When does it stop being a party and start becoming a problem? Is there a way to steer clear of addiction? Every Wednesday, Mike McGowan, host of the podcast "Avoiding the Addiction Affliction," explores substance use disorders with expert guests. The podcast series is sponsored by the Kenosha County Substance Abuse Coalition.
Original cover art created by
Kelly P. of Kenosha, Wisconsin
Therapist with Family Services of Northeast Wisconsin
Not all losses are resolved; not all endings actually end. Cassondra Frisque, a therapist with Family Services of Northeast Wisconsin, talks about ambiguous loss, which is, simply, loss without closure. We experience many losses in our lifetimes, ambiguous or otherwise, from family members and friends to the substances used if we’re recovering. How we handle those losses is unique to each of us. Cassondra can be reached at https://www.familyservicesnew.org/womens-recovery
If you or a loved one needs help for substance abuse, help is available. Contact the Hope Council on Alcohol & Other Drug Abuse by calling 262-658-8166, or explore their website at https://www.hopecouncil.org. You can also find AA meetings here: https://mtg.area75.org/meetings.html?dist=7 and NA meetings here: https://namilwaukee.org/meetings/
[00:00:00] [Jaunty Guitar Music]
[00:00:11] Mike: Welcome everyone to Avoiding the Addiction Affliction, brought to you by the Kenosha County Substance Abuse Coalition. I'm Mike McGowan. You know, lately we've had a number of conversations about loss and grief. It seems like there's a great human need to have everything just make sense. Well, today we're gonna talk about another side of that feeling now making sense, ambiguous loss. My guest today, Cassondra Frisk, is the program supervisor and therapist with Family Services of Northeast Wisconsin's Women's Recovery Journey program. Welcome, Cassondra.
[00:00:47] Cassondra: Hi, thanks for having me.
[00:00:48] Mike: Well, I'm so glad you could do this. Okay. For those not familiar with the term, we might as well just start out with the basics and obvious one first, what is ambiguous loss or ambiguous grief?[00:01:00]
[00:01:00] Cassondra: Yeah, so ambiguous loss is a loss that happens that typically is not concrete, kind of like you mentioned in the intro there. It's something that there's a lesser chance of it having a clear resolution. We might not know what happens or there might not be an actual death that comes along with the loss.
[00:01:29] Mike: For example?
[00:01:32] Cassondra: So a really common one could be people who have a loved one that has like a form of dementia who maybe psychologically is not themselves and maybe doesn't remember their family. And so it's this loss of who that person was. Like, I maybe no longer have that relationship with this person, yet they're still alive. So I'm still grieving this loss of [00:02:00] relationship usually, but they're still alive. So that's technically like what grief is categorized is like grieving the loss of a death. Well, if that person's not dead yet, how do we explain that? And that's where the ambiguous loss comes.
[00:02:16] Mike: Boy, you know that rings a bell.
[00:02:18] Mike: There's a lot of people who go through that with an aging parent who is no longer mentally there or even Alzheimer's. And you hear them talk about that a lot, about that's not my mom, or I miss my mom even though mom is still alive, right? I would think that on that end of the continuum is pretty heavy, but on the other end, I was also thinking, it would apply, you hear younger people, of which I'm not one of them, you hear them talking about meeting somebody online or somewhere else and then all of a sudden they just disappear.
[00:02:52] Cassondra: Right.
[00:02:53] Mike: Google called "ghosting", Cassandra?
[00:02:55] Cassondra: Yes. Yep.
[00:02:57] Mike: Oh, there you go. I'm with it. So that, would also apply, [00:03:00] right? They're out there, but -
[00:03:02] Cassondra: Right. Relationships in general, like we could just kind of generalize that even a little bit more like absolutely having some sort of like loss of conversation with someone, like you don't know where they are, you don't know if they're okay, you know, in the form of "ghosting".
[00:03:19] Cassondra: But then even just like we can feel this ambiguous loss of a relationship like an intimate partner or even a friendship. Even if it's like, well, maybe they moved or maybe we're just not as close as we were before. Like a lot of this happens when people start going to college and maybe they're not as close with people from high school anymore or similarly college, like going into a professional job. They might not have as much time or immediacy to see these people every day. And so we might be kind of grieving the loss of that relationship even though they're still physically here, we can reach out to them, it's just not the same [00:04:00] as what it was before.
