There is a kind of grief many people carry quietly because they do not believe it qualifies as grief. It may look like mourning a parent who is still alive but emotionally unavailable. A spouse who remains physically present yet has emotionally withdrawn from the relationship. An adult child navigating estrangement. A loved one living with dementia, or a sibling consumed by addiction.

The person remains. The relationship; however, has changed or disappeared altogether. Because there is no funeral or no socially recognized ending, many people struggle to name what they are experiencing. But there is a name for it. Psychologists call this ambiguous loss .

Coined by family therapist and researcher Pauline Boss in the 1970s, ambiguous loss refers to losses lacking clarity, closure, or resolution. Boss has argued, “Ambiguous loss is the most stressful kind of loss because there is no closure.” Unlike death, which, while devastating, provides certainty ambiguous loss often leaves people suspended between hope and grief.

What Does Ambiguous Loss Look Like?

Ambiguous loss generally appears in two forms. The first is being physical absent, yet psychologically present. This occurs when the person is no longer physically in another person’s life, but they are still very much a part of their thoughts. For example, estranged parents, divorce, missing persons, adult children cutting contact, immigration separation. The person is absent physically but remains emotionally present.

The second form is physical presence but psychological absence. For example, dementia, addiction, severe depression, personality changes following illness, emotionally unavailable partners. The person remains physically present yet feels inaccessible.

Many people experience both simultaneously. For instance, a daughter grieving a mother who has never offered emotional support, a husband mourning intimacy inside an ongoing marriage, parents grieving children who have become distant. The loss is real and the uncertainty is what complicates healing.

Why Ambiguous Loss Can Feel Especially Painful

Human beings often seek coherence. We want beginnings, endings, and explanations. But ambiguous loss disrupts that. According to Boss, “The problem is not the person, but the ambiguity.”

Without clear endings, individuals may experience guilt, confusion, chronic stress, rumination, anxiety, and difficulty moving forward. They may wonder if they should keep hoping, if they are allowed to grieve or if they are overreacting. A 2023 study published in Occupational Health Science found that unresolved uncertainty itself can contribute significantly to distress, and often keeps nervous systems activated.

Ambiguous Loss Is More Common Than Many Realize

Many people are experiencing ambiguous loss, but do not realize there is a name for what they are feeling. Examples have become increasingly more visible in modern life. For instance, family estrangement. Growing conversations around boundaries and mental health have increased awareness of estrangement. Even when relationships end for valid reasons, grief may remain.

In our current socio-political climate, political polarization has also created ambiguous loss for many. Some families report emotional distance caused by ideological conflict. Aging parents is another common example of ambiguous loss that many people are currently navigating.

Watching parents decline physically or cognitively can create grief long before death occurs. Sometimes people also grieve versions of partners who no longer exist in the same way. Although the feelings persist, the grief often remains unnamed.

How Ambiguous Loss Affects Mental Health

Unrecognized ambiguous loss may contribute to:

  • chronic sadness
  • emotional exhaustion
  • depressive symptoms
  • difficulty trusting relationships
  • identity disruption
  • prolonged stress

Many people believe they should simply move on or pushed past their feelings. However, experts suggest healing may look different. Because ambiguous loss often lacks closure, recovery may depend less on resolution and more on adaptation.

According to Boss’s framework, healing does not necessarily require answers. Possible approaches include:

Name the loss. Validation matters and recognizing grief can reduce shame. Grief expert David Kessler says, “Grief must be witnessed.”

Let go of forced closure. Closure may never occur. So, it is critical to eventually get to a place where you can accept that the closure you expect may never happen and find healing in spite of. Remember, acceptance differs from approval.

Redefine relationships. Be honest with yourself and ask, “What can this relationship realistically offer now?”

Build meaning elsewhere. Although it may be difficult, try to create meaning in other areas of your life outside of the person or relationship you are grieving. Connection, ritual, spirituality, friendship, and community may become protective. According to Boss, “Finding meaning can help people bear the ambiguity.”

Seek support. Therapy can help individuals process grief lacking traditional endings.

Society tends to recognize grief when someone dies. Less often do we acknowledge grief for people who remain physically present but emotionally unavailable, changed, distant, or unreachable. Grief expert Kenneth Doka calls this disenfranchised grief and says, “Grief that is not socially recognized can become especially isolating.”

Yet, those losses may shape lives just as profoundly. Perhaps, one of the hardest truths of adulthood is that sometimes we mourn people who are still alive, and sometimes the absence we grieve is not a person entirely -- but the relationship we once hoped to have.