Grief is always a many-layered thing, composed of intricate notes of memory and emotion that emanate from the deepest parts of our being. It may therefore feel trite to describe some griefs as “complex” (with the inherent implication that others are “straightforward”), but when we are dealing with something as profound as mourning, the words we use are inevitably going to feel like an imperfect reflection of our experiences. In this article, we endeavour to answer the thorny question of “what is complex grief?” and discuss how those affected can seek help.
In the briefest terms, the phrase complex grief refers to a reaction to loss which does not lead to any healing or acceptance. While feelings of heartfelt sadness and even lasting changes in worldview and personality are expected when someone has been bereaved, complex grief goes beyond what we think of as “normal” mourning.
Complicated or complex grief is not only life-altering, but life-hindering, locking people into a state of distress they cannot work through or move on from. Those affected by complicated grief may be unable to cope with the emotional impact of their loss, or find that even as time passes that they simply cannot readjust to any of the normal routines or duties of life.
Complex grief is thought to be especially common in cases where people:
- Have suffered a traumatic loss.
- Have been bereaved suddenly.
- Were particularly dependent on the person who has passed away.
- Had a complicated relationship or unresolved issues with the loved one they lost.
There are some powerful arguments against “medicalising” grief – with the recent recognition of prolonged grief disorder by the Diagnostic and Statistical Manual of Mental Disorders causing controversy in the USA. But while complex or prolonged grief is not a formal medical diagnosis in the UK (and perhaps should not be viewed as such) it does have particular experiences in common, which can help people recognise whether they are affected by this particularly severe form of loss and get the help they need.
Understanding the Signs of Complex Bereavement
When someone special to us has passed away, we come to understand that we face a long road of sadness and heartache before reaching recovery. Everyone’s experiences are different, but most of us walk this road and find that, with time, we begin to heal – even if we are changed, and even if we always miss them.
In the process of healing, we tend to accept the reality of our loss, feel its pain and slowly adjust to life without our loved one. Eventually, we find that although that person is still in our hearts and we feel their loss, their absence in life is no longer dominating our emotions. For people experiencing complicated or complex grief, however, this is not the case, and the impact of bereavement can become unmanageable.
In complex grief, the acute anguish of loss – which is considered normal and inevitable in the months after bereavement – does not fade as time passes but lingers and (in some cases) grows worse. As time goes on, this fastened and heightened form of mourning becomes a burden that does not allow for healing or acceptance, but instead disrupts the normal flow of life.
While the symptoms below are often considered “normal” in the first stages of grief, a person may be suffering from complicated grief if the following feelings and experiences do not lessen with time:
- Deep and all-consuming emotions of sorrow, regret or heartache.
- A sense of numbness, anhedonia or detachment. Believing that life no longer holds any enjoyment or meaning.
- Being unable to focus on anything but the loved one who has passed on, or the manner of their passing.
- Either a fixation on, or excessive avoidance of, any reminders of their loved one.
- Being unable to accept the loved one’s passing, continual longing for their presence.
- Feeling extremely bitter about the loss and having difficulty recalling positive memories.
- Believing they are in some way to blame or could have prevented the loss.
Feeling this way, understandably, has a profound impact on the way that people function in life. They may be unable to cope with a normal routine, struggle at work and cut themselves off from social activities. The undoing of social and professional ties can then go on to compound the loss, and contribute to the “downward spiral” of events which can lead to clinical depression.
Getting Help for Complex Grief
If you recognise the feelings and behaviours described above in yourself, we offer you our sincerest sympathies and condolences, and hope that you can find a way through this emotional pain. Others experiencing complex grief have, with time and support, found a sense of peace and healing, and this isn’t something people have to cope with alone.
If you can, it is important to reach out to friends or family to discuss how you feel. Joining a local grief support group can also provide a vital source of help and comfort (you can search for support groups near you using this NHS tool), and it is always important to seek advice from a GP if you are experiencing significant mental health pressures.
The services and charities below can also provide specialist support and advice if you are struggling to cope with your grief.
- Cruse Bereavement Support – https://www.cruse.org.uk/
- Widowed and Young – https://www.widowedandyoung.org.uk/
- At a Loss (signposting service to counselling and other support)- https://www.ataloss.org/
- Bereaved through Alcohol and Drugs (BEAD) – https://www.beadproject.org.uk/
- Sudden (support for people bereaved by sudden death) – https://www.sudden.org/
- Survivors of Bereavement by Suicide (SOBS) –https://uksobs.org/
- Child Bereavement UK – https://www.childbereavementuk.org/
- Sands (information and support for anyone affected by the death of a baby.) – https://www.sands.org.uk/
The support of others, and knowing we are not alone, can carry us through even the darkest times. We hope that the services provided above help you in your grief.