When Grief Gets “Complicated”

 Of the many social idiosyncrasies Facebook has brought to bear, relationship status “It’s complicated” is perhaps the most iconic. Complication, after all, can indicate any number of unpleasantnesses, none of which seem appropriate for everyday conversation. And when it comes the loss of a loved one, “the tendency socially is to bury the desire to talk about it,” says Dr. Ed Mahoney, D.Min., LLP, “yet grief is a part of life. We all grieve.”

As a Licensed Pastoral Psychotherapist at The Mental Health Center of Greater Manchester, Dr. Mahoney knows a thing or two about grief. It is a natural response to loss, he states, one which encompasses a range of emotions, thoughts, and behaviors and can initiate social, spiritual, and physical changes. While everyone grieves in their own way, there are important similarities that more often than not lead to healthy adaptation. There is an exception to that norm, however, something M. Katherine Shear, M.D., of Columbia University has written about extensively: Complicated Grief.

Also known as Prolonged Grief Disorder, Complicated Grief interferes with adapting to loss, such that it limits day-to-day functioning for an extended period of time. According to Dr. Shear, “[it] affects about 2 to 3% of the population worldwide,” though it can affect upwards of “20% after the death of a romantic partner and an even higher prevalence among parents who have lost children.” A student of Dr. Shear, MHCGM therapist Dr. Ed Mahoney describes Complicated Grief as a function of intensity and duration, the grief reaction exceeding normal cultural expectations of the person affected.

“There are a fair number of individuals who experience difficulty,” says Dr. Mahoney. “For both therapist and the bereaved, being aware of the aspects of grief is important.” Signs that a person may be experiencing Complicated Grief include:

  • Maladaptive Thoughts: second-guessing, grief-judging, catastrophizing the future, and survivors guilt
  • Dysfunctional Behaviors: Excessive avoidance, proximity seeking, substance misuse, and negative health behaviors
  • Problems Regulating Feelings: Difficulty managing strong emotions, low positive emotions, and low self-compassion
  • Severe Social/Environmental Problems: Lack of supportive companionship, harboring blame from others

Thankfully, however, MHCGM offers many Evidence-Based techniques and modalities to treat Complicated Grief once it is identified: Worden’s Task of Grief Therapy, for example, Shear’s Complicated Grief Therapy (CGT), Cognitive Behavioral Therapy (CBT), and Interpersonal Therapy (IPT) . It’s important to remember that grief is personal and no two individuals grieve the same. Consequently, what may appear to be Complicated Grief in one instance may not be in another.

If you or someone you know may be suffering from grief, please consult with a professional trained in grief counseling who can assist in determining whether the bereaved is experiencing Complicated Grief and offer guidance with how to help. Call The Mental Health Center today to schedule an appointment: dial (603) 668-4111 and choose option 4.

As Dr. Mahoney well knows, asking for help is the first and most important step in taking care of your mental wellbeing.