Complicated Grief
“We humans are bound together as much by grief as by love, but we seldom speak of it. We need to change that so that others can do the same.”
“I really don’t want to hear it.” That was the reaction of one child when I asked how he was doing after the death of his grandmother. You may not want to hear about grief any more than I want to speak (or write) about it. Do we really think it’s going away or coming based on whether we talk about it or not? This week the article has to do with getting stuck in grief. It will be on our chaplain web site if/when you or someone you know needs it. There are also other articles on grief that you might not want to read, but might need. Let us know if we can help.
Complicated Grief…What it is…What to do about it.
The short answer to “what it is” = stuck in grief. The short answer to “what to do about it” = get unstuck. But answers that short don’t help when you or one you care about is the one who is stuck. Let me begin with a couple of other short statements that might get us started in the right direction.
Death is inevitable, bereavement is common. Complicated grief is that intense grief that lingers longer than it should and prevents living. Healthy grief hurts longer than we want it to, but it does not make us ill.
Grieving and mourning are two words that I use interchangeably in this article. They are both verbs, words of action that describe us moving on the journey, or the process of grief. I use them interchangeably.
If your physical body were injured, you might bleed, broken bones might need to be set, or surgery might be done. If the injury is severe enough, you might go home in a cast, or maybe from the hospital to rehab, then on home. Grief injures us. It injures us on the inside… in the far reaches of our minds.
If your body was previously injured in the same bone, joint, muscle, or organ there could be weakness from the previous injury that makes it difficult to recover this time. Some diseases have the same effect on us; they leave us weakened and vulnerable. Similarly, if there are emotional injuries that have healed, there could be weakness from the previous injury that makes it a challenge to recover this time.
What about a previous injury that has not healed? What about an injury, whether physical or emotional, that has been “festering?” Maybe you have been able to live without that injury affecting your life too much. Maybe you could live better without that festering injury, but for whatever reason, lack of resources or maybe it just hurts too much to let anyone touch it to try to heal it. You decide to live with the injury. Then you are injured again in that same place. Ouch, it hurts to imagine an old festering wound getting re-hurt.
In this analogy, the loss of a loved one might be more than you can handle on your own. You get stuck in your grief. Please understand thatpast emotional injuries are not the only reason that we get stuck on our grief journey. Not everyone that you know who gets stuck in grief does so because of an old injury. And not everyone with an old emotional injury will get stuck in grief.
Some past emotional injuries might include; abuse (of every kind) especially if the perpetrator is the person being grieved, attachment disorders (failure to establish a loving connection early in life), personality disorders (control freaks fall into this category), poor coping skills (little or no “emotional muscle”), anger that is stuffed instead of aired out and dealt with, overdependence (whether intentional or not), guilt (especially false guilt). And there are others.
Normally, as we are growing up coping skills are developed gradually through childhood and adolescence. In the right environment, a child learns from a parent or caregiver that even the scariest and most painful feelings can be alleviated over time, and that support will be there. However, some who have been abused or neglected in their formative years have not necessarily developed the emotional muscle they need to be able to tolerate the feelings that are an unavoidable component of grief. But these skills can be learned. For some, time will not healthe emotional wound inflicted by the loss of a loved one, at least not until needed coping skills are learned.
When a relationship marked by unresolved issues is ended by death, the survivor may replay those issues for years, perhaps for a lifetime. It is said that death ends a life, but it does not end a relationship. The more complex the relationship was, the more leftover conflicts, questions, and needs the mourner carries with him or her, the more likely the mourner is to remain emotionally entwined with the person who has died.
Survivors of conflicted relationships more often report a yearning for their lost spouse, while those from more loving relationships tend to be more successful in moving on with their lives. Husbands and wives who felt extremely dependent on their lost spouse tend to have more trouble adjusting to their loss.