[00:04:02] Mike: I would think that would be difficult for most people to even identify that I'm going through something, right? Cause we don't talk about this very much. I have a daughter in college now and her friends are scattered all over the country, and I haven't thought about asking her similar things. So how does it manifest itself if they're experiencing that loss? What does it feel like, look like for that person?
[00:04:21] Cassondra: Right. So, and you bring up a good point, we don't really talk about this. The conference that I recently was at, where I presented on this information, I had everybody at the beginning of the presentation raise their hand if they knew what ambiguous loss was and nobody knew. Nobody knew. But by the end of it, everyone could raise their hand and say, yes, I've experienced this. Right? So it's something that we all experience typically, and then also there's a lot of very similar feelings as grieving, like a death for example. However, [00:05:00] it can get really complicated because you're saying like, "Oh, my daughter, she might be going through this and I'm not even, maybe like, I'm not thinking about that." Or you know, I maybe had a coworker leave and I'm kind of grieving the loss of her not being right across the hall from me. And I don't think about that being a loss.
[00:05:18] Cassondra: So it can get a little complicated. I think we're, we're quick to kind of beat ourselves up when we're ,well, why am I sad? I shouldn't be sad. I need to be like, you know, happy or I need to be X, Y, and Z, whatever the case may be. So it gets a little complicated because we're kind of almost invalidating ourselves sometimes of like, well, at least it, they're not this, when we put a name like, oh, I'm experiencing this ambiguous loss, it kind of gives ourselves some grace to be like, yeah, I actually might go through kind of the typical stages of grief that someone would if someone had died.
[00:05:55] Mike: Well, okay. You just said something that really also hit home because [00:06:00] it's a response I think people use a lot. Go back to the one with dementia for a minute. I can just hear people saying, well at least they're still with you. And as we know, when we talk about empathy, the at least stuff doesn't work very well.
[00:06:14] Cassondra: Right? Absolutely.
[00:06:16] Mike: I'm also thinking, we talk a lot about addiction here and I always run the parallels and when somebody gives up something like their drug of choice, they experience a loss.
[00:06:29] Cassondra: Mm-hmm.
[00:06:30] Mike: And it's not just a loss of the drug, it's a loss of all of your using associates. And of that whole lifestyle. Mm-hmm. And we don't talk about that as much as we should perhaps.
[00:06:43] Cassondra: Right? Yeah. I work specifically with women in recovery and I know a lot of them worry about kind of disclosing some of their grief around not using anymore because then, then [00:07:00] providers are like, oh, well then you're not doing enough because if you're not thinking about it then, or if you are thinking about it, then you're in trouble. You know, all this. It's like, but yeah, that is very common and it's something that we should talk about because talking about it is gonna be the only thing that helps kind of alleviate some of that stress that comes from the grief that people might have.
[00:07:23] Mike: You know if you're afraid to say, I miss my drug, then you don't get the therapeutic opportunity to have the person saying, how are you coping with it? Right? And then it becomes that secret, and we know what secrets do to somebody who's using.
[00:07:36] Cassondra: Right. It's a circle.
[00:07:38] Mike: Well it's also divorce, isn't it? Cause you know, we used to joke when we do therapy, who gets to custody of the friends. Cause you can lose an entire social circle based on life circumstances.
[00:07:50] Cassondra: Oh, absolutely. Mm-hmm.
[00:07:52] Mike: So how do you, what do you do with that then?
[00:07:55] Cassondra: Yeah, so I think a good place to start is by [00:08:00] kind of identifying this is a thing that people might be feeling. You know, as a therapist, it's good to just identify and have a name for something. It can make it feel more concrete. This thing of ambiguous grief is already very kinda abstract and not very concrete. We can't fit it in a box like we would like to. However, if we have some sort of name for it and if we have some sort of explanation for what it might be and why we might be feeling this way, that's a good place to start.
[00:08:30] Cassondra: And then also, kind of thinking about like, well what would we maybe do for somebody who is grieving the loss of a loved one? Like a death, what would we do for that? It's gonna be similar to what we could do for an ambiguous loss. And that can be a whole variety of things.
[00:08:49] Cassondra: Pauline's boss, she's kind of the woman who coined the term ambiguous loss. And she's done a lot of research on kind of what to do now [00:09:00] and a big thing that comes up in her research and even in just regular grief research is meaning making. So I love using the example of like you know, if you've maybe lost a loved one to their addiction, so maybe you know they're still alive, but you maybe don't have the same relationship you had with them, okay, well let's make some meaning out of that. I mean, personally, becoming a therapist was kind of my meaning making for when I had a loved one have a substance abuse disorder and, you know, volunteering at some sort of coalition, things like that. That's just kind of one example out of the money that could come up for people.
