Guest Writers, Power Couples

Navigating Pregnancy Loss as a Couple

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Cover photo by Pixabay.

Written by Anna Smith
How does the occurrence of a negative stressful event affect commitment in marriage? Will it tear marriages apart? Or increase levels of loyalty? Luckily, there is no definite answer to those questions. In fact, the outcome of your marriage is completely determined by the actions of you and your partner. This may sound obvious at first, but that answer may be less easy to find when you are embracing the unexpected together. 
Several couples experience significant losses in their marriage. It could be the loss of a job, family member, finances, a house, etc. Today, I want to address a particular type of loss that is all too common and surprisingly undiscussed: Miscarriages, stillborn babies, and pregnancy failure. Today, 15% to 20% of pregnancies unfortunately result in one of these categories of loss (Hiefner et al., 2021).
Photo by Ivan Samkov
Not only does the unexpected loss of a child affect parent’s physical and emotional well-being, but it also can add monumental amounts of stress on a couple’s relationship. Regardless of if a couple experiences a sudden loss of a child, between 43% and 46% of marriages are predicted to end in separation (Shreffler et al., 2012). So, what can we do to preserve our marriages when we find ourselves in such a tragedy?

Try to understand each other. Let your spouse grieve the way they need to. 

Naturally, men and women have differences. Therefore, they have individual perspectives, feelings, experiences, and needs – especially surrounding pregnancy loss. On average, women tend to experience more grief than their spouses, and it lasts for a longer period of time as well (Thomas & Striegel, 1995, McDonald et al, 2022). This could be because the mother develops a stronger sense of attachment to the baby from physical pregnancy changes and feeling the baby move occasionally (Avelin et al., 2013). Because of this, the mother could experience more feelings of pain, depression, guilt, or even more amounts of anger than their partner does (Alderman, et al., 1998). 
As fathers are also facing feelings of depression and grief for their lost baby, they often feel pressure to be the “strong one” and “hold it together” for their partners, which could increase stress and miscommunication (Thomas & Striegel, 1995). In addition, not only do we know that mothers and fathers grieve differently in general, they also are known to express their grief and coping strategies in different ways. Most women tend to seek social support from friends, family, or even the community, while fathers often hold in their grief and avoid using any outward coping strategies (Hiefner et al, 2021).
Photo by Kampus Production
Navigating through differences in grief has the potential to threaten marriage and increase feelings of loneliness (Avelin et al., 2013). But the good news is, it also provides various opportunities to grow closer together as a couple! In a recent survey from The CREATE Project including over 3,000 individuals across the United States, those who reported a pregnancy loss also report feeling more committed to their spouse. Comparing these results to different studies, it has been found that as couples respect each other’s grieving styles and seek to understand one another’s feelings, the negative event of a loss was transformed into a positive growing experience for the couple (Cacciatore et al., 2008).
Photo by Pixabay

Communicate

Among the participants from The CREATE Project, as the couples coped with the loss of their child, they also reported having less communication. This decrease in communication can lead to frequent misunderstanding and conflicts (Alderman et al.,1998).  The perfect way to avoid unnecessary stress while coping with such a loss is to engage in communication specifically about one another’s feelings and needs.  
As mentioned before, mothers and fathers will grieve differently because of the different ways that they perceived the loss. In a study of 121 women who had experienced a pregnancy loss in the last six months, there was a general trend that the mothers felt that their partners were less “emotionally connected” to the loss, or that they “just didn’t understand” what they were feeling. Because of this, the women in the study resulted in feeling alone in their grief as they tried to cope with the recent loss (Black, R. B., 1992). 
The problem with this is, that the mothers in the study could never know if their partners actually felt that way, unless they had specifically talked about it. It is impossible to know exactly what a person is feeling based on their actions (even though that would be really nice!). In fact, the way we express our feelings is different from ways others will, and that is okay! The more we communicate about how we view each other’s feelings, the more unity we will feel in our relationships. Going back to the couples in the study, as they communicated their feelings clearly, they reported that they felt more satisfaction in their relationship and made clear communication an enduring practice in their marriage (Black, R. B., 1992). 
Photo by Isabelle Taylor

Conclusion

As couples face losses in their relationship, each individual will respond in different ways. As humans we are not perfect, and that is why as we cope with loss our communication or understanding will decrease. But this is normal! When you and your partner seem to find yourself in the stress of any type of loss, remember to seek understanding from each other and talk about it. These things sound simple, but you may be surprised by how much good it can do for you and your relationship. 
Not sure where to start? Here are a couple of activities that you can do to help you seek understanding and improve your communication skills in your relationships!
  • Talk about your feelings using “I” statements (i.e. “I feel lonely”)
  • Watch your non-verbal communications that may send the wrong message (eye rolling, not maintaining eye contact, being on your phone, etc.)
  • Put away distractions while communicating (phones, earbuds, television)
  • Ask each other open ended questions (i.e. “Why do you feel lonely?”)
  • When responding to each other, paraphrase what your partner just said to ensure that you understand (i.e. “Okay, what I am getting is that you feel lonely because I work too much. Is that what you meant?”)

