• Melissa Paulsen, MA, LMFT, RPT-S

Grief & Loss: Complicated Grief

Updated: Sep 2


“So it’s true, when all is said and done, grief is the price we pay for love.” – E.A. Bucchianeri, Brushstrokes of a Gadfly


Grief. Grief is always complicated but circumstances surrounding the death can amplify this complication. I attended a training by Dr. Alan Wolfelt last year that discussed the factors that make grief more complicated and will summarize the first 4 (of 12) below:


Societal Contributors


Our culture avoids grief at all costs. Mourning is normal and necessary and our culture often leads us to believe this is taboo which causes those grieving to suppress their grief which creates further stigma around getting support. Please attend vigils, visitations, and funerals. Lean into your grief and feel it now so you can begin to heal.


Circumstances of the Death The circumstances of the death influence our grieving process and how complex it is and many factors should be taken into account:

  • Sudden and/or Unexpected Deaths – A sudden or unexpected death amplifies feelings of shock and denial. Attending a funeral can help us acknowledge the reality of the death and give us some sense of closure.


  • Before-Time Death – The death of a young person is harder to accept. We expect people to live a long, happy, healthy life so the younger the person is, the more sadness we feel.


  • Out-Of-Order Death – When someone dies who should have outlived us, we feel this is out of order which further complicates our sadness. We often say, “Parents are not supposed to bury their children,” which is an example of this thinking.


  • Means Of Death – Certain types of death are more challenging to accept including suicide, homicide, accidents, military deaths, terrorism deaths, and deaths caused by natural disasters. The more tragic, the more complicated. We want everyone to die peacefully in their sleep and it’s hard to think about someone suffering or dying tragically.


  • Uncertainty Surrounding Death – We often need the details of what happened in order for our brains and hearts to begin processing. If the circumstances surrounding the death are unclear, vague, or secretive, our brain tries to fill in the gaps in order to move forward.


  • Physical Distance from the Death – If we are physically far away from the person who has died, we feel further disconnected from it. When time and distance are in our way, it can sometimes feel less real. If we weren’t going to see someone soon anyway it may not feel real until the time comes when we should have seen that person again. Again, going to the visitation or funeral can help us with this realization.


  • Self-Blame for the Death – If we believe we could have done something to prevent the death or have any sense of guilt, regret, or shame this will also complicate grief. Despite knowing we are not to blame, it is important to explore these feelings in order to move forward in our healing process.


The Griever’s Unique Personality Extroverts may struggle to befriend the internal grief work that must take place while introverts may struggle to outwardly mourn or ask for support. Grievers who tend to avoid or suppress their emotions, intellectualize or control their emotions, or express emotions in distorted ways will have more difficulty navigating their grief. Current or past mental health challenges may amplify difficulty navigating grief as well. Those who have struggled with substance use in the past may also be at greater risk to begin using again.


The Griever’s Relationship with the Person Who Died The stronger the attachment to the person who died, the more difficult it will be. A complicated relationship will often lead to complicated grief as well. Unreconciled conflict and estrangement can also lead to complicated grief.


As you can see, it’s easy for grief to become complicated. The more factors you have, the more complicated it becomes, and the more complicated it becomes means it will take extra effort in order to begin the healing process.

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