[00:09:42] Mike: You, you know with women in recovery and many, many, many of the women I've worked with over the years will have this happen in their relationships. So is that wishing for what they knew part of this? Even though it was an [00:10:00] unhealthy relationship it's still that sense of, but at least it was a relationship?
[00:10:07] Cassondra: Yeah, I mean, I think that that kind of can lead a little bit more into like attachment type concerns because there's a lot that happens for people in with an addiction and attachment issues. But I mean, I think, thinking about like how a relationship, kind of what you're explaining here is comfortable. Like we know what to expect, even if it's not something that is great. We know what to expect and so we don't have to kind of navigate like the unknowns. And so by maybe not having that relationship anymore can lead to this ambiguous loss of unknown. Like we don't know what's gonna happen now. Like, am I ever gonna find [00:11:00] someone else? You know, or there might be even legitimate concerns of like, safety if that relationship does end up ending.
[00:11:09] Mike: You know a lot of my therapist friends have talked to me lately and maybe this is a thing because of the pandemic and the influx of people in therapy, but they've talked to me for lack of a better term, of I'll make this up absent while present. So, for example, Parents who bring their children into therapy because their child is acting out but then the parent sits there in therapy and they're just not emotionally or psychologically there. Kids feel this sense of ambiguous loss as well, I would think.
[00:11:43] Cassondra: Oh yeah, absolutely. I mean, which is another like really important reason to talk about it and kind of normalize it, because if these adults don't know what it is or what's happening, then how [00:12:00] can we support the children that are feeling those similar feelings? I mean if we have mom or dad who, or even, you know, a guardian who is kind of supposed to look after us and they're not emotionally there, that's part of that psychological loss that can be categorized as ambiguous loss.
[00:12:23] Mike: Well, you know, the kid, you've worked with the child and you know the child needs an appointment and yet the parent cancels it.
[00:12:29] Cassondra: Yeah. That's, always so tough.
[00:12:31] Mike: So everybody has their own therapeutic style, right? Or technique. I've worked with people who would wanna walk over and just shake that parent and say, snap out of it. How would you handle that? I mean, what would you say to the kid? Because the kid's not understanding that the parent may be doing that because of what the parent needs. Right?
[00:12:50] Cassondra: Right, right. Mm-hmm. Well, I think it's a great I mean, one thing that's super difficult with working with children is [00:13:00] that a lot of the therapy is also done with the parent. I guess in my experience, like kind of you're saying therapeutic style, like that's how I think it's most beneficial is to get the parents involved.
[00:13:14] Cassondra: I used to work with like families and kiddos and I would just have the parent be in session with me, kind of like, okay, this is a little bit of your session too, but really just going down to the basics of talking to the kids, like let's use kind of some "I Statements" or feeling statements on like, I feel sad when you don't watch me play video games, which is really annoying and I think probably a lot of parents don't like doing that, but you know, it makes the kids feel a certain way, and so if they're able to name that at a very basic level, like I'm sad because of this, then seeing the parents, having a therapist kinda model that can hopefully be [00:14:00] somewhat of an easy way for the parent to be like, okay, you know, we don't have to have it be like a mathematical equation. It could be as simple as if mom is feeling tired from work saying, I feel tired because of work, so we're not gonna do this. Right? I mean, kind of just communication in general can really be beneficial in that role.
[00:14:23] Mike: I think that I've always thought that the and I've gone down in age now, what I used to say to 16 year olds, I now say to 12 year olds, right? But at some age I say to kids, "Are you likely to change your parents in the next two years? Or do you think you're gonna be dealing with the same one?" And you could, that also would apply even to somebody with dementia, I would think. Same sort of issue. And it's like, well then how are you gonna cope with your parent and to do that in front of the parent, because the parent's always gonna get defensive when you put 'em in that role, right?
[00:14:57] Cassondra: Yeah. Yes and no. [00:15:00] I think it depends on how it's handled in a sense of like, this needs to be kind of a team effort, and it's also really like, I like that question, but reversing it, like what do you see needs to change in order for your child to change? Because sometimes, oh, well most of the time, and any therapist and probably like regular family practitioner knows that, parents bringing a child in is like, "fix me" like, "fix this kid." I've them for forty-five minutes, maybe every other week if my schedule allows, especially right now, mental health services are impossible to obtain. And so, really like kind of putting that into perspective of like, I can only do so much, like, I'm not a miracle worker, I'm a human.
