Therapist and researcher Pauline Boss talks about dementia as an “ambiguous loss.” An ambiguous loss happens when we lose someone to disease or disappearance and we never really have a chance to grieve or mourn them. What makes a loss ambiguous is when a person is physically absent and psychologically present (a soldier lost in war whose family keeps talking about him as if he were going to come home) or physically present and psychologically absent (a person with dementia treated as if they were already gone). Boss talks about all kinds of losses that come upon us suddenly and leave us yearning for psychological reconnection, enumerating several categories of absent loved ones because of divorce, drug use, dementia or disappearance during military campaigns.
The crucial problem this presents to us as human beings with the need to grieve and mourn is that we have few culturally elaborated rituals for mourning ambiguous losses. This means that much of the grieving is not culturally recognized or sanctioned. Grievers are left to process their feelings of ambiguous loss on their own, and they cannot access culturally sanctioned means for expressing and working with their sadness, ache, nostalgia, anger, or positive forms of remembrance. When grievers find a way to reinvent rituals that allow for them to recognize their ambivalent and complicated feelings around ambiguous loss, this can provide them with the sacred space to mourn outwardly and change how they relate to the loss. They can transform the loss and heal.
I remember that when my father’s mother Maria died, I failed to grieve or mourn her for six years. When I was young, Maria had welcomed each of my brothers and me to stay with her for a week. She was delightful and spoiled us rotten. We felt like princes. She had become less and less herself in my eyes before she died because of Alzheimer’s Dementia, which really began to affect her noticeably when I was in high school and college. I was serving in the Peace Corps in Cameroon with my then-wife Erin, and I felt like it was fitting that she passed and a relief.
I missed the memorial service because I was across the Atlantic Ocean. I didn’t really grieve grandma Maria until the year I was began clinical education to become a hospital chaplain and focused on my unresolved feelings of grief. All of the sudden, I found myself weeping in an All Souls service at the United Methodist Church where I grew up. And in that ritual space of remembrance, I felt wounded and tender and warm all at the same time. It felt like healing. I wept and whispered to myself and anyone close enough to hear me, “Thank you grandma Maria! I miss you!”
In order to do this ritualizing of loss, we need to be able to find expressive ways to remember those who have died, disappeared, left, or become distant or absent because of dementia or drug use or divorce or disease. In my practice of Zen, I have created my own altar space with a statue of Shakyamuni Buddha, crosses, sacred stones, candles, and pictures of my grandparents and ancestors. I use this space as a spatial anchor for prostrations when I remember who I am in my family lineage in the mornings I have time. I wish healing for all sentient beings. In moments of crisis and war, I wish for healing for all the persons involved in the conflict, perpetrators and bystanders and those complicit with violence as well as victims and family members of victims. We all are harmed by violence and need healing!
Ambiguous loss can then be recognized and made into an ingredient of our wisdom and healing once we recognize its presence in us. We just need to find the right useful tool for us, and each person will have different needs and find different tools, to work with the feelings, emotions, intuitions, narratives, and thoughts that come up for us. May you find your own tools for healing and cultivating your wellbeing!
