Loss, Trauma, and Resilience: Living Well in Spite of Adoption Grief

During my little vacation last month, I read  “Loss, Trauma, and Resilience: Therapeutic Work with Ambiguous Loss” by Pauline Boss. It changed the way I think and feel about myself and this adoption “stuff” that just won’t go away.

Last night, I started re-reading it and taking notes, trying to come up with ideas on how this model applies with natural mothers and the unique situation we face within our culture and society at large. The book is directed towards therapists, but since I can’t seem to find a therapist who knows much about grief and even less about ambiguous loss, I figured I should read it and see what I can learn that might help me in my journey. I am going to be a bit bold here, but I believe this book and this model of loss with its attendant therapeutic approaches is the key for a natural mother to learn how to live with the grief brought on by the loss of a child to adoption.

The premise of ambiguous loss and its unresolvable grief is there are two types of loss within a family system that do not fit the traditional definition of “loss (i.e. death).” Family members may be gone physically but are present psychologically (as in adoption loss, kidnapping, soldiers who are MIA, divorce, etc.) or family members may be present physically, but gone psychologically (mental illness, dementia, drug and alcohol abuse).

“Absence and presence are not absolutes. Even without death, the people we care about disappear physically or fade away psychologically….This ambiguity between absence and presence creates a unique kind of loss that has both psychological and physical qualities” (Boss, 2006, p. 1).

In ambiguous loss, family members are left to cope with the enigmatic nature of what this loss-that-is-not-recognized-as-a-loss means for their family. These coping mechanisms end up looking A LOT like those who suffer from PTSD. A lot, to the point that sometimes people struggling with ambiguous loss are treated for PTSD, when in fact that isn’t what ails them. With PTSD, the loss/trauma is contained within a short time period or experience. With ambiguous loss, the loss/trauma is persistent and unresolvable. There are no solutions to fix what is hurting in ambiguous loss. There is only learning healthy ways to live with it.

Unfortunately, society (especially in the U.S.) does not tolerate ambiguity well at all, especially when it comes to the grief brought on by ambiguous loss.  As a society, we expect people to do their grief work the “right” way (Kulber-Ross, anyone?), get over their grief, and do it quickly, too. According to that model, healthy people are the ones who find closure. How many natural mothers were told we could expect to “grieve for about a year” and then we would feel better? And how many of us, when that year passed and we were still suffering, were made to feel like it was somehow our fault, that we didn’t do something “right”, that there was something maladaptive and pathological about our continued grief?

“Many people never achieve the complete detachment described by Western psychotherapists as necessary for normal grieving. A lack of closure after loss, however, is not always an indication of weakness in the individual or family. The force that causes loss to remain fresh decades later and thus be labeled pathological often lies in the context outside of the person rather than in their ego, psyche, or family.…From this more contextual perspective, pathology is attributed to a client’s situational context and environment rather than to the psyche” (Boss, 2006, p. 2).

The history and systems of psychology have long focused on the symptoms of loss and how to treat them.  When a person’s grieving didn’t fit within the prescribed model, (ahem, Kubler-Ross), it has been labeled as “complicated” and “pathological.”  Traditionally, the focus has been on the “maladaptive” coping mechanisms people develop to deal with ambiguous loss. Boss reminds us that when the focus is on the “symptoms of ambiguous loss, we fail to see the healthy adaptations and unique ways people have come to live well in spite of the chronic trauma and stress inherent to ambiguous loss. (Boss, 2006, p. 2).”

This is what the letter to my daughter titled, “Samba de Uma Nota Só or a Symphony?” attempts to explain. In spite of the chronic trauma and stress brought about through her loss to adoption, I actually have learned to live quite well. Unfortunately, most people just see the symptoms of ambiguous loss (the unresolvable grief, the sadness, the guilt, the difficulty handle other smaller losses) and fail to recognize the incredible accomplishment that I am not curled up in the corner eating Twinkies and drooling.

I dare say there are plenty of other natural mother bloggers who have encountered the same treatment from society at large and even their own family. When we speak out about the pain of the loss of our child, we are told (a) something is wrong with us- i.e., our coping mechanisms are maladaptive and (b) the healthy (and UNIQUE) adaptations we have learned are completely discounted. We are told we need to get therapy, get a life, etc.

Another point of the theory of ambiguous loss is that society at large does not usually even recognize it as being a loss. Consequently, it is impossible to find “closure.”

“Ambiguous loss is inherently traumatic because the inability to resolve the situation causes pain, confusion, shock, distress, and often immobilization….In our culture [there] is a tendency to deny loss. Grieving is acceptable, but we should get over it and get back to work. Whereas finding closure is difficult with ordinary losses, it is impossible with ambiguous loss because there is no official recognition of there even being a real loss.” (Boss, 2006, p. 4).

As natural mothers, we are told we are heroes who redeem ourselves when we give a more “deserving” couple the “gift” of our child. We are told it is a miracle and a blessing, that it is an act of love to sacrifice our “wants” for our child’s “needs.” We are patted on the head by social workers, therapists, and the broader culture and told, “There, there. Stop fussing – don’t you see how happy you should be? You are like a God – a family maker!!! a bringer of fertility!!! a giver of children!!!! Plus, it’s not like this baby is really ‘yours’ – God is just using you to get it to the right family and you’ll get over it when you have children of your own.”

