The Lighter Side of Transformation

with Lisa Wessan, LICSW

On the “Myth of Closure,” Ambiguous Loss and Complicated Grief

“Everyone experiences ambiguous loss if only from breaking up with someone, or having aging parents or kids leaving home. As we learn from the people who must cope with the more catastrophic situations of ambiguous loss, we learn how to tolerate the ambiguity in our more common losses in everyday life.” 

– Pauline Boss, Ph.D.

In my immediate family, several of my nearest and dearest have battled with cancer over the years…both of my paternal grandparents, may they rest in peace,  my dear first cousin Stephanie (may she live to be a super centenarian) and my delightful and fierce Aunt Yvette (known as “Auntie”), who is currently receiving hospice care.  It has been a long and grueling journey with cancer for all my loved ones.

Sometimes I struggle with feeling powerless, and living so far away from my family in Sarasota, FL. When they lived in New York, it was so much easier to visit. Sadly,  I can’t make frequent visits to Sarasota. The only “power” I do have is to send intentional healing and loving energy to my Auntie and family…and to practice radical acceptance so that I will function with some measure of inner peace here in my world.

For a while, my Auntie was in and out of the nursing home while she battled her cancer and other complications from treatment. Her life was severely compromised by her illness.  As harsh as this has been is for her, since April 2015,  I have also been witnessing how Auntie’s dying process is affecting everyone around her.

My cousins are fraught with anxiety and grief. Others are a hot mess, watching Auntie dying so slowly, not being able to process their feelings and find some relief.  Some people get trapped in the “Blame Game,” and are always looking to find ways to defocus their pain by pointing at others (that’s a separate article, on the Blame Game, worth exploring soon).

We are all coping with the ambiguity of Auntie being here, yet not here.  She is no longer resembling her true self as we knew her.  Sometimes she is delirious, sometimes she is too weak to talk. As her body deteriorates, she is no longer living the full and robust life she once enjoyed.

ambiguous loss1

This pain we are all experiencing has a name…it is called Ambiguous Loss.  “Ambiguous loss is a loss that occurs without closure or understanding. This kind of loss leaves a person searching for answers, and thus complicates and delays the process of grieving, and often results in unresolved grief.” (Wikipedia)

There are a variety of types of ambiguous loss.  One type is when people go missing and the body is never found.  For example, a person does not return from a sailing trip, or from a hiking excursion, or war, or they are kidnapped.  Their loved ones still feel a lack of closure because the body was not found.   “Maybe they will return…” lingers in the mind.

After 9/11,  all of us in NYC were processing personal and professional ambiguous loss for all of our New Yorkers who were lost in the pile of bodies that were never recovered.

Another kind of ambiguous loss is when people experience a new emotional boundary that hurts.  This happens when people get divorced, or when someone ignores you, stops talking to you, shuts you out of their life.  Any kind of break-up creates ambiguous loss, because the person is still here, yet not here. They are alive, but dead to you.   This is considered more painful loss than when someone actually dies.

ambiguous loss3

Medical illness and addictions cause ambiguous loss.

Ambiguous loss also occurs when a loved one has Altzheimers or dementia, and they no longer recognize social connections. Similarly, when someone is very ill, such as my Auntie, we have ambiguous loss because the illness is transforming our loved one into someone other than the person we always knew. We are mourning the living remnants of our loved one…so excruciating and bitter.

When someone is living with an addiction, this too causes their personal relations to deteriorate and they are not fully present for their loved ones. Again, they are here but not here.

I have a friend who had a beautiful daughter in Cambridge, MA,  who chose to be homeless.  Her daughter was an alcoholic.  My friend tried all methods of intervention and help. Nothing worked. My friend suffered with ambiguous loss for so many years. Her daughter was a pianist, absolutely lovely.   She died a few years ago,  at 35, and it was one of the most heart wrenching tragedies I experienced.  My friend is still recovering from this painful loss.

Learning to live a good life with ambiguous loss

I recently listened to a wonderful and insightful podcast interview with ambiguous loss pioneer Pauline Boss, Ph.D., who originally coined the term “ambiguous loss.”   Krista Tippett hosts Dr. Boss on her podcast, On Being.  You can listen here:

The Myth of Closure [UNEDITED VERSION, 1.5 hours]

The Myth of Closure [EDITED VERSION, 1 hour]

I prefer the unedited versions of Tippett’s interviews, because there are sometimes fascinating nuances that are deleted to make the long form interview fit into an hour. But I’m sure whichever one you listen to will be rewarding!

One of the ideas I took away from Dr. Boss’ talk was that we will never have complete closure from our ambiguous losses, or from our complicated grief.  What we can do is become  more adept at processing our negative feelings and difficult thoughts. Dr. Boss has some wonderful suggestions on the process.

Cognitive restructuring, which can be learned, is a big part of the solution.  Dr. Boss’ stories and explanations are very helpful in deconstructing the different kinds of ambiguous loss that we all have in our lives.

Even though I learned about ambiguous loss and complicated grief in graduate school, it seems I keep deepening my learning about it more every year, from clients who are struggling with painful divorce, adult children with addictions, my Auntie’s battle with cancer, and for all the ongoing loss of freedoms in the world that never seems to subside.

