The Unknown Soldier

Brain injuries and unresolved grief

Content Tools

Brain injury is the signature wound of the Iraq conflict.

Only one soldier in 100 dies of injuries sustained in Iraq, according to the Village Voice (March 27, 2007), compared to seven in 100 during the Vietnam War. Trauma medicine practiced in the field has improved, and body armor affords some protection from bullets. A soldier's head, however, remains vulnerable, and between 10 and 20 percent of all returning soldiers are affected by brain injuries, according to the Defense and Veterans Brain Injury Center. Even the milder cases, which resemble shaken baby syndrome, can wreak havoc for the injured.

Parents, spouses, and children, meanwhile, are left with a seemingly impossible reality: their soldier has returned, but isn't there. Pauline Boss, professor emeritus in family social science at the University of Minnesota, calls their condition 'ambiguous loss.' She worked with the families of soldiers missing in action during the Vietnam War, and today she's training Veterans Administration doctors to help families cope with brain-injured soldiers.

'Ambiguity immobilizes people,' Boss says. 'Closure is a myth.'

Boss, the author of Ambiguous Loss: Learning to Live with Unresolved Grief (Harvard University Press, 2000) and Loss, Trauma, and Resilience: Therapeutic Work with Ambiguous Loss (Norton, 2006), also trained the professionals who worked with the families of victims of the September 11, 2001, attack on the World Trade Center, according to On Wisconsin (Spring 2007). But the psychological construct of ambiguous loss applies to any number of circumstances, including ill children, parents with dementia, and mothers who put their children up for adoption.

Treatment involves coming to accept ambiguity, Boss explains: 'These people have to learn to live with two opposing ideas: 'I have my husband back, but he's no longer a husband to me.''

Families who learn to grasp this living, breathing contradiction gain a particular strength and resilience--one that counteracts the type of black-and-white thinking that got us into the war in the first place. 'We live in a culture that trades in absolutes and certainties, and maybe it helps us to get things done. But much of life is in the gray area,' Boss says. 'Life is full of paradoxes.'