‘Ambiguous Loss’: When Someone You Love Is ‘Physically Present but Psychologically Absent’ Because of Alzheimer’s Disease or Other Factors

Missing someone who is there, but not there

Ambiguous Loss: Learning to Live With Unresolved Grief. By Pauline Boss. Harvard University Press, 155 pp., $22.

By Janice Harayda

Ambiguous Loss is something rare — a book by a therapist who can write. For decades, Pauline Boss has studied what she calls “ambiguous loss” – a kind of loss that occurs when someone is “physically present but psychologically absent” (because of Alzheimer’s Disease or other factors) or when someone is “physically absent but psychologically present” (because of geographic distance or another obstacle that may never be overcome). Boss has found that such losses are uniquely painful, partly because they deprive people of mourning rituals and can go on until the mourner is “physically and emotionally exhausted from the relentless uncertainty.”

Ambiguous Loss describes how people deal with the unresolved grief. But it isn’t a self-help manual so much as a collection of gracefully written stories of men and women who have learned to live with confusion and uncertainty. Case studies in therapists’ books are typically banal, sanitized and, frequently, unbelievable. The accounts in Ambiguous Loss are complex, persuasive and enhanced by apt references to sources from Homer to Steven Spielberg.

Boss may be overreaching when she suggests that the people who are experiencing ambiguous loss may include those married to severe alcoholics, workaholics, and certain others. But her overall argument is strong. And her supporting evidence is never more poignant than when she writes of her own relatives, who left families in Switzerland and moved Wisconsin in the early 1900s, then were prevented by war and financial hardship from returning to Europe. Her grandmother yearned to see her son in America, who couldn’t visit her until she was on her deathbed, and for decades sent letters that began with “My dears” and ended with: “May God protect you always. Mother.” When mail became sporadic during World War II, she wrote wistfully to her kin of the grandsons she had never met: “Even if it is not possible to write, I am with you at all times anyway in my thoughts. I am sure you have two big sons by now. I wish I could see them in person.”

Best Line: “Sometimes the prevalence of ambiguity in contemporary life can be amusing, reaching even into people’s spiritual life. In [a cemetery] in Tokyo, a mechanical Buddhist priest with robotic eyes chants sutras each morning for the recently dead. The question is: Is a priest absent or present?”

Worst line: “Self-blame is dysfunctional because it prevents us from moving on with our lives.” Self-blame can be appropriate if, for example, if you’re Don Imus and slander the entire Rutgers women’s basketball team. At times Boss also uses the word “closure,” which has been so overused that it’s lost most of its meaning, and similar terms, though her book wears its jargon lightly compared with most by therapists.

Recommended if … you want information on the social and emotional context of ambiguous, not a shower of bullet-pointed tips on how to cope.

Furthermore: Boss is a professor of social science at the University of Minnesota, a family therapist and past president of the National Council on Family Relations.

Editor: Elizabeth Knoll

Published: October 2000

Links: www.ambiguousloss.com

© 2007 Janice Harayda. All Rights Reserved.