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Dr. Jeffrey Kreutzer: What Is Ambiguous Loss and How Does It Relate to Brain Injury? What Is Ambiguous Loss and How Does It Relate to Brain Injury?

Comments [3]

Click on any phrase to play the video at that point.
Ambiguous loss refers to a situation where someone is physically present but psychologically absent, so an example would be like a person who has Alzheimer's disease, and they look okay physically, but in another way they're very impaired cognitively, so they're there physically, but they're not there mentally, and it also refers to situations which Pauline Boss studied, wives of soldiers missing in action, and these are situations where people went off to combat, and they disappeared. They could have been dead. They could have been wounded trying to get back to base. They could have been in a prisoner of war camp. These are situations where the person was psychologically present in the family, still considered part of the family, but the family didn't really know if the person was alive or dead and so the ambiguity is--this refers to the fact that there's a lot of uncertainty about the person. There's a lot of uncertainty about them. One issue that came to mind is there was a study that I've cited a lot. It was done probably 30 years ago by a group of nurses, and those nurses surveyed wives and mothers of people who had traumatic brain injury and stroke, and it was interesting because when the wives filled out the survey about a third of them said that they were married but had no husband, and then about a fourth of them said that they were married to a stranger, and when I looked at that survey I realized that Boss's theory or her ideas about ambiguity of loss were also reflected in the brain injury literature. In our society we have beliefs about what needs to be done when a person dies. We have rituals. We say goodbye. We grieve, and what happens with ambiguous loss is the person is still physically alive, but they're a very different person, and the fact that they're still alive makes it very difficult to grieve for that person that they used to be.

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Coined by Pauline Boss, PhD, "ambiguous loss" describes the grief associated with a loss of a person or relationship, in which there is confusion or uncertainty about that person or relationship ... such as a loved one with TBI who may be physically present but pschologically absent, or less present.

Produced by Victoria Tilney McDonough, Justin Rhodes, and Ashley Gilleland, BrainLine.

Jeffrey Kreutzer, PhDJeffrey Kreutzer, PhD is the Rosa Schwarz Cifu Professor of Physical Medicine and Rehabilitation at Virginia Commonwealth University, Medical College of Virginia Campus, and professor of Neurosurgery and Psychiatry. He is director of Virginia's Traumatic Brain Injury Model System.

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Comments [3]

Check out the 2001 film Memento, it addresses the ambiguous loss , very realistically portrayed.

Feb 26th, 2014 5:37pm

It's the first time all attributes to a brain injury that I am suffering from are addressed on one web site. No one tells me that it's "normal" or expected, to feel or to be going through what I am going through because of my brain injury... Everyone just gives me advice & offer solutions which thus sets me up for failure because (for choice of a better word)I am no longer "normal" psychologically. I fight everyday to try to meet my high standard of expectations of myself. I need to stop fighting so hard,and accept & improve where I can. Any improvement is a good thing. I have a hard time saying this to myself. Thank you for your information & audio. I will be looking for better ways to reach out for more Brain Injury advice rather than "normal" people advice. lol *I hate that word- No one is "normal" to begin with really!

May 8th, 2013 1:41pm

Been there after a TBI

Jan 9th, 2013 12:17pm


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