Dealing with Complicated Grief
It doesn’t take high emotional intelligence to understand the pain that the loss of a loved one can bring.
Death is irreversible and also confronts us with the abyss of transcendental questions that we may not understand or do not want to assume.
Grief can include a mixture of reactions where the emotional pain of the loss coexists, the feeling of bewilderment or human helplessness in the face of the unknown or the feeling of injustice if it seems to us that it did not have to happen yet. There may be disbelief, emotional dullness, anger, despair, shock, guilt, anxiety, fear, or sometimes even feelings of relief. Some losses can be devastating and turn a person’s life totally “upside down.” It can be accompanied by depression-like symptoms, including, for example, sadness, trouble sleeping, changes in appetite, difficulty concentrating, memory loss, tiredness, etc. These reactions are normal when we lose someone with whom we were affectively linked and they fulfill an adaptive function, helping us to assimilate the new situation.
To speak of persistent complex grief, at least 12 months must have elapsed since the death of the person and there must be continuous longing for the deceased, which can be accompanied by intense grief and frequent crying, and concern about the deceased or about the way he died. It is convenient to relativize the temporal criterion since each person is different and the important thing is the level of suffering of that person and whether or not they are progressing.
People who get over a grief go through different stages. At first shock and denial of what happened, then emotional chaos with a mixture of anger, guilt and despair, followed by a period of depression when assuming reality. Finally a way is found to get on with life while maintaining some kind of connection with the person who has been lost.
In recent years there is a preference for understanding grief as the overcoming of a series of tasks. The task approach gives the person a more active role, indicating what one can try to do to recover, compared to the approach of the stages through which one has to wait to pass more passively.
In addition, to cope with grief in a healthy way we have to strike a balance between mourning the person who has left and, somehow, continuing to live and function. When a person focuses her energy on getting on with her life and keeping busy by pushing away grief, or vice versa, less progress is made.
According to J.W. Worden, to properly face the duel you have to complete a series of tasks. The objective of working with grief is to help the person overcome the obstacles that prevent them from completing each of these tasks:
1. Accept the reality of the loss. That this person has left and is not coming back. Intellectual acceptance is easier than emotional acceptance. For example, some dreams about the deceased still alive may suggest that the person is in this phase and it is as if his brain is trying to help by reminding him by contrast upon awakening that that person has already died.
In general, it is recommended to communicate the news clearly and directly, giving the person the opportunity to participate in the funeral and other rites (eg visits to the cemetery). These rites serve an important function and help to accept the reality of death (eg, for most people it is important to see the body of the deceased at some point, which is in contrast to the difficult grief of people who lose loved ones whose body is not found or it has not been possible to see).
You have to take time to assimilate this reality. Unhealthy reactions are, for example, acting as if that person is still alive, or immediately letting go of everything that reminds that person and even forgetting her face so as not to think.
2. Work out the pain of loss. Death produces painful feelings that need to be expressed. There has to be a place for this pain. Sometimes society does not help (eg, when someone with good intention advises us not to be sad, that person would like to see us happy). Suppressing grief can extend grief (eg, when you don’t talk about the death and act like nothing). This task is encouraged through emotional expression. It is normal that positive (eg, longing) and negative emotions can coexist towards the deceased (eg, anger or guilt).
The person must be helped to achieve a balance between positive and negative emotions that allows him to redefine the image of the deceased in an adaptive way (eg, my father loved me very much but because of his education he was not very expressive when showing affected). If the person was left with the need to express to the deceased something that he could not tell him or there was an open conflict, there are various strategies to address it (e.g., writing letters, the empty chair technique in which he imagines that he is facing his parent and communicates how you feel, etc.).
Very traumatic images or emotions can be addressed with emotional processing techniques. If the criteria for any psychological disorder (depression, anxiety, etc.) are met, they are dealt with in the usual way and then the issues of grief are addressed. If one parent has passed away, a scrapbook can be made of the deceased that the children can review as they grow and help them integrate the experience.
3. Adapt to the world without the deceased. This adaptation is external, internal and spiritual. External adaptation refers to working out how it has affected daily life (it may involve learning new skills and taking on new roles). This phase is approached with problem-solving strategies for difficulties that arise (eg, learning to keep business accounts, making new social relationships, etc.).
Internal adaptation has to do with the definition that the person now makes of himself and her self-esteem. Who am I now? How has this loss made me different? It is important to redefine ourselves in a positive way, even extracting some good aspects that we discover in ourselves as a result of the loss. The concept of resilience can be helpful to you.
On a spiritual level, loss can shake the foundations of the world. It is important to look for meaning or meaning (the concrete meaning is not important but if you find one: he had to learn something, he finished his task, there is an order in the universe even if we do not understand it, etc.).
4. Find a lasting connection with the deceased as you move on with your life. It is taking him with us, missing him but without heartbreaking pain or anguish, being able to get on with our lives. It is to live again. It is resolved when the person is able to take permission to stop suffering in this way and can think about the deceased without feeling overwhelming pain (eg dreams in which the deceased communicates to the living person that he is well and that he wants him to continue go ahead).
People do this in different ways. Some maintain the bond by identifying with the likes or hobbies of the deceased or by assuming roles in the family that that person previously assumed.
Take some time, take care of yourself more than you did before, be kind and flexible with yourself, seek the support of people who love you and think that if you do your part, this will pass. People can overcome dramatic deaths and move on.
If you feel that you are not making progress, seek professional help. A psychologist can help you work out your grief in a healthier way.