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.

Finding the Courage to Blog about Personal Matters

People often ask me where I get the courage to blog about the personal aspects of my life — first my grief over the death of my long time life mate/soul mate, then my efforts to deal with my schizoaffective brother, now the problems with my aged father.

To be honest, I do find myself a bit ashamed at having to admit my frustrations with my father. Although he is ambulatory and still strong, he refuses to do much of anything for himself. Even the home health aide from the nursing service that had been temporarily prescribed for him by his doctor has admitted he doesn’t need her. He is perfectly capable of taking care of himself. He just doesn’t want to. He claims that doing the least little thing tires him, which I do understand, but so what? Life is exhausting. Being old is exhausting. People in worse shape than he is live alone and have no choice but to do things for themselves.

windNone of this is a problem except that I am generally the one who gets stuck catering to his whims, and it’s especially a problem when he wakes me up in the middle of the night because he is frantic he doesn’t have something close at hand he won’t need until the following afternoon. (As I mentioned yesterday, this sort of behavior is teaching me to stop fretting. To live in the moment. If I don’t have what I might need tomorrow afternoon, then I tell myself to get a good night’s sleep and deal with the matter tomorrow. Although I don’t much like Scarlet O’Hara, she did have a good point in her decisions to worry about things tomorrow. Even better is Rhett Butler’s rejoinder to her, “Frankly, my dear . . . Like Rhett, I just don’t want to give a damn about things that cannot be changed or do not need to be changed at this very minute.)

Other than admitting my frustrations and leaving myself open to accusations of harshness or hardheartedness — particularly since I don’t believe the aged have the right to use their infirmities as a club to control their families — I don’t find that writing about such matters takes much courage. Because I share my stories, others who are in the same dead end situations tell me about their plights, which is encouraging for all of us. Grief for a deceased soul mate, heartbreak of dealing with mentally ill alcoholics, frustrations with taking care of the aged are things so many of us have to deal with. It’s nice to be able to break the ice of aloneness and find encouragement in knowing we are not the only ones with such problems.

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Pat Bertram is the author of the suspense 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+. Like Pat on Facebook.