Pathways of Grief II: Complicated Grief

What is Complicated Grief?

With complicated grief, the griever either avoids or denies aspects of the loss, or remains preoccupied with the deceased, loss of the deceased and the feelings accompanying the loss. He or she tends to remain isolated from others, and does not re-engage with life. It is not the feelings themselves that define complicated grief. It is the inability to accept and work through the feelings and move beyond them. Rather, the griever often feels “frozen in time.”

When is grief likely to be complicated?

Factors that can lead to complicated grief are:

 when a loss is sudden and unexpected, creating a feeling of chaos or loss of control in the survivor

 when the circumstances of the death involve violence, such as suicide, homicide, or motor vehicle accident, creating an increased sense of horror and vulnerability in the survivor

 when the relationship with the deceased was enmeshed, ambivalent, conflict-laden or abusive. In these circumstances, the survivor is often left with unresolved feelings towards, or interactions with, the deceased.

 when the death is untimely, such as a child’s death

 when multiple losses occur at the same time, or the survivor has unresolved losses from the past. When multiple losses occur at the same time, the survivor’s ability to grieve becomes overloaded, tending to cause an emotional shutting down. When past losses were not grieved, those losses and accompanying feelings and circumstances come up with an intensity that can overwhelm the griever and make it difficult to focus on processing the current loss.

 when the survivor has untreated mental illness

How can one move beyond complicated grief?

Psychotherapy, also called counseling, can help a person move beyond complicated grief. Generally, a person suffering from complicated grief will benefit initially from individual counseling. As healing progresses, some people engage in group counseling, which can provide connection with others dealing with similar issues. A psychotherapist/counselor can help the griever sort out and resolve issues that are blocking the ability to grieve. Through counseling, the griever can develop skills to manage, tolerate and understand intense and disturbing feelings in a way that provides a sense of safety, structure and coherence.