Awaiting on the rubble: phenomenological perspectives on ambiguous loss by earthquake survivors

Abstract

Objective

In this phenomenological study, we investigated the lived experiences of ambiguous loss among family members following the February 6, 2023 earthquakes in Turkiye. We explored how they processed the loss, reconstructed their identities, and related to their social environment and future.

Method

We conducted in-depth, semi-structured interviews with fourteen family members who experienced ambiguous loss. We anaylzed the transcribed interviews using content Analysis.

Results

The analysis identified four key themes: Process; Others; Effects; and Self, Family, and Life Roles. Although most participants eventually received confirmation of the death of their loved ones and received their bodies, the initial period of uncertainty caused significant emotional distress and a complicated grieving period. Participants reported intense emotional suffering, but they also described gradual coping through meaning-making and emotional adaptation over time.

Conclusions

The findings underscore that ambiguous loss functions as a distinct and particularly debilitating form of grief, where the initial uncertainty may disrupt the mourning process. The findings highlight the critical need for support systems and interventions that address this type of unique trauma and foster long-term adaptive coping strategies.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-026-04086-4.

Introduction

The earthquakes that occurred on the 6th of February, 2023, in the southern part of Türkiye caused the deaths of more than 55,000 people and left thousands missing under the rubble. After the disaster, families waited for days to find out whether their family members were alive. The uncertainty inhibited their mourning rituals, disrupting individual grieving processes and family systems.

Grief in the aftermath of natural disasters diverges from other types of grief partially because the lack of clear evidence prevents family members from initiating culturally meaningful mourning rituals (e.g., [2, 4]). Under such conditions, funeral and burial rituals that usually facilitate the acceptance of loss become broken, and the emotional adjustment process is delayed. Contemporary grief theories emphasize that meaning construction is vital to coping with loss and that cultural norms play a critical role in the process [11, 27].

Ambiguous loss is defined by uncertainty regarding the fate or whereabouts of a person [12, 14]. After the earthquakes in Turkiye, many individuals expressed that although their relatives were missing physically, they were still psychologically alive. In other words, they experienced what Boss [11] defines as “boundary ambiguity.” Boundary ambiguity refers To the uncertainty about who is a part of the family system and how roles are distributed in the family. As uncertainty persists, families have difficulty for organizing responsibilities, adapting, and making decisions about the future [13, 18]. They may experience hope/hopelessness, shifting emotions, identity confusion, and tension [8, 12]. Not knowing whether a loved one is dead or alive interrupts the mourning process and leads to varying degrees of psychological pain. Moreover, the absence of the body, which is a central element of mourning in many cultures, makes meaning construction more difficult and can prolong the duration of grief indefinitely [20, 35]. Thus, individuals find themselves trapped in a frozen time between mourning and hope [28].

Types of ambiguous loss

There are two types of ambiguous loss [14]. In the first type, although the body is missing, the person is psychologically present in the family. Losses due to earthquakes, wars, and abductions are of this type [8]. More recently, during the COVID-19 pandemic, many cases of death are the first type of ambiguous loss [7]. The the second type of loss is when the individual is physically present but psychologically absent. Examples of such losses include Alzheimer's patients, alcoholics, workaholics, and disowned individuals [4]. Our study focused on the first type of ambiguous loss.

Effects of ambiguous loss

Research suggests that the presence of the body in situations of loss may be culturally bound. Mourning rituals, meaning attributed to death, and the process of acceptance vary across cultural contexts [13]. However, ambiguous loss violates societal expectations [20]. The mourning period offered to the remaining relatives is usually shorter [34]. Remaining family members may be isolated as early as the first weeks of loss [21], and they may withdraw from society [35]. Additionally, when grieving individuals are emotionally or physically isolated, they may become doubtful of their feelings [32]. Such a state of exclusion may prevent individuals from making sense of their loss and asking for help [41]. Society puts pressure on those left behind to cope with grief rather than to experience it [14]. This leads to more stress [38]. Based on Doka’s [20] conceptualization, ambiguous loss is often within the framework of disenfranchised grief. Ambiguous losses are less frequently socially recognized or legitimized.