Mourning can also be complicated by the circumstances of a death, which can burden the mourner with traumatic memories that stand in the way of healing. Traumatic death …too terrible to remember…too vivid to forget…no matter how hard you try.You just can’t “un-see” horrific scenes. A survivor of a loss by suicide might feel shattered, as if their relationship has not just ended but has been blown completely apart…and then comes the feelings of guilt…no matter who is to blame.
Sudden, violent death takes a terrible toll. Mourning becomes difficult and complex, partly because of the traumatic aftereffects, including the trial, which must be dealt with. PTSD(Post Traumatic Stress Disorder, called shell shock following World War II), commonly applied to those who endured up close and personal wartime trauma, and the fears of events like 9/11 as well as many other traumatic experiences. TheEmotional Trauma from these can hinder those first steps of grieving and interfere with their capacity to feel and process emotions much like physical trauma can prevent or at least delay the rehabilitation needed for a physical recovery.
A long, drawn out, or painful death that takes our loved one from us “an inch at a time” can leave images of our loved one that open emotional wounds.
What is normal? Sometimes it can be hard for someone who has experienced a loss to know whether their raw emotions are normal grieving experiences or if they are stuck and need help. Life happens. We fall down and when we fall down we get hurt. People die and when they die, we hurt. Grief gets complicated because life is complicated and because we are fragile and complex beings.
Depending on which author you read, as much as 1/3 of people who grieve will experience complicated grief…they get stuck. Of that 1/3 of people who get stuck about half will manage to find enough resources on their own to get unstuck all on their own. Others need help. People stuck in their grief sometimes ask, “Am I going crazy? Is my situation hopeless?” Most people, even those who believe that they will never recover, do.It might help to remember that. In almost all cases you are going to survive. It is not a matter of whether you will survive, you will, it is a matter of how you will live.
Whatever framework we use to describe healthy grief or healthy mourning- a journey(even though with many possible detours and an uncertain destination) - a process(for which there is no manual or standard work instructions) - or stages (through which we stumble from one to the other then back) - or steps (which we might fall down head-long just as we think we are reaching the top)…whatever framework the essential characteristic of healthy grief is MOVEMENT. For people who get stuck, nothing seems to change. It’s as if the death happened yesterday. Time stops, and with it the mourner’s involvement in life.
So, what can we do to get unstuck? I don’t have a short and simple answer to that, and we have limited space in this article, so let me speak in some generalities.
- Grief seems to go smoother if we don’t fight it or try to “should” ourselves out of it.
- We are all individuals and each loss is individual and must be grieved (mourned) individually.
- Even if society in general or our closest friend tells us that we shouldn’t grieve so much (the “get over it and move on because your grieving makes me uncomfortable”syndrome), the only way is to grieve our loss.
- Some process externally (talk it to death), and others internally (go inside myself and wrestle it to death). Still, finding a safe person or group of people where you can say what needs to be said, helps. A support group can be of tremendous value.
- Many ask, “How long should this last.” There is no expiration date on your grief. However, most express grief in terms of years instead of months, and certainly not in weeks. In most grief experiences you won’t always hurt as much as you hurt now.
- Writing seems to help. It is said that writing orders the mind and if you identify with the list of emotionsin the Ball of Grief below, writing your thoughts and feelings might help you bring some order to them. Writing helps move memories from the inside to the outside where you have the benefit of light and reflection. Reading them makes it possible to remember difficult times without reliving them. It also relieves us of the need to continually replay our memories; we have them, they are there, they’re not going to disappear.
- The good news is, Help Is Available! If it is urgent that you find help right this instant, move down to the next to last paragraph, otherwise, read on.
Anyone who is mourning is likely to feel stuck at one time or another. Losing a loved one is hard and painful. When someone I care about is in pain, I want to make it quit hurting. I have come to realize that is not possible when the pain is the pain of grief. Even if I could take the pain away, it wouldn’t really be helpful to the person. Emotional healing happens not because pain is taken away, but because it is given its due and allowed to run its course.