References

Alderman, L., Chisholm, J., Denmark, F., & Salbod, S. (1998). Bereavement and Stress of a Miscarriage: As it Affects the Couple. OMEGA – Journal of Death and Dying, 37(4), 317–327. https://doi.org/10.2190/DQNQ-PFAM-7V00-52F3
Avelin, P., Rådestad, I., Säflund, K., Wredling, R., & Erlandsson, K. (2013). Parental grief and relationships after the loss of a stillborn baby. Midwifery, 29(6), 668-673. https://doi.org/10.1016/j.midw.2012.06.007
Black, R. B. (1992). Women’s voices after pregnancy loss. Social Work in Health Care, 16(2), 19-36. https://doi.org/10.1300/J010v16n02_03
Cacciatore, J., DeFrain, J., Jones, K. L. C., & Jones, H. (2008). Stillbirth and the couple: A gender-based exploration. Null, 11(4), 351-372. https://doi.org/10.1080/10522150802451667
Hiefner, A. R. (2021). Dyadic coping and couple resilience after miscarriage. Family Relations, 70(1), 59-76. https://doi.org/10.1111/fare.12475
Hutti, M. H., Armstrong, D. S., Myers, J. A., & Hall, L. A. (2015). Grief intensity, psychological Well‐Being, and the intimate partner relationship in the subsequent pregnancy after a perinatal loss. Journal of Obstetric, Gynecologic & Neonatal Nursing, 44(1), 42-50. https://doi.org/https://doi.org/10.1111/1552-6909.12539
McDonald, S. A., Dasch-Yee, K., & Grigg, J. (2022). Relationship outcomes following involuntary pregnancy loss: The role of perceived incongruent grief. Illness, Crisis, & Loss, 30(2), 146-156. https://doi.org/10.1177/1054137319885254
Shreffler, K., Hill, P., & Cacciatore, J. (2012). Exploring the increased odds of divorce following miscarriage or stillbirth. Journal of Divorce & Remarriage, 53(2), 91-107. https://doi.org/10.1080/10502556.2012.651963
Thomas, V., & Striegel, P. (1995). Stress and Grief of a Perinatal Loss: Integrating Qualitative and Quantitative Methods. OMEGA – Journal of Death and Dying, 30(4), 299–311. https://doi.org/10.2190/X0E4-536U-6YWP-CPYL

 

Anna Smith is from Bountiful, Utah and is currently a Junior at Brigham Young University. She is studying Family Services and plans to become a Licensed Social Worker. Anna loves to spend time with others, and is passionate about helping individuals and families achieve stability and happiness.
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Love, Me

Your Hero’s Journey

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Photo by Mairon Silveira from Pexels

Written by Dray Salcido
“The cure for pain is in the pain.” – Rumi 
“Behind every beautiful thing, there’s some kind of pain.” – Bob Dylan 
For the most part, people avoid pain. Our brains are wired to fight, flight or freeze when they detect danger. Because most of us are no longer running from lions or physically fighting for our livelihoods, danger often shows up in less obvious ways. This includes mental health, interpersonal struggles, academic stress, neglect, physical illness, occupational pressure, familial betrayals, grief and loss, political contention and other situations that may not be life threatening, but are certainly painful. Our internal aching may not be apparent to those around us. Some of you may consider yourselves the silent sufferers of this world. Please know you’re not alone. There is hope for alleviation and transformation. This article explains that discomfort can be a wise teacher, and how we can benefit from our painful moments. 

Pain Challenges Us

Image from conorneill.com
Let’s examine a common plot of a story. The protagonist receives some call to adventure. They begin hopeful and excited. Perhaps even ignorant and innocent. As the story progresses, roadblocks, challenges and danger appear. Then there is a period of decision making. Will they rise up to the challenge, or turn back? Usually the hero will face their fears. They are pushed beyond their limits. Often there is a symbolic rebirth and transformation. The hero finishes their voyage finding that it was not what they expected in the slightest, yet they come out wiser and truer. They are whole as a result of their painful path. This is known as “the hero’s journey.”
Photo by Daisa TJ from Pexels
When we watch a movie or read a book this narrative is so familiar to us, we often have no fear for the characters whose lives we observe. We trust that all will work out in the end, because it always does. While we may feel certain of the outcome, the character spends the majority of their story in the unknown. A few things are certain such as their call to adventure, or the facts of their surroundings. The rest of their life, however, is unclear to them, and usually their original intentions must change in order to meet the demands later placed on them. 
We love stories such as these because we relate to them. There is something so human, and even beautiful, about the sacredness of struggle. Yet, we forget so often that we, like the hero, must spend the majority of our own adventure in the unknown. If only we could remember that when we are in the thickest, most difficult parts of our tale. It is good to be impelled. Pain gives us a reason to learn; to overcome; to grow stronger. So, rise up to the challenge, even in your unknown. Trust that it will all work out – because it always does. 
Photo by Külli Kittus on Unsplash

Pain Connects Us

Masters of the wisdom traditions teach that pain is the great equalizer. Whether mental, emotional or physical it is a marvellous opportunity to connect with one another. Our natural tendency is to feel with others. It goes against our true nature to ignore our inner worlds, or to abandon others in their sorrow. A beautiful demonstration of this is from the movie Inside Out (Docter & Del Carmen, 2015). Riley, the hero, feels a great amount of discomfort throughout the film. She tries to cope by isolating, but only spirals further. When she finally shares her struggles with her parents, she feels deep love and gratitude from their listening ears and gentle hugs. Essentially their empathy heals her. The parent’s ability to see her for who she is in non-judgemental love makes her struggle worth it in the end. Connection is the goal in any story, including our own. 