Accepting individuals who are not physically present as if they were can trigger depression, anxiety, and conflict [11, 12]. These emotional tensions can result in systemic dysfunctions in the family. When family members lack clarity about the whereabouts of the missing person or whether their role in the family continues, family cohesion, communication, and adaptability are weakened [16]. Such uncertainty can lead to parental over responsibility, role reversals among siblings, or unresolved relationship tensions. When stress accumulates, families can be plunged into a state of chronic crisis, severely disrupting their daily functioning [11]. Therefore, ambiguous loss is not only creates psychological burden but also structural problems that destabilize the family system. Depending on how family members perceive ambiguous loss, it is possible to observe boundary ambiguity in a continuously increasing and decreasing variability [16]. Boundary ambiguity is uncertainty about who is considered a member of the family system and how familial roles and responsibilities are defined under conditions of unresolved loss [12, 14]. A higher level of uncertainty may hinder stress management within the family and weaken the flexibility of individuals [13]. As a result of inhibited cognitive functions [10], individuals' decision-making abilities may be delayed. Due to a lack of information, coping processes may be stalled [12, 14].

It is difficult to predict the impact of ambiguous loss on those left behind [14]. Nonetheless,stress, anxiety, depression (e.g., [5, 6]), helplessness, confusion [14], headaches, fatigue, stomach disorders [40], hopelessness, immobilization [24], attention problems, excessive crying [31], indecision [15], guilt, substance abuse, violence, identity problems [17], and other physiological, cognitive, behavioral, and emotional symptoms [33] are common. Moreover, the ambiguous nature of loss can suspend the mourning process for as long as a lifetime,in some cases, such as slavery and the Holocaust, it can even last for generations [3, 8].

In the cases of ambiguous loss, prolonged uncertainty about the fate of loved ones may prevent engagement in culturally meaningful mourning rituals. Such periods of waiting can trap families in a state of “frozen time,” in which the inability to mourn or maintain realistic hope complicates the grieving process [28]. Previous research further highlights that in ambiguous loss hope functions as a dual process, both as serving a necessary psychological resource and a potential source of distress [39]. Therefore, our aim was to explore the ambiguous loss experiences of individuals who lived through the February 6, 2023, earthquakes, with a particular focus on how prolonged uncertainty shaped family dynamics, roles, and individual meaning proc construction processes. By adopting a qualitative, phenomenological approach, this study contributes to the literature by providing context-specific evidence from a large-scale natural disaster and elucidating the reciprocal relationship between individual experiences and family systems.

Method

Research design

We used phenomenology to describe survivors' experiences, perspectives, feelings, and thoughts about ambiguous loss. Open-ended questions in the interviews provided detailed narratives. To ensure variation in perspectives, we employed a maximum variation sampling strategy [29]. We purposely sampled survivors who lacked definitive information about the fate of their loved ones for three to fifteen days following the earthquake. For example, two participants knew that their relatives were under the rubble but could not confirm their status until heavy machinery removed the debris. The help of psychologists and counselors working in the affected regions was employed in identifying participants.

We established contact points through the existing psychosocial support networks and professional groups working in the earthquake-affected areas. Within these networks, psychologists and counselors helped in identifying potential participants based on the inclusion criteria: Having a missing relative for a minimum of three days and expressing willingness to participate in the study. Once we identified prospective participants, we informed the psychologists and counselors about the study and, with their approval, the research team communicated with the family members. This ensured that participant recruitment was ethical and structured.

As a result, the study included 14 survivors (six women and eight men) who experienced ambiguous loss during the earthquake. The age range of the participants varied from 23 to 58 years. All participants are at least high school graduates. The sample included diverse participants in terms of age, gender, occupation, and city of residence. Participants from different provinces (i.e., Hatay, Adıyaman, Malatya, and Kahramanmaraş) ensured a heterogeneous sample. None of the participants was from the same family, in fact all were unrelated to one another. Table 1 presents the descriptive characteristics of the participants.

Table 1.

Demographic characteristics of the participants

Participant	Gender	Age	Missing Relative	Missing Period (Days)	City	Occupation
P1	Man	34	Wife Daughter	12	Adıyaman	Unskilled Worker
P2	Woman	42	Husband	14	Hatay	Housewife
P3	Man	50	Cousin	10	Hatay	Engineer
P4	Woman	30	Husband	15	Adıyaman	Teacher
P5	Woman	23	Uncle	14	Malatya	College Student
P6	Woman	55	Mother Husband Son	9	Kahramanmaraş	Housewife
P7	Woman	62	Son	15	Malatya	Housewife
P8	Man	49	Father	13	Kahramanmaraş	Physician
P9	Woman	60	Daughter Grandchild	10	Malatya	Housewife
P10	Man	43	Sibling	3	Hatay	Engineer
P11	Woman	47	Cousin	11	Hatay	Housewife
P12	Man	58	Wife	13	Kahramanmaraş	Retired
P13	Woman	25	Mother Father Sibling	8	Kahramanmaraş	Unskilled Worker
P14	Man	41	Brother	13	Adıyaman	Teacher

