Complicated Grief

I’ve been working on my book about grief, which is why you haven’t seen me here much. I’m spending most of my words on the book; most of my time, too, so I haven’t had anything much to talk about.

Until today.

In my research for the book, I keep stumbling upon a particularly odious phrase, “complicated grief.” We all know grief is complicated, straining, as it does, all our physical, mental, emotional, even spiritual resources beyond their limits. Complicating grief even more is its illogicalness, our inability to rationalize death, the unexpected and sudden triggers and upsurges of sorrow, having to find meaning and rebuild our lives after the death of person fundamental to our life, and a dozen other such complications.

But this is not what the professionals call “complicated grief.” To them, complicated grief is a medical condition that needs treatment. According to the Mayo clinic, signs and symptoms include:

  • Intense sorrow, pain and rumination over the loss of your loved one
  • Focus on little else but your loved one’s death
  • Extreme focus on reminders of the loved one or excessive avoidance of reminders
  • Intense and persistent longing or pining for the deceased
  • Problems accepting the death
  • Numbness or detachment
  • Bitterness about your loss
  • Feeling that life holds no meaning or purpose
  • Inability to enjoy life or think back on positive experiences with your loved one

Um, folks. This is called grief. Pure and simple.

The professionals say everyone grieves differently, but if your grief differs too much from other people’s grief, then you might have complicated grief disorder. I’ve been reading enough scholarly papers to know how they decide what is “normal.” They interview people. And if you’re one of the 7-15% whose grief falls outside the “norm,” then you have complicated grief disorder, no matter who died or how they died. (Apparently, in their studies, an aged parent who died quietly in bed should be grieved the same as a child who was murdered, and if it’s not, then the murdered child’s parent might have complicated grief disorder.)

They say grief takes as long as it takes, but if your grief takes longer than other people’s, then you might have CG. (Cute name, huh?)

According to one research paper I read, reactions such as having difficulty accepting the death, searching for and preoccupation with thoughts of the deceased, or being stunned by the death may well indicate complicated grief if they are present beyond the first few months after the loss. Thus, complicated grief involves the presentation of certain grief-related symptoms at a time beyond that which is considered adaptive. We hypothesize that the presence of these symptoms after approximately 6 months puts the bereaved individual at heightened risk for enduring social, psychological, and medical impairment.

Six months? Huh???? It takes at least a year just to get over the shock of it all!!!

The same study says: Complicated grief is the failure to return to preloss levels of performance or states of emotional wellbeing. Again, huh? Don’t they realize that once you have lost your life mate/soul mate, you can never return to preloss levels of anything. Everything changes, including us. Grief is a matter of becoming. Becoming the person who can survive the loss. Becoming the person who can live comfortably in a suddenly alien and hostile world. Becoming the person we need to be in order to find a new state of emotional wellbeing.

The professionals say if you have strong feelings of yearning for your deceased loved one, you might have complicated grief disorder, but studies have shown that yearning is the primary emotion of grief after the death of someone intrinsic to our lives.

They say that everyone’s loss is different, but they treat all losses as if they were the same. The Center for Complicated Grief at Columbia University says: Mental health training does not usually include learning about the syndrome of complicated grief. However, trainees often are taught that grief is complicated if there was an ambivalent relationship to the person who died. This is a misconception. Adapting to a loss is more difficult if a person can imagine how things could have been different. People might do this because the relationship was conflictual. However, this is uncommon. Most people with complicated grief have had an especially strong and rewarding relationship to the person who died.

So, let me get this straight. If we have had an especially strong and rewarding relationship with the person who died, as we do with a life mate/soul mate, the resulting profound grief is . . . wrong?

How the heck to do these people think? Don’t they read what they write? Do they truly have no idea that the loss of a distant cousin, for example, no matter how well loved, might . . . just might . . . be different from the loss of the person we intimately shared a life with?

Or maybe they are saying that the strong relationship is bad? Oh, right they do say that. They call it co-dependency. Cripes. What a world.

Apparently, they don’t understand that love is an interdependent relationship. They don’t understand how important love is and that the loss can be so devastating that you cannot get over it in a few months, and that such grief is not a disorder but an absolutely normal order. They don’t understand about the constant triggers that remind us that we’re alone. When you lose your one true love to death, all of a sudden you are supposed to be able to slough off your loss as if love didn’t matter, and go on with your life. Everyone else is celebrating their love, but you are supposed to accept that yours is over and you are supposed to have a good attitude so you inconvenience others as little as possible.

Because oh, yes, not only do we have our grief to contend with, we have the whole sociological horror to deal with: friends and family — and even mere acquaintances — who don’t understand what we’re going through trying to control our grief, sometimes with gentle (and not so gentle) reminders that we have to move on. People who are uncomfortable in our presence or who find our grief and inconvenient reminder of the fragility of life shunting us off to the side.  And of course, amateur and professional psychologists who try to define our grief as a disorder or a syndrome.

