Week 7: Lesson 6: Ambiguous Loss, Trauma and Resilience • Readings: Loss, Trauma and Resilience: Chapters 3-5; Supplemental Readings: Luster, Qin, Bates, Johnson, & Rana (2008) • Lectures: o Unit 3: Loss &Trauma, transcript • Assignment: Discussion 4: A study of ambiguous loss: “The Lost Boys” For this discussion I want you to draw linkages between Pauline Boss’s chapters on loss and trauma and research that was conducted on The Lost Boys. In your original post, briefly describe the study in relation to Boss’s concepts of how individuals and families can be resilient by finding meaning, tempering mastery, revising attachment, and finding hope. The questions below can help you with this task. • What was the goal of the research study? That is, what research question(s) were the researchers trying to answer? • Who was in the study sample and how were they recruited to be in the study? Describe how many, some characteristics (e.g., age, gender). • What were the main findings of the study, and how do they related to Boss’s work on trauma, loss, and resiliency? o What traumatic experiences did the participants in the study have? o Did the participants experience ambiguous loss? How do you know?(describe evidence of this in terms of Boss’s work). o What strategies did the participants use to deal with their loss and trauma? Describe this in terms of Boss’s work. Focus on the most relevant concepts that link your research reading with the assigned chapters (e.g., finding meaning, hope, etc.) • What is the most important information you take away from the study you have read? What do you learn from it that you might be able to use to help those who experience ambiguous loss such as this?Include appropriate citations and references in your post (use APA), and remember to provide feedback that engages and stimulates discussion. 1Course Title: HD 301: Loss & Trauma Slide #1 Slide Title: Loss & Trauma Unit 3 HD 301 Rodgers Audio: In this lecture on ambiguous loss, I am really going to do a broad brush stroke on some of the main concepts that Pauline Boss discusses in her book about ambiguous loss and her ideas about that topic. Slide #2 Slide Title: What is ambiguous loss? Boss defines it in two ways: When family members are psychologically present but physically absent When family members are perceived as physically present but psychologically absent Most stressful type of loss one can experience Physical loss is acquainted with ambiguity of family roles and/or who is in or out of family In either case… The loss is not clearly defined, may have few rituals for dealing with it, and can affect psychological functioning and family interactions/health Audio: Now Boss defines ambiguous loss in two ways. The first way is a loss that is experienced when family members are psychologically present but they are physically absent. The second kind of ambiguous loss is when family members are perceived as physically present but they are psychologically absent. Boss discusses that the most stressful type of loss one can experience is the physical loss when it is accompanied with the ambiguity of family roles. For example, who is in or out of the family? For example, when we have a physical loss such as someone missing in action in a war zone or war experience, they are physically no longer present but there is a lot of ambiguity about where they are, when they will return, or will they return. And as the family begins to live their lives, the roles can be ambiguous about if we talk about this person as present or absent, and who takes over their roles in the family So in either case whether there is psychological presence and physical absence, or the other way around, the loss is not clearly defined. This is what creates the strain. It is ambiguous. Another thing about ambiguous loss is there are few rituals for dealing with ambiguous losses. It is this combination of lack of definition, ambiguity, and having few rituals that can affect the psychological functioning of family members. And can actually affect family health as well both 2 individuals and family as a whole. Slide #3 Slide Title: Assumptions of FSP o Stress is caused by change o When the change (stressor event) results in ambiguous loss, families may respond in less optimal ways o Looking at the outside source of stress can help define the problem (i.e., identifying the ambiguity of the loss as a stressor) o Families are resilient and can learn to cope ? Despite ambiguity, people can learn to manage stress. Audio: Now there are a few assumptions of the family stress perspective that Boss presents. One is that you have learned from earlier lectures with others around the issue of family stress is that stress is caused by change. When the change or the stressor event results in ambiguous loss, Boss suggests that families may respond then in less than optimal ways. So what she is arguing is it is this ambiguity itself that creates a stress. In addition to the stressor that may be coming with a transition or a change. Looking at the outside source of stress, she says can help to find to find the problem. For example, in other words, identifying the ambiguity that is associated with, or the ambiguity of the loss that is associated with a stressor. Boss also