Demystifying Complex & Complicated Grief
Grief is a natural response to loss. It’s what our brains and our bodies do in reaction to the heartbreaking and devastating reality of loss. We humans are extremely resilient, and a vast majority of us will find a way back to living a meaningful life in our own time. Sometimes though, we can get derailed in that natural grieving process and that’s when it may be time to reach out for support.
When it comes to complicated grief, there’s an analogy involving a broken bone. When we break a bone, we don’t actually knit the cells back together; instead, it’s a natural healing process that happens over time. While we can often manage smaller cuts and bruises on our own, sometimes we may need a little extra support in the healing process. For example, we may need to wear a cast, or use crutches. A little extra support! With complex grief, let’s say this broken bone also has an infection in the area that’s trying to heal, or perhaps there’s a secondary break in the bone. Again, we need some extra attention, some additional nurturing that helps the natural healing process stay on track, or to get the healing back on its trajectory.
Let’s break down complicated grief and complex grief a bit more so that you can get an even clearer idea of what they are, the differences between the two, and to see if any of it resonates with what you may be experiencing.
What is complicated grief?
Sometimes, complicated grief is referred to as “prolonged grief disorder” or “persistent complex bereavement disorder”. It’s a specific type of grief that is marked by an intense and prolonged mourning process. People experiencing complicated grief may struggle to adjust to life after the death of a loved one, and their grieving process can become “stuck” or unproductive, leading to significant distress or impairment in daily functioning. Complicated grief can last for months or even years, and causes so much pain and interference with life. While typical grief is painful, usually it provides some form of emotional recovery over time. Complicated grief feels like there’s absolutely no reprieve.
How might complicated grief feel?
Complicated grief might feel: “empty, numb, or disconnected from the world”, and you may notice yourself wanting to avoid people, places and things that remind you that the person you love is gone. You tend to cry a lot whenever your mind wanders, maybe as you’re driving alone in the car or grocery shopping. Oftentimes, it feels as though the death just happened, even though you know that’s not true. You’re filled with an extreme longing and yearning for the person who died. You think about your loss so much that it’s hard to do everyday things that used to be second nature, like cooking, exercising, paying bills, focusing at work, or simply enjoying a walk in the neighborhood.
From a day-to-day perspective, it can feel like there’s nothing to live for, or that you wish you had died instead of or along with your loved one. You feel stuck. You may try to escape the pain or your reality by sleeping during the day, over-eating or not eating enough, or by drinking, or ignoring your health altogether. In relationships, you might notice that you feel envious of others that haven’t lost someone, or that you feel like people want you to get over it and move on. Or, you want to keep talking about the person who died while simultaneously thinking it makes other people feel uncomfortable. You feel lonely and isolated, even when you’re with other people. It’s like you want to be part of things, but can’t be, and feel like that’s no longer possible.
The shame that can come from living with complicated grief can feel too big to hold, yet impossible to escape. I want you to know that I see you and know you’re safe to explore the dichotomy of this painful experience with me. Your love for the person who you lost is important. You are important, too. There is a way forward.
What is complex grief?
Complex grief is a broader term that can encompass both complicated grief as well as grief that is influenced by multiple factors. While complicated grief is typically focused on the severity and persistence of the grieving process, complex grief can refer to a situation where the loss is complicated by other issues. We’re looking at how the grieving process is impacted by various compounding factors, making it feel like it’s even more difficult to navigate.
What are some examples of complex grief?
You may feel like others cannot understand your experience because the death of your loved one may have been sudden, violent, or traumatic, making the grieving process even more difficult to endure or explain to others. You may have a pre-existing mental health condition and be struggling with depression, anxiety, or other which has your grief experience feeling more intense or prolonged.
Complex grief can also occur when the loss of your loved one is not clear-cut. For example, your loved one is a missing person, or the person who died had developed a major chronic illness that changed their personality or capabilities. If there were unresolved relationship dynamics, issues, or ambivalence in the relationship with the deceased, this absolutely makes for a complex grieving process.
