Ambiguous loss is an unclear loss that continues without resolution or closure. It is a relational rupture that can be physical or psychological. The chronicity and complexities of ambiguous loss create symptoms that may be construed as medical disorders such as depression or persistent complex bereavement disorder. Because the family’s story of loss may never have an ending, the therapeutic goal shifts to resiliency. The authors present six guidelines about meaning, mastery, identity, ambivalence, attachment, and hope. They have been found useful in empowering individuals and families to move forward with their lives despite the ‘not knowing’. Links to chronic sorrow and disenfranchised grief are also discussed.