Data collection

Before collecting the data, we informed the participants about the purpose of the study. We debriefed them at the end of the interviews. Written informed consent was obtained from all participants prior to data collection. All interviews were conducted and completed in March 2024. All interviews were conducted individually and nobody else was present during the interviews. We informed all participants prior to the interviews that the study findings, including anonymized verbatim quotations, would be published in academic journals. Consequently, we obtained written informed consent from all participants. No identifying personal or clinical information was included in the manuscript. Data collection consisted of three parts: Completing a consent form, a demographic data sheet and a semi-structured interview. We asked five open-ended questions during the interviews. Open-ended questions were developed jointly by the researchers and independently evaluated and finalized by five professionals working in the field of mental health.

We structured the interviews in Turkish, the native language of the participants, in an open-ended format to allow participants to convey their experiences. The questions posed are as follows: What did you think when you could not get any information about the status of your missing relative after the earthquake? How did you feel?’ ‘What were your feelings and thoughts about those around you at that time?’ ‘How did this uncertainty affect your life and your thoughts about the future?’ ‘In what ways did your perspective on yourself, your family, and your roles change during the earthquake?’ and ‘Who do you think is responsible for what happened?’ All responses were documented verbatim and used at the word level in the analysis process. Interviews were conducted face-to-face and lasted 60 to 90 min. We audio-recorded and transcribed the interviews immediately afterwards.

Procedure/ethical issues

We conducted the study after the approval of the Ethics Committee of Necmettin Erbakan University (Approval No: 2024/237) and in accordance with the ethical principles outlined in the Declaration of Helsinki. The researchers identified and contacted individuals who had a missing relative. None of the researchers had any previous information about or contact with them. We initially assumed that these individuals were experiencing ambiguous loss. We made appointments with prospective individuals. The first author conducted the interviews. All other researchers took part jointly in the other stages of the research process. We conducted interviews in the regions affected by the earthquake. The thematic analysis process was conducted jointly through regular meetings. Rigor, consistency, and multiple perspectives ensured the interpretation of the data. We coded the participant names to ensure anonymity. Three researchers lived in areas not affected by the earthquake, whereas one lived in the region but did not personally experience any loss.

Data analysis and interpretation

After data collection, we employed Colaizzi's seven stages of content analysis [19] to reveal the relationships and concepts, classify similar data into themes and categories, and present the data in a discernible format. Data analysis started with the researchers reading the transcriptions (in Turkish), which provided an in-depth understanding of the content. During the readings, we identified significant statements from the participants. The researchers discussed and reinforced these meanings, repeating the process until achieving a common understanding. We used a multi-researcher perspective to avoid potential researcher biases in the data collection and analysis. We aimed to strengthen consistency and validity through shared decision-making and regular team meetings in the analysis of the interviews. We derived the themes inductively from participants’ responses rather than predetermining them by interview questions. We used the semi-structured questions solely to facilitate participants’ narration of their experiences.

We used descriptive analysis to generate the themes. ‘Descriptive analysis’ refers to the steps of Colaizzi’s phenomenological method, including identifying significant statements, forming meaning units, and organizing these units into categories and themes. Thus, descriptive analysis is not a separate analytic technique but a component of Colaizzi’s systematic process of transforming participants’ accounts into thematic structures. Content analysis revealed the categories belonging to the themes. We divided the data into groups to obtain themes and categories. We also included verbatim participant statements in the findings section to ensure the accuracy of the analysis and provided readers with access to raw data. This approach strengthened the depth and richness of phenomenological research, increasing the transparency and accuracy of our participants’ perspectives. We coded the data obtained from the interviews (e.g., P1, P2, P3…Pn).

We followed the standardized procedures (COREQ) to ensure transparency, reliability, quality enhancement, and comparability of the qualitative study [36]. In line with the COREQ standards, we stated the relevant sections of the text (information about the researchers, number of participants, and rationale for selection). We included verbatim sample statements related to the categories in the findings section. Original verbatim transcriptions in Turkish were translated into English by two independent translators, using forward and backward translation to maintain the integrity of the reporting phase of the study.