Are Complicated and Complex Grief the Same?
While they are often used interchangeably, "complicated grief" refers more specifically to the prolonged and debilitating aspects of grief that don’t resolve with time, whereas "complex grief" is a broader term that can include grief with multiple complicating factors (such as trauma, ambivalence, or pre-existing mental health issues). Complex grief might include complicated grief but can also encompass other nuances of loss that make it harder to process, even if the grief doesn’t meet the specific criteria for complicated grief.
Key Differences:
Complicated Grief: Focuses on prolonged, intense grief that disrupts functioning and does not improve over time.
Complex Grief: Refers to grief influenced by multiple complicating factors, not necessarily prolonged, but more difficult due to the nature of the loss or the person's circumstances.
At Woven, we offer a holistic, dynamic approach to healing from grief, because we believe foundationally that the brain and the body have the capacity and the intelligence to essentially heal themselves. We’re just here to help support and guide that process.
The idea of seeking support, and how we’ll navigate therapy together isn’t to get you to stop grieving. It’s to take care of the ways your grieving process may have been derailed; hone in on some of the behaviors you might be engaging in that are inhibiting your ability to move forward, working through particular thoughts you’re having, and restoring your sense of moving through the world.
We’ll explore questions together like: “what does life look like now? How am I going to lean into new experiences, what happens if I test out not avoiding this person, place, or thing?”
Just like in ketamine therapy where we’re building new neural pathways and massaging our learnings into the nervous system so that it retains and remembers, we’re exploring new life pathways with grief, and massaging that into the nervous system to build back trust, safety, and empowerment within the body and the Self, all while honoring and keeping your loved one sacredly in your pocket. We’ll be looking at building self-regulation resources, pendulating in and out of the pain, and exploring capacity while knocking up against the perimeter of acceptance. You are deserving of support and you are deserving of exploring what the next wave of life looks like for yourself.
As I wrap this up, I feel compelled to share one of the reasons why I decided to lean into grief as one of my clinical specialties, aside from my personal experiences with grief, of which there are many:
There’s something about the strength and connection to others I feel in going against the grain of the way our society tends to operate. It enrages me how we tend to collectively put a time limit on the grieving process; in the workplace, within family dynamics, friendship circles, etc. There’s an expectation that the process needs to be “done” or “complete”, or that we need to be “good at grieving”; we’ve internalized so much of this on an individual level. It also devastates me how culturally, so many of us are disconnected from death and the dying process, or judgemental towards the way someone else tends to grieve, their rituals, or remembrances. We don’t know how to collectively hold grief, talk about grief, or be with it, which contributes to even more isolation, disconnection, and pain when we do lose someone.
I think there’s something powerful about questioning all of that, and getting to hold space for people to explore their own stories, create their own timelines, and honor their loved ones in a way that feels right for them. It’s a small way to confront and challenge the systems in place that we function within. I believe we’re all like discoballs; glass that has been cracked over and over again, and we’re constantly being put back together into a beautiful piece of art that shines and glows and radiates. Art takes time! We take time. We need space to be able to put our pieces back together, plus support, acceptance, and permission to explore and try something new. I believe that creating space takes practice, so practice is what we do. Over and over again, and it all eventually emerges over time. We emerge.
If any of this feels like a gentle, warm, curious yes in your body, if you feel seen by reading this, please reach out for a free 30-minute consultation. It would be my honor to sit with you.
These blogs talk more about the basics of EMDR:
You can read more about Ketamine Assisted Psychotherapy here:
References:
The Grieving Brain by Mary-Frances O’Connor
Shear MK, Ghesquiere A, Glickman K. Bereavement and complicated grief. Curr Psychiatry Rep. 2013 Nov;15(11):406. doi: 10.1007/s11920-013-0406-z. PMID: 24068457; PMCID: PMC3855369.