by Jae Ran Kim
As an educator, social worker and adult adoptee, I search for ways to help adoptees, adoptive families, and those who interact with us better understand the nuances and complexities of our experiences. Ambiguous loss is a concept that provides a rich framework for thinking about the losses in adoption.
The word “ambiguous” has several meanings—it can mean “open to more than one interpretation,” it can mean “unclear” or “unstructured.” It can mean “doubtful and uncertain.” “Ambiguous loss” is a way of thinking about losses in one’s life that are confusing, or seem to have unclear resolutions or boundaries. It’s a concept developed by Dr. Pauline Boss, a researcher and professor at the University of Minnesota.  Her work on ambiguous loss was not specifically focused on adoption, but the concept fits well with the experiences of adopted people and their families.
Boss describes two different types of ambiguous loss: physical absence coupled with psychological presence and physical presence coupled with psychological absence. Examples of physical absence with psychological presence include divorce, parent incarceration, soldiers missing in action, foster care and adoption. In these examples, the “lost” person is not present on a day-to-day basis, but the person suffering from ambiguous loss is thinking about and grieving for that person on a regular basis. Examples of physical presence with psychological absence include relationships with persons with mental health and chemical dependency issues. The “lost” person is physically available but is not emotionally or psychologically available to others in their lives.
In her book, Ambiguous Loss: Learning to Live With Unresolved Grief, Boss writes, “The greater the ambiguity surrounding one’s loss, the more difficult it is to master [the loss] and the greater one’s depression, anxiety and conflict.” What makes ambiguous loss so hard to “resolve”? One reason is that there isn’t a familiar symbolic ritual for this type of loss. Also, the loss is not socially recognized or is hidden from others. The person suffering loss is not acknowledged as grieving, and/or the circumstances that led to the loss are perceived negatively by others.
When a loved one dies, one or more rituals usually take place to memorialize the lost loved one and their survivors—a wake, memorial service, funeral, shiva, burial, or scattering of ashes. The rituals for this type of loss are socially approved—society recognizes the mourners and they are publicly supported.
With death, there is a “script” for how to respond. Many people are familiar with the five stages of grieving (denial, anger, bargaining, depression, and acceptance) that Elizabeth Kubler-Ross outlines in her book On Death and Dying. Friends and family may be able to recognize, “Oh, that person is in the anger stage.” But other types of losses are harder for people to recognize, even if they want to be supportive. With adoption, people either are not aware that losses exist or they may think the losses are erased because of the gains. Claudia Jewett Jarratt, author of Helping Children Cope with Separation and Loss, writes, “Just because the adults involved think the [adoption] offers a great many benefits and is a cause for celebration doesn’t mean the child will agree or adjust quickly to the new family constellation without mourning for the old family, wishing or hoping for reunification, or regretting what might have been.”
For most, the ritual of finalizing an adoption is a “joyous” time; however, not all adopted youth understand or feel happy about the finalization—especially if the child is older at the time of the adoption. For children who remember their first parents, finalization day may actually be a reminder of their loss. The “gotcha” day, or anniversary of the adoption, may be a sad reminder of what the adoptee has lost rather than a celebration of what they have gained.
For adoptees who experience ambiguous loss, the birth family may be present psychologically in their mind well into adulthood. The ways ambiguous loss can show up in an adoptee’s life may be unexpected. For example, one adoptive parent related that it took her several years to understand why her child had such a difficult time on the last day of school each year. While other children were rejoicing, her child would have emotional meltdowns in the classroom. It finally dawned on the mother that the losses on the last day of school were overwhelming to her child. The child saw the last day of school as the loss of a relationship with the teacher, the loss of an expected routine, and the loss of the daily interaction with classmates and friends. The last day of school was yet another extension of the ambiguous losses her child was experiencing.
We know that children are very concrete in their thinking from pre-school throughout pre-adolescence, and they tend to think in absolutes. As parents and as a society, we often reinforce those binary concepts, sometimes unintentionally. We need to help our kids think through these societal absolutes, so that they can learn to hold two different feelings and concepts in their minds at the same time. For example, we can help them understand that missing and/or loving their birth family does not mean they can’t or don’t love their adoptive family. John Bowlby, the renowned researcher on attachment, found that children are better able to resolve losses appropriately when:
- the child has enjoyed a reasonably secure relationship with the person who is leaving or gone;
- the child receives prompt, accurate information about what has happened and is allowed to ask questions;
- the child is allowed to participate in the grieving process (both publicly and privately);
- and the child has a relationship with a trusted adult who can comfort and provide a continuous relationship.
