Complicated Grief

To help us understand ‘complicated’ grief, first let us discuss what we define as ‘normal’ grief. Normal grief is a troubling term of course – What is normal? Our grief reflects the uniqueness of, and meanings we ascribe to, our relationships. The term ‘normal’ doesn’t quite convey how special our human relationships can be... But for the purpose of this conversation, it is useful to lay down some accepted understandings regarding grief and how it is commonly experienced:

• It is normal for grief to have an impact on our emotions, thoughts and functioning. This can last over weeks, into months, and even beyond. It can be re-experienced at significant times – e.g. birthdays, anniversaries, remembrance. Resurgence of strong feelings and emotions are normal, to be expected and even prepared for.
• It is normal for grief to generate painful, distressing feelings, different behaviours and affect our ability to think or process things – but over time, it is normal for the pain and intensity experienced to subside and differ in its impact.
  
  
• It is normal for grief to trigger a change in our world view and understanding of our place in the world. Looking back, we may see ourselves as different. This realignment of our ‘sense of self’ – a new identity due to grief – is normal.

Normal grief changes over time. We suffer acute, intense feelings and thoughts at first, then we learn to adapt and integrate the loss into our lives so that we can move forward.

Acute grief almost always “includes strong feelings of yearning, longing and sadness along with anxiety, bitterness, anger, remorse, guilt and/or shame. Thoughts are mostly focused on the person who died, and it can be difficult to concentrate on anything else. Acute grief dominates a person’s life” (Columbia University). This is often experienced over the first 6 or so months following death.

Our grief doesn’t end after 6 months, but it does change as we come to terms with our new reality. When we experience integrated grief, “thoughts, feelings and behaviours related to loss are integrated in ways that allow [bereaved people] to remember and honour the person who died. Grief finds a place in their life” (Columbia University).

But for some, it doesn’t go like this. Sometimes, people’s acute experience of grief continues and it is as painful and debilitating as it was from the beginning, with no change over time. They are unable to integrate their grief and it impacts their thinking, functioning and wellbeing significantly. This is known as complicated grief.

“A person with complicated grief feels intense emotional pain. They can’t stop feeling like their loved one might somehow reappear, and they don’t see a pathway forward. A future without their loved one seems forever dismal and unappealing” (Columbia University).

Reasons for experiencing complicated grief can be numerous, and their interaction on each other complex. For example, it may arise out of a person’s attachment style, personality, age, gender, previous loss history or how the death occurred. It is therefore helpful to seek professional support if you feel you may be ‘stuck’ in complicated grief. A counsellor can help you unravel, process, understand and ultimately integrate your grief so that you can move forward. They can’t take the pain away, but they can offer you a safe space and professional guidance to help you regain emotional balance and find a manageable way to live with your grief.

For further information, and guidance for professionals, see Columbia University’s webpages dedicated to complicated grief.

If you are struggling with your grief, no matter when or how the death occurred, call our free helpline (0808 802 6161) or start a webchat on this site, to speak to one of our kind, compassionate and highly experienced volunteers. They will offer information, advice about any next steps, or just someone to talk to about the loved one you’re missing. Please do not feel alone. We are here.