What is “ambiguous loss”?

What is “ambiguous loss”?

Losing an irreplaceable person or object is called “loss”. When we experience a “loss”, a grief response appears immediately afterwards. Over time, we gradually recover from that grief. Grieving is very natural.


“Ambiguous loss” refers to a situation where the loss itself is ambiguous and uncertain. Dr. Pauline Boss defined this “ambiguous loss” as “a loss experience that remains indistinct and cannot be resolved or settled.” She says that, unlike normal loss, those who are experiencing ambiguous loss “cannot move forward” because of endless sadness.


Additionally, in an ambiguous loss situation, we often lose track of “who I am”.

When a husband is missing, a woman may wonder “Am I still wife or not?”.  If a farmer is unable to work due to the nuclear power plant accident, they may ask, “Am I still a farmer or not?” …

In ambiguous loss, one’s identity and role are said to be threatened.



What is lost due to “ambiguous loss”.

  • Loss of a relationship and attachment that existed prior to then, due to the absence of a loved one
  • Loss of the certainty of your future, with losing your loved one’s future
  • Loss of a sense of being in control of your own life
  • Loss of future hopes and dreams
  • Loss of your identity and your role as a wife or child
  • Loss of confidence that the world is a safe place


About Dr. Pauline Boss

About Dr. Pauline Boss

Dr. Pauline Boss, Professor Emeritus of Family Sociology at the University of Minnesota, has been a pioneer in interdisciplinary research on family stress and family therapy for many years. She is also a loving disciple of Carl Whitaker, who was called the master therapist of family therapy.


She has been developing her own family theory based on family therapy and family social psychology for over 30 years. Ambiguous loss is a theory that she has proposed based on her own experiences, and the construction of that theory and her work in many family therapy cases are some of her most important and highly acclaimed achievements.



Her books and publications

・Boss, P. (2016). Family Stress Management: A Contextual Approach.

SAGE Publications, Inc.


・Boss, P. (2011). Loving Someone Who Has Dementia. How to Find Hope While Coping with Stress and Grief. San Francisco, CA: Jossey-Bass/Wiley.

(Japanese translation available from Seishin Shobo. Supervised translation by Wada, H.)


・Boss, P. (2006). Loss, Trauma, and Resilience: Therapeutic work with ambiguous loss. New York: Norton.

(Japanese translation available from Seishin Shobo.  Supervised translation by Nakajima, S and Ishii, C.)


・Boss, P. (2004). Ambiguous Loss Research, Theory, and Practice: Reflections after 9/11. Journal of Marriage & Family, 66(3), 551-566.


・Boss, P., Beaulieu, L., Wieling, E., Turner, W., & LaCruz, S. (2003). Healing Loss, Ambiguity, and Trauma: A community-based intervention with families of union workers missing after the 9/11 attack in New York City. Journal of Marital & Family Therapy, 29(4), 455-467.

 DOI: 10.1111/j.1752-0606.2003.tb01688.x                    


・Boss, P. (2002). Family Stress: Classic and Contemporary Readings. SAGE Publications, Inc.


・Boss, P. (1999/2000-paperback). Ambiguous Loss: Learning to live with unresolved grief. Cambridge, MA: Harvard University Press.

(Japanese translation available from Gakubunsha.  Translated by Minamiyama K.)



Two types of “ambiguous loss”

Type1  Physical absence with a psychological presence

Typical examples of “Leaving without Goodbye”:



 Missing, disappearance, distress, abduction, lost without a trace, etc.

*More common:

 Divorce, adoption, immigration, etc.



Type2 Psychological absence with a physical presence

Typical examples of “Goodbye without Leaving”:



 Alzheimer’s disease and other dementias, brain injury, addiction to drugs or alcohol, depression, etc.

*More common:

 Absence of a loved one, homesick, workaholic, etc.


Note) “Catastrophic” refers to a tragic situation in which many huge changes occur in one’s environment.