Many times it helps to identify what we feel and why. Dr. H. Norman Wright suggests looking at the list he calls “Grief-A Tangled Ball of Emotions” to identify what we are experiencing. Not everyone experiences all the “list” of feelings, but it’s definitely normal to experience them.
Some people get stuck in the darkness of complicated grief from self-protection “gone wild.” I thoroughly believe that no one wants to be stuck in grief, but we tend to prefer to “live with the demons we know” than to confront the demons we don’t know, or those we have locked away. We naturally protect ourselves. Grieving is painful; therefore we tend to protect ourselves from it even though the only way to “get over it” is to go through it.
The goal in complicated grief is not to take their/your pain away, but to un-complicate the mourning. To discover what is preventing them/you from moving forward so that the natural healing process can resume.
This is not something that only a therapist or counselor can do, there is only so much that even the best professional can do. A therapist can help. A friend can help. Groups can help. Family can help. But it is the bereaved person who is stuck has to do the healing. In the end, much like our physical bodies, healing can only happen from the inside out. If you are thinking, “That is easier said than done,” you are correct. But rather than shove someone toward the light, we need to find what compels them to stay in the dark.
Sometimes we have to hit bottom and get mad enough to fight our way out of the muck. That is more likely to happen slowly, gently, knowing that there are resources available, resources of assurance, comfort both internal and external. If I am focused on my own weakness, I might need you to lean on for a while. I might not actually lean on you that much as I learn to live again, but knowing that you are there may give me the courage to want to live again.
Grief itself has no cure. That is because grief is not a pathology…not an illness. Grief is an unavoidable consequence of the loss of connection. However, grief can worsen a number of different illnesses from physical things like high blood pressure to more complex emotional issues. In the absence of the things that get us stuck in grief, people generally do not remain in intense grief for years on end. Butneither does their grief disappear entirely, as any mourner knows.
Trigger points; anniversaries, birthdays, holidays, family get-togethers, weddings, graduations, changes of the season, a particular perfume or food, make us remember and we feel the stab of pain. But it is a pain mixed with the comfort of realizing that we haven’t forgotten what we loved about someone who died, and that we never will. For increasing periods of time, grieving people move through their lives and are not preoccupied by memories of someone they’ve lost. But for someone who is stuck in their grieving, grief remains just around the corner.
Dr. Phyllis Kosminsky in her book, Getting Back to Life When Grief Won’t Heal, suggests three commitments for people to help get unstuck from their grief.
1.Be gentle with yourself and others who share your grief.
2. Seek the truth and come to terms with it.
3. Look to others to help you through this difficult time.
If you feel like you or someone you love is stuck in your grief right now, let me offer a few suggestions.
- Call me or one of our other chaplains, my phone number is 479-228-7652. Or you can contact me through the HR department at any of our Simmons facilities.
- Talk to a pastor or a close friend or family member that you trust.
- Find a Grief Support Group in your area. If you don’t know how to find a Grief Support Group near you, call a local funeral home and ask them. Call a local hospice company and ask them. Look in the newspaper; some may be listed in the personal ads.
- When you speak with a counselor/therapist the first time, ask how familiar they are with complicated grief. If they give you a blank look, keep looking for the right counselor. Help is available.
People who know how to love, and who have loved deeply, have the capacity, and with time, the desire to love again. We humans are bound together as much by grief as by love, but we seldom speak of it. We need to change that so that others can do the same.
Chaplain Larry Hendren
Helpful Resources:
Getting Back to Life When Grief Won’t Heal by Dr. Phyliss Kosminsky, McGraw Hill Publishing Companies
The New Guide to Crisis & Trauma Counseling by Dr. H. Norman Wright, Regal Press (division of Gospel Light)
The Journey of Grief Video by Doug Manning, Insight Books, Inc.
Don’t Take My Grief Away From Me by Doug Manning, Insight Books Inc.