Ambiguous Grief Differs from Typical Grief—Here’s How to Cope

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A loss without closure—known as ambiguous grief—can cause you to get stuck in the grieving process. Here's why it happens and how to cope.

Going through a loss without closure

“My grief feels hard to define,” says Amy D., 35, of Arvada, Colorado. Along with her husband and two sons, she’s been taking in foster children for several years, and while it’s never easy, she’s recently found herself in a particularly difficult situation.

Violet (name has been changed) had been homeless since she was eight years old. At 14, she found a loving home with Amy and her family. For the past year, they’ve watched her grow and thrive. But Violet has a biological family member finishing rehab, and she’s now being transitioned to a different home in a different city.

While Amy is happy for her to be reunited with her biological family, she’s also feeling a lot of grief over losing this child she loves. “It’s a pretty devastating blow to our family because we are ‘losing’ a kid. She isn’t dead, but we will mourn her,” she says, adding that they will be unable to communicate with Violet directly after she leaves their home. The inability to stay in touch with Violet and the understanding that information about her will be limited makes Amy’s grief even worse.

“It’s just a strange sensation being someone’s mother one day, then needing to communicate with them via a government agency the next,” she says. “The sting is pretty visceral.”

These conflicting feelings of joy, hope, grief, confusion, worry, and uncertainty make grieving this loss difficult—not just for Amy but also for the kids who’ve grown to see Violet as a sister.

“It’s such an ambiguous loss that is really hard to articulate, and people have no idea how to console us,” she says.

This type of grief has a name, and Amy and her family aren’t the only ones experiencing it. This is known as ambiguous grief.

(Here are some mourning quotes that may help after a loss.)

What is ambiguous grief?

Simply put, ambiguous grief is a reaction to a loss that has no closure, says Ashwini Lal, lead clinical psychologist at the Kaiser Permanente Bernard J. Tyson School of Medicine in Pasadena, California. Without facts or information to support your understanding of the loss, this can leave you feeling lost, stuck, and searching for answers.

Grief researchers have identified two types of ambiguous grief:

When the body is present but the mind isn’t

The first is when someone is physically present but psychologically absent. Examples of this type of loss include severe mental illness, addiction, or significant cognitive impairments like dementia.

This cognitive dissonance between who you remember the person to be and who they are now can be very jarring and upsetting. “Though the person is physically there, they are not who they used to be,” says Lal.

When the person is gone but they’re still on your mind

The second type is when a living person is physically absent but still psychologically present in your mind. This is the type of loss Amy and her family are suffering. This may also include losses like a loved one who has gone missing, a baby in a closed adoption, when a loved one is incarcerated, or a difficult breakup where there’s no contact between you and your ex.

It can be hard to navigate and move through the grief process when you don’t have answers and you may even feel frozen in time as you wait for information that may not ever come, says Gail Trauco, a certified oncology nurse, licensed grief mediator, and author of Conquering Grief From Your Own Front Porch.

(This is what Day of the Dead can teach us about grieving.)

Why ambiguous grief may be harder than typical grief

Part of the normal grieving process is learning how to integrate the loss in your life in a meaningful way—you don’t forget the person or stop loving them, but you learn how to live without them. However, with ambiguous losses, not having closure makes it difficult to integrate the loss in a typical way and move forward with your life, says Abigail Nathanson, professor of grief and trauma at New York University in New York City.

“Typical loss has an ‘index date,’ like the day your loved one died, and it’s a way of marking ‘before’ and ‘after’,” says Nathanson. Many ambiguous losses don’t have this, and without it, even something as simple as putting up a grave marker can feel devastating.

What if you don’t know if your loved one is dead, much less when they may have passed on? What day do you commemorate their memory? Is assuming they are gone forever giving up on them? Do you keep their things and, if so, for how long? When do you stop expecting them to return?

(Here’s how to cope with anger and grief.)

There are often practical concerns that must be taken care of by the grieving person, says Trauco. Those include filing a missing person report, dealing with law enforcement, arranging child custody, paying rent or bills, organizing a memorial service, dividing assets, and other legal issues. These are difficult under the best of circumstances but can turn into logistical nightmares when you don’t have answers.

Dealing with these tasks can add a lot of stress, anger, confusion, and frustration to your grief. It can also cause an increase in conflict within the family, Trauco says.

Unhappy depressed senior woman sit alone on sofa, closeup viewfizkes/Getty Images

Symptoms of ambiguous grief

All grief is mourning some type of loss, and the process of grieving, while different for every person, generally follows a similar pattern. Broadly speaking, people can expect to experience denial, anger, bargaining, depression, and acceptance.

With ambiguous grief, you may get stuck in one of the phases, putting you at a higher risk for mental illnesses like depression or anxiety, says Lal. Feelings of self-recrimination and guilt can “freeze” you in the process. And feeling bad about your negative emotions will only make you feel worse.

It’s also common for sufferers to show a high level of agitation, both physically and mentally. That’s a result of your mind trying to reconcile the cognitive dissonance, says Nathanson. You may find yourself feeling restless, unable to sit still, and unable to focus on daily activities. Or you might ruminate constantly over questions and worries.