firmly comes from the perspective that families are resilient and that they can learn to cope with stresses even when that stress is through an ambiguous loss, she believes that people, individuals and families collectively can learn to manage the stress. Slide #4 Slide Title: Assumptions of FSP o To help, professionals should share information with families ? This can minimize the ambiguity o Unresolved grief is similar to PTSD, but the trauma (ambiguity) is persistent and present (rather than past) Audio: To help, she argues that professionals should share information with families. What she means by that is when family members are equipped with information about their situation, then that can help to minimize the ambiguity and can help them to feel less stressed. Another aspect of ambiguous loss is what is called unresolved grief. She argues that unresolved grief is similar to post traumatic stress disorder, but the difference is that the trauma with 3 ambiguous loss is the ambiguity itself. This ambiguity is persistent and present whereas with post traumatic stress disorder the trauma is in the past and it is being relived through flashbacks and such. These are really the distinctions but the idea here is the unresolved grief is a trauma within itself because it is that ambiguity around that lack of resolution that continues to be persistent and present and creates the stress. Slide #5 Slide Title: Ambiguous loss can be found in many family experiences o Stress and trauma is from lack of closure or sense of control ?Immigration ? Adoption ? Divorce/remarriage ? Alzheimer’s or chronic disease ? Child leaving for college ? Missing child or person at war ? Lost love in a relationship (slow process) ? Alcohol or other drug addiction o Culture and family patterns influence how members address the ambiguity Audio: Ambiguous loss can be found in many family experiences as you will read in your materials. Stress or trauma is from a lack of closure or a sense of having no control. Here are just some of the ways that families might experience them and this is by no means an exhausted list. This is just some of them. One might be immigration. People who immigrate to this country may have a very exciting experience. It is an opportunity. There are often feelings of loss of what was familiar. Loss of family member who are still in the old country. These feelings are not always tangible or something somebody can really put their finger on. There is an ambiguity around that. Adoption is another experience that can bring about ambiguous loss. Divorce and remarriage are experiences in which one can experience ambiguous loss. For example, the loss of role or status. The changing of roles can represent a loss that individuals cannot really put a finger on necessarily. Persons with Alzheimer’s or chronic disease can experience ambiguous loss. One of the things about Alzheimer’s or diseases that are progressive is that it is slow change that happens over time makes it really difficult to say when the changed happened, so it is that progression that is sort of ambiguous and can leave a feeling of loss. Even children leaving for college, parents can experience ambiguous loss around that situation. A missing child because of abduction or a person at war is two situations in which ambiguous loss can be experiences. A child who has run away or no longer has contact with the family is another situation. And when we think about the processes that happen in families as they begin to dissolve , lost love in a 4 relationship can be a very slow process, you cannot really put a finger on when that happens. That in itself can be an experience of ambiguous loss. And finally, families who experience alcohol or other drug addictions may also experience ambiguous loss. So as you read about ambiguous loss be thinking about these and other kinds of situations in which the trauma is really resulting from a lack of closure or sense of control around these experiences.Now clearly culture and family patterns will influence how family member address ambiguity. So there is not one particular way, right or wrong, in which families should address ambiguous loss. The point Boss makes is that identifying the lack of closure and the feelings of lack of control can help one to take steps to address them. Slide #6 Slide Title: Mixed Emotions o Mixed emotions or ambivalence about the loss can create distancing in families o Coping ? When families understand that ambiguity is part of stress, they can begin to find ways to minimize the ambiguity OR accept it Audio: Often when there is ambiguous loss, families will experience mixed emotions. It is this mixed emotion around ambiguity that can create distancing in families. But when family members understand that ambiguity is part of the stress, they can then begin to find ways to minimize the ambiguity or at least accept it. They may not be able to minimize the ambiguity entirely. They might say, “Hey, you know what? Life is going to be ambiguous. We really do not know what happened to this person, but we are going to accept it and live with it.” It is that experience, in fact, that perception, the way of looking at the ambiguity of the loss and mixed emotions that allows families to start