Grieving the Ambiguous Loss of COVID-19

Maybe you have been fortunate that you have not lost a loved one to coronavirus. No one you know has died and those who did get COVID-19 have recovered.

What is ambiguous loss?

Ambiguous loss, first coined by Dr. Pauline Voss in the 1970s, is a type of loss that occurs when there is a physical absence with a psychological presence, or a psychological absence with a physical presence. Ambiguous losses often do not have a clearly defined beginning or end and lack the rituals and traditions that normally help us grieve. Common examples are a loved one that goes missing in action or is kidnapped, a spouse with dementia, divorce, adoption, and miscarriage.

I first heard this term from my friend licensed marriage and family therapist Dr. Kelly Maxwell Haer at a professional counseling conference. Dr. Haer’s dissertation research was adapting ambiguous loss to the experience of prolonged singleness, something I experienced through most of my 20s. She taught me that prolonged singleness in which a person desires to be married and thinks about a spouse, is a psychological presence but physical absence. There is no end date for singleness, no way to find closure. This sense of ambiguity leads to painful and unresolved feelings of grief.

The Ambiguous Loss of the Pandemic

During this COVID-19 pandemic, we have all experienced loss even if we have not physically lost a loved one. We are grieving the loss of our normal daily schedules. We are grieving the loss of planned celebrations, of graduations and birthday parties and baby showers and weddings. We are grieving the physical separation from friends, family, older relatives, and our church family. And we may be grieving the loss of jobs, work routines, and financial stability.

When the pandemic first hit, I was hopeful I could continue my usual self-care skills to find relief from the constant undercurrent of anxiety and stress. I tried to find my calm in the midst of chaos. However, as the pandemic has turned into a marathon, not a sprint, as we have no end date in sight, and as it is becoming clearer that things will never “go back to normal,” I find myself with a heavy sense of grief and loss.

According to Dr. Pauline Voss, there are six steps for coping with the impact ambiguous loss and building resiliency. I want to address a few of them here and give suggestions that I am working toward in my own life:

Acknowledge your grief and loss.

You have to name it to tame it. Acknowledge what you are feeling. Name it and label it as grief. Remember, you don’t have to experience the death of a loved one or a job loss to be grieving. You can name the discomfort, lack of motivation, anxiety, and anhedonia (lack of pleasure) as what it is: grief.

Validate your feelings.

I spend a lot of my time as a therapist teaching my clients how to validate themselves. We are told as children “don’t cry,” “don’t be sad,” and “you shouldn’t feel angry”. We are taught not to trust ourselves, our experiences, and our feelings. Instead, practice validating yourself. Say to yourself, It’s ok to feel sad. It’s normal to be anxious. It is understandable that I am having a hard time right now. And my personal favorite–I am doing the best that I can.

Avoid comparative suffering.

Brene Brown has a great podcast episode on comparative suffering, when we rank our pain and use it to invalidate our emotions or another person’s emotions. I struggle with this, but it’s something I am working to avoid. We know we’re engaging in comparative suffering when we say things like, “They still have a job and I don’t, so how can they complain about their change in work schedule?” or “Since I don’t have kids in school, it’s not as hard for me to try to work from home. I shouldn’t be struggling.”

All pain is pain and we have to learn to validate ourselves and others. I can struggle with the changes in my routine and have empathy for those who have been sick. I can validate the loneliness of my single friends during quarantine and still acknowledge my own struggle of not having childcare (our childcare was limited during quarantine while both my husband and I worked from home). Let’s be sensitive to others’ pain and unique challenges while still validating ourselves.

Maintain self-care and mastery.

The first thing we forget when we are grieving is our own self-care. In therapy, I like to teach a skill from dialectical behavior therapy called PLEASE Master. This skill stands for basic self-care strategies: treating physical illness, balanced eating, avoiding mood-altering substances, getting sleep, exercising, and building mastery. We build mastery through doing activities that give us a sense of competence and confidence as well as working toward and accomplishing our personal goals. Don’t neglect the very simple practices of eating, sleep, and exercise to help you through this time of loss.

Find meaning.

Make meaning in the suffering. Find value in your pain. Part of this is finding the silver living of the pandemic. Can you find joy in spending more time with your spouse and kids, even though they drive you crazy at times? Can you find fulfillment in Zoom groups and drive-by parties, in the people who still seek to celebrate and support you, even though it’s not in person? Finding meaning doesn’t mean invalidating our feelings–a lot of this pandemic still sucks–but it means we actively search for ways to make meaning and acknowledge the deeper purpose in our pain.

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