Complicated Grief: How to Cope with Loss in Complex Situations
"How lucky I am to have something that makes saying goodbye so hard.” — A. A. Milne, author of the “Winnie-the-Pooh” children’s books
For better or worse, loss is an unavoidable part of life. Loss can come in many forms, such as the death of a loved one, a life-altering injury or medical diagnosis, the breaking-up of a family, the termination of a friendship or romantic relationship, or even the untimely end of a job or career. A loss can be large, small or somewhere in between, and it can affect us in a wide variety of ways.
Grief is one common and very normal reaction to loss. In its simplest sense, grief is deep sorrow or distress that we feel because of a loss. Grief is our natural response to the loss of something that was familiar or comforting to us, and grieving is our way of coming to terms with that loss. The grieving process could take days, weeks, months or even longer, but it usually ends with acceptance and a return to relative peace.
However, grief can sometimes be so intense that it does not go away on its own. Rather than diminishing over time, feelings of grief may sometimes remain unchanged or even get worse as the loss fades into the past. This type of persistent, unresolved grief is known as “complicated grief,” and it can severely impact a person’s mental health and their ability to live a normal life after experiencing loss.
In order to heal from complicated grief if and when it occurs, it’s important that we understand what it is and how it affects us. In this blog post, Cummins school-based therapist April Allgood explains how complicated grief differs from regular grief, what types of loss may cause a person to experience complicated grief, and how someone who is suffering from complicated grief can begin to heal from their loss.
Layers of Loss, Layers of Grief
"Especially over the past few years, I've really had to become comfortable with grief, because about two-thirds of my caseload deals with complicated grief," says April Allgood, MSW, LSW, a school-based therapist at our Boone County office. April works with school-aged youth and their family members in her day-to-day work.
As mentioned above, the first major difference between regular grief and complicated grief is that regular grief goes away while complicated grief does not. “Typically, individuals are able to adapt to a new normal and learn how to move on,” April explains, “but with complicated grief, symptoms are persistent. They don’t go away, and they impair the person from moving on to what life was like before the loss.”
Just as everyone experiences grief in their own way, complicated grief doesn’t present itself the same way from person to person. In general, though, it is typically characterized by extreme, seemingly unbearable feelings of sadness, guilt or hopelessness. A person is also more likely to experience complicated grief if they’ve suffered multiple losses at the same time or if their grief has multiple layers.
April offers a few examples:
“Especially with COVID-19, there are individuals who are not able to be at their loved one’s bedside to have that final goodbye, or maybe they can’t have the typical funeral or celebration of life. That puts those individuals at a higher risk for complicated grief, because they’re not able to mourn the loss of their loved one in the way they normally would. Another example is when a child is removed from their home. For parents, having their child removed is very tragic and very hard, but sometimes they also have to come to the realization that their choices resulted in their child’s removal. Or maybe one parent is struggling with the loss of their child, so they may potentially resort to substance use, and then maybe they are incarcerated. For the remaining parent, not only was their child removed, but their spouse was then incarcerated for substance use, so they might experience complicated grief because they lost two big entities of their life and their support system.”
Another common difficulty of complicated grief is that each layer of grief can distract from the others, effectively prolonging the overall process of grieving and healing from loss. “Say it’s that parent—when they’re managing the emotion connected to their spouse going to jail, it takes their focus off of grieving their child’s removal from the home,” April says. “It creates a deeper layer because there’s two different things they have to grieve.”
Strategies for Coping with Complicated Grief
Although complicated grief can be an extremely difficult experience, there are many ways a person can cope with their feelings and begin to work toward some sense of resolution. First and foremost, it is always important to reach out to people who can provide emotional support. This support can be found through professional behavioral health services as well as among friends, family members, teachers, coaches, and other individuals who care about our personal well being.
When it comes to professional services, therapists and counselors can help a person make sense of the emotions they are experiencing and understand that their feelings are normal and valid. “It’s my job to help them understand what they’re going through and how it impacts their body, their emotions and their thoughts,” April says. “But I also try to help them comprehend the loss and address the grief. In my office, I try to create a safe, non-judgmental space where that individual can share what’s on their mind and understand that it’s OK to have the emotions they have.”
In addition to seeking support, April stresses the importance of increasing self-care and maintaining regular wellness behaviors like getting plenty of sleep, exercising regularly and eating a healthy diet. Another coping strategy that people sometimes overlook is emotionally preparing for upcoming holidays or anniversaries of their loss. “I help a lot of people of all ages prepare for those moments, because they can be a big shock for families and individuals to go through, especially if they’ve not had to process or deal with that before,” April says.
Professional therapy or counseling can also help the entire family deal with the ramifications of complicated grief, as it frequently affects others who are close to the grieving person. April explains,
“As professionals, we are trained to help not only children, teens and adults navigate this new way of life, but the family as a whole. Grief can be an uncomfortable topic to discuss, but we’re well trained in that area, and it’s not an uncommon topic for us to deal with. Therapists can help caregivers and guardians understand how to talk to their loved one about the loss, and we can also help them come alongside the grieving person to help them develop healthy coping skills and a new way of surviving life without that person who’s potentially gone forever or just gone temporarily.”
Ultimately, the goal for someone who is experiencing complicated grief is not only to move past their loss, but to emerge on the other side stronger than they were before. “I really try to help them understand their resiliency,” April says, “because anyone dealing with a loss is also creating very strong character traits. I try to help them understand that they’re sometimes stronger than they think they are.”
For more resources to help someone build resilience after a loss, we recommend reading our blog posts on gratitude and learned optimism below!