Grief is one of the most painful experiences we go through in life. Losing a loved one, either because he or she passed away or the relationship has been definitively broken, can cause excruciating pain that is difficult to overcome. Accepting the new reality takes time and effort. Some people find it more difficult than others, and there are those who get caught up in an complicated grief.
What is complicated grief?
As a general rule, when we face a loss we go through a series of stages that help us to overcome the grief. We go from a first phase of denial that allows us to soften the pain of the news, to experience great anger at the loss and sink into the deepest sadness to finally come to acceptance.
In complicated griefs, we don’t go through all these stages, we get stuck in one of them, so we don’t end up accepting the loss. Our inner world is not restructured to accept reality because we cannot get rid of recurring thoughts about the person who left us, which prevents us from getting back to life.
Signs of a complicated grief
A research conducted at Columbia University found that most people end up accepting loss and grief in a more or less healthy way, so that they can move on. The average time they need to overcome the loss is usually between one and two years. However, 7% of people get stuck in denial, anger or sadness, without reaching the necessary acceptance.
1. Denial of loss
One of the symptoms of complicated grief is denial of what happened. The person refuses to emotionally accept the loss. Although he or she is aware that the other is gone, his or her mind has set up defense mechanisms to protect himself or herself from a huge pain.
These people generally refuse to talk about what happened and do not express feelings of pain, sadness or anger. If we ask them how they are, they will respond with a curt “fine” and change the subject. The affective state that predominates is emotional anesthesia, almost everything is indifferent to them and they live on automatic pilot.
2. Hypersensitivity
Losing a loved one leaves us battered and vulnerable. No doubt. During the early stages, it is normal that the memory unleashes very intense and difficult to manage emotions. However, as time goes by we get used to the new reality and our sensitivity decreases. Sadness gives way to nostalgia and pain to gratitude for what was.
In a complicated grief, the person can remain in this state of hypersensitivity for years. He or she is left with a bundle of nerves. This extreme sensitivity is manifested not only when talking about loss, but in different areas of life. As his or her resources for emotional coping have been drained considerably, any small setback seems like an insurmountable challenge. Everything overtakes the person, so he or she gets irritated, frustrated, or crumbles at the slightest problem.
3. Guilt
One of the most common signs of a complicated grief is a sense of guilt. When we suffer a loss, it is normal for us to question our role in what happened, because we feel an urgent need to make sense of things. However, we can run the risk of getting caught up in what is known as the “negotiation stage”.
We feed the fantasy that we could have done something to change the facts. We get caught up in questions like: What if…? Could I have done something to change what happened? In this way, it is not difficult for us to end up blaming ourselves – for what we did or did not do – falling into a toxic loop of reproaches in which reason abandons us and guilt and remorse are established.
4. Somatizations
Emotions and stress are reflected in the body. When going through a complicated grief, it is normal for these tensions and anguishes to end up targeting the body, expressing themselves through different symptoms, which vary from one person to another.
In fact, it has been observed that during grief the pain threshold decreases, which causes us to experience more discomfort than usual. A study conducted at Semmelweis University found that people who go through complicated grief experience more somatic symptoms, most of them related to anxiety and depression. We can experience from muscle aches to digestive disorders, insomnia, headaches and skin problems. In those cases, the emotions speak through the body.
5. Loss of meaning
“Grief turns out to be a place none of us know until we reach it… the unending absence that follows, the void, the very opposite of meaning, the relentless succession of moments during which we will confront the experience of meaninglessness itself”, wrote journalist Joan Didion.
A common symptom of complicated grief is the loss of meaning, especially if life orbited around that person or it was someone close who provided us with happiness and comfort. When we don’t elaborate the grief, we can’t move on. Everything seems gray and anodyne to us, nothing excites or motivates us because we are incapable of looking to the future and making plans. We simply limit ourselves to surviving in a routine.
The difficult mission of overcoming the grief
For a long time, many psychologists have defended the idea that to overcome grief it is necessary to go through several phases or stages. However, the American psychologist J. William Worden thinks that this approach puts us in a passive position regarding pain and suffering, as if we can do nothing more than sit and wait for time to heal the wound.
Instead, he proposes the concept of “grief tasks”, which allows us to take a more active stance in elaborating the loss. One of those tasks consists precisely in reconsidering the emotional place occupied by the person who abandoned us. It is not about forgetting him or her, but about giving him or her a new space in our emotional life.
We need to find a place for the person who went away, so that we remain attached to him or her, but that link does not prevent us from moving on. To do this, we need to find new ways to remind him or her that don’t cause us deep pain but generate that feeling of longing and gratitude for what he or she was.
Sources:
Vedia, V. (2016) Duelo patológico: Factores de riesgo y protección. Revista Digital de Medicina Psicosomática y Psicoterapia; 6(2): 12-34.
Shear, M. K. et. Al. (2014) Bereavement and Complicated Grief. Curr Psychiatry Rep; 15(11).
Konkolÿ, B. et. Al. (2012) Mediators between bereavement and somatic symptoms. BMC Fam Pract; 13: 59.
Shear, M. K. & Mulhare, E. (2008) Complicated Grief. Psychiatric Annals; 38(10).
Worden, J. W. et. Al. (2006) Considerations in Conceptualizing Complicated Grief. Omega; 52(1): 81-85.