Fun fact: Ambiguous loss is clearly part of our psychospiritual journey — for it forces us to grow and move to new levels of compassion and acceptance of things we cannot control.  “Lack of power, that is our dilemma,” says Alcoholics Anonymous  (Bill W., 1976).  Yes, in our culture, we seek to control, cure, fix and manage everyone and everything as much as possible. We don’t like messy endings.

Yet what I have come to know, is that true mastery of life is being able to live in ambiguity with peace, even joy.  My life is far from perfect…yet I am more often feeling positive, grateful,  uplifted, inspired and anticipating good interventions that will transform it.

If we can learn to live in that “not knowing” place and be peaceful — that is a vast improvement on “hating ambiguity” and perhaps yelling at G-d or the Universe, or twisting into knots over why bad things do happen to good people…again, very messy, so annoying.

The truth is, when it comes to matters of love, there is no closure. As they say at the Grief Toolbox,  “Closure is not part of the grieving process, nor is it necessary for healing. A connection formed in love can’t be closed.”  Dr. Boss confirmed this with her years of research on ambiguous loss, leading to her forthcoming book on “The Myth of Closure.”

ambigousloss5

As Dr. Boss discussed in the interview, our Western culture wants neatly packaged endings and for everyone to move on as quickly as possible.   There is plenty of shaming that goes on, as in “Aren’t you over that yet?”

Sadly, our culture does not tolerate ambiguous loss very well at all.  It requires more Eastern, dialectical thinking.  To be able to say non-binary statements such as “She is alive, but also dead,”  “He is not here, but he is possibly still alive,”  or “She looks like Auntie, but this is not Auntie anymore,” requires a leap from dualistic thinking to a more dialectical thinking which allows us to embrace opposite beliefs without sinking into a deep depression or disruptive anxiety vortex.

Solution Focused Suggestions

For today, I invite you to learn more about ambiguous loss, and start to apply these non-dualistic, non-binary, dialectical thinking ideas to your situation.

  • Listen to the podcast above, and learn some skills to help process your ambiguous grief.
  • Perhaps find a good therapist who can help you learn to cope better with your struggles.  Good news: coping skills can be learned!
  • Learn to laugh at the absurdities, paradoxes and incongruities of life (Gavin, 2010; Wessan, 2013).
  • Practice your Distress Tolerance skills …join a Dialectical Behavior Therapy group.  You may then find it easier to work through the painful moments, and allow yourself to live in ambiguity with, dare I say it, some joy!

 

Onward and Upward,

Lisa Wessan

 

References

Gavin, J. (03 Sept 2010). Laughing with the Joys and Troubles of Life Leads to Growth. The Chelmsford Patch. Found at https://mirthmaven.blog/2010/09/16/lisa-wessan-interviewed-in-the-chelmsfor/

Pauline Ross, Ph.D. https://www.ambiguousloss.com/

W., Bill. (1976). Alcoholics Anonymous : the story of how many thousands of men and women have recovered from alcoholism. New York:Alcoholics Anonymous World Services. Fourth edition, Chapter 4, We Agnostics. P. 45. 

Wessan, L. (2013).  Using Humor and Laughter in Therapy. Focus Journal. National Association of Social Workers.  Vol. 40, No. 4. 3,11.

Copyright © by Lisa Wessan 2019. All rights reserved.
www.LisaWessan.com

 

 

 

 

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Moving beyond binary thinking: what are dialectical and non-dualistical truths?

“Even when all the experts agree, they may well be mistaken.”  ~ Bertrand Russell

“In preparing for battle, I have always found that plans are useless,
but planning is indispensable.” ~ Dwight Eisenhower

“The reverse of truth has a thousand shapes
and a boundless field.” ~ Michel de Montaigne

“Whoever is winning at the moment
will always seem to be invincible.” ~ George Orwell

“Family values don’t stop at the Rio Grande.”  ~ George W. Bush

“Sometimes you need to get knocked down before you can
really figure out what your fight is.” ~ Chadwick Boseman

What do all these quotes have in common?  They are blending opposing beliefs into a non-dualistic framework, which is, for most of us, is not easy to hold in our minds without some cognitive dissonance.

As those of you who follow me know, I teach Dialectical Behavior Therapy Skills (DBT), which helps people live with massive emotional and cognitive dissonance and yet not have an emotional meltdown (or self harm from the pain).

For example, when you get into the DBT flow of consciousness, you realize that you can both love and hate someone.  You realize that on some level, you are amazing, perfect and rocking as is, yet you can improve.   You realize that you are sometimes brilliant, and sometimes really foolish, but still lovable, no matter what. You embrace the FACT that you inevitably will make mistakes, but you are NOT a mistake.  You are still awesome, lovable and worthy, no matter what cocka-locka-cuckoo stunt you got into, either consciously or unconsciously.

So dialectical thinking helps us get out of the black and white mental trap, the “All or Nothing,” Right or Wrong, Worthy or Unworthy, Perfect or Imperfect name game.  Practicing dialectical skills helps relieve so much of our nasty inner dialogue.  Over time, DBT gently muzzles the harsh inner Critic and lets us move forward with plans to grow, learn, change and improve ourselves, our relationships and our lives.