Because this type of grief often comes with increased levels of stress, you may experience physical symptoms of prolonged stress and worry, including stomach problems, chronic pain, headaches, over- or under-eating, an increase in addictive behaviors, insomnia, and alcohol abuse, says Trauco.

How to cope with ambiguous grief

“The goal of grief is not ‘How do I stop being sad?’ but ‘How do I carry this and still live my life in a meaningful way?'” says Nathanson. There is no one “right” way to grieve, nor is there a prescription for getting through it, but there are some things that many people find helpful during the process. (Here therapists’ tips for coping with Covid-19 grief.)

Name it

It is helpful to be able to label your grief as “ambiguous,” as Amy did. Naming it gives it a sense of normalcy and reassures you that your reactions and feelings are legitimate, says Lal. (You may find inspiration for how to talk about your experience in these quotes on pain and how to deal with it.)

Accept the uncertainty

Don’t arbitrarily create certainty by inventing answers; rather, learn to live with the idea that you may never know the full story, says Nathanson. Accepting uncertainty may feel frightening at first, but it can help you find meaning and ultimately truly acknowledge the loss in a way that allows you to move forward.

Make your own closure

You may not have an “index date” to work from, but that doesn’t mean you can’t still use a tradition, ritual, or some other meaningful action to create the closure you’re lacking, says Trauco. For instance, you could write a letter to your loved one, put it in an envelope, and then toss it in a fireplace or on a barbecue. Or you could choose a different date, like their birthday or a favorite holiday, to remember them in a special way. (On the flip side, this type of grief is why you shouldn’t “ghost” someone.)

Allow yourself to feel all the feelings

Not having answers may make you want to “delay” grieving. It’s okay to keep hoping for closure, but in the meantime allow yourself to feel the grief, says Nathanson. “Whether or not you acknowledge the grief, it still happens,” she says, adding that this doesn’t mean you’re “giving up” or “abandoning” your loved one. (Here’s a list of things to never say to someone who’s feeling sad.)

Find a support group

Whether you find a support group online or in real life, it’s important to find people who understand the type of loss you are going through, says Lal. Amy says that talking to other foster parents has helped her immensely, both in dealing with the practical issues and her complex feelings. (Here’s what to say—and what not to say—to someone who is suffering.)

Take a break

With an ambiguous loss, you may be constantly surrounded by reminders of your loss, like photos of your loved one or clothing left behind. It can be healing to take a break and go somewhere new—somewhere you don’t associate with them. Amy says she and her family find great comfort in going to a cabin in the mountains to be together and talk.

Be aware of triggers

Processing grief isn’t a straight line, even in typical situations, and ambiguous grief can be even more of an emotional roller coaster. Grief often comes in waves, ebbing and flowing, and it’s not uncommon for a wave of grief to be triggered by something in your environment, like an anniversary date or a song or something else that reminds you keenly of your loss, says Trauco. Being aware of these triggers can help you prepare yourself and deal with them more effectively.

Meditate

A powerful way to deal with unresolved (and unresolvable) feelings is to meditate, says Lal. You can sit quietly, do a guided grief meditation online, or do a type of moving meditation, like yoga or hiking. Or try one of these stress relief meditations you can do anywhere. The important thing is to find a way to clear your mind that works for you.

Enjoy a simple pleasure every day

It can be easy to get caught up in trying to find answers, to the point where the grief can feel all-consuming. It’s important to take time every day to do something that makes you happy, says Trauco. Eat a cupcake, go for a walk in the sunshine, buy yourself a bouquet of flowers, dance to a favorite song, or try one of these things you can do to feel instantly happier.

Seek outside help

Despite your best efforts, you may find yourself getting stuck in the grief process. If your grief is preventing you from being able to effectively live your life, it may be time to ask for help. Loved ones can be vital sources of support. Or turn to a professional grief counselor. These mental health workers are trained to help you navigate these complicated feelings and support you through the process. (Here’s what one person learned from a support group for social anxiety.)

Don’t judge your grief

Understand that grieving is a normal part of being human, and everyone will experience it differently, says Nathanson. However your process works is OK. “Grief isn’t an illness. It’s not a sign something went wrong. It’s actually a sign something is going right,” she says. “It’s a sign that you loved them.”

Next, learn how happy memories of loved ones make you healthier.

Monica Rodriguez/Getty Images

What Is Day of the Dead?

Sources
  • Abigail Nathanson, DSW, doctor of social work, licensed social worker board-certified in palliative care, and professor of grief and trauma at New York University in New York City
  • Gail Trauco, RN, BSN-OCN, a certified oncology nurse, licensed grief mediator, and author of Conquering Grief From Your Own Front Porch
  • Ashwini Lal, PsyD, lead clinical psychologist at the Kaiser Permanente Bernard J. Tyson School of Medicine in Pasadena, California

Charlotte Hilton Andersen
Charlotte Hilton Andersen has been covering health and fitness for many major outlets, both in print and online, for 13 years. She's the author of two books, co-host of the Self Help Obsession podcast, and does freelance editing and ghostwriting. She teaches fitness classes in her spare time. She lives in Denver with her husband, four children, and three pets.