rather than a single event that has flashback effects. People feel helpless, and no longer act, because they cannot have their hopes raised and dashed so many times.

Though not the focus of the book, Boss makes specific reference to the losses in adoption, and the effects on the mother who loses her child to adoption. She indicates that for the mother and for many of the adopted people, knowing each other is necessary to resolve the loss, even if their search yields news that is less than ideal. She feels that adoptive families should recognize that their boundaries are fluid and include the children’s first parents, and that leaving unspoken ambiguity about the family structure is unhealthy for the children.

Pauline Boss indicates that with ambiguous losses, there is no right answer for resolving them. Each person must create the best possible answer for the moment, and understand that the answer will need to be revised in the face of changing circumstances. Complicated losses may seem hopeless and irresolvable, but the power to change can never be taken from us, she says. . The confusion we feel is due to the ambiguity rather than to anything we did or didn’t do. She describes denial as an adaptation that can be useful, but over time becomes less function. It is neither something to avoid nor to advocate. What assists the most is a combination of optimism and realistic thinking. People can manage this with support from their own community and the professional community. Of course, for those who have lost their children or their first parents to adoption, this understanding is sometimes more difficult to find.

It is in reunion that I personally can relate to Pauline Boss’ explanation that we must temper our hunger for mastery and learn to redefine our relationship to the person we’ve lost. The pain of losing my child and the joy of him finding me again led me to want to regain what had been lost: I wanted to be a mother to my son. However, as I came to know him, I realized that I had to constantly redefine what I hoped for in the situation. In the end, the relationship I have built with my son is deep and loving, but it is not entirely a mother/son relationship. There is ambiguity in it. This ambiguity is not my fault, and it is not his fault. It is inherent in the flawed institution of closed adoption. The situation is wrong; we are not. We are damaged by it, and learning to heal from it.

Boss recommends that seeking information is an initial step to resolving ambiguous loss, thus giving support to first parents and those adopted to search for and find each other. She recommends that therapists help people to understand what ambiguous loss is, and that it’s normal to feel ‘stuck’ in the grip of it. It is the situation, not the person, that is sick, she says. A strength of the book is Boss’ understanding that individuals are unique and that each person needs to find their own way to resolve the loss. She sees that people need time for respite as well as time to engage the loss.

Finally, Boss echoes Frankl's Man’s Search for Meaning, saying we must make meaning of our losses. She has found four factors which affect how we find meaning in our losses:
  • Our family of origin and early social experiences affect what meaning we see in situations. This is where we develop rules, roles, and rituals for making sense out of loss.
  • One’s spirituality influences how we make sense of losses.
  • Our own optimism or pessimism affects our thinking about our losses.
  • Our view of the world also affects how we make meaning of our losses. Is we see the world logically, as a fair and just place, we find it hard to tolerate ambiguous loss, because we see it as what we deserve. On the other hand, if we see that bad things can happen to good people, and that an external force caused the loss, it is still tragic, but this frees the person to act again. Hence, understanding the greed of society for the children of unwed mothers, and the lack of protection and support for these mothers, means that they can stop seeing themselves as wholly to blame for losing their children.
I would highly recommend this book for all parents who have lost children to adoption, and those adopted also. Though the book deals with many types of ambiguous losses, and only in a small way specifically with adoption losses, the applicability of the information is clear and helpful to those of us who’ve lost by adoption.

"Contrary to popular belief, mothers don't go on in this world after "giving up" a child, enjoying their lives and forgetting the child ever existed.  Even though people would love to think this is true, its not the reality of the situation for most of us.  Our lives are colored by the tramatic event and we are never the same afterwards.  Most of us grieve for years ....  Losing a child to adoption in many ways is worse than losing a child to death.  With death we have closure to some degree, with adoption we know that we have a child out there in the world somewhere.  ... and we know we love them sight unseen." - Jaymie Frederick, first mother, professional searcher and licensed PI


Note: The terms "unwed" mother, "birthmother", "birthmom", "birthmoms", "dear birthparent", "birthparent", "birthparents", "birthfather" "biological" make a parent appear to be less than the mother or father they are. These terms dehumanize and limit the parent's role to that of an incubator. Using the honest terms "mother", "single mother" or "natural mother" help the public to understand why real family members must not be separated to obtain babies for adoption. These terms are used on this website for search-engine purposes only.


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