[00:15:49] Mike: I love that. You know, and it's like, well, this isn't working, so I quit. Right?
[00:15:53] Cassondra: Yes. Oh my gosh, yes.
[00:15:55] Mike: I hear that a lot. I hear that lot.
[00:15:57] Cassondra: Yeah. Yep.
[00:15:58] Mike: It seems like we all [00:16:00] have this need to wrap things up in a tidy little bow. But you know, that's not the reality. There's a lot of our relationships, if we all look back, that are unresolved.
[00:16:12] Cassondra: Yeah. Mm-hmm.
[00:16:15] Mike: And so we are all dealing with this ambiguous loss every day. I would think.
[00:16:22] Cassondra: Yeah, I mean, to some extent for sure, right? There's some, I mean there's some things that are easier to cope with in general, you know, like maybe being a couple minutes late to work. Like, okay, we can usually kind of cope with that and move on from our day. Most people, if we can't, then maybe there's something else going on. But when it's something as like, I actually just recently had this happened to me, I had a coworker that I was pretty close with who ended up leaving the agency for personal reasons and, you know, I come to work every day and I [00:17:00] see that her office is empty and I'm just like, I recognize for myself like, oh my gosh, I actually kind of miss her.
[00:17:07] Cassondra: And yes, I could reach out and, you know, make sure that she's okay, that kind of thing. But it's on a different level, it's not the same as, as what it was before. I can cope with that. I also don't really give myself like time to think about like, oh yeah, this is kind of like a loss that I'm grieving, even though I know she's fine, even though she hasn't died.
[00:17:31] Cassondra: I think we are quick to kind of like you said, like wrap things up in an nice little bow. We're we're quick to push positive good feelings to each other. People don't know what to do with sad people typically, and it's just all about like, oh, let me make you better. And it's like, well, it's okay to feel sad. That's part of the healing journey is [00:18:00] accepting that I feel sad, this sucks. Like that's that empathy, like, yes, my feelings are valid and I don't need to do anything different right now, unless I feel like it, but right now I'm like, yeah, it sucks, but it's okay to be here. And I think that's often kind of to your point of wanting to wrap it up in a nice bow. Usually there's not a benefit to that. Usually wrapping it up in a nice bow, it will end up exploding over time anyway.
[00:18:30] Mike: That's right. Well, you know, you're talking about change, right?
[00:18:34] Cassondra: Yeah.
[00:18:34] Mike: And relationships always change, and as you were talking, I was mentally doing what I think you probably did for the people in your workshop, who I might add, were all professionals, right? So this wasn't a lay- person workshop. But yeah, when my kids, all went through elementary, middle, and high school, if they're active, you end up spending an unbelievable amount of time on the sidelines, on the court, [00:19:00] with a group of people who you become close to.
[00:19:03] Cassondra: Yeah.
[00:19:03] Mike: You know, their parents, team parents. You go to events together, you see 'em every week, several times a week. And then, it slams shut like a door.
[00:19:13] Cassondra: Yeah.
[00:19:14] Mike: We're gone. And it's not one person being gone, it's a set of people being gone.
[00:19:19] Cassondra: Yeah. Like a support group almost.
[00:19:22] Mike: And I was also thinking about my uncle who lived to be a very old age, and when he was in his nineties, he looked at me and said, everyone I knew is dead.
[00:19:32] Cassondra: Yeah.
[00:19:34] Mike: I mean, how do you relate to that? Right? So he's experienced that a lot.
[00:19:39] Mike: Okay, so let me try to tie this up in a bow, which is so stupid for me to do, right? How do we move on then - that's the point - from something that's unresolved and how do we come to terms with a package that might never have a bow on it?