Colaizzi's method enabled the systematic elicitation of subjective meanings through a gradual process of content development. On the other hand, we used the COREQ checklist [36] to increase methodological transparency and reporting rigor of the qualitative study. The combination of these two approaches ensured both the depth of phenomenological interpretations and the scientific credibility of the research process.

Findings

Through inductive content analysis of the transcribed interviews, we identified four overarching experiential domains: Process; Others; Effects; Self, Family, and Life Roles; and Responsibles. Within these domains, participants’ narratives revealed recurring emotional, relational, and meaning-related patterns. While these patterns were analytically organized under each domain to enhance clarity, they should be understood as dynamic and intersecting aspects of participants lived experiences rather than as fixed or mutually exclusive categories.

The identified themes represent broad experiential domains through which participants described their ambiguous loss. Within each theme, categories capture recurring emotional, relational, and meaning-related patterns that emerged inductively from participants’ narratives. Accordingly, categories such as empathy, anger, and traumatic experiences are not treated as standalone themes but are understood as cross-cutting experiential patterns manifested within different domains of loss.

The process theme

The analysis of the waiting period revealed that participants' experiences were structured around three profound and often intersecting emotional responses: Empathy, Hatred/Anger, and Traumatic Experiences. Presenting them as distinct categories serves an analytic purpose; in lived reality, these responses coexisted and fluctuated, defining the very fabric of the ambiguous loss process.

The thematic analysis of the waiting period was organized around these three core responses. While Traumatic Experiences were the most prevalent in the narratives, the depth and significance of Empathy and Hatred/Anger were equally critical in capturing the full emotional spectrum of the ambiguous loss process. The following are sample verbatim participant statements under their respective categories.

Empathy: P2 said: “I was crying thinking why such a thing happened to us. My husband was not there […] is he dead or is he alive?” P12 expressed his state as “I am sad like everyone else.” These statements show that participants were not only confined to their own loss but also empathized with other victims. In particular, the complex emotions experienced by P2 reveal both personal anxiety and a general level of empathy.

Hatred/Anger: P1 said: “I felt so helpless, […] it was like I was in an infinite absence and no one could hear me. Even now I am filled with feelings of anger and hatred.” P7 uttered: “I am sad, I am very angry, I am offended at people and I feel helpless about it.” P4 said: “I was angry with life at first. It was as if I was growing an anger inside me that I didn't know exactly what and whom to direct it at…” These participants stated that the feeling of lack of control and helplessness caused by uncertainty, which turned into anger over time. Although the target of anger was often unclear, internal accumulation and external feelings of unresponsiveness fed this feeling.

Traumatic Experiences: P3 expressed: “The feeling of fear was predominant in me, […] if we don't die now, everything will collapse in the next earthquake and somehow we all will die.” P14 said: “Even if you know that you will die, even if there is a tiny hope, you hope that it will come true, but you know that it will not happen. […] and you taste death while you are alive. You cannot recover from that uncertainty even after it becomes certain. This time the question of whether it should have continued to be uncertain haunts your mind. If there is already the beginning of a life in limbo, it is that day.” P5: “I couldn't breathe when I thought about my relatives in the rubble, […]. I have never felt so helpless in my life. I have never felt so tired in my life. Uncertainty was one of the most exhausting situations. Uncertainties made me feel very worthless.”

Participant statements in this category reveal that ambiguity is not only a mental process but also causes physical exhaustion and long-term psychological damage. Some participants expressed a lingering sense of death, whereas others emphasized that the ambiguity was more debilitating than death. These statements are indications of profound and potentially long-lasting traumatic impact described by participants in the aftermath of ambiguous loss.

The others theme

Similarly, participants' narratives about their social world were permeated by the same core emotional patterns. The categories of Empathy, Hatred/Anger, and Traumatic Experiences again emerged as critical lenses through which relationships with others were strained, negotiated, or sought for solace.

The three categories under the Others Theme are Empathy, Hatred/Anger, and Traumatic Experiences. The most frequently reported category under this theme was Hatred/Anger. In the interviews, participants expressed both feelings of empathy and solidarity as well as anger, frustration, and isolation. Whereas some individuals received emotional support from other survivors during the process, others felt excluded or isolated. These experiences reveal accumulated emotional burdens related to social reactions, lack of support, and neglect.

