Grief & Unhelpful Labels

Educational, Grief, Grieving Voices Podcast, Pespective | 0 comments

I listened to this podcast episode recently, followed by the follow-up interview episode with Pauline Boss. Pauline Boss coined the term “ambiguous loss” in the 1970’s. It wasn’t until recently that I heard the phrase. I’ve also heard it be compared or similar to “complicated grief.”

I want to dissect these labels and terms a bit more today. Although I agreed with much of what Pauline Boss shared in the podcast interviews, even more so in the follow-up episode regarding current times, I disagree with the labels.

What is Grief?

Let’s start with the definition of grief in simple terms. Grief is the normal and natural reaction to loss or any change from what is familiar in life. It is the emotional response to change. It can be defined as a feeling associated with the things we wish might have been different, better, or more in any relationship. Whether it is with a person, a pet, a job, an educational experience, or even a place of residence doesn’t matter. Grief can be a result of unmet hopes, dreams, and expectations in any relationship as well.

Grief can manifest itself in a variety of ways. Some people find that the confusing feelings that grief generates interfere with sleep, while others find it challenging to get up and function after waking up. Some people find that they feel sad or cry over things that never seemed to bother them before. Many find themselves longing for that relationship lost, and others find, especially when they discover that friends seem to be able to offer little meaningful help, that they lose some of their ability to trust others. Some find themselves easily irritated, while others do not have the energy to feel much of anything. For some, the memories leading up to and including the moment of loss overshadow all of their fond memories of that relationship.

Simply stated, grief can be overwhelming!  Just as overwhelming can be the labels that are put on grievers and the advice that they are given.

What is Complicated Grief?

In the 1990s, a new term, “complicated grief,” was coined to describe prolonged grief associated with death. The problem with this term is that all grief is complicated in one way or another. The grief each person experiences is influenced by a variety of factors. The intensity of that emotional relationship, the amount of unfinished business in that relationship, and how we try to deal with the pain of the loss are among the primary elements. Since most people have very few effective learned behavior patterns to deal with loss, it is often challenging to deal with the impact of emotional pain. The average person tries to deal with emotions on an intellectual level. The problem is that emotions are not logical and do not respond to intellectual reasoning.

The symptoms of “complicated grief,” according to a Mayo Clinic paper, are the same as those of “normal grief.” The defining element of complicated grief is the duration of these feelings. And, I would ask: how do you feel being assigned a label for your grief simply based on the timeframe you have the feeling that you do? It doesn’t make much sense, does it? Could it even be damaging? Leaving you to feel inadequate or as if there’s something inherently wrong with you because you are “grieving too long?”

A Little Background Information

The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-4), from the American Psychiatric Association, set the normal time for grieving at two months. The DSM-5, published in 2013, changed this period to one to two years, indicating that most physicians and grief counselors felt that this time frame was more realistic. The DSM-5 also included the term “complicated grief” as a mental disorder.

Time and Grief

The reality of things is that time, in and of itself, is not a factor in true emotional recovery from loss. Over time, we may become used to living with the pain of loss. As time goes by, most people simply learn to bury their feelings, rather than to take effective action to deal with that pain. Obviously, two years, rather than two months, gives you more time to bury and discount your feelings. If, after an arbitrary amount of time, you have persisting feelings of emotional pain and try to utilize medication to treat the “problem,” you are often just treating the symptoms of grief without actually doing anything to deal with the underlying problem.

How is “Complicated Grief” different that “Normal Grief?”

What defines complicated grief, according to Dr. Katherine Shear at Columbia University, is that it occurs in only a small percentage of grievers. For people that suffer from this problem, their other relationships tend to be very difficult, and they can ultimately have other health issues. Many with this diagnosis lose a purpose for living. The determination of “complicated grief” is most often reserved for those who have a family or personal history of mental health disorders.

What is Ambiguous Loss?

On her website, Pauline Boss states that ambiguous loss differs from ordinary loss in that there is no verification of death or no certainty that the person will come back or return to the way they used to be.

She’s not labeling it, per se, as a type of grief. Instead, these types of losses lead to a certain kind of grief – complicated grief, as mentioned in the podcast interview.

As I listened to Pauline describe a scenario where a woman’s child went missing and applying the label to that loss as “ambiguous,” it had me perplexed on how or why this label is helpful. Does giving it a name help someone whose never experienced it understand it better versus someone who hasn’t? I’ve never had one of my children go missing. I will never understand what that is like until it would happen to me. And even then, if I experience a similar [ambiguous] loss, does that similarity make it easier for the other griever? Does it lessen the pain they feel? Yes, I will be able to empathize in a way others cannot who’ve never experienced that loss; however, it’s grief all the same. And, my relationship with my child is, and always will be, vastly different than anyone else’s relationship to their child who experiences the same type of [ambiguous] loss.

