Ambiguous loss is a term that defines the heartache and grief that comes with losing a person or relationship that is surrounded by confusion or uncertainty about that person or relationship.  Finding closure is difficult with normal losses, such as death, but it is impossible with ambiguous loss when the loss is not officially recognized or final.

Think about children who are unable to grow up in their biological family.  In addition to being separated from their family of origin, they lose all that is familiar to them. They experience the absence of their birth family, but know they are still present in the world. The foster or adopted child, as well as the birth family, may think about and be curious about the other. They may dream about what it would be like to be together. Adoptive parents may also experience ambiguous loss because of pregnancies that ended in miscarriage or from the loss of their dream of having biological children.  This article will focus on children, specifically as they reach school age, and begin to realize their losses. This time may bring about feelings of hurt and grief the child may have never acknowledged in the past. These losses are not commonly addressed in society and few rituals exist to allow an adoptee to express their loss.

Recently, I was talking to my teenage son, who was adopted from a Central American country as a toddler.  I talked to him about how ecstatic I was to return to the U.S. to introduce him to our family and friends, who were very happy about his arrival into our family.  At the same time, I shed tears as we flew away from his country of birth, knowing he was leaving behind his foster family, his birth family, his siblings (both foster and biological), his country of birth, first language, culture, traditions, religion, racial connections, medical history, genealogy, favorite foods, smells, etc.  I said, “We showered you with gifts and joyfulness, no one has ever talked to you about all that you lost. When someone dies, we go to their funeral and take a casserole to their family, but we’ve never really done anything to help give closure to all that you have lost.”  Even if no one dies, there is still loss in these situations.

There are two types of ambiguous loss. Type 1 is when a person is physically absent but psychologically present, meaning that the birth parent continues to influence the child’s thoughts, emotions, behaviors, identity and family unity. Type 2 is when there is a psychological absence with a physical presence.  This can be due to a mental or physical illness or a substance abuse problem.  This sometimes leads to Type 1 when the child is removed from the parent due to neglect.

Ambiguous loss has some warning signs that can look different from the normal response to grief throughout life stages:

• When an infant or toddler is grieving, it is normal to show some separation anxiety.  However, if your foster or adopted child in this age range shows behavioral regression, confusion, or night terrors, it could be attributed to ambiguous loss.
• School age children typically have difficulty identifying and expressing their emotions related to grief so they experience physical complaints such as stomachaches or headaches and show increased irritability.  Warning signs include acting-out behaviors, a loss of interest in school, teachers seeing poor concentration, regression, night terrors or an obsession with retelling.
• Normal reactions to loss in adolescents is very similar to adults. They frequently experience feelings of guilt and often look to peers for support.  If you see a change in their energy level, poor concentration, loss of interest in school or if they seem emotionally numb or start to withdraw, these are warning signs of grieving ambiguous losses.  Signs of depression and anxiety, an inability to cope, difficulty with change and transitions, difficulty making decisions, decreased ability to cope with routine childhood or teenage losses, and PTSD symptoms are common responses.  The child may display learned helplessness or hopelessness or have feelings of guilt.

Ambiguous loss is overwhelming and confusing because the outcomes are not clear and cannot be determined.  The foster child or adoptee has trouble pressing forward because the loss lacks resolution – it’s unknown if it is temporary or final.  They want transparency about their past but at the same time refrain from receiving new information.  Ambiguity can wear away a child’s sense of mastery causing them to feel hopeless and creating feelings that the world is biased, dangerous, unpredictable and unruly. The stress of ambiguity, or vagueness, can be eased by helping the child acquire information.

The effect of unresolved loss on children can be great.  The bigger the ambiguity surrounding the child’s life, the more challenge they will have in mastering it.  In other words, increased uncertainties make it difficult to deal with the loss and has potential to cause increased depression, anxiety and internal conflict.  They can feel a lack of control over their situation or feel that people outside their family have more power than their parents.  Anxiety and fear can have a great influence if they were “taken away” or removed from their home, family, or country of origin. The child sometimes feels that they are the reason for the separation from their parents and have lost their ability to trust adults.  We can help influence a child’s reactions by validating their grief, inviting them to express their feelings, sharing similar experiences of other children and accepting the child’s spectrum of feelings.

Here are some ways to help your child deal with ambiguous loss:

• Give voice!  Explain the feelings of ambiguous loss and acknowledge the difficulty of living with not having the answers.
• Help the child understand as much as possible – Knowing what happened to the birth parent who left and why, or knowing what situations caused the loss and why it happened are key in helping the child understand.  This will allow the child to grieve which involves experiencing the painful feelings associated with the loss.
• Help the child identify what has been lost – parent, extended family, loss of home or town where they were born, family that looks like them, last name, birth country, language, etc.
• Find a way to commemorate the loss – Honor, recognize and acknowledge the memory of the people, places and things that are no longer part of the child’s daily life.  This leads to moving forward and permits the child to learn that the pain of grief lessens and the legacy of their past lies within themselves.
• Create a “loss box” – find a box that can be decorated, if desired, and allow you child to place things inside the box that represent things that they have lost.  This can serve as a ritual and a way to revisit the losses in the future.
• Events through the lifetime (holidays, birthdays, adoption anniversary, etc) can trigger feelings of loss.  Acknowledge the child’s feelings and add a family ritual to recognize important people or relationships that have been lost.  Example: Adding an extra candle on the birthday cake to represent the child’s birth family; or say “I bet your mom and dad are thinking about you today”.
• Do not allow new relationships to be a replacement for past relationships.  Acknowledge your child’s birth parents and their previous foster families.  Look for ways to recognize members of their birth family.  Share their story and talk about it from the time they arrive home and continue this over time.  We can free our children from the past by giving opportunities to process and grieve their past losses.
• Give your child permission to grieve without guilt!
• Model ways for them to communicate their thoughts and the questions they may have.
• Support your child’s emotions as he copes with his grief – It is impossible for us to fix the loss but we can validate and affirm their feelings.
• Don’t expect that grief associated with ambiguous loss can be resolved within a specific time frame.  Understand and explain that these feelings will come and go at different times in life.  Always provide a safe place for your child to express those feelings.
• Get in touch with your own grief!
• Seek support from a therapist who is an adoption-competent professional.

While I have heard the term “ambiguous loss” for several years working in adoption, I’ve become passionate about the topic after sharing the term and the theory with my son.  I honestly feel like it was a turning point in his life and our relationship.  He understands that I know he has questions to which we have no answers and that I am familiar with some of what he has lost.  He knows that not having answers makes figuring out who he is, as well as the grief process, more difficult.  I’m pretty sure he identifies me as his safe place when he needs to express his feelings.  I’ve told him if he wants to search for his birth family to try to get more answers, I’ll be his biggest supporter.  I have more work to do to help him through his grief and loss and I understand there will be triggers as he grows and matures.  Having an understanding of ambiguous loss and the ability to explain it to him was a big step in the right direction.  I encourage you to start talking to your kids as soon as they are placed in your home and keep talking, especially as they reach adolescence, when it becomes increasingly more difficult.

By: Dana Poynter