From Confusion to Clarity: Tools and Insights for Coping with Unclear Grief

Years ago, I designed a methodology/framework to work with?clients navigating the challenges of change in their life - personally +/or professionally, self-imposed/imposed upon. These days, I AM navigating myself through change and have been experiencing a deep and transformative period in my life. Growing through this personal shift has offered me new insights into that framework and has revealed areas where it can be further refined. I AM opening the doors and choosing to share my very personal story with the hope to offer a more nuanced perspective on the challenges of change, grief and loss.

I’ve been seeking to better understand my grieving which was initially brought on a few years ago when I “inherited” the role as essential caregiver to my Dad who is living with dementia amongst other things. Now I find myself also navigating through a divorce after almost 2 decades together. Navigating the loss of two significant relationships simultaneously is incredibly complex and painful. The grief I’ve experienced is compounded by the intensity and multiplicity of these losses.

Several weeks ago, I did some work with the Alzheimers’s Society, and learned the term “ambiguous grief/ambiguous loss” for the first time. Dr. Pauline Boss’s concept has provided me a profound way to understand the complexities of my situation. Ambiguous grief can be particularly challenging because it involves a sense of loss without that clear-cut closure typically associated with more straightforward forms of grief.

There are 2 types of ambiguous grief:

1. Type 1 – Physical Absence with Psychological Presence: The end of a significant relationship, such as my long-term marriage, represents that physical absence from my daily life as I knew it. Even though my husband is no longer present in the same way, the psychological impact remains. This ongoing presence had make it difficult to fully move on from the loss at times, as the memories and emotional ties continue to influence my life.
2. Type 2 – Psychological Absence with Physical Presence: With dementias, the person I once knew is still physically present, but the psychological connection I’ve had with my Dad is lost or certainly significantly altered. This creates a grief that is more about the gradual fading of his identity and the emotional connection we once shared.

To be clear, it is my grief that is ambiguous, not what I’m losing.

Understanding that my grief is ambiguous has provided me greater clarity and validation for all of the emotions I continue to experience. It’s a normal response to a non-traditional form of loss, and understanding this has eased the burden I've carried and has opened the door to continue stepping forward. It was what I needed to know and understand to prompt a more compassionate approach towards myself.

Personally, my experience with the “long good-bye” and the metaphorical “waiting room” has felt like ongoing trauma. This kind of extended grief is especially taxing because it doesn’t provide the usual markers of closure that might come with more definitive forms of loss. In this complex emotional landscape, I would like to offer some of my thoughts and strategies that have help me immensely and that I believe will help you should you be navigating through changes associated with ambiguous grief/loss as well.

• Acknowledging the Grief

Ambiguous grief, where the person is physically present but psychologically absent (or vice versa), creates a unique kind of mourning. Validating your feelings as grief can help in processing them, even if the loss isn’t as clear-cut as death.

• Navigating Identity and Roles

Your sense of identity and roles will understandably be in flux.

a) Reflect on your values and strengths: Consider what is important to you now and how these core values can guide you through this transition. For example, by focusing on my core value of health during these challenging times has been a powerful way to anchor myself and maintain resilience. By prioritizing what I consume — whether it’s food, media, or activities - I have created a more supportive environment for myself.

b) Create new narratives: Begin to craft new stories about who you are and who you want to be in this new phase of life. This can include setting new goals or finding new sources of meaning.

• Managing the “Frozen Grief”

Being in a state of waiting or “grief limbo” can indeed feel like ongoing trauma. Here are a few approaches that have helped me:

Mindfulness and Grounding Techniques: Practices such as meditation, breathing exercises, or grounding techniques can help you stay connected to the present moment and manage anxiety or stress.

Small Steps Forward: Allow yourself to take small steps toward re-engaging with life outside of your current situation. This might include pursuing hobbies, reconnecting with friends, or exploring new interests.

Seek Professional Support: Therapy or counseling can provide a space to work through these complex emotions and offer strategies tailored to your specific situation.

• Creating a Routine

Establishing a daily routine can provide a sense of normalcy and control amidst the uncertainty.

Self-Care Practices: Regular exercise, healthy eating, and sufficient sleep can significantly impact your emotional well-being.

Routine Activities: Engage in activities that bring you joy or relaxation, even if they seem small or insignificant.

• Accepting the Process

Living with ongoing uncertainty can be incredibly challenging. Accepting that some aspects of this situation are beyond your control can help reduce the stress of trying to manage the unmanageable:

Focus on the Present: BE in the NOW! Focus on what you CAN control in this very moment.

Develop Flexibility: Adapting to change and being flexible with expectations can ease some of the pressure.

Understanding that ambiguous grief is not linear and that it’s okay to have good and bad days. This alone can help ease some of the pressure you’re putting on yourself. You may have to remind yourself of this more often.

• Process your experience

Allow yourself to grieve in whatever way feels right for you:

Journaling: Writing down your thoughts and feelings can be a therapeutic way to process your emotions and finding clarity.

Creative Outlets: Art, music, or other forms of expression can be powerful tools for working through grief.

• Planning for the Future

While it’s challenging to look ahead during such a time, gently exploring what you might want for your future once this period concludes can offer some hope and direction.

Visualize Possibilities: Think about what might come after this period of waiting and what steps you might want to take.

Set Intentions: Setting small, realistic goals for the future can help you feel more hopeful and directed.

Ambiguous loss can indeed be particularly isolating because it lacks the clear boundaries and social acknowledgment often associated with more definitive forms of grief.

It is CRUCIAL to integrate the concept of ambiguous grief/loss into mental health discussions so that we can work towards better understanding and supporting those experiencing it. Recognize and validate that ambiguous loss is a significant and legitimate form of grief. Just because my loved one is still living does not diminish the depth of the emotional pain I've been experiencing. Increasing awareness about ambiguous loss can help others understand that grief can exist in complex and less visible forms. This recognition can lead to more empathy and support.

Nothing could have prepared me for this level of change. These past few years have rocked my world in unimaginable ways - both in good and not-so-good ways. I AM immensely grateful for the support I've had and continue to have.

It's been said that the only constant is change. Now, I AM even more prepared to handle what comes at me!