Empathy: “I felt everyone's pain because so many people were affected. I saw people I didn't even know […] waiting to find their bodies. […] what they felt and the fires in their hearts were so familiar that it was as if I had known them for years… But I thought that people living in areas where the destruction was not intense or in areas that were not affected by the earthquake could never understand us, could never feel what we felt. Because empathy is really difficult in such times…” P9: “Other people wanted to support us, but I felt like I was the most painful. Our whole building collapsed. No one could reach their loved ones for days. But we always tried to say positive things to each other.” P13: “No matter how empathetic they are, I don't think anyone who hasn't experienced it can understand what happened. The people who tried to help left after a while. I think they were bored, they wanted to change their agenda, but I am still living in this reality.”

Hatred/Anger: P1 said: “There is a saying that only someone who has fallen off a donkey can understand my situation. For this reason, the people around us tried to be with us, God bless them, but after a certain period of time, they left us as if to say come on, you can solve this yourself. I am not angry with them, no one can mourn for something they don't know. I just have a different kind of resentment.” P7: “You actually get angry and hurt at other people anyway, it feels like everyone didn't do their best enough.” P8: “I am angry with everyone, whether they are related to the subject or not.”Traumatic Experiences: P5: “Everywhere I looked, I saw something much worse, that is, the upper limit of my terror and sadness changed with each maneuver. I didn't know who and what situation to feel sorry for […]. The dismembered, the missing, the unidentified… I honestly thought that no one could be strong enough.” P10: “I found my brother myself three days later. I went home and brought materials and took him out myself. I called for an ambulance, it can't come, the roads were closed, how could I blame anyone? I took him to the hospital… There is no such thing as a hospital left… Then I realized that my brother was conscious and I took him to Kayseri [another nearby city].”

This theme reveals feelings of empathy and anger intertwined with social insensitivity. Although some participants received support from their communities during and after the disaster, the majority felt isolated, not understood, and excluded over time. In particular, the lack of support or early sense of abandonment triggered resentment and anger reactions. On the other hand, some participants found the empathy of others insufficient in the face of the magnitude of their own tragedy, leading to social disengagement. Narratives of traumatic experiences reveal that this rupture is intertwined with not only emotional but also tangible and physical challenges.

The effects theme

The Effects Theme comprised three categories: Disrupted Future Orientation and Traumatic Uncertainty, Threatened Safety, Insecurity, and Anger, and Spiritual/Value Disruption and Loss of Meaning. Participants’ narratives were predominantly concentrated within the category of Spiritual/Value Disruption and Loss of Meaning, indicating that ambiguous loss extends beyond physical deprivation to profoundly affect individuals’ sense of meaning, core values, and relational world.

Disrupted Future Orientation and Traumatic Uncertainty: P1 said: “We were going to buy a new house, my husband and I were both working… I decided not to make long-term plans for the future.” P4 reported: “As such, none of your dreams and expectations for the future matter. You just spend the day.” P5 briefly said: “Thousands of dreams were built and destroyed and I was buried under them. We couldn't escape, of course…” P6 expressed: “I may have started to look at the future more pessimistically.”

Threatened Safety, Insecurity, and Anger: P3 said: “Actually, the house where my brother lived collapsed and they died, but two children survived. If the house had not collapsed, nothing would have happened to anyone. My father bought the house on the land at the time. It got old over time…” P10 said: “I mean, I came to the conclusion that one should stress too much about life, as material possessions are fleeting. “

Spiritual/Value Disruption and Loss of Meaning: P3 said: “One cannot be so sad even for the death of one's brother. After all, we believe in death, but my nephew is nowhere in sight, is he dead or alive? His parents passed away. There is the thought that she is entrusted to us now, but there is no girl. It's like time froze during that time.” P5 said: “But the emptiness of my friend, the emptiness of those I lost was never filled.”

The statements in this theme show that the ambiguous loss triggers reassessment processes both materially and spiritually. Hopes and plans for the future are disrupted and long-term goals are replaced by ambiguity and a focus on daily life. Material losses increase the need for security; especially losing the house creates both physical and symbolic trauma. Most participants focused on spiritual and value-based losses, expressing loneliness, emptiness, and loss of meaning. These statements indicate that ambiguity may not only be a condition but also a holistic experience deeply intertwined with, and potentially disruptive to, one's identity and value systems.

The self, family, and life roles theme

Three categories were identified under this theme: Heightened Insecurity and Hypervigilance, Emotional Distress and Psychological Strain, and Role Overload and Family Restructuring.

Heightened Insecurity and Hypervigilance: P9: "Worrying about myself and my family was one of my biggest sources of anxiety during the earthquake." P13: "I started to put myself more in the foreground." P8: "…I started to try to spend quality time with my family as much as I could."

