The Complexity of Grief
By Vanessa Gonzalez
Grief is a common yet distressing aspect of life that everyone will experience at some point in their lives. There are common symptoms, even though there is no specific or normal way to grieve. When working with therapists, they may describe grief in different ways.
One way to describe grief is through metaphoric language. One example a therapist may use is the imagery of a beach. Right now, the beach may feel like the waves are crashing, and there’s an intense storm. However, the storm may clear over time, and the beach looks clear and steady again. However, sometimes that storm returns with less intensity or is just as intense as the first time it came. So the reactions each time can ultimately vary.
The individual does not completely heal from the grief of losing something or someone they once cared about. Instead, it’s learning to live with a new normal, and there is no right or wrong way to grieve that loss. Typically, these feelings last at least one year during common grief.
Common Symptoms of grief include:
• Numbness• Anger• Fatigue• Yearning• Sleep disturbances• Appetite disturbances, • Social withdrawal,• Dreams of the deceased• Tightness in the chest• Shortness of breath • Lack of energy• Panic attack-like symptoms• Disbelief • Confusion • Lack of concentration
Five Stages of the Kubler-Ross Model
The five stages of the Kubler- Ross model are denial, anger, bargaining, depression, and acceptance.
1. Denial: The first stage, denial, is a way in which one protects themselves from the reality of the loss.2. Anger: The second stage, anger, is the step in which the individual acknowledges reality and is the easiest emotion to manifest all of the complicated feelings. 3. Bargaining: Bargaining is when an individual tries to have some control over the situation and negotiate the pain and hurt.4. Depression: Depression is when the individual confronts the reality of the loss and accepts it’s not within their control.5. Acceptance: acceptance is when the individual realizes there is nothing they can do to change the situation and no longer protests against it
Complicated Grief
Referring back to the beach metaphor, eventually, that beach clears, and waves come and go. So there may be another response that can prolong the “storm” and immobilize the grieving process called complicated grief.
Complicated grief is a period of overwhelming grief that persists at least six months after the loss. It is marked by a profound yearning to be reconnected with the deceased, significant distress, intrusive thoughts of the loved one, disturbing images or memories of the vent of losing the individual, avoiding any reminders of the loss, and a longing to feel closer to the deceased.
Counselors need to understand the difference between common grief symptoms and when it becomes distressing to the individual. Depression, on the other hand, shares many diagnostic criteria with complicated grief.
According to the DSM, to differentiate grief from major depressive disorder (MDD), it's important to remember that grief and loss are significant in grief. In contrast, persistent depressed mood and loss of pleasure in activities and things they enjoyed are predominant in MDD (American Psychiatric Association, 2013). While grief may include depressive symptoms and lack of happiness, it is typically due to feelings surrounding the loss of the deceased and the loss itself.
Treatment
There are many different ways to treat grief. Complicated grief is often treated with psychotherapies and medication. Treatment can be done in individual counseling, group counseling, Cognitive-behavioral therapy (CBT), or medication.
Since grief is individualized, so should treatment. Speak with a mental health professional if you need support after losing a loved one. Grief is difficult, but you don’t have to go through it alone.
