Ambiguous Grief & Loss in the Face of Mental Health
Updated: 2 days ago
By all accounts, our guest blogger Julia remembers a happy childhood. By the time she was 16, her father had begun his descent into the depths of depression, where he remains today. It was two decades later, after her uncle's death, Julia realised she had been grieving the loss of her own father, even though he was still physically present in her life. It's a grief that gives rise to a sense of being in a perpetual state of limbo and is associated with ambiguous grief & loss.
This realisation took Julia on a journey to learning about ambiguous loss and its relationship to the grief associated with her father's mental illness...... to understanding the grief associated with losing someone who is still present.
Originally written for a university project, I'm grateful that she has shared this valuable understanding with our readers. Although related to personal circumstances, Julia believes her work is a small contribution to a larger discussion about perceptions of loss and grieving, particularly in regards to mental health.
"Here But Not Here"
It’s a strange feeling, feeling like you’re ready for your father to die when he isn’t anywhere close to death.
As I was walking up the stair, I met a man who was not there. He was not there again today. Oh, how I wish he’d go away.
I don’t quite understand.
When I was young, I remember staying every second weekend with my father at his flat on the Northside of Brisbane. The fridge was always full of Coke and Tim-Tams, and my poorly made father's day card in the shape of a cockatoo was stuck beside his bed. He told me stories about his job as an electrician and answered all my questions about how power sockets work.
He would play Pink Floyd on the stereo while I listened to the Spice Girls on the Walkman he gave me.
When I was a bit older, I remember visiting him in his flat in Spring Hill. It was above a pub,and I was amused by the fact that the fridge was so small and that there was a sink near his bed. He told me stories about his surfing days and passionately talked about the unique majesty of being out in the ocean.
He would listen to Led Zeppelin on the stereo while I listened to Britney Spears on the Discman he gave me.
When I was a young teenager, I remember visiting him in Gympie. It was a boring town, but I found a newsagent which I liked to visit and spend time in, flipping through magazines. He told me stories about how he hitchhiked around Europe in 1979 and learned how to say ‘two beers please’ in almost every European language. He told me about how he saw the Berlin
Wall before it came down.
He would listen to Neil Young on the stereo, while I listened to Jack Johnson on the cylindrical mp3 player he gave me.
Then I started to lose him.
The worsening state of my father’s mental health continues to take him away while he remains firmly in place. Severe and unrelenting chronic depression has had its hands on my father for a long time. Since I was a child, their grip had loosened, tightened, loosened and then tightened again. I remained unaware, living in a childish bubble of naivete. Ten years ago, at a time when this bubble was not as easily inhabitable, they found their strength and were only tightening. The man, who was a highly skilled electrician, was now unemployed and living with his parents. The man who once hitchhiked around Europe and savoured his time in the ocean now found it difficult to leave the house. Their grip continues to tighten. He remains here, but I continue to lose him.
The Nature of Ambiguous Loss
As defined by the Oxford dictionary, loss is ‘the fact or process of losing something or someone,’ and ‘the feeling of grief after losing someone or something of value. When we talk about grief as related to loss, we work within the simplest binary of them all; someone is dead, or they are alive. To move beyond such a frame of reference when thinking about the loss of life defies strict logic. To perceive someone as lost when they are still very much here sits beyond dichotomous thinking that is easier to comprehend and talk about.
How then does one label and comprehend loss that exists within the vague space between the dichotomised notions of death and living? How can something so complex be more simply understood; how can something that sounds so irrational be rationalised? A possible answer lies within the concept of ‘ambiguous loss.’
Ambiguous loss is a term that was first used in the 1970s by Professor Pauline Boss, who had been studying the families of soldiers who went missing in action. It is a loss without closure or understanding. For some, this is physical loss, such as when a plane goes missing, and nobodies are found, and the parents of one of the passengers do not know whether their child is dead or alive.
Type 1. They are physically absent but psychologically present. They are ‘gone, but not for sure.’ For others, it is psychological loss, losing a loved one to the cruel and unflinching grasp of Alzheimer’s and dementia, for example.
Type 2. They are physically present but psychologically absent. They are ‘here, but not here.’
My father is here, but not here. I start to understand.
Recently, I helped my cousin through the grieving process after the death of her father. Not having had anybody close to me die meant I felt underprepared and concerned that I could not be of help beyond being a literal and figurative shoulder to cry on. What I was not expecting was to see the grief, recognise the grief and very quickly understand the grief. At that moment, I realised that I, too, had experienced grief. At that moment, I realised that I would trade places with her, to spare her the grief, if I could. I did not want my father to die, but if he did, the worst of my grieving would be done.
