Ambiguous loss: On training, treatment, and resilience in times of crisis - opinion
As a social worker, Jungian psychotherapist, and profiler, I accompany families of the missing, kidnapped, prisoners of war, and entire communities struggling with the ambiguity and uncertainty.
By GALIT ITZHAKI DRAIZINUpdated: FEBRUARY 28, 2025 17:25 Hostage family members march in Tel Aviv, including former hostage Yocheved Lifshitz, holding a photo of her husband, Oded Lifshitz, who was killed in captivity.(photo credit: Zohar Bar-Yehuda)
In a world where traumatic events occur constantly, from wars to natural disasters, I find myself focused on the field of ambiguous loss in Israel for over a decade. I witness daily the profound pain and immense hardship of families awaiting their loved ones and of returning hostages. As a social worker, Jungian psychotherapist, and profiler, I accompany families of the missing, kidnapped, prisoners of war, and entire communities struggling with the ambiguity and uncertainty brought on by times of crisis.
My professional partnership with Prof. Karen Shalev, head of the Institute for the Study of Missing Persons in England, has deeply influenced my journey in this field. It was under her inspiration and guidance that I entered this field. Even before the events of October 7, 2023, Prof. Shalev and I recognized the growing need for specialized training in addressing ambiguous loss, particularly in the context of missing and abducted individuals. This led us to collaborate on developing training programs for therapists and community members, equipping them with the tools and knowledge to support those facing these unique challenges. When the crisis of October 7 unfolded, the importance of this work became even more evident, allowing us to quickly mobilize and provide crucial support to those affected.
The events of October 7 personally impacted me when my son miraculously survived the horrors of the Supernova music festival massacre. This traumatic event underscored for me the urgent need to pass on the knowledge and experience I have gained to other therapists so they can assist as many families as possible. Read More...
Subsequently, thanks to a generous donation from the Jewish Federation of San Francisco, the opportunity arose to establish an academic center in Israel dedicated to the issue of ambiguous loss. I received an invitation from Dr. Sharon Ziv Beiman, director of the psychotherapeutic institute at the Mifrasim Institute, to head the establishment of the center. Thus, Safe Harbor was established – an academic center that opened its doors after October 7. It now serves as an academic home for the field of ambiguous loss trauma, providing treatment and support for the missing, kidnapped, hostages, and those who return. The center is affiliated with the Academic College of Tel Aviv-Jaffa and serves as an invaluable source of knowledge and support. I also incorporate a unique therapeutic tool into my work – Narrative Hope cards. They help patients express emotions and thoughts in a non-verbal way. Today, I am very busy training treatment teams and families on the complex issue of returning hostages. Ella Ben Ami, daughter of Ohad Ben Ami, speaking at a press conference after her father’s release. (credit: ALON GILBOA)
Ambiguous loss
Ambiguous loss is one of the most difficult challenges a person can face. It is a loss without closure, without a clear end point. There is no body, no certainty about the fate of the loved one. Families live in a kind of perpetual limbo, between hope and mourning, between presence and absence. The events of October 7 only intensified this problem, leaving hundreds of families with difficult questions and no answers.
As the director of training and knowledge development at Safe Harbor at the Mifrasim Institute, I work around the clock to develop unique therapeutic models tailored to the complex and changing reality we live in. My work integrates various approaches, from Jungian theory and psychological profiling to practices of community resilience.
Innovative therapeutic approaches
Treatment for ambiguous loss must be personalized for each patient and each family. There are no magic solutions, and it is important to be attentive to the unique needs of each person. One of the biggest challenges is helping families cope with the hope and despair that constantly accompany them. How can they continue to function when they don’t know what happened to their loved one? How can one find the strength to deal with the uncertainty? These are difficult questions, and they do not have simple answers.
I am proud of my work with the Safe Harbor team and the assistance we provide to families of the kidnapped. We train skilled teams capable of providing emotional and practical support to families and helping them build family resilience.
‘The Magic Spiral’: A tool for coping with complex emotions
My book The Magic Spiral is another creative tool I have developed aimed at helping children and parents cope with anxiety and ambiguity. The book combines a narrative story with symbolic images and allows families to express complex emotions around separations, transitions, and loss. The Magic Spiral touches the hearts of children and adults alike and provides them with comfort and hope.
The ongoing war and the therapeutic challenges
The ongoing war in Israel creates a continuous national trauma. Children and adults deal with uncertainty about the future. As a therapist, I see the severe effects of the situation on the mental health of many people. At the Mifrasim Institute, we lead intervention programs in educational institutions, assistance in the transition from captivity to meeting the military to returning to being a civilian, and mental health systems, and help people cope with trauma.
A unique support model
The collaboration with clinical psychologist Keren Cohen and social worker Margo Moyal – two formidable professionals – has led to the development of a unique model of support for family members who are part of the second and third circles of the abductee, forming his or her natural resilience envelope. These family members do not receive recognition and support from the state; hence, a unique model was created for them. The model was adapted based on Dr. Sarah Wieland’s approach to fit unique Israeli needs. The Ella Center currently implements this model and helps families deal with their unique challenges.
A vision for the future: Continued development and global networking
There is a need to continue developing new therapeutic tools and models tailored to the changing needs of society. I am working to expand support for therapists in Israeli communities around the world and to create a global network of therapists who can share knowledge and experience.
Holding the ambiguity together
I see ambiguous loss as a professional and social challenge of the highest order. It is important for me to continue researching the subject and to develop new ways to help families cope with the immense difficulty. “Ambiguous loss teaches us that sometimes the greatest resilience lies in the ability to live with questions without answers,” I say. “Our challenge as therapists and as a society is not to look only for solutions but to hold the ambiguity together – in a safe space.”■
The writer is a Jungian psychotherapist with an MA in social work.
