Fascinating topic alert!

As a new researcher on the Care Pathways and Outcomes Study back in September 2021, I spent a considerable period of time looking through all the existing work that has already been done on the project.

There was a theme that came up with which I was familiar in the ways we can be familiar with something because we experience it in our own lives. It struck a real chord with me. I just didn’t know the formal name for this experience. It has continued to draw me and I decided I would like to explore it a little more through our blog. It is the experience of ambiguous loss.

What is ambiguous loss?

Pauline Boss is the scientist behind the theory of ambiguous loss and defines it as,

"a loss that remains unclear and thus without closure."

I have experienced ambiguous loss in my life and you may well have too. For me it was present when my dad became ill with Lewy Body Dementia. We lost him bit by bit as the condition progressed and he changed dramatically in terms of who he was as a person. We still had his physical presence but the man we knew was gone. This is one type of ambiguous loss.

Types of ambiguous loss

Ambiguous loss can be of two main types.

The first type of ambiguous loss happens when a person is physically here but is no longer psychologically present and is the experience we had while we watched our dad psychologically disappear in front of our eyes while still having his physical presence still with us. Family members involved in the research of ambiguous loss describe this as

"here, but not here."

The second type of ambiguous loss happens when a person in physically gone but very much present in a person’s thoughts. This could happen when a person is missing and the family do not know what has happened to them, or they may be in prison. A person is physically absent but is very much psychologically present. Family members involved in the research of ambiguous loss describe this as

"gone, but not for sure."

I find this type of loss to be particularly haunting and sad. So, what does this mean for our children and young people.

How is ambiguous loss relevant to the Care Pathways and Outcomes Study

The children and young people in our study frequently indicate that they are experiencing ambiguous loss and this is a topic that was addressed in the 2013 book published through the study – “Comparing long-term placements for young children in care: The care pathways and outcomes study-Northern Ireland” (McSherry et al., 2013). Both types of ambiguous loss are experienced by the children and young people in our study, as well as a third experience which is transitioning between these types of loss (McSherry et al., 2013). It sounds very unsettling and confusing doesn’t it?

The first way in which the children or young people have expressed experiences of ambiguous loss is when a child has parent or other family member who is physically present but for reasons such as addiction, is no longer able to be psychologically present. That experience of “here, but not here.”

The second way our children and young people experience ambiguous loss is that once a child is no longer living with their family, those family members may be no longer be physically present in their lives but they are often very present psychologically. This type of loss is described in the research further as, ‘leaving without goodbye’ (Boss, 2007).

For our children this can be because a parent has died, as in the case of Luke whose mother had died. Luke still viewed his mum as very much part of his family and she was often in his thoughts. Something any of us who have a loved one who has died can relate to.

The other circumstances in which this loss manifests for our children are less common and so much more complex. When children were fostered or adopted, as in the case of Claire and Morgan who were two sisters who were adopted, they can experience ambiguous loss. The sisters had no contact with their birth family as it was a closed adoption but they thought about them and they missed them.

“I feel sad because I miss them.” – Claire

Particular complexities

Something that we have noticed in the study and which is noted in both the book and in the latest paper published is that often the foster or adoptive parents are not aware of these feelings of ambiguous loss experienced by their children.  This illustrates the nuances and complexities of the foster or adoptive family dynamic. The interview excerpts below both discuss how Bridget feels about her birth parents. The first is from an interview with Bridget, the second from an interview with her adoptive parents.

Interview 1

Researcher: So, if you had to pick somewhere you were going to live when you were 16 or 17, it wouldn’t be anywhere but just with your friend, just living with your friend [child had initially indicated she  would like to live with friends]?

Bridget: Well, I might go and live with my birth parents.

Researcher: Your birth parents?  You might like to live with them?  Why do you think you would want to live with them?

Bridget: Because   I’ve never  seen them   before  and I  don’t  know anything about them.

Researcher: So you’d like to find out a bit about them, would you?

Bridget: Mmm [assenting noise].

Interview 2

Adoptive mother: Her father  will send  cards to Social Services and they send them on.

Researcher: Would that be regularly?

Adoptive mother: Birthday and Christmas.

Researcher Right. And how does she respond to that?

Adoptive mother: We  haven’t  given them   to  her yet.  Because   she’s not really . . . she’s not interested. We have them  all for her, but he does send, to my mind, inappropriate cards. Like it’ll be ‘Happy birthday darling daughter’.

Researcher: And would she  know  that you receive  them,  but that  you haven’t given them to her?

Adoptive mother: No, I don’t think she does, because  he sent gifts and things through too in the early days. So they’re all there  for her when she wants to talk about him. I mean she can have them  all but as I say, anytime  we try to broach it, she  just doesn’t want to know.

Although this is the only example we have come across of information on birth parents being withheld by adoptive parents from children in our study, I think this highlights the very complicated dynamics that happen with ambiguous loss, and particularly so for the children, young people and families involved. Boss contends that this loss is potentially the most traumatic kind of loss as it generates muddled perceptions about family, belonging and identity (Boss, 1999).

These losses have no resolution, there are no comforting rituals and there is no closure. People who experience this type of loss are caught between hope and despair and are left on their own to cope (Boss et al., 2016). Boss describes the experience poignantly (2006) as follows,

"With ambiguous loss, family members have few options: to hold out for the truth or to develop a new narrative they can live with. In the absence of truth, we hope for the latter. To do this requires increasing the tolerance for living with unanswered questions. Without definitive information to clarify the loss, many learn to live well within the paradox of absence and presence."

I hope this blog has provided a very introductory level exploration of the experience of ambiguous loss. It is most definitely only the tip of the iceberg. I am sure you will agree it is an important topic to be addressed with children who are placed in the care system and my hope is to address the topic more in future papers. So, look out for them and thank you as always for reading our blog.