Grief can be complicated...

Written by listed counsellor/psychotherapist: Sara Lindsay MBACP Accred Reg, Dip Sup Humanistic Counsellor & Supervisor

24th January, 20170 Comments

Related information: Bereavement, Post-traumatic stress disorder (PTSD)

Tracking and reading the news on a daily basis can keep me up to date with what’s happening in the world, and it can also shock and sadden me greatly. In particular I felt very struck by just how many tragedies can be beamed into my home via my television, phone and tablet. What comes to my mind are senseless acts like the Christmas market in Germany; the truck driven into the crowds in Nice; missing Malaysian passenger planes; the massacre on the beach in Tunisia; and more recently the act of God, the shock avalanche in the Italian ski resort. There are too many tragedies to mention, I know I haven’t acknowledged all of them.

I noticed my heart going out to the families, friends and colleagues of those who lost their lives; who, overnight, found their worlds turned upside down; who felt flattened and frozen by grief and loss. I began to wonder whether those lost and those left behind had said all that needs to be said; were they ‘good’ relationships? Was there unfinished business that the bereaved have been left holding? An unexpected, violent or sudden death through abnormal circumstances, or a death with unfinished relational business can sometimes leave us with a very complicated grieving process. These burdens can present as part of what is called complicated, or abnormal grief.

A ‘normal’ grief pattern mostly follows a path or cycle, or set of tasks to move through grief (including some expected backwards steps) over a period of time that is tough, painful, heartbreakingly sad, and sometimes filled with anger. However, eventually we can reach a point where we find ourselves engaging with life again. Although we are absolutely forever changed by our loss and life doesn’t feel the same, we have engaged with an altered ‘normal’. Feeling lacklustre at Christmas; wanting to hide away on the anniversary of our loved ones death and always noticing their absence at social gatherings is all part of that altered ‘normal’.

So what does 'complicated grief' feel like?

However, complicated grief can feel like we are forever stuck or weighed down in those earlier phases of grief, as if our loved ones death happened just yesterday. We can feel as if we have forever withdrawn from life and relationships, with an isolating lack of intimacy. We seem enduringly robotic, going through the motions of life with no connection or engagement. Our bodies seem to be plagued by illnesses, pains and disease for many months, even years later, a physical manifestation of that prolonged stress, ‘gripping or holding on’ unable to move forward. 

One of the enduring presentations of complicated grief is being stuck in those early phases or tasks: Where we haven’t really accepted our loved one is gone; where we feel so enduringly raw that we need to numb ourselves or withdraw. Enduring or prolonged use of alcohol, drugs, or developing a substance dependency, could be indicative of complication grief.

We may be stuck in the intensely emotional phase of grieving, where we experience enduring anger, lashing out in a blaming way, embittered (understandably) about our loss. We could be frenetically busy all the time, filling every waking moment of our lives with activity, new found hobbies, travel plans, and DIY projects. We may have lost someone through sudden or unexpected death, where the shock of this loss has made it almost impossible to accept.

Most tragically, we may not have the opportunity for a funeral, if like the relatives of the victims of the missing Malaysian flight, they don’t have a loved ones’ body to mourn over, bury or cremate. Their suspended grief could be compounded by the relentless pushing to maintain the search; campaigning for justice and answers. I am always awe-struck by the robustness of the human spirit in the face of insurmountable challenges. They just don’t know what has happened to their loved ones! The bereaved may be caught in that limbo-like state of feeling like mourning could be a betrayal to hope.

Combining loss and the trauma of how our loved one died and the frozen alertness and hyperarousal of shock, we may be prone to develop post-traumatic stress disorder symptoms, diagnosable by a mental health professional, such as a psychologist and requiring specific treatment.

Do you suspect that you or someone you know may be stuck in a complicated grief process? Have you, or they, for many months or years...

• ...found that grief gets in the way of day-to-day life?
• ...found that you/they are very avoidant of any form of change, almost living in the past?
• ...found that you/they can see little beyond your sorrow or sadness?
• ...found that you/their grief is persistently isolating you from the life and the people you knew?

You may find that there are steps you can take to help:

Spirituality:

Although you may feel hopeless and have lost faith in your higher power, increasing an element of spirituality in your life may give you a lift. Old friends from your place of worship may still be around to offer support.

Noticing the small things around you could help you connect with the spiritual wider world: A beautiful sunrise or sunset; spring bulbs pushing up through the ground to bring some spring colour to the world...

Social contact:

Reaching out to others, through setting small manageable goals can start to be a lifeline and bring a different energy into your life. Talking to someone on the bus, putting a ‘shout out’ on Facebook, texting/emailing or calling a friend, chatting to a neighbour for a few minutes as you pass on the street might bring some kindness and caring back in your life.

Finding a way to say goodbye:

If you haven’t yet visited the garden of remembrance or graveside, this might be a way of completing some unfinished business. Write down what you’d like to say first, and you could take a good friend or family member for support if that helps?

Or, if you don’t have a place to go, a private ritual to communicate your unfinished business to your departed loved one may be a real release for you. Some bereaved people light candles and talk to their loved one; or create a memories box with photos and meaningful objects in it. Another possibility may be to write a letter and take it to a meaningful place to read out, or send a message to the heavens on a helium balloon. The idea here being to help your emotional and psychological process take a step forward. 

Movement or exercise:

The body and our mood are integrally linked together.  When we take even light exercise, the body’s pituitary gland release hormones linked with restful sleep, mood lift, healthy appetite and digestion like dopamine, serotonin and endorphins.

Physical movement and exercise also help to ‘unfreeze’ the body from the weight of sadness, when our body feels more freed up, so do we, and vice-versa.

Consider taking a walk in your local park, or join a walking group, or your local gym or exercise class that also has a social aspect to the gatherings.

Medicines and talking therapies:

Grief can feel like a depression, but it isn’t depression much of the time. However in more complicated grief, the prolonged life stress and other factors could bring on depression. It’s important to discuss this fully with your GP, as anti-depressants may help to lift the ‘fog’ you’ve been living with for so long, to give space for you to resolve your grief process. 

Talking therapies like counselling or psychotherapy may be an invaluable way for you to talk and work through the thoughts and feelings you may have been hiding from friends and family for a long time. Counsellors can help you normalise what you’re experiencing and help find the path to acceptance. This could free you up to resume relationships you’ve been avoiding.

If your family are finding it very difficult to function together or you feel like you’re in crisis, you could consider attending systemic or family therapy to find a way to move forward together.

If your loved one passed away at a hospital or hospice, there could be bereavement services available there, including support, talking therapies or signposting to other services. Hospices may also offer group support alongside other bereaved people, which could bring an added benefit of socialising too.

Useful resources:

Books:

For practitioners – Grief Counselling & Grief Therapy; J. William Worden (Brunner-Routledge)

For the bereaved – Living with Loss & Grief; Julia Tugendhat (Sheldon Press)

Organisations:

www.cruse.org.uk (a national gateway service offering support, advice, information, and also training for organisations supporting staff who are bereaved)

www.childbereavementuk.org (a charity with online information for bereaved young people)

www.samm.org.uk (a national charity offering support after losing a loved one to murder or manslaughter)

These resources are by no means exhaustive but could offer you a useful starting point in your search for your first step forward.