to find and utilize some coping methods around that loss. Slide #7 Slide Title: What is frozen grief? ? When the grief, sadness, melancholia associated with ambiguous loss prevents one from getting on with life. ? The person may be “stuck” in grief, unable to utilize coping mechanisms. ? Can result in depression, anxiety, conflict in families ? Defining and recognizing the loss as ambiguous can help individuals and families come to terms with the loss. ? Can give new ways of looking at it; give permission for the situation to be unclear Audio: Another concept that is addressed with ambiguous loss is the idea of frozen grief. What is that frozen grief? Boss defines frozen grief as grief, sadness, or melancholia associate with 5 ambiguous loss. And the loss itself prevents one from getting on with life. That is why she talks about it as frozen. With frozen grief, the person may actually be stuck in the grieving process. And when they are stuck in that process, they are unable to utilize their coping mechanisms. Frozen grief can result in depression, anxiety, and conflict in families. When individuals and family members can define and recognize the loss as ambiguous, they can begin to come to terms with the loss. By coming to terms with the loss, they begin to have new ways of looking at it. Also sometimes what can happen is family members can be given permission or give themselves permission for the situation to be unclear. Sometimes there is this tendency for us to want to fix problems or make things really clear so we can address them, but the whole point here with ambiguity is that sometimes situations will be unclear. If we can allow that to happen, then that will reduce the stress. Slide #8 Slide Title: The paradox of coping with ambiguous loss o In order to gain a sense of control over the ambiguous loss, we must accept ? There is no one perfect solution ?Identify the source of helplessness (as other than ourselves) o This then allows for finding ways to deal with the ambiguity ? Revise our perception of the situation ? Express feelings in non-destructive ways ? Find respite and use humor ? Find mastery through spiritual acceptance Audio: Now there is a certain paradox of coping with ambiguous loss. That paradox is in order to gain a sense of control over the ambiguous loss, one must accept that there is no perfect solution and be able to identify the source of their helplessness. It may be something that is completely out of our control, or out of one’s control. This is really the paradox. When that acceptance happens, Boss argues that this then allows individuals and family members to find ways to deal with the ambiguity. For example, say there is no one perfect solution. Maybe there are multiple solutions. Or maybe we just have to accept that this is ambiguous. This can begin to help them revise their perception of the situation. Once that revision starts, then feelings of frustration can be expressed in non-destructive ways finding positive ways to deal with feelings around the ambiguity. And that can help families and individuals find some respite. She also argues that families and individuals who can use humor around ambiguity are going to feel far less stressed than those who cannot. So humor is really an important tool for dealing with ambiguity. Finally, finding mastery is really important. Boss argues that she has observed in families that often families and individuals can find mastery 6 through some sort of spiritual acceptance. That does not necessarily mean that it is a particular religion but that there is a sense of belief that there is a higher power who has control and an individual and families cannot always control things. This sort of belief system can help them find mastery over the ambiguity. Slide #9 Slide Title: Making Meaning of Ambiguous Loss o Meaning making = tolerance for ambiguity o Helping other is a way of coping by giving meaning to one’s loss. ? Forming foundations for missing children ? Forming campaigns against breast cancer ? Petitioning for new laws or policies o Changing or modifying family traditions o Spiritual beliefs help give meaning to ambiguous loss Audio: Families who can make meaning out of ambiguous loss will experience lower stress as well. So this meaning making really means tolerating the ambiguity and finding a way to be tolerant of it. Helping others is one way that family members can find a way to cope with ambiguity. For example, individuals who have experienced a loss of a child have been known to form foundations for missing children. Forming campaigns against breast cancer is another example of how someone took an experience of loss and created something and made meaning out of it. Not only for themselves but for many other people in society. Another example of having made meaning out of loss is the petitioning for new laws and policies. For example, the Amber alert that we are all familiar with now really came out of a loss that a family experienced. So the ambiguity around that, they were able to take that and make meaning out of it and push for a new law or policy. At the family level, we can think about changing or modifying family traditions that can help to cope with the ambiguous loss. There is an example once of