Thursday, October 15, 2009

Thursday’s Therapy - Complicated Grief: Does Any Professional "Get It"?!

Thursday’s Therapy

Complicated Grief:

Does Any Professional "Get It"?!

Mayo Clinic’s Definition of Complicated Grief:

Mental health experts are still analyzing how complicated grief symptoms differ from those of normal grief or other bereavement reactions. During the first few months after a loss, many signs and symptoms of normal grief are the same as those of complicated grief. However, while normal grief symptoms gradually start to fade, those of complicated grief get worse or linger. Complicated grief is like being in a chronic, heightened state of mourning.

Complicated grief treatment hasn't been standardized because mental health providers are still learning about the condition. Research studies testing various types of treatment have had mixed results. That isn't to say that treatment isn't helpful, though. More study is needed to help determine which treatment options may be best for complicated grief.

American Psychiatric Association's Evolution of Assessment of "Complicated Grief":

One group of researchers... is examining factors that identify people at risk for complicated grief, (Robert) Neimeyer (of the University of Memphis) says. The researchers are objectively assessing risk factors by reviewing the circumstances surrounding deaths.

Chronic and unremitting grief is typically associated with sudden, unexpected and traumatic death, the loss of children or young people, and the relative closeness of the bereaved person to the deceased, the report says. Particular risk factors include excessive dependency in the relationship with the decedent or a history of mental illnesses such as depression in the bereaved, Neimeyer says.

In the past, the mental health community defined varying reactions to grief, such as delayed onset of grief, as disorders, Neimeyer says. In particular, people who grieved in ways uncharacteristic for their cultural background were labeled as disordered.

But new research and a growing understanding of grief has prompted psychologists to use different diagnostic factors for complicated grief, such as changed relationships with family and friends, feelings of meaninglessness and ruptured beliefs, which are more apt to spur health-threatening grief, he adds.

In fact, says Neimeyer, the American Psychiatric Association has formed a panel of experts under (Yale University psychologist, Holly) Prigerson to consider including "complicated grief" in the next version of the Diagnostic and Statistical Manual of Mental Disorders.


In my opinion, the norm for any grieving parent who has been thrown into a parent’s worst nightmare of the loss of one’s child is a state of grief that physicians would call “Complicated Grief.”

Any loss of a loved one will throw a person into grief for weeks, months, and to a milder degree through the years.

But the loss of a child is a whole different kind of loss.

My husband and I are trained at the master’s level in mental health counseling; we are trained at the master’s level in Christian counseling. We are rock solid in our faith. Our marriage of thirty years is intimate and sweet. Our years of raising our children were steeped in love and endearing intimacy with our precious three children. Each of our children asked God into their heart when they were age six or younger. Our lives have been blessed. Yes, we have had many traumas; we live in a fallen world. But the trauma of losing our precious youngest child, our only daughter has just about taken us off the map in terms of grief, trauma, sadness, debilitation, life-stopping, career-stopping complicated grief. In my humble opinion (of course), I would challenge you to find two healthier people to be your normal, healthy specimens to walk into such a severe loss to report back to you “normal” grief reactions in a loss such as this.

So I am telling you, I am going on record to the medical community and the psychological community to say COMPLICATED GRIEF is to be considered the norm for child-loss grief-struck parents.

So please do not call this depth and degree of grief a “disorder.”

Please do not say these parents are people who are “stuck” in their grief.

Please do not call this “prolonged grief.”

Complicated Grief in the case of grieving the death of a child IS JUST parent-grief, normal, ordinary parent-grief when parents lose the heart and soul of their life in the loss of a precious child.

So when you are busy “analyzing how complicated grief symptoms differ from those of normal grief or other bereavement reactions" (Mayo Clinic), I would ask you to reconsider and take it from another professional colleague in your field who has been there,


Please rewrite your books.

Please rewrite your manuals.

Please revamp your antiquated studies.

Child-loss brings a whole different kind of grief to a person.

The closest description I can find to date that best captures this grief might align somewhat with what you would call “complicated grief.” And yes, it is complicated. And yes, many times, it can also be called "traumatic grief" because it very often brings its own trauma into a parent’s life.


And none of these symptoms should be signals of anything “unhealthy” or “problematic” for the grieving parent; in child-loss, they just ARE.