Pain Deepens Us

Photo by Brian Lundquist on Unsplash
A hero is willing to be in their pain for however long is necessary. Consider what was taught by J.R.R. Tolkien in the dialogue between two heroes:
Sam: It’s like in the great stories Mr. Frodo. The ones that really mattered. Full of darkness and danger they were, and sometimes you didn’t want to know the end. Because how could the end be happy? How could the world go back to the way it was when so much bad happened? But in the end, it’s only a passing thing, this shadow. Even darkness must pass. A new day will come. And when the sun shines it will shine out the clearer. Those were the stories that stayed with you. That meant something. Even if you were too small to understand why. But I think, Mr. Frodo, I do understand. I know now. Folk in those stories had lots of chances of turning back only they didn’t. Because they were holding onto something.
Frodo: What are we holding onto, Sam?
Sam: That there’s some good in this world, Mr. Frodo. And it’s worth fighting for. (Tolkien, 1991).
As imperfect people we frequently “turn back”. We betray our value system through numbing, abandoning, and blaming. We tell ourselves we won’t make it, can’t do it. The discomfort will consume us, ruin us or destroy us. However, avoiding our pain only intensifies it. Judging our suffering keeps us thinking in circles. Staying with our pain is the only way to come out the other side. This is far easier said than done. In fiction it appears obvious, worth the struggle or the practical choice. Our realities are much different. Our pain often lasts longer than the 2 hour film, or a 300 page novel. 
Photo by Marcos Paulo Prado on Unsplash
Our struggles may seem less dramatic, but more persistent than the characters in stories. Yet, storytelling can be a powerful way to work through the anxiety of necessary pain. Research suggests that rewriting your own narrative increases pain resilience (Nurser et. al, 2018). So, how can we rewrite our past narrative in a way that serves us? The following outlines this practice:
  • In a journal start with a difficult past memory, and write out everything you felt and still feel about it. Be descriptive and honest. Identify the main takeaway or message you gleaned from this experience.
  • Notice in your current life when that same message comes to mind, and write it down in the story you created. 
  • Ask others connected to the memory how they remember it, and add their perspective to this narrative. 
  • Now think of times when people proved you wrong. When someone did something, or something occurred that doesn’t fit the message from the past incident.
  • Write another section of the things you’ve learned having lived through that experience, and ways you’ve grown stronger.  
  • Once you’ve compiled all the data around this core belief, rewrite it in narrative form. Write this in third person. Be the author, not the main character and feel excited about the hero about which you’re writing. This final story should be at least a few pages.
  • Notice the difference you see in the original perspective of the incident and the end of the story you’ve created. You’ll find that when the pen hits the paper it will lead you to a more hopeful resolution as your mind looks for meaning and purpose.
  • Now, go share it with others. Tell your story. Inspire yourself and others through the power of storytelling. 
One study found that practicing sharing our stories and using our imaginations through conversation, journal writing and meditation can have positive effects on our overall health (Burton & King, 2009). So, be brave enough to day dream a little. We have to have the vision, even in the pain, to create the lives we want. 
And ultimately: Be grateful for what pain makes possible.
This Week:
  1. Ask yourself, “What am I to learn from this pain?”
  2. Listen. Be Open. Be patient. Learning what our pain is teaching can take time. Often it’s realized in hindsight.
  3. Allow others to help you. Accepting love and support can feel like an added risk when you’re already in a dark spot. This choice is well worth it.
  4. Practice more adaptive storytelling. Use your imagination to create bold and hopeful outcomes. Remember that heroes in stories don’t know they will prevail. They required faith just like we do.                                       

References

Burton, C. M., & King, L. A. (2009). The health benefits of writing about positive experiences: The role of broadened cognition. Psychology and Health, 24(8), 867-879. 
Docter, P., & Del Carmen, R. (2015). Inside Out. Walt Disney Studios Motion Pictures. 
Nurser, K. P., Rushworth, I., Shakespeare, T., & Williams, D. (2018). Personal storytelling in mental health recovery. Mental Health Review Journal
Salcido, A. (2020). Heartfulness: Understanding our deep feelings and empathic nature. Healthy Humans Project. https://www.healthyhumansproject.com/heartfulness-understanding-our-deep-feelings-and-empathic-nature/
Tolkien, J. R. R. (1991). The lord of the rings. HarperCollins.

