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Complex Grief

The feelings of loss sometimes become debilitating and do not improve after time passes. This is called complex or traumatic grief. In complex grief, painful emotions persist with such severity that people have trouble recovering from the loss and resuming their own life.

Grief recovery includes:

  • Acceptance of the reality of the loss

  • Fully experiencing the pain of loss

  • Adjusting to a new reality where the deceased is no longer present

  • Ability to resume old relationships and build new ones

If someone is unable to move through these stages more than a year after the death of a loved one, they may have complicated grief. In this case treatment can help process the grief and enable to victim to move through it in a healthy manner.



Normal grief symptoms gradually start to fade over time, but with complicated traumatic grief they continue and often get worse. The possibility of healing seems less possible over time.

Internal signs and symptoms of complicated grief may include:

  • Intense sorrow, pain and rumination over the loss of a loved one

  • Focus on little else but the 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 the loss

  • Feeling that life holds no meaning or purpose

  • Lack of trust in others

  • Inability to enjoy life or think back on positive experiences with the loved one

External signs of complicated grief also may also include:

  • Having trouble carrying out normal routines

  • Isolation from others and withdrawal from social activities

  • Depression, deep sadness, guilt or self-blame

  • Self-blame, the feeling that the victim did something wrong, or could have prevented the death

  • Feeling that life isn't worth living without the loved one

  • Wishing to have died along with the loved one and suicidal thoughts

Complicated traumatic grief may be treated with a type of therapy called complicated grief therapy. It's similar to psychotherapy techniques used for depression and PTSD. This treatment can be effective when done individually or in a group format.

Therapeutic goals include:

  • Understanding complicated grief and the associated treatment

  • Processing complicated grief reactions, its symptoms, adjusting to loss, and redefining life goal

  • Building coping skills

  • Processing feelings of (self) blame and guilt

In complex traumatic grief, the patient may also be treated for anxiety, depression, and PTSD. 

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