Ambiguous Losses: a brother’s cancer diagnosis

Editor’s note: we thought this relevant to the time we are living in when many are struggling with the prospect of a loved one dying.

Dear Dr. Neimeyer,

Five years ago my younger brother, Eric, was diagnosed with cancer, though he was only 15 at the time.  Our life as a family seemed to change overnight, as we all were faced with the fear of what this might mean, and my parents became totally absorbed in his chemotherapy, hospitalizations, and care.  As the healthy child, I understood, but I had to pretty much fend for myself as I finished high school, and tried not to make many demands on my parents and to be helpful with my brother.  Mostly I’ve done fine, but I miss the closeness we once had as a family, as everyone has been so focused on Eric’s treatment, and I’ve sort of had to become an independent adult.  Now I’m finishing college, which makes me anxious about what will come next for me, because school has always been my “safety zone.”  But I don’t want to trouble them about it, even now that Eric seems to be in remission.

I’m not even sure that what I feel about loss of closeness or security is grief or not, because no one has died.  But I guess I am just trying to sort out where I am now, and what if anything I can do about it.  Thanks for any thoughts you can offer.


Dear Lenore,

One of the hard things about difficult transitions like the one associated with your brother’s cancer diagnosis is that we have little language and few rituals to recognize them:  unlike losses through death, where nearly everyone acknowledges our grief, offers support, and joins us in memorializing our loved one, serious illness and other unwelcome changes often go unnoticed, or are even actively avoided as uncomfortable topics by those outside our family.  For this reason grief counselors often refer to these as “ambiguous losses” that commonly lack recognition or validation, though they are very real to those who suffer them.  And among other reactions, they clearly can engender real grief.

In your case, like many siblings of an ill child, you seem to have encountered secondary losses that are easily missed or minimized by others, even your parents, as they mobilize to provide life-saving care to Eric.  In such a case, it is not surprising that you felt a loss of family connection, having had to deal with many smaller scale challenges on your own without “burdening” your preoccupied parents.  Now, as you face another major life transition as your brother’s condition stabilizes, you have an opportunity to step back toward the family, perhaps especially during the coming holiday season.  There is much to share and celebrate in Eric’s apparent recovery and your pending college graduation, and finding understanding and hopeful words to secure once more bonds of love that were frayed by the illness may be the greatest gift you could give one another this year.  Your ability to write me about this in compassionate rather than angry terms suggests you are ready to take this important step from ambiguous loss to clear gain… for all of you.

–Dr. Neimeyer

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