 

Dray Salcido is from Elkridge, Utah. She is the youngest of seven and enjoys close relationships with her siblings. She graduated with a Bachelor of Social Work from Utah Valley University. She works at a law firm and volunteers with various populations. She enjoys researching and writing about the human experience, and hopes to make that her creative, life’s work.
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Guest Writers, Love, Me, Mental Notes

Coping With Parental Loss

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Cover photo by Omar Ram on Unsplash

Written by Haddie Todd Fry
After almost six years of cancer treatments that were followed by stretches of remission that we were told would never come, the fact that my dad was in the hospital again wasn’t too overwhelming. He had bounced back before, and I figured that he would continue to do so far into the future. As a result, my mom’s text requesting that I come to the hospital on that calm, warm night in early June wasn’t too disturbing—until I arrived and saw all of my siblings in the parking lot. Evidently, they’d received the same message.
We made our way silently to the “end-of-life” floor, where the walls were painted a serene blue and the nurses watched solemnly as we passed. Once we had assembled as a family in the hospital room, my parents explained that the doctors had finally run out of options—giving our ever-resilient, 45-year-old dad only a few weeks to live.
Photo courtesy of the author
It was a unique experience to be able to spend my dad’s last days at home, surrounding the recliner that had been brought into my parents’ bedroom where we tried to help him be as comfortable as possible. Though the next two weeks were difficult and we didn’t know when the end would come, we stayed in that room for the better part of every day, eating popsicles, playing card games, and reflecting on every good family memory we could conjure up to distract us from concentrating on the tubes coming out of my dad’s body and his flagging strength.
Parents are influential people in a child’s life (Gross, 2016). They often provide safety, emotional and financial support, and teach important, life-lasting values to their children (Wentzel,1998). My dad was there for me and exemplified everything a good man is. He provided me with a model of what I should look for in any guy who might come into my life. He had a way of keeping each of his children safe and feeling secure, and he taught me through his example about respect, hard work, and trust.
Because of the incredible influence my father had on my life, his passing was especially painful. In fact, losing a loved one to death is considered one of the most stressful events an individual can experience (Koocher, 1986). Today, about 4% of children and adolescents lose a parent (Melhem, Porta, Shamseddeen, Payne, & Brent, 2011), and as my five siblings and I ranged from 14-21 years old at the time, we quickly became part of that statistic. The late teens and early twenties can be the most transformative years of an individual’s life, and if a parent passes during this crucial period, perception of self and support throughout life will likely significantly change (Wagner, 2016).
Photo by Peter F. Wolf on Unsplash
Many have offered suggestions for those trying to cope with the death of a parent while in their childhood and teen years (Stordahl, 2017). Although the coping techniques young people choose can vary, the bereaved typically end up defining the loss as part of their identity (Koblenz, 2016). The reality is that through many years, the grief comes and goes, and then comes again. However, adapting to life’s challenges can have a positive side and be strengthening. Each trial can be another badge on the “life is hard” achievement sash, another aspect of one’s identity.

How to Cope With the Loss

I found the following three coping strategies to be especially helpful after my own father’s death and feel they may be valuable for others who are dealing with loss:

Don’t Be Afraid to Tell Someone What You Need

The temptation after experiencing a parent’s death is to huddle down inside your own world, to try to be “strong,” and to refuse help. Coping, grieving, and healing will go more smoothly if you can get what you need to make it through the process.
The people around you generally want to help but may not know how. I came to understand that I needed to tell them. Since this was the time I needed people the most, this was also the time that I needed to allow them into my life, and be honest about what I needed from them. If someone texted me asking if they could do anything, I responded. I found that often the simple things were the most helpful and bonding, like asking a friend to just sit silently in a park with me and feel the wind blow across our faces.
Photo by Priscilla Du Preez on Unsplash

Keep Your Friends Out of the Dark

Don’t blame those around you if they don’t understand how to act or what to say. It may feel easy, or that you have a perfect excuse to draw the curtains and cancel all plans, but everyone’s grieving experience is different and shutting people out will just confuse those who want to help you. You can let people know that you need space while still nurturing and valuing the space that their friendship has occupied in your life until this point.
After that night when I was told that my dad was dying, I didn’t feel like talking to anyone about anything. Unfortunately, I was turning nineteen in a few days, and there were plans that would have to be cancelled so I could stay home with my family. Some of my friends didn’t even know my dad had cancer, and now I would have to tell them that things were cancelled because he was dying. These were difficult and awkward conversations to have, but once they knew, my friends didn’t have to be confused if I was a little “absent.” They knew that I valued our friendship enough to not keep them in the dark about my struggles.

Take Comfort from the Parts of Life that are Predictable

In reaction to the unpredictable event of my dad’s death, I began to crave parts of life that were predictable. The sun still rose and set every morning and night, I still needed to brush my teeth every day, and the dog still had to be fed. These routines had no special meaning tied to them, but I needed the consistency.
Photo by Dimitri Houtteman on Unsplash
As a family, it was important for us to continue the routines that existed when my dad was alive. Working in the yard every Saturday morning as a family meant so much more to me because I knew my dad would’ve been right there with us if he were alive, in the same old hat and well-loved tennis shoes he always wore. He’d be asking one of us kids to help him hold up a piece of siding so he could nail it onto the shed he was building, racing against daylight to get as much done each week as he could. Keeping up with routines helped give me a sense of satisfaction and accomplishment, especially knowing my dad would be happy to see me working hard.
Now that all but my two little sisters have moved out of the house, I try to go over on a Saturday as often as I can to help my mom with the yard, attempting to keep it looking as good as he left it. It will always need work, and the continued routine helps keep the memories of wonderful bygone days fresh.

