When Grief gets Complicated

Prior to the two World Wars, traditions surrounding grief, in Europe, particularly in England, were commonly known by all. They involved the wearing of black, not attending any festive or social events for a year, often not leaving the house, to name a few. All knew the signs of someone in grief. 

During those wars, particularly WWII, there was so much loss that if everyone followed the traditions of grief, the whole economy would shut down. Governments stepped in, urging  people to put aside their grief in order to function and continue with their daily lives. Slogans like, “Keep Calm and Carry On.” Were an encouragement to continue on with life so that society could and survive this insane period in history. 

Unfortunately, when the war was over, people did not pause to process their grief, or return to previous traditions, most just carried on. Their children watched their parents and took from their actions that when grief hit, the task of the griever was to continue on as best they could as if nothing had happened, taking as little time to grieve as they could, and showing as little emotion as possible.

In North America, these days, those of European descent has lost traditional ways of grieving and no longer seem to have a clear idea of what normal grief looks like. When people do have normal grief reactions and need more than a couple days off from their normal life routine, they, and others, often feels that something is wrong. Medications are dispensed, workplaces encourage counselling with an aim to “get over it” so that their employees can return to productivity. Well meaning friends and family encourage individuals to distract themselves, “go on a trip, get back to work, start dating again.” Most people find being around a grieving person extremely difficult, we just wan to make them feel better and we worry about them. These ways of pathologizing grief have become the norm in our society and serve to intrude on a healthy grief process. 

Recently, there has been a movement to challenge the pathologizing of grief by talking about the normal grief responses in their wide and varied states. Articles, books, seminars on grief note that experiencing a wide variety of emotions, such as anger, relief, sadness, joy, guilt, (to name but a few) are all normal. Experiencing sadness for years on end is also normal. Difficulty with sleep, appetite, motivation, concentration and memory can also all be part of a normal grief process. 

I hope, this movement continues on and that our society makes room for normal grief in more tangible ways, through much, much longer compassionate leaves, through acceptance of grief in all of its forms, and through encouragement to feel what you feel and to care for yourself in your grief process.

The question, at this point in history, while working our way out of a time when grief has been so pathologized, might be, how do we know when there is a problem with grief?

How can we tell when grief has been interrupted, co-opted or made complicated by something else and needs specific treatment or attention? 

This is a difficult question to answer, because a lot depends on context. However, I will say that no matter what your grief process is looks like, it is always okay to talk to a counsellor about what is happening. Even if your process is 100% normal and healthy, you may find it difficult to find other people to talk to about it who are not fearful or uncomfortable with your grief. Or, you might just want to talk to someone who is not affected by the same grief you are. 

Here  are some things that you might want to pay attention to, when grieving:

Thoughts of suicide

Wanting to be with your loved one is not abnormal. In many part of history it was not considered pathological to have thoughts of suicide after losing a loved one and, in some cases, to attempt or complete suicide. These days, it is commonly agreed that thoughts of suicide are something worth addressing with a a professional. If you are having thoughts of suicide, call a crisis line, tell a doctor or a mental health professional. They will often ask you questions about whether you have specific plans to complete suicide and if you’ve put any plans in place. They will ask about any timelines you have for carrying out these plans and some questions about what might stop you from carrying them out. Depending on how urgent the situation is, they may take immediate steps to ensure that you are safe, such as asking to speak to someone who is with you who can help to disable the plan. If you are alone and there is a fear that you might act on those plans quickly, as in, you have a weapon or the means to end your life within your reach and you have intention to use it, they may need to call for emergency help. 

Physical Health

While sleeplessness and loss of appetite are normal parts of grief, pay attention to your health. Make a doctor’s appointment so they can see how much weight you might have lost and let them know how much sleep you are, or, are not getting. Lack of sleep and extensive weight loss can impact your ability to process your grief and may prolong or complicate it. Again, there is always a context. In the early stages of grief, you may need to force yourself to eat some days, but it is okay to not be up to your regular appetite. Sleeplessness is sometimes better served by following good sleep hygiene, (See When You Can’t Sleep), giving yourself time to reengage with activities like getting outside, exercise, etc. which may reinstate normal sleep patterns, in time. Some doctors are quick to respond to their patients concerns about these things with prescriptions, but ask if there is any danger in trying more natural methods of re-instating good sleep and eating patterns. Sometimes medication can get in the way of normal sleep processes. Check out (Mental Health & Medication). Ask your doctor what would tell you that your health is in danger and that it might be time to consider a sleep aid. 

Historical Trauma and Unresolved Grief

The death of a loved one or of someone close to you can awaken previous trauma. If the person who died was connected to  previous trauma, such as abuse, this can sometimes be triggered when they pass. Memories of events and emotions connected to that time can come flooding back. This can be confusing if the events were a long time ago and, particularly. if you feel like you’ve already processed these things. If you’re feeling particularly overwhelmed by these thoughts and memories, it would be a good idea to talk to someone about them.