Effects of ambiguous loss

1.General effects

  • Immobilizes individuals and relationships
  • Confuses decision making for the system
  • Freezes grief
  • Blocks coping
  • Tempts wanting everything to be in black and white
  • Dreams of struggle to find answer



2.Effects on individuals

  • Complicated grief; frozen grief, anger
  • Depression (Note difference b/w sadness and medical depression)
  • Increased anxiety, stress, and stress-related illnesses
  • Traumatization  (Note difference b/w experiencing trauma and medical PTSD)
  • Feelings of ambivalence*, guilt, and/or shame become stronger (Note difference b/w social ambivalence and psychiatric ambivalence)
  • Feeling helplessness and hopelessness
  • Harder to make decisions
  • Increased risk of turning to drugs or alcohol or abuse oneself or others



3.Effects on relationships (with family and the community)

  • Immobilizes every member of the family
  • Fewer conversations and less shared feelings within the family
  • Withholding judgment when making a decision
  • The role in the family remains unclear
  • The relationship boundaries become blurred
  • A cessation of celebrations, rituals, and family vacations
  • Community members disatant
  • Conflicts arise between family and community members, often keeping them at a distance



*What is “Ambivalent”?

To have totally conflicting feelings. It means experiencing both feelings, such as “that person doesn’t exist,” or “I’m sure he exists.

This often results in a conflicted state, both consciously and unconsciously.  This is an important concept in understanding the problems of the mind.

(See next section.)

About ambivalent thinking

It is said that those who experience “ambiguous loss” always have two conflicting feelings (called ambivalent) and thoughts.




For example, the following thoughts.

  • He (she) may not come back, or maybe he (she) will come back
  • He (she) is gone, but he’s (she’s) still here
  • I’ll continue to live with him (her), but I also have to think about how to live alone
  • I want to value my family’s thoughts, but also my own thoughts
  • I don’t want closure for this loss, but I also want to take a new step forward
Coping with ambiguous loss

Coping with ambiguous loss

The stress from ambiguous loss is said to be one of the most difficult stresses to cope with.


You don’t know who you are or how to live, and you feel as if you’ve lost the art of living.


However, even in the midst of all that, all is not lost. There is always a key to recovery and hope available. 


The following is a list of things you can do to help when dealing with ambiguous loss. Look for things you can do, even if only for a little at a time.


Something to help you cope

■Even if you can’t do it every day, have a conversation with your partner or family several times a week. It’s OK to disagree. It’s even more important to listen to each other. If there is a place for people to understand themselves, it can be a source of hope for any person.


■Invite your children to participate in family conversations. You don’t need to elaborate with your little ones, but you should let them know what parents and other adults around them are worried about. For any person, knowing even a little is better than not knowing anything at all.


■Let’s try to sort out a little bit what we have lost and what remains. Before we can sort it out, we often unknowingly suffer from complex feelings of guilt, shame, anger, and sadness. If possible, talk to someone you trust a bit about them. Sorting out such things and talking about them can make you feel better.


■When you are thinking or talking to people, you may feel a variety of emotions. At such times, be kind to yourself. Every emotion and thought is caused by an ambiguous loss. You don’t have to overly blame yourself, feel ashamed, or pass judgment. Also, all people are tempted to blame someone when things don’t go their way. However, try not to let that alienate your family and others too much.


■Gather information. Information is power. There are many sources of information: people you know, experts, and the Internet. Based on this information, think about whether there are any new options for your current life or way of thinking. If possible, talk about it with your family or someone you trust.


■Look for someone who you can express your thoughts comfortably, who understand you, and who you want to be close to. Such a person is called “psychological family “.


■Don’t be afraid of change. It is a very important part of our lives.


■If there is a place where you can connect with people who have had the same experience, please join. Those people will understand your suffering better than anyone else, even if they don’t have much to say.



The ambiguous loss that children experience

Unlike adults, children’s experiences with loss are completely different in terms of understanding and perceiving loss, depending on their stage of development. It is also said that children are more resilient than adults, even in adversity. Despite this, problems of the mind may become more apparent over time. The cause is more often due to the situation the child is in and the involvement of surrounding adults, rather than the child’s own problems.


Using a disaster as an example, if one parent goes missing, the child may not be properly informed of the circumstances of the disappearance. Children can also be left in a state of anxiety with no idea of what is going on, while their families and those around them are scrambling to look out for their safety.


If there is a child in the family who is dealing with ambiguous loss, it is important not to put that child “out of the loop.” No matter how harsh the experience may be, it is important that the adults treat the child as another member of the family who is facing a loss.

When a child feels respected, they will seek out their own way through the grief and grow into it.