An interview with Elizabeth J. Bruce, Ph.D., & Cynthia L. Schultz, Ph.D.

Q: How is nonfinite loss defined?

A: Nonfinite loss is loss that is enduring and evolutionary in nature. Example: A young girl is diagnosed with epilepsy or diabetes. Given her stage of cognitive development, what implications of this diagnosis can she actually "know"? As she grows, its meaning and significance will slowly evolve; the part that it ultimately plays in her life will be revealed only in retrospect. How will she define her loss? Largely by the benchmarks provided by the lives of her peers.

Who else might experience nonfinite loss? Anyone who experiences an irrevocable loss of something that plays a central role in who they perceive themselves to be. Recurrent grief throughout life about the manifestations of this loss - be it a person, wish, dream, goal, health - identifies the loss as nonfinite.

Q: How does therapy for nonfinite loss differ from traditional therapy for grief?

A: Unfortunately, mental health professionals have often regarded grief as a process that has redefined stages and phases leading toward an ultimate goal of acceptance. This creates considerable psychological tension for individuals whose grief does not follow this precise pattern. Capturing the normality of loss and grief as paralleling an individual's development and so shifting the focus from notions of acceptance to adaptation are key elements in therapy for nonfinite loss. In understanding that nonfinite loss involves cyclic themes, mental health professionals can reduce the tension inherent in prescribed stages of grief and acceptance to normalize the recurrent nature of emotions.

Q: How can a mental health professional identify a person experiencing nonfinite loss?

A: Any individual who has a life experience that creates a lack of synchrony with one's peers and "the world that should have been" will experience nonfinite loss. Individuals experiencing nonfinite loss will invariably draw on words such as "isolated", "lost", "odd", "lonely", and "different" to describe their psychological state. Their perception will be that nobody else experienced their trauma and no one understands their reality. Often, these feelings will be further complicated by the stigma attached to being different and a perceived rejection by peers.

Q: What are some examples of people experiencing nonfinite loss and what specialized therapeutic techniques can be used to counsel them?

A: Experiencing nonfinite loss could be likened to living permanently in a house haunted by a ghost. The house represents the world as it really is - less than ideal - and the ghost is the world that you had once expected and dreamt about - the ideal. Individuals who are experiencing nonfinite loss are grappling with relinquishing ideals or ways of being in the world that are normally taken for granted. The obstinate hovering ghost may be that of a typically developing child, the healthy body, the happy marriage, the unconditionally loving mother and father, the athlete, or the conflict-free family. The examples are endless. Always, the grieving is complicated. For instance, fearing the depth and irrevocability of their loss, individuals may avoid their grief. Often, in the absence of social sanctions, the individual does not feel personally entitled to grieve.

How does an individual come to terms with the ghost? Three primary developmental and biographical contexts form the framework for therapy: the world that should have been (ideals), the world that is dreaded (fears), and messages learned about one's self (self-talk). We introduce a three-pronged psychoeducational approach that aims to help clients gain a sense of mastery over their grief: an adaptation that encompasses the preservation of their identity; control over their emotions, cognitions, and behavior; and an attachment to the emerging reality. Picture a trapeze between the world of ideals that must, in some part, be relinquished and the world that is evolving: the specialized therapeutic techniques that are employed aim to shrink the ideals of the first, defuse the dread related to the latter, and manage the grieving related to the crossing over on the trapeze.