Ways That Friends Can Help

Even though I am one who has experienced parental loss, I still sometimes feel powerless when I see someone else grieving. Here are a few suggestions that may be helpful as you reach out to comfort a friend who has experienced a loss:

Use Sensitivity in Offering Help

Asking, “How are you?” does not provide quality support that the bereaved need, they’re really not going to be “fine, thanks.” Instead, ask what you can do. My neighbor was sensitive in the way she worded her offers for help. She would text me and ask, “What do I need to leave on your porch that you feel like eating today?” She wouldn’t let me say that I was fine or deny her the opportunity to support me, but she also respected my need to be alone. She sensitively recognized that leaving things on the porch for now would help me feel a measure of comfort without the stress of maintaining a social presence or answering questions. She was consistent and kind—her offers were always about me and not about her feeling “less guilty” because she had reached out. Her sincerity spoke volumes.
Photo by Vitor Pinto on Unsplash

Come Back and Offer Sympathy a Year Later

Sympathy typically expires before grieving does (Koblenz, 2016), meaning that people will generously help in the beginning right after the loss, but the support often soon trails off, though the grief remains. Don’t stop bringing flowers or meals after the first week. Anyone can send a little gift with their condolences right after the tragedy happens, but you can be the person that can catch your loved one or friend in a darker time further down the road—just when they need it. The loss will still hurt 5, 10, or 15 years later.

Preserve Memories Through Maintaining Rituals

A friend can be helpful for those who need to remember what life was like before the loss. True friendship for someone who is grieving means carrying on the continued existence of gatherings and outings and doing what you can to help the bereaved feel comfortable during the activity. Remember the good times of the past while not being afraid to create new memories. Support your friend by maintaining the consistency that they need to feel normal, instead of “the one whose dad died.”
Photo by August de Richelieu from Pexels
As in my case, family rituals—events that are repeated and have meaning—are a powerful tool for helping to soften parental loss. Though some family traditions will need to be adjusted to meet the constraints of the present, try to keep the sentimentality of the ritual, so as to preserve that part of “normal” family life that existed before the loss of the parent. Help those you know get up and go to the annual family Thanksgiving turkey bowl, make that special ham recipe, do the birthday lunch at your favorite restaurant with your best friend, or go to the traditional Christmas Day movie.
Since that June evening where I gathered with my family in the hospital and learned that my life would never be the same, I have grieved, boarded up my emotions, embraced my emotions, and then boarded them up again at times. It still hurts, but I am now more sensitive to how important the journey of grief is and how it can bring families together. Healing takes time and there is no reason to ever feel like you need to “get over” your loss (Cincotta-Eichenfield, n.d.). Do your best to stand by others and realize that life, love, and grief are all journeys—ones that can change us for good.
This week, choose a friend or family member who may need some extra love. Think about ways you might be able to help. Do they need a babysitter so they can have a few hours to themselves? Maybe a meal? Someone to listen to and just be with them? Decide on one specific thing you can do to help them that week, and then offer that help! If they tell you no, that is okay! The point is to practice being intentional and thoughtful about the way you show up for those you love.

References

Gross, G. (2016, August 15). The power of parental influence in child development. Retrieved from https://www.huffpost.com/entry/the-power-of-parental-influence-in-child-development_b_57a6a8b5e4b0c94bd3c9a60a.
Wentzel, K. R. (1998). Social relationships and motivation in middle school: The role of parents, teachers, and peers. Journal of Educational Psychology, 90(2), 202–209. https://doi.org/10.1037/0022-0663.90.2.202
Koocher, G. (1986). Coping with a death from cancer. Journal of Consulting and Clinical Psychology, 54, 623–631. https://doi.org/10.1037/0022-006X.54.5.623
Melhem, N., Porta, G., Shamseddeen, W., Payne, M. W., & Brent, D. (2011). Grief in children and adolescents bereaved by sudden parental death. Archives of General Psychiatry, 68, 911–919. https://doi.org/10.1001/archgenpsychiatry.2011.101
Wagner, D. M. (2016). Loss of a parent: A retrospective phenomenological exploration of lived experience (Order No. 10125515). ProQuest Dissertations & Theses Global. (1796375581).
Stordahl, N. (2017, December 7). 8 tips for coping with the death of a parent. Retrieved from https://www.huffpost.com/entry/eight-tips-for-coping-with-the-death-of-a-parent_b_6672504.
Koblenz, J. (2016). Growing from grief. Omega: Journal of Death & Dying, 73(3), 203–230. https://doi-org.erl.lib.byu.edu/10.1177/0030222815576123
Cincotta-Eichenfield, A. J. (Ed.). (2019). Loss of a Parent, Cancer. Retrieved from https://media.cancercare.org/publications/original/68-fs_loss_parent.pdf

 

 

Haddie Todd Fry has lived in Washington, Colorado, and is currently living in Provo, Utah. Haddie is working on a degree in Family Life and Human Development. She works at a residential treatment center for autistic adolescents and enjoys learning about human relationships and behavior. Haddie is one of six children, and has been married to her husband Jacob for one year. Besides Jacob, her loves include her family, flowers, art, movies, sunshine, and rain.
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Guest Writers, Love, Me, Mental Notes

