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The Trauma and Complicated Grief of Ambiguous Loss

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Ambiguous loss is a newly identified type of loss that occurs when a loved one is physically present, but psychologically absent. Dementia is just one example. Because the lost person is here, but not here, grief is frozen, life is put on hold, and people are traumatized. With no official verification of death, no possibility of closure, and no rituals for support, there is no resolution of grief (Boss 1999). Clergy, especially pastoral counselors, can witness and provide comfort for such uncanny loss because people rely on them for support, not just from the clear loss of death, but from the ambiguous losses, catastrophic and ordinary, that inevitably will occur across the life course.

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  1. While the ambiguous loss theory is useful as well for understanding and intervening with distressed communities (congregations, for example, where a pastor is incapacitated), I limit my focus here to the couple and family levels. For details, see Boss (1999, 2006) and

  2. For research and development of ambiguous loss theory and its clinical application, see Blieszner et al. 2007; Boss, 1999, 2002, 2004, 2006, 2007a, b; and Boss and Greenberg, 1984.

  3. Sometimes, if the loss is so incomprehensible, people say it never will make sense (e.g., a suicide without a note). I tell them that this is also a meaning—it will never make sense! That bring us back to the nonsensical and how people still find new hope. See Boss (2006).

  4. There are times when ambivalence leads to ambiguity such as when someone is conflicted about having a test for cancer, let’s say, and then discovers it is too late to be treated for it; or when the young man whose father has Lou Gehrig’s disease prefers to live with the ambiguity rather than risking the knowledge that he has the same fate as his father.

  5. This article should not be viewed as training, but rather as information about a new kind of loss that is common in congregations. I refer you to Boss (2006) for more details. For further information about training as a certified pastoral counselor, see


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Correspondence to Pauline Boss.

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Boss, P. The Trauma and Complicated Grief of Ambiguous Loss. Pastoral Psychol 59, 137–145 (2010).

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