When it comes to adoption, it is rare that each one of these conditions has been met. What can adoptive parents do if they believe the child is expressing behaviors or emotions resulting from the ambiguous loss of adoption?
To begin with, it is important that parents normalize the child’s feelings. It is also helpful to “give voice” to the ambiguity. Parents can help their children identify what she or he has lost: people and things in their lives, including birth family members, but also the loss of a birth name or surname, a home town or birth country, the loss of a language, the loss of family resemblance. Embracing these losses may seem scary to adoptive parents. For some, it may mean learning to re-define “family” to include those in their child’s past.
As parents, we need to be honest about what we do and don’t know. Kids look up to us, so we can model ways of managing ambiguity in our own lives. Toddlers and preschool-aged children are very egocentric. They are the center of their own worlds. We need to be very careful about the language we use to discuss adoption losses during this time in their lives. This is the time when kids are hungry for their adoption stories—because they are the stars! This gives us an opportunity to incorporate the language of ambiguity. Many parents have experienced forms of ambiguous loss themselves. By drawing on their own experiences and talking about how they have coped with these losses, they can provide role models for their kids.
Some families find it helpful to develop rituals for ambiguous losses. Some ideas include creating an altar, “loss box,” or a space (such as the top of a dresser, a shelf, or a bulletin board) where the child can create a “living memorial” to the people or things they have lost. It is important that the child be allowed to decide what to place in the memorial. Other ways to help children ritualize loss include creating a family “orchard” that acknowledges birth families, foster families or other pre-adoption relationships, or helping your child put together a life book (a scrapbook of the child’s history). Some families alter existing family rituals to include memories of lost relationships by adding an extra candle on a birthday cake, a special ornament on the Christmas tree, or including a special prayer or acknowledgement at meals or holiday get-togethers. For families whose children shy away from public rituals, these rituals can be used to memorialize all absent family members, so the adopted children do not feel singled out.
Many children may be hesitant to talk about their feelings around ambiguous loss. Using pop culture characters can help. Many superheroes and fictional characters have experienced ambiguous loss. Superman, Spiderman, Harry Potter, and Luke and Leia from the Star Wars movies are just some of the well-known figures who were adopted or fostered and whose fictional journeys included struggling with ambiguous loss.
Ambiguous loss is present throughout the adoption triad. The birth family experiences tremendous ambiguous loss too. Not only the birth parents but siblings and extended family members may grieve the loss of a child who is not dead but is no longer present. Adoptive parents also experience ambiguous loss, especially if they come to adoption because of infertility. And even if they don’t experience infertility, they have the ambiguous loss of genetic connection or a kinship link. They can also have the socially invalidated (or less-validated) life of being single or LGBTQ or some other lifestyle experience that embodies an ambiguous loss. There may have been miscarriages that aren’t recognized the same way that the death of a child is.
Most adults are not familiar with the concept of ambiguous loss, even though many of us have experienced it in our lives. As a result, parents may need to help educate extended family members, friends, and others who interact with the family about ambiguous loss and grief. This includes teachers, babysitters and caregivers who spend a lot of time with your child.
For many of us adopted persons, the lingering effects of ambiguous loss follow us into other relationships in our life. If we can’t resolve the very first, primal relationship we had, that with our birth mother, it makes sense that other relationships will be fraught with issues of trust and loyalty. There is no pre-determined timeline when our grief over our losses will be “cured” or “resolved.” The aim is not to eliminate ambiguous loss, but to help our families learn to live with ambiguity and the full range of feelings that accompany it.
JaeRan Kim, PhD, MSW, was born in South Korea and adopted to the United States in 1971. She contributed to the seminal anthology “Outsiders Within” and created the influential blog Harlow’s Monkey. She has worked in foster care/adoption (both public and private), with at-risk young moms, and with adults with disabilities in residential care. Jae Ran completed her PhD in Social Work at the University of Minnesota and was a Project Coordinator at the Center for Advanced Studies in Child Welfare at the School of Social Work. JaeRan is currently Associate Professor and BASW chair in the School of Social Work and Criminal Justice at the University of Washington – Tacoma.
 Pauline Boss, ed., Ambiguous Loss: Learning to Live with Unresolved Grief (Harvard University Press, 2000)