Losses with More Questions than Answers: Navigating Ambiguous Loss

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Cover photo by Tatiana Syrikova from Pexels
Written by Hillary Bowler Davis, Marriage and Family Therapist
What does loss feel like to you? Some might describe it as a painful gap, hole, or chasm. Through grief work and healing, the gap generally becomes more manageable as it closes little by little. Except when it doesn’t. 
Some losses are ongoing. They raise questions without answers, pain without resolution, and they lack a clearly defined path to closure. To put it simply: “Something is lost, but something is still there” (Boss, 2009, p. 31). Pauline Boss, a therapist and researcher specializing in family stress, named these ambiguous losses, extreme and persistent losses that result in a frozen grief (Boss, 2007). Her theory sparked an entire movement and a field of training for therapists.
Ambiguous loss is generally experienced in one of two ways: a physical absence and psychological presence (leaving without goodbye) or a psychological absence and physical presence (goodbye without leaving) (Boss & Yeats, 2014). A typical loss, while hard in its own way, has a finality to it because of the clear physical and psychological absence (leaving and goodbye). 
Photo by Engin Akyurt from Pexels
When there aren’t clear boundaries defining what’s been lost, there’s a lack of tradition to tell how you mourn it (Cacciatore et al., 2008; see Figure 1). Examples include miscarriage, infertility, estrangement, divorce, chronic illness, severe mental health disorders, suicide, dementia, missing persons (soldiers missing in action, accidents or disasters leading to missing bodies, kidnappings), desertion/abandonment, adoptions, immigration and incarceration (Boss, 2007; Boss, 2009; Boss & Yeats, 2014). 
As with most things, there is a spectrum of loss experiences. Many everyday losses can also carry enough ambiguity that it disrupts the grief process. For example, a young woman who successfully broke off an unhealthy relationship may struggle with how much she misses her former partner, despite it being for the best. A parent might grapple with their newly empty nest—excited for the opportunities ahead for their adult children but struggling to put a finger on why they feel suddenly unsure of themselves. We constantly navigate transitions and changes where we simultaneously gain and let go, and it leaves us with a mess of emotions.
Some ambiguous losses cause mild distress and avoidance—we don’t talk, think, or acknowledge our feelings about it. Time does heal some wounds, and people are remarkable for their ability to adjust. However, the greater the ambiguity, the worse the symptoms, and the more likely the loss becomes traumatic (Boss, 2007). Symptoms can include anxiety and depression, identity issues, substance abuse and self-harm, and feelings of guilt and helplessness, just to scratch the surface (Boss, 2006). 
Imagine experiencing a loss so confusing and so painful that you also seem to lose your relationship with yourself and others around you. Families, couples, and individuals can become completely immobilized, struggling to communicate and make decisions, reconcile differing grief experiences, and carry on with their lives (Boss & Yeats, 2014). The challenge at hand is not only attempting to move forward after a loss, but to move forward, period. 
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How do you manage grief for a loss that by its very nature seems to have no resolution? How do you change something that won’t change? 
Boss proposes that the change happens not because the situation will ever change, but because we can learn to change ourselves, nurturing tolerance for ambiguity and the resilience to live our lives in spite of the ongoing gaps (Boss, 2009). She developed six ways to manage ambiguous loss (Boss, 2006), and the following suggestions are adapted from her work. 
To navigate the painful losses and ambiguities in your life, try the following:

Define the loss and find meaning

A critical component for managing ambiguity is making the experience as concrete as possible (Brier, 2008). For example, researchers have found that when parents who experienced a pregnancy loss used a name or label for their loss (even tender nicknames such as “Little One”), it increased their coping (Sawicka, 2017). Defining the loss strips away the first layer of ambiguity to not only make it more tolerable but also to open the door for the rest of your healing process.
Once it is acknowledged and defined, people naturally try to make sense of the loss. However, by its very nature, ambiguous loss defies logic and is therefore difficult to make meaningful. 
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Your first attempts at making meaning out of the situation might even be negative, such as wondering whether this loss is some kind of a punishment (Boss & Yeats, 2014). Keep going. You can seek a healthier meaning by investigating what this loss really means to you personally. Be gentle with yourself as you move you through the following:  
  1. You have experienced a loss.
  2. You have lost _____.
  3. This loss means____.
Meaning making is at the heart of all ambiguous loss work (Boss, 2009). It is just your first step toward healing— consider this your “rough draft” meaning. 

Let go of what you can’t control, master what you can

You might be familiar with the idea of choosing to focus on what you can control and letting go what you can’t. But an ambiguous loss pulls back the curtain on something that has always been true: There’s not much that is under your control. 
Since you can often do little to restore what is lost, ambiguous loss experts recommend finding a balance through self-mastery: prayer, meditation, creative endeavors, goal setting, exercise, etc. 
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While these disciplined activities can help you take charge of yourself in moments when everything feels out of control, they are not meant to replace the truth. They must be tempered with acceptance and surrender, which can be cultivated with activities like mindfulness (Boss & Yeats, 2014).

Reclaim old identities, construct new identities

As mentioned before, it can be helpful to find things you can make more concrete to ease the ambiguity, and your identity in relation to what or who was lost is one of these points (Sawicka, 2017). Are you still a mother? A son? A spouse? How has your identity changed with this loss?  You can’t have resilience without flexibility and clinging to what was will keep your grief frozen. You have the opportunity to redefine you as someone who lives well, questions and all.