Borderline1

DBT makes it so much easier to “Disable the Label” of our diagnosis, gender challenge, financial issue, body image or weight issue and more.  As I’ve often said before, I believe DBT skills will someday soon be taught to everyone by the 3rd grade level.

It is essential that we all move out of this painful and extremely unproductive dualistic perfectionist damnation of ourselves and others!  Enough is enough, right? The exquisite radical acceptance that comes from dialectical thinking starts within, and then permeates into our relationships, politics and the world at large.

Yes, it is possible to temporarily hate ourselves for a few minutes for being a bit unconscious or even whacko in the moment, and then with the help of improved self-talk, gently shift back to a more bearable level of acceptance, possibly reach a more comfortable forgiveness level and then back to a more loving baseline. With training, this could be reduced from days/weeks of self hate to a few minutes…that’s a big win in my practice!

This DBT process uses evidence-based skills culled from the vast Mindfulness research, Interpersonal Effectiveness, Distress Tolerance and Emotion Regulation fields.  These skills help people move from being in the extreme of “Emotion Mind” or “Rational Mind” into their “Wise Mind” and function better on every level.

Ven diagram 1 Wise Mind

Here are some of the common myths that we deconstruct in our DBT groups:

“Dialectics reminds us of the many paradoxes that are built into our Universe:

  1. The universe is filled with opposing sides/opposing forces. There is always more than one way to see a situation, and more than one way to solve a problem. Yet two things that seem like opposites can both be true.
  1. Everything and every person is connected in some way, in the way that the waves and the ocean are one. It is also believed that the slightest move of the butterfly affects the furthest star.
  2. Change is the only constant. Meaning and truth evolve over time. Each moment is new; reality itself changes with each moment.
  1. Change is transactional. What we do influences our environment and other people in it. The environment and other people influence us.” (Linehan, 2015)

For today,  I challenge you to start letting go of your dualistic mind traps, and gently start to shift into a more compassionate, empathetic and dialectical mind set that will allow yourself and others to be good enough around you, as is, while you are all improving.  Here’s the emotional math: less judging, more inner peace.  Simple, but not easy!

Onward and Upward,

Lisa Wessan

 

Reference:
Linehan, M. (2015). DBT Skills Training Handouts and Worksheets. Second edition. New York: Guildford Press. Page 150.

 

Copyright © by Lisa Wessan 2019. All rights reserved.
www.LisaWessan.com

 

 

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Lisa Wessan’s hotline review…

Lisa Wessan’s hotline review…Suicidal? Homicidal? PMS? Boozer? Tune in @ 10 AM for the lighter side of hotlines….listen here.

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TREMBLING WITH JOY…

Imagine my surprise when I was decluttering some ancient papers from B.C. (before Chelmsford) this morning… and what turns up in the paper casket? A quote from a 2001 interview with Julia Childs, co-author of Mastering the Art of French Cooking, “You should not be engaged in anything that doesn’t make you absolutely tremble with joy.” (Time Out New York, April 19, 2001, p. 176).

Bravo, Julia! To answer my question, “What is joy?” Julia is reminding me that if I follow my bliss, follow my most joyful attractions, and do what I love, I will never have to work another day in my life!

What about trembling? Thank you Julia for reminding me that trembling is good… First, it’s normal to want to be passionate about one’s work. Second, a little shaking and being wobbly, perhaps being out of my comfort zone, is often when the joy slips in after the challenge is completed. Living on the razor’s edge between fear and excitement can certainly lead to more joy in living.

I am reminded of my first tango lesson with my husband. We were both nervous… understandably so, being in a new environment with mostly slender, chic, graceful people around us. We were the only two chubbettes on the dance floor. But I felt proud that we were pursuing our joy regardless of our plus-sized bodies. Turns out, we love to tango, and we’re pretty good at it too. The initial trembling and excitement has blossomed into one of our sexy and fulfilling shared pastimes.

Whenever we take a new tango class, we may revisit our initial trembling – on the mild side – because we never know if the teacher will be good, non-judgmental, patient with beginners and so on. But therein lies the excitement of life, in not knowing… wouldn’t it be truly dull to know it all ahead of time?

What will happen in 2010? Where will we go? Who will we meet? How many creative new ways will we find to express our love? Will we learn to deeply forgive, accept and move on quicker in 2010? Will we finally clean out our basements, attics, closets and drawers?  Will we hit that high note in our career? Therein lies the excitement – in NOT KNOWING.

One of my favorite teachers once said, “True Mastery is learning to live in ambiguity with JOY!” When I first heard that in my early twenties, I was crushed – it seemed impossible for me at the time. Yet I have always held that up as a goal, to be able to live in the ambiguity, the paradox, the incongruity, with a more positive mindset, or at least be able to laugh at the absurdity of it all. What a concept! I continue to practice this one, perhaps for lifetimes… OY!… the fun never ends.

What do you think?

©2009 by Lisa Wessan. All rights reserved.

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