Sunday, November 11, 2007

Miracles and Ambiguous Loss

Joel 2:24-26 (NIV) The threshing floors will be filled with grain; the vats will overflow with new wine and oil. "I will repay you for the years the locusts have eaten.... You will have plenty to eat, until you are full, and you will praise the name of the LORD your God, who has worked wonders for you; never again will my people be shamed."

The symptoms of unresolved grief from ambiguous loss are similar to post-traumatic stress disorder. Ambiguous loss is also a psychologically distressing event that is outside the realm of ordinary human experience; like the events triggering PTSD, it lacks resolution and traumatizes. But with ambiguous loss, the trauma (the ambiguity) continues to exist in the present. It is not post anything. Ambiguous loss is typically a long-term situation that traumatizes and immobilizes. Ambiguous Loss by Pauline Boss (1999) p. 24

Dh's being here today is a blessing and a gift. I'm certain he is still alive and part of his family for a reason. Briefly, I'll recount the miracles that led us here.


I don't remember being given dh's chances of survival, but now as I type this I remember that maybe I was, "fifty-fifty." After a week or so, I was told he would survive, but be in a coma or coma-like state for possibly months, after which "he will have to learn everything all over again." Later no one would ever tell me if he could walk again and his therapist would caution that even if he could walk with her, it would be a far cry from walking in a community setting with uneven surfaces and distracting surroundings. Early on, a consulting neurologist told us dh was blind. And months later, even after he came home, we were told the left arm very likely would remain unresponsive. As for being independent, I was told that dh would be able to stay at home, but would accomplish activities only if rigorously trained to rely upon lists. Though dh has a far way to go, he has greatly surpassed all of these expectations.

Still, almost everything he does must be planned, organized, directed, and evaluated by another brain - usually mine. Though generally dh has a pleasant demeanor, his emotional life remains very shallow. When I strained a muscle trying to fold the wheelchair he no longer needs, he watched impassively, not asking if I was okay, not empathizing with my pain. The few flashes of emotion expressed are anger. When in bed I reached out to pat dh on the shoulder and accidentally touched his face, dh grabbed my hand and twisted it, letting go only when I repeatedly told him not to hurt me. Not dismayed at his lack of control, he also did not apologize without being told to do so.

So many things are mixed blessings. I think God I have a sound mind and body (such as it is!). Just as a silly but telling example, we've camped once since his accident and I'm planning for us to again this weekend. Of course, I do the planning, all the packing, loading, unloading, tent set-up etc. Then all night long I'll be escorting dh back and forth to the bathroom. A consequence of the brain injury can be an overactive bladder and, Mark insists, trees are not a suitable substitute for the restroom. Dh had been the parent who was more adventurous, who would take the kids mountain climbing, mountain-biking, fishing, kayaking, etc. Once I could walk the dog and children along trails. Now dh's walking speed is so slow and balance precarious enough that his job is to hold down the fort at fireside. Mine is to attend to him.

Dh is not the man he once was. We hold on to realistic hope that things will continue to improve for months and years to come. But our lives, particularly the lives of our 9 and 12 year old children, can't stand still waiting for Daddy to come back. What is it like to watch movies with a man, whom you once looked up to and relied upon as the bedrock of security in your life, who now guffaws at puerile humor that as a nine-year-old you don't think is funny anymore? You have a dad who thinks he still takes you to school and helps with your homework, but really has to be told when to go to bed before your own bedtime. Your dad once spent all Christmas holidays making rockets for you and now doesn't remember it, can't cross the pastures launch the rockets, and doesn't understand how they work anymore?

Of all the losses experienced in personal relationships, ambiguous loss is the most devastating because it remains unclear, indeterminate.... People hunger for certainty. Even sure knowledge of death is more welcome than continuation of doubt. (Ambiguous Loss p. 6)


Ironically, the greatest source of ambiguity is dh's improvement. How will he finally be re-integrated into our family? As a dependent who nevertheless still can help around the house or as a person with his own thoughts, feelings and desires? Even better, as someone who has a concept of the future and who recognizes others' feelings and still cares for them?

How does ambiguous loss make people feel helpless?

  1. The loss is confusing and not amenable to problem-solving. Lack of mastery ... increases not only perceptions of helplessness but real helplessness. (p.79)
  2. Because of the ambiguity, adjusting roles and rules in the family relationships is difficult.
  3. There are no symbolic, supportive rituals (such as funerals) to help the greater community to validate or verify the loss.
  4. The clear evidence of the unfairness of life as well as the ambiguity constrains community and extended family members from lending support.
  5. Ambiguous loss goes on and on, exhausting caregivers in the grip of relentless uncertainty.
  6. In the midst of turmoil, the family must reconstruct itself and manage daily lives in a new way.(paraphrased pp. 7-8, 20)