Relational Distress and Empathic Strain: P5: "In the later period, I saw aggression and a state of war in people and in my own family, for example." P6: "Although the presence of my grandchildren gave me some hope, nothing would ever be the same." P11: "I reinterpreted life and reevaluated it."

Role Overload and Family Restructuring: P1: "It didn't happen… Now I am trying to play my role as a father for my son." P2: "Apart from my role as a mother, I had to take on the roles that my husband did." P3: "I can say that I started to be more flexible towards myself and my environment, even though there were no such 100% changes." P4: "We had a routine life and suddenly everything turned upside down." P7: "It hasn't changed in my house. I am already both the mother and father of my house." P14: "How much responsibility you have answers your question."

Participants' feelings of individual responsibility and search for emotional balance come to the fore. For some participants, ambiguous loss caused them to assume new roles within the family, with the responsibilities of parenting and caregiving being particularly emphasized for women. The need for safety and protection increased the anxiety level of many participants, causing them to develop a more cautious and withdrawn stance towards the future. In addition, participants tried to make sense of life and their own roles after the loss and sometimes resorted to defense mechanisms such as denial and non-acceptance. This theme provides an important framework for understanding the dynamic between individual vulnerability and resilience.

The responsibles theme

This theme captures how participants attributed responsibility during their experiences of ambiguous loss following the earthquake. Analysis revealed two primary attribution patterns: Internalization of Blame and Guilt, in which individuals directed responsibility toward themselves, and Externalization: Anger, Accusation, and System Blame, in which responsibility was assigned to other individuals, institutions, or broader structural factors.

Internalization of Blame and Guilt: P6: "…But our non-existent budget did not give us much chance when choosing a house." P12: "We are all guilty living in it."

Externalization: Anger, Accusation, and System Blame: P3: "Yes, even though the earthquake is a natural disaster, everyone who built the apartments and signed the permits to live in those buildings is guilty. And I don't forgive them. One should ask oneself how the building that didn't collapse didn't collapse." P4: "I directed my first anger towards fate. I blamed fate for this." P5: "I think the buildings that stood up until that day are murder tools and everyone who caused this is guilty, the manager or the homeowners who didn't want to lose their house… Measures, precautions, help that didn't come on time…" P11: "There are so many factors such as the materials used, static calculations, unsupervised constructions."

P14: "Since the idea of looking for a responsible person made the situation insurmountable, I emotionally accepted it and decided to continue our lives as much as it was happening."

Most participants blame structural problems and systemic negligence rather than individual responsibility for the ambiguous loss. Participants who tend to externalize blame many factors ranging from unplanned urbanization to the negligence of local governments. On the other hand, some participants did not ignore the impact of their own decisions and assumed individual responsibility for issues such as the choice of house, lack of financial means, or inability to take precautions. In this theme, the way responsibility is directed may be considered not only as an explanatory strategy but also as a coping mechanism.

Discussion and conclusion

Interviews with individuals who experienced ambiguous loss after the earthquake revealed that they were in a state of mind that created unique difficulties and confusion, as indicated in previous studies (e.g., [12, 30]). Most individuals actively participated in rescue efforts. We determined that men took a more active role in search and rescue processes. This may have enabled men to be more socially organized or connect more easily with people who understood them during the process. In this context, Solheim et al. [34] argue that family support serves as a buffer during difficult times. Indeed, during times of ambiguity, earthquake survivors tried to overcome the situation by acting together. These shared coping mechanisms are shaped not only by immediate social networks but also by broader cultural norms about loss and mourning. However, our findings indicate that these collective solidarity efforts were simultaneously intertwined (and at times created tension) with the rapidly shifting roles within the family system and individuals' attempts to adapt to these changes, as captured in the Self, Family, and Life Roles theme.

Death and mourning processes vary considerably. For example, the presence of a funeral ceremony is considered an important element in Mexican culture (e.g., [26]), whereas mourning is often considered a period that should be overcome quickly in the United States (e.g., [4]). In Turkish culture, mourning periods range from three to ten days [23], however, in our study, the missing period ranged from three to 15 days. Consequently, participants were deprived not only of individual mourning processes but also of a cultural rite of passage that allows the family to collectively acknowledge the loss, negotiate the new reality, and formalize the redistribution of roles. This deprivation may have contributed both to individuals' sense of spiritual and meaning loss (i.e., Effects Theme) and to the increased complexity and ambiguity in restructuring family boundaries and roles (i.e., Self, Family, and Life Roles Theme).