Sometimes grief brings up previously suppressed grief or suppressed emotions, in general. For example, if a friend’s aunt, whom you never met, dies, and you find yourself unable to get out of bed for days due to overwhelming grief, you might ask what this situation reminds you of or what it is about this situation that brings on such strong feelings. It maybe a response to previously unacknowledged or avoided grief.

Anxiety

When a death is unexpected, the shock can be overwhelming. You might find yourself fearful of things that are similar to the circumstances in which that person died. If it was a car accident you might find yourself avoiding driving. If a child died, you might find yourself becoming overly protective of your own children. Sometimes when people are feeling particularly anxious after an unexpected death, they might know, on one level, that their fears are overblown, but feel unable to move past them to make rational decisions about their lives. At this point, it would be a good idea to talk to a counsellor about how to address these fears. Addressing this type of anxiety with a counsellor, often looks like talking through the circumstances that led to these fears and taking steps towards re-engaging with these activities. Reengagement will often happen slowly, while paying attention to your emotional responses and learning ways to calm your fears, until you are able to do what you need to do in the course of your life without freezing up or panicking. (See A Good Time to Panic).

Post Traumatic Stress Disorder

If you’ve witnessed the death of someone, you might find that you cannot seem to get certain images out of your mind. You might find yourself replaying events over and over again. For many, nightmares and panic attacks are common. Fear of going to sleep or being unable to sleep due to intrusive memories and nightmares may be a part of this experience. This is not, strictly speaking, part of the grief process, but related to the trauma of what you witnessed or experienced. There is good treatment available for Post Traumatic Stress Disorder and it is well worth talking to someone about it if you are experiencing these kinds of symptoms. (See also Men & Trauma- Anger, Anxiety, Addiction & Depression).

Avoiding Grief

Nobody loves feeling painful emotions. We are taught from very early on that painful feelings indicate that something is wrong and that we need to do something to stop the pain. With grief, we often try to stop the pain through distraction. Distracting ourselves can be helpful when we have responsibilities that we need to carry out. It may bring temporary relief from strong emotions and enable us to function at some level. For example, if we are caring for children or needing to support ourselves, make decisions about estates, etc. we may avoid thinking about our loss for a time. But distraction it is not a solution to the experience of grief. Grief needs room to be experienced. For some, distraction might take the form of  drug or alcohol abuse. When any kind of distraction is used too long, then there is a risk that we delay and/or complicate the grief process. (Giving Grief the Time of Day)

Guilt about how we are grieving

When we are unsure what is normal grief we can start to overthink what we are feeling, and start questioning if we are feeling the right things at the right level of intensity, at the right time. Others may believe something is wrong if we are not expressing the same feelings or the same intensity of feelings as they are.

The loss of an individual is likely to be, at least, as complicated as our relationship with that person when they were alive. Losing someone does not transform our memories of them both positive and negative. This can be difficult to process when others have had different relationships with that person and are focused only on one aspect of their personality. (see Truth & Celebration)

Guilt about experiencing less grief or even having any positive feelings can stop us from processing all of our emotions in a way that allows us to incorporate the loss into our lives. It can be extremely painful and difficult to accept that someone is really gone and not try and keep them constantly in our thoughts. If we are not feeling intense loss and sadness we might fear that we are ‘losing’ them again. We do need to come to the painful acceptance that this person really has left and that, over time, we will not be as connected as we were. But there is another way to think about this change. In the same way that we might be hyper aware of a wedding ring, early on in a marriage, over time, that awareness fades but we do not become less married, it simply becomes a part of who we are. In the same way, those whom we’ve lost can become part of who we are, not just who we remember, or think about, or grieve. In this way, we do not ever lose them completely. (See Good Grief Work). 

A NOTE TO FRIENDS AND FAMILY OF THE GRIEVING

It is important not to assume that another person’s grief process has become complicated or that there is something needing professional attention. If you are noticing some of the things that were discussed earlier in the post, in others’ grief, you might ask them about it in a way that is not assuming there is a problem, but assuming you do not know and want to check in with them about how they are doing. Supporting others who are grieving is about listening, being available to help in practical ways and not being afraid of strong emotions. If we can do this for each other, I believe grief has a much better chance of being processed in ways that allow us to carry on with hope.

For more on supporting loved ones who are grieving, see Same Trauma, Different Outcome – Why some people have a harder time getting “over it” and 5 Ways We Respond to Other People’s Tragedies and How to Reduce Suicides – A Guide for Everyone.

 

For more on grief see:

Grief Without Death

Death Education for Children – Don’t wait for Grief

Depression Vs Grief – When You’re Down

 

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