Do you see where this label does nothing for recovery? Whether a loved one goes missing, and we’re left with unanswered questions, or a loved one dies in an instant of unexplainable death, or we watch our loved one mentally deteriorate before our eyes, these all are grief-causing experiences. Adding a label does nothing to help those who experience these kinds of losses other than giving their loss a name. Just like “complicated” grief can be hurtful, so can the label “ambiguous loss” because, truthfully – as a griever, are you going to want to educate others and explain what “ambiguous loss” means? You’re never going to describe a missing loved one as an ambiguous loss. And, in a clinical setting, being told that’s the kind of loss you experienced, does nothing for your recovery either. It neither takes away nor adds.

The dictionary meaning of ambiguous is this: unclear or able to be understood in multiple ways. The word ambiguous alone means unclear. Isn’t that how we feel in grief? Unclear! We are anything but clear-headed in grief, right? And so, to experience an “unclear loss” doesn’t add anything constructive to the experience of a griever, does it?

Therefore, I view “ambiguous loss” as just a factual, intellectual observation about a certain kind of loss. And again, when we start separating and compartmentalized losses, we’re looking at grief from an intellectual viewpoint rather than a heart-centered, feeling one. 

These phrases/terms are only more labels for losses and types of grief. And the means of action that need to be taken, regardless of the kind of loss, doesn’t change when it comes to grief recovery with The Grief Recovery Method.

Grief is grief. End of story. There are no labels necessary. There are no timelines that need to be applied to call it by another name. There need not be a certain kind of loss that only creates separation and comparison among grievers – which is anything but helpful.

Does labeling your grief as “complicated” help you recover?

A label alone does not make things better. It is merely a label. Having a member of the psychiatric community assign this label to a griever may give them a reason to give up. Some people, when diagnosed with a mental disorder, will use this for justification as to why they cannot recover.

Does being told you have a particular type of loss help you recover?

No, of course not. Because you’re still going to have the feelings you have. You’re still going to attempt to intellectualize your loss and revert to the lessons you’ve received growing up in how to address grief. The kind of loss experienced does not change the fact that you’ll always return to what you know – unless you have the education and new tools necessary to complete the loss – regardless of the circumstances of the loss.

Grief is the normal and natural reaction to loss.

Since grief is the normal and natural reaction to loss, doesn’t it make better sense to try to take personal responsibility to take effective recovery action, rather than to allow it to control your happiness? Most grievers want to feel better. Even if someone has suggested that you might be suffering from complicated grief, that does not mean you cannot take action to recover from the emotional pain of your loss. Grievers, do not let a label, which may or may not be accurate, keep you in misery.

The reason that people have a difficult time recovering from the pain of emotional loss is that they do not have the tools to take action. “The Grief Recovery Handbook” is a step-by-step action plan for recovery. It starts at the beginning with what you learned in your childhood about dealing with loss and why many of the “tools” learned were ineffective. You’re then given “new” tools to deal with the unfinished business in that relationship. It offers you the opportunity to deal with those things that make remembering painful safely. It will allow you to be able to enjoy your memories and share them with others, rather than finding them overwhelming.

The first loss with which I dealt, using these tools, occurred 30 years earlier. This timeframe is obviously over that two months to a two-year period for “normal grief” to persist. In actuality, I did not realize how much that loss was still impacting my life. I had become used to living with that pain. Once I took effective action with the Grief Recovery Method, I found a whole new level of happiness. As I have taken more action with other relationships, I have found that I now can truly enjoy my memories, rather than being overwhelmed by my losses.

I encourage you to do this, as well. Do not let grief define you! Do not let a label define you! By taking action, those lost relationships don’t have to cause you to revert to painful memories, regret, shame, or any other painful emotions associated with that relationship. It is possible to reflect on lost relationships with warmth in your heart again. And, know too – that if the relationship was anything but pleasant, recovery will allow you to leave those feelings in the past and give you the emotional freedom you seek. I’ve personally experienced both – it is possible.

There is hope. And, from where I sit, society could use a lot more hope and fewer labels.

P.S. Did you know I have a podcast? It’s called Grieving Voices! Every Tuesday, I share educational grief content and, give grievers the time, space, and platform to share their grieving voice. It is my mission that, as a society, we talk about grief like we talk about the weather. Check it out here!

*a portion of this blog post was adapted from The Grief Recovery Method blog.