Ride the ups and downs 

Without a doubt, dealing with ambiguous losses can leave us feeling ambivalent, having mixed and conflicting emotions (Boss, 2007). It is perfectly normal in any context to have feelings that might contradict one another, but ambiguity tends to polarize these mixed feelings and cause even more confusion and distress (Boss & Kaplan, 2004). On top of this, you might also feel ashamed over specific emotions like anger, envy, and loneliness. When you anticipate ambivalence as part of the process, it can neutralize shame so that other feelings can flow. Remind yourself it is normal to feel strong emotions, refrain from requiring your emotions to make sense, and accept them as they are. They will pass.
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Remember the certain

The societal push to “get over it” is likely even stronger when the loss doesn’t make sense— if you can’t make it fit into a predefined storyline, it’s tempting to cut it out entirely. In reality, the answer lies in finding a healthy balance between letting go and remembering. In therapy, traditional grief work often directs people toward some final stage of acceptance where the person says goodbye, which is usually not an option with ambiguous loss. 
An alternative approach might be especially helpful in cases of ambiguity. Rather than forgetting and moving on, you can deliberately remember and keep whatever or whomever as part of your life (Carr, 1998). Boss’s theory about “revising attachment” walks the line between keeping and letting go, and it requires some decision making on your part. In the case of some ambiguous losses such as divorce and abandonment, you won’t want to keep the person, but you may want to keep an idea or symbol. Perhaps you want to get married again, or you want to break unhealthy cycles in your family. Keep what serves your healing.
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Another way to balance keeping and letting go is to turn your focus to what is still certain despite the uncertainty. Your love for the person might be certain. Your happy memories might be certain. Your other remaining relationships might be certain. Your dedication to finding a healthier opportunity or new relationship might be certain. In fact, clarifying roles, rules, and boundaries within our remaining relationships can help ease ambiguity and provide a sure context for the lost person, experience, or idea, to remain alive in our lives (Boss & Yeats, 2014).

Discover new hope

Waiting for closure hinders your ability to heal from an ambiguous loss (Boss & Yeats, 2014). Consider this: What if a sense of justice, peace, and resolution is something you can create? This is the step where you create options for yourself. What rituals, traditions, or other activities can you engage in? Can you join or start an organization? Make a donation? Celebrate a certain day? 
Hope is more an action than it is a feeling. Don’t wait for it to happen.
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Find meaning…again and again

While each of these research-based tips can be considered steps to healing, they are often circular in nature rather than sequential, meaning that healing continues when the steps begin again (Boss & Yeats, 2014). Odds are that once you have worked through the previous steps, your definition and meaning of the loss will change. Apply these again and again until you are living well.
Lean into the ambiguity by engaging with, rather than avoiding, your complicated sense of loss. You can work through the first few steps above through journaling or by speaking up: talk to your spouse, a family member, or friend, to name the loss and begin the work of meaning making. Many of these losses are traumatic. There is no shame in seeking professional help as you work through these steps to develop hope and resilience in the face of all types of losses.

References

Boss, P. (2006). Loss, trauma, and resilience: Therapeutic work with ambiguous loss. New York: W. W. Norton & Company, Inc.
Boss, P., & Kaplan, L. (2004). Ambiguous loss and ambivalence when a parent has dementia. In K. Pillemer & K. Luescher (Eds.), Intergenerational ambivalences: New perspectives on parent-child relations in later life (pp. 207-224). Oxford, UK: Els
Boss, P. (2007). Ambiguous loss theory: Challenges for scholars and practitioners. Family Relations, 56(2), 105-111.
Boss, P. (2009). Ambiguous loss: Learning to live with unresolved grief. Harvard University Press.
Boss, P., & Yeats, J. R. (2014). Ambiguous loss: A complicated type of grief when loved ones disappear. Bereavement Care, 33(2), 63-69.
Brier, N. (2008). Grief following miscarriage: a comprehensive review of the literature. Journal of Women’s Health, 17(3), 451-464.
Cacciatore, J., DeFrain, J., & Jones, K. L. (2008). When a baby dies: Ambiguity and stillbirth. Marriage & Family Review, 44(4), 439-454.
Carr, A. (1998). Michael White’s narrative therapy. Contemporary Family Therapy, 20(4), 485-503.
Sawicka, M. (2017). Searching for a narrative of loss: interactional ordering of ambiguous grief. Symbolic Interaction, 40(2), 229-246.
https://www.ambiguousloss.com/

 

 

Hillary Bowler Davis was born and raised in Riverton, Utah. After starting her career in writing and marketing, she took a leap of faith to study to become a therapist. She graduated from Brigham Young University with a master’s degree in marriage and family therapy and works as an associate therapist in the Salt Lake Valley with individuals, couples, and families. Hillary is passionate about personal growth and healthy relationships and gets most excited about digging into life’s hard questions. Her next big adventure is building a family with her husband.
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Love, Me, Mental Notes, Power Couples

Grieving After a Miscarriage

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Cover photo by John Looy on Unsplash