You might better use these “symptoms” of Complicated Grief in your manuals as “landmarks along the way” for the "grief of child-loss" to help that grieving parent know they are not crazy; they are not losing their minds; they are not abnormal – they are just dealing with the worst loss life could throw them, and these symptoms are just hurdles along the way that they might expect to undergo…

Now that I’ve gotten a little of that disgust out of the way, I would like to go back to your manuals that aren’t all bad because they do tend to capture some (a small portion of) a child-loss parent’s grief. Of course, I will give my responses along the way just to remind you professionals of our very real reality!


(Mayo Clinic)

Signs and symptoms of complicated grief can include:

Extreme focus on the loss and reminders of the loved one (You know what? That is what it takes to work through a grief of this nature! You professionals just need to deal with it!)

Intense longing or pining for the deceased (We love our children! We miss them! We want to hug them again! We want to talk to them again! We are normal human beings who miss our children deeply. This is a healthy component to parenting! And therefore, this is a healthy part of processing through our grief of losing our precious child!)

Problems accepting the death (Who can immediately accept their child’s death? Having trouble accepting the unacceptable seems pretty normal to me.)

Numbness or detachment (Well, you try having a 2-ton weight on your heart all day, and see if you don’t get a little numb or feel a little detached every once in awhile for at least a little breather! You aren’t really numb, you just don’t have anything left over for anybody else, so you may just appear to be numb and detached while you are very attached to your own need for healing, thank you very much!)

Preoccupation with your sorrow (Yup, that’s just the nature of the beast. Sorrow over your child’s loss is there, waiting to be dealt with, like it or not. To NOT focus on it in order to help to relieve it would be abnormal and unhealthy in my opinion.)

Bitterness about your loss (Well, you and I might have a different definition for bitterness. Bitterness is anger that never gets resolved; can you give us a little longer than 2-3 months, or 2-3 years, or maybe even 2-3 lifetimes if need-be to get our hurt and anger resolved?)

Inability to enjoy life (Are you telling me you could? Then I would say maybe you aren’t in touch with your emotions!)

Depression or deep sadness (You’d better believe it, and it ain’t going away any time soon, I can promise you that. Three years now…for us. I would just have to ask you, “Do you even have a child? Are you emotionally connected to them at all? Do you feel a responsibility for their love and safety and health?" Well then you should understand our depression setting in and staying for quite awhile…quite a long while, if not for an entire lifetime!)

Difficulty moving on with life (See description for next symptom below)

Trouble carrying out normal routines (Well, yes, these "normal routines" have been pushed aside to make room for the heart to find some way to survive and breathe, much less thrive in the midst of pure hell being dropped in your lap. "Trouble carrying out normal routines" would be like saying to the tsunami victim, "You just can’t seem to move on with life in any normal way!” Of course not! He simply cannot! Life is NOT normal!)

Withdrawing from social activities (This is perfectly normal I would say. When your heart is so raw, it would be tantamount to walking around in public with no skin on; wouldn’t you as a physician wisely recommend “withdrawal from social activities” so as to avoid any potential toxins along with affording yourself private intensive care to heart, soul, mind, spirit, and body in the privacy of one’s own home? I certainly would hope so; that is what you do for a patient in the hospital when all of his skin is ripped off!)

Feeling that life holds no meaning or purpose (Well, come on now, our hearts have been shot out of us—a little difficult to ascertain life’s meaning or purpose when you’re trying to find your heart, get it repaired, and get it put back into place, knowing it will take a lifetime of comfort to even approach some healing for it.)

Irritability or agitation (You better believe it – and you professionals might want to watch out for our irritability and agitation.)

Lack of trust in others (Pardon me, but would you not be somewhat mistrustful of others when you know they may, and I say may, be able to sympathize (feel pity or sorrow) with your grief, but they can in NO WAY empathize (understand and share the feelings of another) with your grief because they have never "been there"; they cannot possibly "get it" I know, because we as well-trained mental health counselors would not have gotten it either before having been thrown into it hook, line, and sinker ourselves (mostly sinker...).


May God bless all child-loss grieving parents as you walk through the Land of Mourning to the best of your ability. I pray that you would have others who "get it" to come by your side on the journey. May God comfort your broken hearts,


1 comment:

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