It's complicated


This week I want to briefly touch on the very broad subject, known by people in the industry as ‘Complicated Grief’. I could write innumerable books on this subject without ever reaching a completion point. My desire is to simply raise the truth of its existence and to encourage anyone whom may be in fact ‘stuck’ in complicated grief to seek support and professional help – to see you unstuck from its crippling grasp.

“Grief” is a very simple word for a very complex and unique experience. Therefore, many would assume that all grief is complicated. Although this is in many ways true, we use the term complicated in the medical sense, meaning that something is interfering with one’s coping mechanisms when dealing with a loss.

Think of losing a loved one as somewhat like a physical injury and the psychological issues that interfere with grief, like an infection that complicates the ability for the wound to heal. This is what we mean by complicated grief. 

Complicated grief (CG) is the condition that occurs when the instinctive adaptive response to bereavement becomes stalled.[1]

On many occasions, I have heard the common misconception that complicated grief only occurs when there were “issues” in the relationship between the deceased and the person(s) experiencing the complicated grief. However, this is not always the case, in fact, recent research indicates that it is more often those who were extremely close and in strong relationships with the deceased who most experience the paralysing impact of complicated grief.

I particularly like the way summarise the notion of complicated grief:

“It is natural to experience intense grief after someone close dies, but complicated grief is different. Troubling thoughts, dysfunctional behaviors or problems regulating emotions get a foothold and stall adaptation. When this happens acute grief is prolonged.[2]

They go on to highlight three other areas that could indicate an individual is experiencing complicated grief. They are

  1. Troubling thoughts
  2. Avoidance of reminders
  3. Unable to regulate the intense emotions

These three observations are a very narrow insight into the complexity of the issue… for which I would personally also add the following:

  1. The inability to return to ‘normal’ days such as work, sport, friends, etc.
  2. The loss of hope for your own life
  3. Isolation from others
  4. Intense and paralysing pain (emotional and/or physical)

In the Handbook of Thanatology, Robert Neimeyer and John R. Jordan offer the following ‘Diagnostic Features of Complicated Grief.’[3]

  1. Duration of bereavement of at least 6 months.
  2. Marked and persistent separation distress, reflected in intense feelings of loneliness, yearning for or preoccupation with the person who has died.
  3. At least 5 of the following 9 symptoms experienced nearly daily to a disabling degree:

a. Diminished sense of self (e.g., as if a part of oneself has died)

b. Difficulty accepting the loss on emotional as well as intellectual levels.

c. Avoidance of reminders of the reality of the loss.

d. Inability to trust others or to feel that others understand them.

e. Bitterness or anger over the death.

f. Difficult moving on or embracing new friends and interests.

g. Numbness or inability to feel.

h. Sensing that life of the future is without purpose or meaning.

i. Feeling stunned, dazed or shocked by the death.

4. Significant impairment in social, occupational, or family functioning.

I wonder if you or a friend of yours can relate to all or some of the above list?

The good news is that people can and do come through complicated grief to successfully reengage with a fulfilling life. With support, professional guidance, commitment to recovery, and time, people most certainly do come out of the paralysing effects of complicated grief.

It is our heart here at OMG to see you or those you know and love also come through the significant challenge of Complicated Grief.


By Steve Morrison

[3] Meagher, D. K., & David E Balk. (2013). Handbook of Thanatology: The Essential Body of Knowledge for the Study of Death, Dying, and Bereavement (2 edition). Routledge.