Written by McKay Strong
Around 15% of pregnancies in the United States result in a miscarriage (Swanson et al., 2009). A miscarriage — sometimes called a “spontaneous abortion” — occurs when there is a sudden loss of pregnancy prior to the 20th week. So many factors go into the creation and growth of a fetus, and yet often, the cause of a pregnancy loss can never truly be identified. Although there has been an increase in the discussion surrounding miscarriages, it seems that many women are unaware of both the physical and psychological impacts of a miscarrying (Mcgee et al., 2018). Not only is there a lack of knowledge, but there is a stigma surrounding miscarriages and pregnancy loss. Although a large part of a miscarriage involves medical symptoms, focusing only on that neglects the psychological and relational aspects as well.
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Photo by Drew Hays on Unsplash
Research shows that following a miscarriage, women, in particular, tend to experience “an initial shock, … ongoing symptoms, and … a forever missing piece” (Mcgee et al., 2018). If you have ever experienced a miscarriage, feeling an overwhelming sense of grief is normal. From the moment a woman (or a couple) finds out that they are expecting, their entire mindset changes. They begin preparing for a child’s arrival. They discuss baby names, they buy cute infant clothes. Every thought tends to revolve around the upcoming addition to their family. “Grieving a miscarriage [tends] to be difficult because [there are] no accepted ritual[s] for processing grief…” (Mcgee et al.,2018). And unfortunately, many feel like they need to suffer in silence. 
When a child is lost earlier in a pregnancy, parents-to-be are expected to accept it and easily move on. If neither the mother- nor father-to-be has felt their unborn child, or even had an ultrasound or heard a heartbeat, those outside of the relationship may think there is nothing to mourn.

Miscarriage

As someone who has lost multiple members of my immediate family, I can tell you that losing an unborn child is a completely different type of loss. I don’t think there is a way to prepare yourself to go through it, so just be patient and don’t be afraid to feel what you are feeling.
In their research study, McGee, PettyJohn, & Gallus found that, “Nine out of the ten women described a sense of isolation following miscarriage” (2018). Because women do experience so many physical symptoms of pregnancy, even if they have a male partner in the picture, mothers-to-be tend to feel isolated. Men have a hard time understanding what women are experiencing physically, and because men are mourning the potential of fatherhood, not motherhood, women tend to have a more difficult time understanding their pain in turn. Miscarrying tests a partnership in a different way than any other trial can. Be sure to give each other room to grieve in whatever way each of you needs, and be patient with one another. Share how you are feeling, seek to express empathy, and don’t hesitate to just cry together. 
Pregnancy or even trying to get pregnant after a miscarriage can be especially difficult. Not only can your body exhibit different symptoms, but there also tends to be deep-ingrained anxiety. It’s hard not to expect and assume you will miscarry again. These feelings are real and valid, but it is best to acknowledge why you are feeling this way and practice ways to help calm your fears. Discussing your anxieties with your partner or a loved one is a good place to start. What are your biggest fears in regards to pregnancy? How much of that stems from your experience miscarrying? Don’t be afraid to feel what you are feeling. 
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Photo by cottonbro from Pexels
If you have gone through a miscarriage, stillbirth, or pregnancy loss of any kind, please know that you are not alone, no matter how it may seem. You may be 1 in 4 women, but you are so much more than a statistic. That was your baby, and it’s okay to not be okay – no matter how long ago you may have experienced this. Time may not heal your wounds completely, but it will help you better understand what you are feeling. There is no specific way to grieve, and it is okay to feel angry or sad or even indifferent. 
Pregnancy loss may be common, but that doesn’t make your experience any less significant. Don’t be afraid to reach out to those around you if you are going through a miscarriage. Be patient with yourself and your body. Additionally, be patient with your partner and try your best to understand their experiences through a pregnancy loss.
Personal Practice 1Self: If you feel comfortable doing so, write down your experience with miscarriage. You can share this with others if you want, but try to reflect on how you may have felt during that time.
Others: If you yourself have not experienced a pregnancy loss, but know of someone who has, reach out to them. Be willing to listen and be prepared to talk about the baby.

References

Brin, D. J. (2004). The use of rituals in grieving for a miscarriage or stillbirth. Women & Therapy, 27(3–4), 123–132. https://doi-org.erl.lib.byu.edu/10.1300/J015v27n03_09
Mcgee, K., PettyJohn, M. E., & Gallus, K. L. (2018). Ambiguous loss: A phenomenological exploration of women seeking support following miscarriage. Journal of Loss and Trauma, 23(6), 516–530. https://doi-org.ezproxy.uvu.edu/10.1080/15325024.2018.1484625
Puddifoot, J. E., & Johnson, M. P. (1997). The legitimacy of grieving: The partner’s experience at miscarriage. Social Science & Medicine, 45(6), 837–845. https://doi-org.erl.lib.byu.edu/10.1016/S0277-9536(96)00424-8
Swanson, K. M., Chen, H., Graham, J., Wojnar, D. M., & Petras, A. (2009). Resolution of depression and grief during the first year after miscarriage: A randomized controlled clinical trial of couples-focused interventions. Journal of Women’s Health, 18, 1245 – 1257 https://doi.org/10.1089/jwh.2008.1202

 

 

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McKay Strong is from Texas. She graduated from Brigham Young University with a Bachelor of Science in Family Life. A super experienced wife of a year, McKay works full-time at a local nonprofit and has more side hustles than she should (she still doesn’t know what she’s doing with her life). She is a proud Ravenclaw and an even more proud cat mom. McKay is passionate about self-love, body positivity, healthy sexuality, and breaking the stigma against mental illnesses. Also, Harry Potter.
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