Caregiving

Explaining 'Complicated Grief': When Grief Doesn't Go Away

Expert guidance to work your way through overwhelming grief.

It’s not unusual to feel sad after someone close to you dies, like a parent or spouse. But sometimes your emotions – yearning, anger, bitterness – become so intense they derail the grieving process and interfere with your ability to function. That type of grief is called complicated grief, and older adults are especially vulnerable. In this lightly edited interview, Colleen Bloom, a social worker and manager for the Center for Complicated Grief at Columbia University, explains what complicated grief is, how to recognize it and how to find help.

What is complicated grief? When we lose someone close, there are unique challenges we face, and meeting these challenges helps us adapt to the loss. Adapting doesn’t mean that grief is gone, or we’ve moved on. When we lose someone we love, we will always grieve. What it means is that grief becomes integrated into our lives in a way that allows for purpose and meaning and joy and satisfaction.

In complicated grief, something gets in the way of adaptation. Grief remains intense and continues to dominate a person’s life. The future seems bleak and empty. A person feels lost and alone. It’s important to know that derailers, or the things that get in the way, are natural to experience. Some examples of derailers are judging grief too harshly or trying to control its intensity, having no one to share the pain with, blaming yourself or others and avoiding reminders of the loss.

Why are older people more vulnerable to experiencing this type of grief? Older adults are more likely to have lost someone close, like a parent, sibling, a close friend, their spouse, or even a child. Older adults are also more likely to be socially isolated, which can get in the way of that process of adaption to the loss.

How can someone, especially the griever, understand that he or she may be experiencing complicated grief? One of the questions that we ask people is, “Do you have strong feelings or yearning or longing for a loved one, or thoughts and memories that are so persistent and intense that it stops you from living your life in a meaningful way?” We also have a screening questionnaire on our website with five questions you can ask yourself to see if you might be suffering from complicated grief. We think that knowledge of the condition can be powerful. We talk to so many people who say, “I felt like I was going crazy, and no one could understand what I was going through. Then I read about complicated grief and it made me feel hopeful that there’s a name for what I’m experiencing.”

What are some ways complicated grief can be treated? It’s really important to have someone to talk to. Grief is often confused with depression, and they can overlap. But they are different. A special therapy has been developed and tested called Complicated Grief Therapy. It identifies what’s getting in the way and helps foster adaptation to loss. Our center’s website maintains a directory of therapists trained in this approach. Or if you find someone you are comfortable working with, have them contact us and we will help them learn about this.

What else can sufferers do to deal with their grief? You don’t want to push grief away or judge it too harshly. Practice being kind to yourself rather than self-critical. Additionally, there are likely calendar days that are especially difficult for you, like a holiday or anniversary. It’s natural to want to avoid thinking about these days, but it can be helpful to plan ahead. Think about ways you might honor your loved one on that day.

Maybe there’s something special you can do by yourself or with others. Maybe it’s going around the table and sharing a favorite memory. Also think about how others can support you and lighten the load.

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