Individuals who experienced ambiguous loss after the earthquake first expressed their feelings and thoughts about the traumatic experiences. Participants expressed how helpless and worthless they felt and how tired they were. People maintain a certain degree of self-esteem, but at the same time, they direct feelings of hatred and worthlessness towards themselves or their environments [1]. These individuals had more intense feelings of indecision and anxiety compared to others [17]. These intense internal disturbances did not remain confined within the individual's psychological boundaries. As evident in the Others Theme, such emotions frequently transformed into anger and alienation directed towards the surroundings (e.g., P1, P7, P8). Within the family, they manifested as emotional distress and psychological strain (detailed under Self, Family, and Life Roles Theme), thereby eroding communication and mutual support capacity among family members [16].

Although death is one of the most stress-inducing events, ambiguous loss is even a greater stress source [25]. Ambiguous loss often leads to depression, anxiety disorders, helplessness, identity problems, substance abuse, violence against self or others, anger, and shame reactions [11, 37]. In addition to these internal difficulties, social relationships are also affected by this process. Participants felt that people who experienced similar pain understood them much better. Boss [9] stated that families whose members were not lost in the earthquake or who did not look for them distanced themselves from people who were experiencing ambiguous loss. In this context, our participants expressed that people who did not have similar experiences could not fully understand them. This profound sense of being misunderstood, coupled with (real or perceived) distance from the outside world, triggered an inevitable search for culpability. As clearly demonstrated in the Responsibles theme, participants attributed the source of their unbearable pain and felt marginalization not to personal failings but to external systems (governance, construction companies, fate). While this externalization may function as a coping mechanism, it can also feed a cycle that deepens the rift between the individual and the 'uncomprehending' wider society.

Following any loss, certain rituals and funeral ceremonies that are culturally bound support individuals' grief process [4]. However, in ambiguous loss, societies usually isolate families who resist closure [35], which may lead to even higher levels of stress [20, 38]. Individuals reported more disputes within the family during ambiguous loss. Such behaviors suggest that if bodies are not found, individuals' mourning processes become more complex and they withdraw from the environment. The disruption of mourning rituals not only prevented participants from engaging in culturally meaningful grieving practices but also contributed directly to spiritual losses. For many participants, the absence of ritualized farewell weakened their sense of meaning, spiritual continuity, and value orientation, leading to feelings of inner emptiness and unresolved loss.

We found that focusing on material damage is less common in the process of ambiguous loss. However, in a recent study that investigated the effects of ambiguous loss during the February 6th earthquake, Gülırmak Güler and Albayrak [22] found that individuals had statements on both material and moral losses. In this study, the participants mostly talked about the loss of their loved ones. In other words, spiritual and relational losses were emphasized the most. This may be because the relational nature of ambiguous loss [9], unlike material losses, complicates the process and mourning within the family [4].

One of the reasons why ambiguous loss is so challenging is boundary ambiguity [12]. Participants in the present study expressed that their responsibilities toward themselves and their families increased greatly. For example, mothers took on the role of a father at home in cases of ambiguous loss. These roles were not voluntarily chosen but rather people were stuck with them in the process [4]. In other words, families were undergoing a restructuring within this paradox of presence and absence [8]. Another possibility is that rituals are canceled for more prolonged indefinite losses and roles are not fulfilled as the missing person continues to exist indefinitely [8]. Due to contradictory situations, individuals continue their lives in a psychologically and physiologically frozen state [11, 12, 14]. This forced restructuring of roles and the attendant 'boundary ambiguity' did not merely represent a practical challenge; it functioned as a powerful stressor that reciprocally shaped individuals’ psychological states. The overwhelming responsibilities (e.g., mothers assuming paternal roles) exacerbated feelings of anxiety and hypervigilance (i.e., Heightened Insecurity Category), whereas the lack of a clear familial structure deepened the emotional distress reported by individuals. In turn, this collective distress within the family system appears to have hindered coherent reorganization and mutual support, suggesting a potentially self-perpetuating cycle of strain that warrants further investigation. Although no direct information was obtained from the interviewees about the intensity of boundary ambiguity, we observed that in families with severe boundary ambiguity, stress management weakened, and individual and relational well-being were negatively affected. The pressure and unresolved situation brought about by these roles led to emotional reactions.

