When Does Grief Become Complicated?
Complicated or prolonged grief (also called persistent complex bereavement disorder) may be present when intense grief symptoms persist for more than 12 months (6 months for children) and significantly impair functioning. Signs include intense longing or preoccupation with the deceased or lost relationship, difficulty accepting the death or loss, feeling that life is meaningless without the deceased, bitterness or anger about the loss, difficulty engaging in activities or relationships, emotional numbness, feeling that part of yourself died, and difficulty envisioning a future with meaning or satisfaction.
How Can Treatment Help?
Cognitive-behavioral therapy for grief focuses on helping you process your loss while moving toward acceptance and adaptation, maintain a continuing bond with the deceased while also reinvesting in life, address complicated thoughts that impede grieving (guilt, anger, blame), develop coping skills for managing intense emotions, gradually re-engage with life and relationships, and find meaning and purpose after loss.
Treatment does not aim to eliminate grief or “get over” your loss. Rather, it helps you carry your grief while also living a full life. Your relationship with the person you lost continues, but in a different form.
Grief therapy may involve telling the story of your loss, exploring your relationship with the deceased, addressing unfinished business or regrets, engaging in meaningful remembrance activities, and gradually confronting situations you’ve been avoiding due to reminders of your loss.
How Effective Is Treatment?
For complicated or prolonged grief, evidence-based treatments can significantly reduce symptoms and improve functioning. Many people find that therapy provides a safe space to express emotions that others may no longer want to hear about, validation that their grief is understandable, and guidance in navigating the difficult path of adaptation.