The grief — the normal grief — for a life mate can take years. We’re not necessarily actively mourning all that time; we often have long patches of peace. (According to the American Cancer Society, mourning is the outward expression of loss and is part of the grieving process. Grieving is the process of coming to terms with the loss. Researchers often get this backward, which complicates even further their already complicated papers on complicated grief.)

It takes a very long time to process death, to come to terms with our shattered couplehood, and to find a new way of living that can encompass the loss. In fact, I have found a distinct pattern to grief after the loss of life mate to whom we had a particularly strong attachment, and if the professionals had been reading this blog all these years, they’d see it too.

I do understand that some people get stuck in unhealthy thoughts and actions and so need help to get unstuck, but for most of us who have lost our life mate/soul mate, if we let grief do its work — no matter how hard it is or how long it takes, and no matter how abnormal it might appear to outsiders — we will get to where we need to be.

Maybe I should write a book about grief and tell the truth.

Oh . . . right. I am. Perhaps the professionals will even read it and learn something.

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Pat Bertram is the author of the suspense novels UnfinishedMadame ZeeZee’s Nightmare, Light BringerMore Deaths Than OneA Spark of Heavenly Fireand Daughter Am IBertram is also the author of Grief: The Great Yearning, “an exquisite book, wrenching to read, and at the same time full of profound truths.” Connect with Pat on Google+. Like Pat on Facebook.

Grief Rant

I still have some anger in me, apparently. I occasionally “flame out” as one friend said when I disagreed with an email that friend sent. I am regaining my equilibrium, though, able to get through my days mostly even tempered, but one thing continues to raise my ire: when people assume all grief is the same, and especially when they assume they understand the grief of someone who lost a soul mate because they lost a beloved pet. Such a comment set me off tonight, and when my reply ended up being longer than some of my blog posts, I decided to publish the comment here rather than get in a grief match (“my grief is worse than your grief”) because, honestly, all loss is devastating, especially when it happens to you.

And yet . . . the death of a pet, no matter how beloved, is not the same as losing a soul mate. Nor is the trauma of losing a brother or a mother the same as losing a long-time spouse. The only thing that comes close is losing a child. (My younger brother’s death hastened my mother’s death. She died a year after he did.)

I understand there are all kinds of grief, and I know they all have to be honored. Grief of any kind that is not processed can cause additional problems. (Or not. Some people seem to do quite well walling off their grief.)

My concern has always been for those who have to deal with the death of a spouse, whether a life mate or a soul mate because that sort of all-encompassing grief is more than most people can comprehend. I thought I understood grief — after all, I grieved the deaths of my brother and my mother — but until the death of my life mate/soul mate, I never even knew such profound grief existed. During the past two and a half years, I have met dozens, maybe hundreds of women who have lost their mates, and they all mentioned the same thing — they had to hide their grief because no one understood. That is unconscionable. (I didn’t have this problem. I’m a quasi hermit, so no one was around to see me mourning.)

The truth is, it’s the very prevalence of grief that makes people uncomfortable with the profound grief of someone who lost a soul mate. People figure they got over their grief, whatever or whoever it was for, so you should, too. The trouble with losing your mate is that your grief is not just emotional, but also physical. In addition to the unimaginable agony of loss, you have to deal with shock, a blizzard of hormonal reactions, changes in brain chemistry, an incredible level of stress (losing a mate is considered the most stressful thing a person ever has to deal with; many people end up being treated for PTSD). Your death rate climbs 25% for all causes.

Added to that are all the horrendous “death” chores you have to deal with such as planning a funeral and filling out all the official and financial paperwork involved in “removing” someone from the world. As your emotions begin to stabilize, you have other griefs to deal with since a soul mate is more than a spouse — he’s also a best friend, companion, sometimes even a business partner, and all those losses have to be processed. You also grieve for the loss of yourself, at least your coupled self. And then you have to deal with the restructuring of your life. Your dreams are gone as are your plans for the future so you need to find new reasons to live. Sometimes you have to leave your home. It takes years to sort out all the losses so you can process them and begin again.

I don’t mean to belittle anyone’s grief. But, as I explained in my post, Why I Write About My Grief, people who have lost a mate deserve a lot more consideration and understanding from their family and friends than the assumption that their loss is comparable to the loss of a beloved pet.

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Pat Bertram is the author of the conspiracy novels Light Bringer, More Deaths Than One, A Spark of Heavenly Fire, and Daughter Am I. Bertram is also the author of Grief: The Great Yearning, “an exquisite book, wrenching to read, and at the same time full of profound truths.” Connect with Pat on Google+