During the process of ambiguous loss, insecurity, shame, and anger mixed with resentment may be observed [35]. Experiences of ambiguous loss in natural disasters are shaped not only by individual trauma but also by widespread uncertainty, disrupted mourning practices, and collective social breakdown, as suggested in previous research (e.g., [8, 39]). The suddenness of loss, prolonged ambiguity, and disruption of social and cultural structures intensify the psychological impact of ambiguous loss. Our findings highlight the potential value of designing post-disaster psychosocial interventions that address not only trauma-related symptoms but also the interconnected domains revealed in our analysis. Such interventions could, for example, facilitate culturally congruent rituals, support communication, and create spaces. This perspective acknowledges that healing from ambiguous loss requires simultaneous attention to the individual's internal world and the relational system in which their grief is embedded.

Individuals are expected to stop blaming themselves and externalize to dispose of their guilt [11, 42]. This process can provide individuals with relief and increase the likelihood of receiving professional support [39]. That is, individuals are more likely to perceive themselves as powerless if they internalize [4]. More than half of the individuals who participated in the current study were able to externalize. We believe that the reason for this is culturally bonded.

Limitations

The study has several limitations that should be considered when interpreting the findings. First, we were able to interview a small, purposive sample consistent with the phenomenological inquiry. Whereas data from fourteen participants provide a rich, in-depth understanding of the experiences of those who endured ambiguous loss, the generalizability of the findings to broader populations is limited. Second, all participants were from specific provinces affected by the 2023 earthquakes. Therefore, the findings are influenced by the cultural context, the scale of the disaster, and local response systems and may not fully represent experiences in different geographical regions or following other types of disasters. A third limitation pertains to the inherent subjectivity of the phenomenological method. Researchers' pre-understandings and interpretive lenses inevitably play a role in the data analysis process. To mitigate the impact of such subjectivity, we employed multiple-researcher involvement in coding, regular team meetings for consensus, and verbatim participant quotes. Finally, data were collected at a single point in time. Given that ambiguous loss is a dynamic, evolving process, participants' experiences, coping mechanisms, and meaning construction efforts may fluctuate over time. The study offers a cross-sectional snapshot of the process. Longitudinal research designs would be valuable to capture the evolution of ambiguous loss and adaptation more comprehensively. These limitations do not diminish the value of the study but clarify the contextual and methodological frame within which the findings should be viewed.

Future research could address these limitations by employing larger and more diverse samples, exploring the phenomenon in different cultural and disaster contexts, and utilizing longitudinal designs to trace the trajectory of ambiguous loss over time. Beyond replicating the established phenomenology of ambiguous loss, a key contribution of this study lies in elucidating the dynamic interplay between its experiential domains. Our findings illustrate how the internal turmoil of the process spills into social relations with others and fuels externalized blame, while the disruption of cultural rituals deepens spiritual and value-related losses and complicates family restructuring. It is within these reciprocal influences between individual distress and systemic ambiguity that the unique challenge of post-disaster ambiguous loss resides. Consistent with previous works by Pauline Boss, the present findings suggest that certain experiential patterns of ambiguous loss may recur across different contexts. However, rather than implying universal generalizability, our results indicate contextual convergence in how ambiguous loss is experienced and articulated. At the same time, cultural and regional factors shape the expression and meaning construction of grief, underscoring the need for further comparative qualitative studies across diverse settings [14, 24].

Authors’ contributions

Conception and design of the study: Fadim Büşra Keleş, Şahin Kesici Analysis and/or interpretation of data: Fadim Büşra Keleş, Mustafa Baloğlu, Şahin Kesici Drafting the manuscript: Fadim Büşra Keleş, Mustafa Baloğlu, Mehmet Ak Revising the manuscript critically for important intellectual content: Fadim Büşra Keleş, Mustafa Baloğlu, Şahin Kesici, Mehmet Ak Final approval of the version to be published: Fadim Büşra Keleş, Mustafa Baloğlu, Mehmet Ak Agreement to be accountable for all aspects of the work: All authors accept joint responsibility for all aspects of the work.

Funding

The authors did not receive any financial support for the work in this article.

Data availability

The data supporting the findings of this study are subject to ethical restrictions to protect the privacy and confidentiality of the participants. Written consent for public sharing of identifying or detailed data was not obtained from the participants. Therefore, the dataset is not publicly available. However, anonymized data may be made available from the corresponding author upon request, provided that ethical approval and necessary data sharing agreements are in place to ensure participant confidentiality.

Declarations

Ethics and approval and consent to participate

This study was approved by the Ethics Committee of Necmettin Erbakan University (Approval No: 2024/237) and was conducted in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained from all participants prior to data collection.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.