Attachment Injury, Grief, Moral Injury, and C-PTSD

Some losses are difficult to name because the person we are grieving is still alive. Ambiguous loss can occur when an important relationship becomes unavailable, disrupted, or fundamentally different from what we needed it to be. Examples can include estrangement, divorce, incarceration, deployment, dementia, addiction, emotional absence, harmful parenting, traumatized family dynamics, or the loss of a secure relationship with a parent or other significant person. Ambiguity can also be part of vocational loss, particularly when a meaningful vocation, role, community, or hoped-for future remains psychologically present even when it is no longer accessible in the same way.

These losses can also involve disenfranchised grief, a form of grief that is not fully recognized, socially acknowledged, or supported. We may experience a profound loss while others do not understand why we are grieving, may minimize the significance of the relationship or experience, or may believe that we should simply move on. This can be particularly painful when grieving an estranged family relationship, the loss of a hoped-for relationship, a change in vocation or community, or a relationship with someone who is still physically present but emotionally unavailable. When a loss is difficult to name or others do not recognize it as a legitimate loss, we may also struggle to give ourselves permission to grieve.

An ambiguous loss can also follow an attachment injury, a rupture in felt safety, trust, or connection within an important relationship. This may involve emotional absence, neglect, estrangement, or the loss of a relationship in which we once experienced security and belonging. When the relationship remains physically present but the connection, safety, or sense of belonging we needed is absent, grief can become particularly complex.

We may find ourselves grieving not only what was lost, but what we needed and deserved but did not receive. When attachment injuries are also traumatic or morally injurious, grief may become intertwined with questions of trust, dignity, identity, belonging, and what we believed relationships were supposed to be. When such experiences are chronic, repeated, or occur within important relationships in which we depend upon others for safety and care, they can contribute to complex trauma and, in some circumstances, to symptoms consistent with complex post-traumatic stress disorder (C-PTSD).

These experiences do not always exist separately. An attachment injury may involve an ambiguous loss. That loss may bring grief, which may also become disenfranchised when it is not recognized or supported by others. When the experience also involves a violation of dignity, trust, responsibility, or what we understood a relationship ought to be, it may carry a moral dimension. When traumatic experiences are repeated or prolonged, particularly within relationships of dependence, they may also affect the ways we understand ourselves, others, safety, connection, and the world around us.