Grief Journaling V

Therapy for Complicated Grief

And How a Grief Journal Can Help Facilitate the Each Form of Therapy

Mostly it is loss which teaches us about the worth of things.

—Arthur Schopenhauer

What someone going through complicated grief needs to do is to work through their experience of the loss. In other words, to grieve in a normal manner. But unlike simple grief, complicated grief requires professional/clinical intervention, because it is chronic and debilitating. A therapist or a counselor steps in to guide them in the task of incorporating the meaning of their loss into their life to enable them to carry on without resorting to denial or any of the other negative emotions/reactions that would otherwise remain unresolved.

Therapy for complicated grief can be done through either of the following methods:

Cognitive behavioral therapy

Complicated grief is sustained by maladaptive thinking (a belief that is false and rationally unsupported) and maladaptive behavior (behavior that inhibit one’s ability to adjust to situations). Complicated grievers confront the loss with irrational thoughts, perhaps thoughts that give them pleasure by imagining the deceased loved one to be still alive. In a complicated grief, the loss signifies an end of life instead of a change in life. The person is unable to manage and work through the loss because they can’t tolerate it; and rather than find meaning in it, they regard it as senseless. And in thinking this way, they contrast their pain with the pleasure they derive from their closed-ended irrational ideas, which assures them on the subconscious level that they can continue hanging on to the lost loved one instead of recovering from the loss and moving on, and thereby letting go.

In this form of therapy, the grieving person is guided through a 180-degree turn to rational thinking and full awareness of the reality of their loss. This reorientation lessens the yearnings for the lost loved one, undermining the pleasure/reward cycle.

How journaling can help

A journal can serve as a practice tool for the mourner to redirect their thoughts. They can document and track their progress through regular journal entries that show how steadily they are veering away from where they started and how far they still have to go before they reach full healing.

Exposure therapy

One key sustaining feature of complicated grief is avoidance. The mourner doesn’t want to be reminded of the loss. They want nothing to do with events from the past, and they refuse to entertain thoughts about the future that don’t include the deceased loved one.

In therapy that is based on exposure, the person grieving is must allow themselves to be exposed to all the people and events that are a part of their lives, and they must carve out a time just for grieving, to allow themselves to experience the pain and acknowledge that the loved one is gone. They must also slowly remove excessive reminders of the deceased loved one, which, up to this point, has stranded them in an unhealthy state of mourning.

How journaling can help

Writing about the loss can ease the mourner into confronting the reminders of the loved one as well as explore and elaborate on the implications of the loss. Through a journal, the mourner can recount the story of the loss, including its most distressing aspects, and describe how they really feel about the loss.

Meaning therapy (meaning-making)

Grieving requires grievers to make sense of their loved one’s death using existing understandings and prevailing beliefs around death (e.g., viewing the death as God’s will), or accommodate the loss through meanings that reorganize, deepen, and expand the way they understand themselves and life as a whole (e.g., recognizing the need to act as a surrogate parent to one’s younger siblings with the death of the remaining parent).

How journaling can help

A journal offers a private space for the kind of introspection, often painful early on, that makes meaning-making happen. Writing without any form of editing or proofreading is a cathartic aspect of grief journaling that helps guide the mourner toward resolution and acceptance.

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The above methods of therapy are just the most commonly used in complicated grief therapy. Other methods may include a combination of either two or include elements from all three. Still others may still be experimental. There’s also little solid research on the use of psychiatric medications to treat complicated grief, although if clinical depression is a major feature in a given complicated grief, antidepressants may be prescribed.

We at Journalz would like to help in your journey, or that of someone you know, through a healthy grieving process and toward healing.