What is Complicated Grief?

April 29, 2018

The term “complicated grief” is greatly misunderstood by the bereaved, in large part because the word “complicated” has recently become a pop culture buzzword. Many people have said to me, “ALL grief is complicated,” which is evidence of this misunderstanding. Because all grief is NOT complicated. The majority of people move toward restoration and healing in an expected, healthy — non-complicated — manner. So what does complicated mean in this context?

Think of it this way… you’ve heard of medical procedures that have “complications” when something doesn’t go as expected; something interferes with the expected trajectory of healing. In bereavement, a person is supposed to adapt and adjust to their new reality over time. But if the person feels/functions exactly the same way three years after the loss as he/she did three weeks after the loss, there is a complication.

Complicated grief is also known as “prolonged mourning disorder” or PGD, which I think is a much better way to describe it.

It is normal and expected that we will grieve and feel deep pain when we have a loss, but it is also normal to eventually find peace again. The process of healing depends on many factors, including:

. The relationship with the deceased (spouse, child, etc)
. The type of loss (violent, traumatic, illness, expected vs. unexpected, etc)
. The innate psychological make-up of the griever
. The quality of one’s family and community support
. Whether the death is socially acceptable
. Belief systems that can undermine healing

These are very brief descriptions and broad generalizations (for the sake of brevity).

You can learn more by reading this article from Psychology Today. If you’re interested in a more in-depth academic analysis,  take a look at my 2018 essay on complicated grief.

In the last 40 years there has been a wave of new academic and medical research on grief, and we’ve also learned a lot from looking at how other cultures work with grief (thanks to mass media and the internet). Based on this information, we know that although the grief experience is different for everybody, there is a more or less normative trajectory for regaining equilibrium after a loss. When a person does not follow that trajectory, there are “complications,” and that is when help — such as counseling — is needed.

Important to note… grief counseling is a very specialized field, and most therapists and counselors are not specifically trained in that area. If you are considering counseling, please make sure the provider has specific training and experience with grief and trauma.

 

Terri Daniel

6 Comments

  1. Marilyn Patterson on June 3, 2018 at 6:59 am

    Yes I think I may have had are still do have complicated grief. My sister crossed over 5 years ago do to suicide. Which I feel maybe I am partly to blame. But what makes it complicated is after her passing I started seeing things I have never seen before. Which makes it hard to accept and move forward. I do know there is an afterlife. But I still see all these people and images on a daily basis.

    • Rev. Terri Daniel, MA, CT on June 3, 2018 at 7:19 am

      You didn’t say exactly what kind of images you’ve been seeing. If they are images of trauma, terror or punishment, that is certainly an indicator of complicated grief. However, if you’re receiving comforting messages and signs from departed loved ones, that is something completely different. Even though most of the psychology community considers that a symptom of CG, I think communication across dimensions is normal and expected, and certainly not pathological. So if that’s the only issue you’re experiencing, then I would encourage you to develop your intuitive skills rather than view them with suspicion. However, if you’re experiencing traumatic imagery that is causing you to struggle with normal functioning, then I suggest you seek the help of a counselor who is specifically trained in this type of work. Most people don’t realize that typical therapists and counselors are not trained in grief, much less in complicated grief. So if you’re seeking help, please find a counselor who is specifically trained in grief and trauma.

  2. Rona on June 3, 2018 at 1:47 pm

    My daughter had bipolar from the age of 11 and had a very strong Faith. She Is a Baha’i. In the scriptures Baha’u’llah talks about how beautuful the Kingdoms of God are. Jenni had 3 very bad psychotic episodes and was reading about the after life on her 3rd recovery. She had tried to kill herself 16 times already and I think her Faith gave her the courage to end her life. When she died I partly blamed her Faith. Nowadays I see this very differently. Baha’u’llah gave her the hope of peace and she wanted peace from thus very aggressive illness. ?

    • Rev. Terri Daniel, MA, CT on June 3, 2018 at 1:55 pm

      One of the most profound spiritual lessons we can learn from loss is to stop seeking blame. Bravo for you for taking that bold step!

  3. Millie Hue on January 2, 2019 at 4:35 pm

    Thanks for helping me understand that a person who is unable to get over that phase after three years might have something called complicated grief. I guess I need to hire a counselor to help my best friend since she hasn’t been herself after more than three years. Her mother died August of 2015 due to a heart attack that is why the death was really sudden. This made it harder for her to accept it.

  4. Taylor Anderson on January 6, 2020 at 1:02 pm

    I had no idea that complicated grief was also called prolonged mourning disorder. My mother died when I was 10, and 13 years later I still have problems. Because of this, I’ve been thinking of getting grief counseling. Thanks for the great information on complicated grief.

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