The language of grief need not be reserved for just the dead, but it is easier to understand it that way. It is more rational. In a state of ambiguous loss, people feel that they can’t rightfully grieve because although it feels like a loss, it isn’t really one. Once again, the dichotomous frame of reference triumphs. Yet here I was, having occupied a grief-filled, ambiguous in-between space, without even being aware of its existence. This space, rather than being illuminated and mitigated by the language of ambiguous loss, was laden with confusion and uncertainty about the validity of my loss and my feelings.
But upon realising I had grieved, somehow, for someone who was alive, I finally had a way to articulate how I had felt and the emotions I had gone through in the past. It suddenly made understanding an inherently complex situation quite simple. I had not consciously walked the path to get to that understanding. If I were aware earlier that there was a simple label given to the complicated state of loss I was feeling, a simple label that helped validate my feelings of desperation for finality, that path could have been less fraught with more guilt and confusion that is already felt within ambiguous loss. It quickly became apparent that the rocky path through this irrational loss could be rationalised through Boss’s conceptualisation of ambiguous loss and its effects; effects I have come to realise closely resemble the oft asserted traditional stages of grief.
It begins to make more sense.
The Stages of Grief
‘The uncertainty prevents people from adjusting to the ambiguity of the loss by reorganising the roles and rules of their relationship with the loved one.’
He now perceived himself as reducible to his illness, despite being the same interesting man with the same stories and the same life experiences. I did not want to accept that this was now his lot in life and that this was mine. I was uncertain whether things would get better but wanted to believe they could, so I did not rearrange my own perceptions and expectations of our relationship.
‘They may even feel anger at someone they love for unintentionally keeping them in limbo, only to be consumed by guilt for having such thoughts.
I felt angry at him. Angry about not having the father figure I wanted. Angry about his inability to see beyond his own mind and see how his illness was making me feel by keeping me in limbo. Angry that I had to go through this. Guilty that I felt angry.
I will do anything to make this better. I promise I’ll do this. I’ll promise I’ll do that. Glimmers of hope would come and go, and with them would bring an influx of these thoughts.
‘Perceiving loved ones as present when they are physically gone or perceiving them as gone when they are physically present, can make people feel helpless and thus more prone to depression and anxiety.’
Indeed it did.
How strange, having to construct meaning and rearrange perceptions of relationships within this paradox of absence and presence.
This ambiguity brings to mind the thought experiment conducted by Erwin Schrödinger. Put in the simplest terms, he explained that if a cat were put into a sealed box that could not be seen into, along with a dangerous substance that could potentially kill the cat, you would not know whether the cat is dead or alive until you open the lid and look inside. The cat is, in a sense, both dead and alive.
Unlike Schrödinger’s experiment, however, ambiguous loss provides no way to lift the lid and reveal the truth. The box many remain unopened forever. Uncertainty prevails. The loss continues indefinitely and may never reach a point of finality. It is for this reason that Boss believes that ‘closure is a myth.’ Rather than a feeling of closure, she explains, there exists resilience. As tolerance for ambiguity increases, so too does resilience.
‘The absurdity of ambiguous loss reminds people that life is not always rational and just; consequently, those who witness it tend to withdraw rather than give neighbourly support,’ Boss further explains. People who were aware of my situation weren’t quite sure how to talk about it because it was as confusing for them as it was for me. Yet, in the last few years, my personal tolerance for the ambiguity of my father’s situation has significantly increased, which has made it easier to talk about it with others and also with myself. I am resilient.
My situation is not comparable to those whose family members are missing in action or were a passenger on a missing aeroplane, nor can it reasonably be compared to the upsetting realities of Alzheimer’s.
In coming to understand ambiguous loss, however, what is validated and solidified is that it is possible to feel the loss and grieve for the living. It is a process that is likely being undertaken all around us every day, but the absurdity of the situation makes it hard to recognise and talk about in the same way as we talk about grieving for that which is definitively gone. If the right sort of understanding is given to people with altered perceptions that transcend the binary of death and living, perhaps it could be talked about more openly and thoroughly. Meaning could more easily and therapeutically be constructed within this paradox of absence and presence. Perhaps this absurd in-between space may not seem quite as absurd.
It’s a strange feeling, feeling like you’re ready for your father to die when he isn’t anywhere close to death. I don’t want my father to die, but I have grieved for the loss of what he once was and for the loss of the relationship I always wanted with him. But for now, we sit in our space of ambiguity and listen to Pink Floyd, Led Zeppelin and Neil Young together. I am not ready to lose that.
Last night I saw upon the stair, A little man who was not there. He was not there again today. Oh, how I wish he’d go away.
I understand now.
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