A Conversation with Bob & Dr. Pauline Boss | How to Cope with Loss During the Pandemic

Loss is everywhere. Hundreds of thousands of deaths worldwide, and many more jobs lost. These are the big visible losses. In addition, we are sustaining many smaller, less obvious losses. While some of these less visible things in our lives have been put on hold, others are gone forever. Consider, for example, all the high school and college seniors who worked so hard to get to graduation day, and who now miss the parties and the hugs and the in-person celebrations. And their parents and grandparents who have dreamed of seeing their children and grandchildren in those caps and gowns. So many cancelled sports competitions, high school musicals, wedding celebrations, dance recitals … the list is endless. How do we mourn these losses, and how do we find ways to move forward in our lives?

During a Kitchen Table Chat with Dr. Pauline Boss, Professor Emeritus at the University of Minnesota, we talked about how best to cope with the many losses we’re facing now. Dr. Boss is an educator and scholar who is widely recognized for her groundbreaking research on what is now known as the theory of ambiguous loss. She has taught university students, practiced as a clinician, and trained family therapists and humanitarians around the world to help people suffering from the trauma of ambiguous loss and its grief that has no end. Among other projects, she has worked with families in New York who lost family members during 9/11 and families in Kosovo who lost loved ones in waves of ethnic cleansing and terrorism.

Dr. Boss pioneered the concept of ambiguous loss – loss that has no defined beginning or end. She describes two kinds of ambiguous loss.

1. Physical loss – where the loved one is missing – for example, families whose loved ones were soldiers who disappeared in the Vietnam War whose bodies were never discovered.
2. Psychological loss – where a loved one is present physically but absent psychologically — for example, when someone suffering from Alzheimer Disease slowly fades away mentally.

Ambiguous losses come in many forms. During COVID-19, death in a hospital ICU cannot be witnessed by family, though this helps relatives affirm the reality of the loss. We have lost freedoms that we used to take for granted – the freedom to gather in bars, to go to restaurants. Many of us have lost trust in our leaders. There is no beginning and no clear end to such losses – which makes them ambiguous.

It’s a paradox: the more we keep someone we lost in our hearts and minds, the more likely we are to be able to move forward and live a happy life.

Why is ambiguous loss so difficult? Dr. Boss talked about our wish for certainty, and the human brain’s difficulty tolerating uncertainty.

One reaction to uncertainty is trying to deny or minimize the importance of a loss, but this way of coping proves unhelpful. For example, a teenager’s sadness over not being able to see her friends is a real loss. Telling her not to be sad because others have worse problems leaves her grief unacknowledged. Accepting and sympathizing with someone’s loss is the way to help them move on.

Both-and-thinking is a concept that can be useful in talking about ambiguous loss. This refers to the idea that there is not one absolute truth about a loss that is real yet hard to see or define. Dr. Boss notes the importance of naming losses – because naming them alone can be therapeutic. So, for example, writing about a loss can help in the process of coming to terms with it.

Dr. Boss offers six steps or processes that are useful in coping with ambiguous loss. She emphasizes that these do not generally happen in a linear sequence. Instead, they form a circle, and we return to each coping mechanism over and over again.

1. Finding meaning – we must understand what we have lost so that we can begin to move forward.
2. Adjusting mastery – when we are accustomed to fixing or solving a problem, we need to readjust our sense of what “solving” means to include living with uncertainty around this loss.
3. Reconstructing your identity – “who am I in the face of this loss?” For example, if a partner disappears and is never found, is the spouse a widower or a spouse?
4. Normalizing ambivalence – tolerating the tension of mixed emotions and conflicting feelings.
5. Revising attachment – letting go and at the same time holding on to someone or something we love.
6. Finding hope – the challenge is to find new hopes and dreams when we are forced to give up the dreams we have lost.

Dr. Boss reminds us that isolation often prevents us from coming to terms with loss, while connection with others is a great resource. Directly facing the way we’re feeling and sharing it with others is the most important step in moving forward.