[00:19:54] Cassondra: Well so first of all, I love the idea of moving forward, not [00:20:00] necessarily moving on, because this is something that no matter the loss, whether it is a death or whether it is, you know, a psychological loss, maybe they're not like mentally here with us anymore, or physical loss, like maybe they're incarcerated, that could be another example. This is somebody or something that has been impactful in our lifetime. And I think sometimes moving forward can give us a sense of like, this is a part of me and I've kind of learned something from it. That meaning making, you know, there's meaning from it, and now it's gonna help me kind of propel myself in the future for whatever I might be interested in accomplishing. So with the thought of moving forward and kind of ways that we can work towards that is, like I mentioned earlier, naming it, like now hopefully people have a name that they can put to a friend that you know, maybe ended up moving across the country [00:21:00] and we're not as close to anymore, you know, so we have a name for that. That's usually very validating and a way for our brain to be like, okay, this is the thing I have. Because our brain is very, is very much like that, it wants to categorize things. So this is that feeling I'm having, and now I have a name to attach to it. So I can kind of compartmentalize it a little bit and then working towards acceptance, saying, okay, yes. Again, kind of like I mentioned, like maybe this sucks, having some of that empathy like, yes, this sucks and I can move forward. This is something that's going to you know, be my reality. And that can suck. That's kind of just what it is. People don't typically like that, but it's like, oh, that's just kind of what it is. Which can be helpful to do with a professional. So if people are maybe stuck in some of these thoughts and feelings, not necessarily maybe the stages of grief, but if they're kind of feeling [00:22:00] maybe really stuck in a certain emotion that they're not really sure how to move forward from having some sort of professional support or a support group in general could be really helpful in kinda moving a little bit.
[00:22:13] Cassondra: Sometimes we're really bad at challenging ourselves. We want to stick in that comfortable position. So having someone else challenge us a little bit could be helpful.
[00:22:27] Cassondra: And I think also I mentioned the meaning making. So I gave the example earlier of myself. I have a loved one that has a substance use disorder and while I was going through my master's program and was kind of in the thick of it, and that really kind of motivated me to continue my work. So, okay, maybe I can help someone else so they don't have to suffer through this. Put some of that negative energy or feelings that I had towards something a little bit more positive, kind of [00:23:00] flipping in a little. And then lastly, I've given some examples here, but lastly just being kind to yourself, knowing that there are gonna be good days, there are gonna be bad days, and both days are just as important as the other, and like kind of allowing yourself to feel those emotions that you have. That's really important.
[00:23:20] Mike: You know, I like that actually. And especially the last thing. Because if you're in an unhealthy spot, you're moving forward, you're going to attract unhealthy things, right? So if you are taking care of yourself, everything changes all the time, right? Just because I no longer see those people I was on the sidelines with, and by the way, only some of them were great losses. The others were a gain , sorry. Just because I don't see 'em doesn't mean I don't have new relationships from new things I've moved on to right?
[00:23:53] Cassondra: Right, exactly.
[00:23:54] Mike: So if you're constantly looking backwards you're not gonna be aware of what's forward for [00:24:00] you.
[00:24:00] Cassondra: Yeah, absolutely. Or like open to accepting something new.
[00:24:04] Mike: So let me, well, I said that would be the last one, but I lied. So what about, since you work with women, can you literally see that transition take place where their vision switches from looking backwards to forwards?
[00:24:18] Cassondra: Yeah, and I mean, it's interesting because some women come to us like that already. Some of them are like, this is it, like if I don't do this, then I know I'm gonna either end up dead or in jail for however long. So some people kind of come to us already knowing like, okay, this is my awakening. But yeah, there are definitely women who have a hard time giving up some of the control, and I shouldn't say giving up some of the control, but realizing that the things that they've been through, they're also able to do something about, like they are able to be more in control of their [00:25:00] lives. And when people get that, when people notice like, oh, I can do this for myself, that's kind of the thing I notice the most is they're like, I don't have to depend on whatever in order to get better. Like this is about me.
[00:25:20] Mike: I like that. It's about me. And I don't have to depend on the person in the relationship I was with, the drug I was taking. Oh, I like that, it's about me. Well, that will become part of the title to this, I think. Cassondra, this is great. I hope we get a chance to talk again.
[00:25:35] Cassondra: Yeah, for sure. Yeah.
[00:25:37] Mike: Those of you listening, you know that I put the link to Cassondra's program on the end of this podcast. It's up in brown County which is the Green Bay area, right?
[00:25:45] Cassondra: Yep, yep.
[00:25:46] Mike: Which right now is a balmy, probably 12 .
[00:25:50] Cassondra: Yeah.
[00:25:52] Mike: Cassandra, thanks so much for joining us and for those of you listening we encourage you to listen again next time. Until then, [00:26:00] please take care of yourselves. We look forward to sharing the air with you then. Stay safe and stay healthy.
The Kenosha County Substance Abuse Coalition’s mission is to support networking, encourage education, explore gaps, and realize solutions to improve treatment and reduce alcohol and other drug abuse in our community with a primary focus on families.