(Side note = That last sentence is ONE OF THE THREE BIGGEST ADOPTION LIES EVAH’. Having more children only serves to remind a natural mother of what she has lost. It doesn’t make it any easier, folks. Not. by. a. long. shot.)

When an ambiguous loss occurs, families freeze and boundaries become unclear. A natural mother may become “stuck” at the age she was when she relinquished her child, unable to move past the loss and resulting trauma. As her families grows, defining the boundaries of who is family and who is not family grows more difficult.

This is particularly evident in reunion situations. A natural mother may have spent a lot of time convincing herself (and others) that her relinquished child was not “really” her child, that her child “belonged” to another family. When she is confronted with a person who says, “Actually, I am your child” all. hell. breaks. loose. People and families become preoccupied with the lost person and may think of little else. Other relationships are neglected. Behaviors revert to the time period the ambiguous loss occurred.  Boss says, “The premise is that ambiguity coupled with loss creates a powerful barrier to coping and grieving and leads to symptoms such as depression and relationship conflict that erode human relationships” (Boss, 2006, p. 1).

Wow. Just wow.

Think of that in context of an adoption reunion and how many of them go south eventually. A family system endures the ambiguous loss of a family member, usually the firstborn child. Then natural mom finds adoptee or the other way around. All of the sudden, the natural family has to redefine roles and boundaries and the adoptee does, too.

The more I think about it, the more I understand why reunion is so difficult, particularly for adoptees. Not only do they have to deal with the ambiguous loss of their natural family and those redefined roles, but also the shifting definitions of “family” with their adoptive family, too! And if they end up with a set of adoptive parents who are not supportive or flexible in their relational roles once the adoptee enters into reunion with their natural family? Wow. I can’t even begin to imagine that burden.  As if those kinds of pressures aren’t enough, add in a shame-based, guilt-driven religious culture that has created a golden calf of the two-parent family with a stay-at-home-mother and frankly, it’s a recipe for a reunion disaster of epic proportions.

So how do we – meaning those of us who have endured an ambiguous loss –  deal with the unresolvable grief? How do we survive this loss? We try to make sense of it in any way we can (that is what these letters are about, me trying to make sense of this loss-that-my-culture-does-not-call-al-loss*) and we focus on shoring up our resiliency.

“…not knowing if a loved one is absent or present, dead or alive, can create so much ambiguity that the stress is traumatizing and immobilizing. This new view of loss, trauma, and resiliency centers on this psychological family and making sense of ambiguous absence and presence” (Boss, 2006, p. 2).

In short, we adapt and find unique ways to learn to live well in spite of adoption loss, we find ways to learn to live well in spite of the grief that never goes away.

Boss’s theory of ambiguous loss is it is less pathology-based than most models of loss and grieving. It recognizes, “The intellectual and relational uncertainty of living with someone both here and not here produces a terrible anxiety of bizarre human experience.” (Boss, 2006, p. 5). Unlike traditional grief models, getting rid of ambiguity is not the goal. Learning to live well with it is. I also appreciate it focuses on the family system, because the truth of the matter is, I didn’t just loose my daughter, but my entire family lost her. She lost me and her siblings, and countless uncle and aunties and cousins. Our whole family system is affected by adoption loss.

I think most natural mothers are very familiar with the symptoms of unresolvable grief and ambiguous loss. What has been lacking is a clear model to treat this loss within their family system.  Boss offers up a model that is compassionate and realistic and perhaps most importantly, doesn’t blame natural mothers for the symptoms that endure across the decades.

Watch for more letters about this topic in the future as I digest this book and its teachings. Right now, I am off to see if I can locate any journal articles about studies applying this model to natural/first/birth families. I don’t have high hopes of finding any, but I have to start somewhere.


*P.S.* The other day, someone left a comment asking why I keep writing these letters. She implied there was something maladaptive or pathological about them (her exact words were “strange” and “disrespectful“).  I didn’t feel the need to explain myself to her then, and I still don’t. However, I had to smile a bit when I read in Boss’s book about one of the unique and normal ways some (though not all) people learn to live well with the ambiguous loss of a family member: They talk to the missing person. And not in the crazy-tin-foil-hat-wearing way, but in the you-are-still-in-my-heart-even-though-you-aren’t-here-with-me kind of way (Boss uses more technical language than that in her explanation, but that’s my quick distillation). Since I am not a big talker but I am a writer, writing letters is my way of talking to my daughter, my missing family member.

So there it is. My unique method of learning to live well with her loss is not strange, disrespectful, maladaptive, or pathological. It is normal. It is healthy. What is strange, disrespectful, maladaptive and pathological is a culture that seems to think a woman should “get over” losing a child to adoption, that her grief and coping mechanisms should fit within a little tidy box, and that she should just “move on already” because it wasn’t really a loss, after all. She “chose” it, didn’t she? Now that is strange indeed.