someone, there is always somebody who has always been the person who has carved the turkey. As they age and become less capable of being able to actually physically manage that, it would be important to change that tradition. Maybe that turkey gets carved in the kitchen oppose to in front of everyone where the shaking hands maybe does not look so pretty. So changing those family traditions so everyone may be able to still maintain people’s dignities or roles but still to have some sense of maintaining tradition. Finally, spiritual beliefs can help give meaning to ambiguous loss as was suggested in the previous slide 7 Slide #10 Slide Title: Tempering Mastery o Adjusting perceptions about fairness and control of situations o Decreasing self blame ? Self blame or blame of others is dysfunctional because it prevents closure Audio: The last kind of thought that Boss has is taking this idea of tempering mastery. Tempering mastery refers to being able to adjust your perceptions about fairness and control. In other words, to be able to accept that life is not always fair and situations are not always fair and we do not always have control of situations. But being able to do this to adjust that perception and accept the lack of fairness and accept the lack of control, she argues that this is the tool of tempering mastery and this is important for dealing with ambiguous loss. And another tool is the notion of decreasing self-blame. When there is a tendency to blame oneself or to blame others in light of this tension around ambiguous loss, that only serves to create distance and does not help families. It can really be dysfunctional because it prevents the individuals and family member from finding some closure. So being able to decrease the selfblame or decrease the blame of others, allows families then to move on and find some kind of closure because blaming others or blaming one’s self is not going to do that. Slide #11 Slide Title: Coping with Ambiguous Loss o Denial ?It might also be adaptive for some families ? Can be maladaptive when it ? Blocks creative solutions, prevents family members from transforming and moving on in life, invalidates the presence of a member. ? With impending death, may rob family members of opportunity to say good bye to their loved one. Audio: Paradoxically sometimes coping with ambiguous loss is done through denial. For some families this can be adaptive. One example that she gives in the book, a family who had a child abducted in a very remote rural area. It was highly unlikely that one of their sons would be abducted. For forty years, this family put an ad in the newspaper just letting the child know they were still thinking about him and if he was out there to contact them. They never did really connect with their son but for this family it was adaptive because it did not stop them from 8 living. They continued to live but it became a tradition for honoring and remembering their son. So in this way, that sort of denial was a functional denial for them. Sometimes denial can be maladaptive. It is maladaptive when it blocks the creative solutions and 10/9/2015 A study of ambiguous loss: “The Lost Boys” http://academicassistersblog.com/astudyofambiguouslossthelostboys/ 9/9 prevents family members from transforming and moving on in life. It is also maladaptive when denial it invalidates the presence of a member. For example, denies if someone is present. It does not address that closure. Denial can sometimes be adaptive and sometimes be maladaptive. Sometimes with denial, for example with an impending death. When families deny that death is coming, it may actually rob them of the opportunity to make reparations or to say good bye to the loved one. So in those situations denial can be maladaptive. Slide #12 Slide Title: Coping with Ambiguous Loss o Boss argues that families are better off making an educated guess about the loss than to remain in limbo o She calls this the “family gamble”—weighing the probability of loss recovery versus the probability of permanent loss. o Successful launching of children requires that parents and children accept new roles and responsibilities. Audio: Boss argues that families are better off making an educated guess about the loss than to remain in limbo. Because at some point the ambiguity can create a sort of frozen grief for them. And she calls this the “family gamble.” And this gamble is weighing the probability of loss recovery versus the probability of permanent loss. She suggests, for example, that the successful launching of children requires that parents and children accept new roles and responsibilities. So during this transition when children are establishing themselves and are still sort of semidependent on parents, the roles can be ambiguous. She suggests that it is important to make that gamble and accept that the children can have those new roles and responsibilities because this is important for development. It also reduces that ambiguity. These are just some of the thoughts around coping with ambiguous loss from the book you are going to be reading. Of course, you will want to read in more depth and really take note of these ideas as they are applied to the other situations and contexts that we talk about throughout the course.