Grief Journaling IV

What Is Complicated Grief?

And Can Journaling about Personal Loss Help You Take the Difficult First Few Steps Out of the Dangerous Loop of Unresolved Grief?

There’s grief, and then there’s complicated grief. Or as DSM-V calls it, persistent complex bereavement disorder (PCBD). Are you or someone you know stuck in the latter?

Simple grief and complicated grief share the same characteristics during the first few months following a loss. But while normal simple grief dulls over time, complicated grief persists, stranding the grieving person in a chronic state of mourning.

People who grieve are expected to be unpredictable in the way they navigate through the different stages of grief, pinballing from one emotion/reaction to another—from shock to anger to depression, back to shock, to fear perhaps, and so on. In a simple grief situation, the person eventually resolves their emotional responses within the normal grieving period. Meanwhile, in a complicated grief scenario, the normal process that will eventually lead to healing is hijacked, leaving the person pinballing among emotions and reactions without reaching any semblance of resolution.

What are the telltale signs of complicated grief?

People suffering from complicated grief exhibit at least one of the following symptoms:

• Extreme focus on the loss and reminders of the loved one
• Intense longing or pining for the deceased
• Difficulty in accepting the loved one’s death
• Numbness or detachment
• Preoccupation with one’s sorrow
• Bitterness over the loss
• Loss of the ability to enjoy life
• Profound sadness or depression
• Trouble carrying out normal routines
• Social withdrawal
• Sense of meaninglessness or lack of purpose
• Irritability or agitation
• Paranoia, lack of trust in others

What causes complicated grief?

Complicated grief can be brought on by either of the following factors:

Unresolved past grief or trauma. Things happened in the past that the grieving person wasn’t able to process, most likely due to a lack of means to do so, either because they were too young to understand it or no one else knew about the trauma, and therefore no one could help.

Delayed grief. The grieving person is unable to react to a loss as they should and when they should have, because of circumstances preventing them from doing so (e.g., a mother whose child is very sick may shut down over the loss of her own sister).

Ambiguous or hidden loss. Losses like the loss of a baby through a miscarriage are invisible and therefore unacknowledged by others.

Compounded losses. Multiple, concurrent losses can be nearly impossible to process together in a healthy manner.

Traumatic loss. Sudden, lingering, or violent losses are descriptive of traumatic loss. A lingering loss, for example, is characterized by a recurring disruption or contradiction of an established belief about ourselves, someone, or something that in the long run creates trauma and leads to complicated grief.

Assumed responsibility for the loss. The grieving person is convinced they did something to cause the loss, or failed to prevent it from happening

An invalidated loss. Invalidation is rejecting, ignoring, mocking, teasing, judging, or diminishing someone’s feelings. When we invalidate our loss, we view our normal grief over it as an overreaction instead, which prevents us from having an honest experience that is necessary for our grief to resolve itself. Invalidating a loss may be a form of going along with the general reaction toward it (e.g., the rest of your family is only mildly sad that your puppy died, and you follow their cue to avoid being ridiculed or accused of being dramatic). It is influenced by the circumstances surrounding the loss as well as by the culture in your family, your community, and so on.

Who are most likely to experience complicated grief?

The people more prone to succumb to chronic grief typically share the following elements in their background:

• a history of depression and anxiety
• emotional dependence on the person they lost
• alcohol and substance abuse

Journaling as part of the steps one takes toward healing

DSM-V classifies persistent complex bereavement disorder as a condition requiring further study because of its level of complexity. Because of the emotional confusion inherent in complicated grief, meaning-making becomes an even more critical aspect of the process of overcoming. And because meaning-making requires the grieving person to be able to make coherent associations and connections among events, emotions, and other people related to the loss, grief journaling can help cultivate the mindfulness that facilitates the process.

Explore how we at Journalz, in our own way, can help you or someone close to you start the long-overdue process of overcoming an unhealthy grief and moving on toward healing.