Unresolved Grief: It’s Complicated

Unresolved Grief: It's Complicated

by Erin Doeberl

Kate was a 38-year-old mother of three and sister of two. She had lost her eldest sister, Jane, unexpectedly to suicide. It was a terrible shock for Kate — this was her big sister, the one who understood Kate the best and was always there for her. “How could I not know?” Kate would sometimes exclaim to herself. “What am I going to do now?”

Kate began suffering regret, remorse and guilt almost immediately following the news of Jane’s death. Kate’s reaction was not unusual. The first few months after the sudden death of a loved one bring about a variety of different feelings, sometimes a sense of pervasive numbness, other times a rapid shift of emotions, like a roller coaster ride.

Kate expected to be emotionally inconsistent for a while. But a year and a half later, she was still feeling the same way, except possibly worse. She found herself avoiding anyone associated with Jane. She stopped calling Jane’s husband and didn’t reach out to anyone else in Jane’s family, not even around the holidays, which only exacerbated her feelings of loss and loneliness.

Kate also noticed that small triggers, such as a sad line in a song or a sentimental greeting card, would send her into intense emotional outbursts with prolonged crying jags. It got so bad that Kate even gave up on basic daily routines, like bathing and washing her hair and changing out of her pajamas. She just didn’t see the point anymore.

While a majority of people bereave in a healthy, appropriate manner, there is a smaller percentage of people whose emotional response remains unresolved, which is known as complicated grief. This inability to heal and move on from a loss can be related to many different factors. For example, with suicide, family members and friends often feel either responsible for their loved one’s death or the guilt of negligence, not having foreseen the tragedy to come. This kind of response is like quicksand. As you sink deeper and deeper into the malaise of your guilt, you become fully stuck and unable to move forward with your life.

Shame and a lack of understanding regarding the reason for the suicide can leave the survivor, like Kate, in a vicious loop, replaying over and over the events and interactions leading up to the suicide, looking for some clue to help understand why it happened and subsequently overcome their guilt. But this precludes mourning and grieving in a healthy way, and simply keeps you locked in a cycle of regret, unable to move beyond your self-imposed shame.

Other people suffering with complicated grief might be experiencing feelings of anger and abandonment surrounding their loss. For example, sometimes a loved one passes away when there are unresolved problems between the two of you, when you’re not on speaking terms, for example, or when there are issues of physical, financial or emotional dependency. Sometimes the bereaved fears the grieving process — in their mind, it will bring on terrifying feelings of isolation and abandonment.

Others suffering with complicated grief may have difficulty mourning because they don’t want to appear weak or emotionally unstable. Often people fear that dealing with death will elicit intense emotions that they won’t be able to manage or might cause them to unravel emotionally or psychologically. But avoiding grief can, ironically, lead to chronic grief, in which the bereaved does not make any emotional progress and remains stuck. This can cause dysfunction of previously functional relationships, symptoms of anxiety and depression, and a deterioration of the values you’ve held for years.

Fortunately, Kate was able to attend therapy sessions to learn how to grieve the sudden loss of Jane. By working on redefining her relationship with her sister, she was able to move forward in accepting her loss.

The following are important steps in overcoming complicated grief:

  1. It is important to create coping mechanisms (i.e., breathing and/or relaxation techniques like yoga) to help manage any overwhelming thoughts or feelings that may arise when thinking about the deceased.
  2. The goal is not to put the deceased out of mind, but to develop a new relationship with them. For example, remembering positive moments with this person, creating an internal dialogue with the loved one, like asking them how to get through a difficult situation or sharing new and exciting life events (“It’s your niece’s wedding today and I wish you could be here, but I know you would be proud of her”). Keeping the loved one in mind and in memory can help to provide the bereaved with some reassurance that they don’t have to completely say goodbye.

Identifying grief as unresolved or complicated is important. If someone is isolating from family members or friends who knew the deceased, demonstrating symptoms of anxiety or depression, having intense emotional outbursts over minor triggers, or having trouble with personal relationships or simple daily routines, they may be suffering with complicated or unresolved grief. It is important that they seek help from a counselor to help address these issues and allow for some release of their grief. This kind of pain and anxiety will not cure itself.

Erin Doeberl, LPC, is a therapist with Family Centers. Serving Greenwich, Stamford, Darien, New Canaan, CT, and Westchester County, NY, Family Centers is a United Way, New Canaan Community Foundation and Community Fund of Darien partner agency that offers counseling and support programs for children, adults and families. For information, call 203-869-4848 or visit www.familycenters.org.

Thank you to Grace Bochain Luddy for the use of her photo.

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