Grief comes in many shapes and sizes, but when it comes to discussing it in the therapeutic sense, we categorize it in one of two ways: normal grief and complicated grief. Understanding the differences between the two can help you to validate your own experience and better approach your treatment.

“Normal” grief is the clinical term for the excruciatingly painful emotional response to a loss. The DSM-5 indicates that the experience of bereavement last about two years. In my practice I find that this is true. The first year is spent tolerating a life without someone you have loved and is painful for this emptiness. In the second year, sadness is triggered as a griever fills the emptiness with other experiences and people. Missing a loved one changes the experience of life, but life is driven forward into the future nonetheless.

We are built for grief. Our bodies, minds and spirits accommodate the loss and integrate it into our life stories. Life moves on because we are designed to do so. With each passing month we learn that we can survive the loss, and after a while, we begin to enjoy life again bit by bit, sometimes feeling guilty because we are “moving on.”

Certain losses have an impact on the self-esteem however and therefore constitute what’s called a complicated bereavement. This is very different from normal bereavement. In a normal sense, grief forces us to change our lives to accommodate a loss. Complicated grief stalls or prevents healing in some way. Life is also stalled or stagnated as a consequence. Here are four situations that would indicate the need for professional help:

  1. Disenfranchised loss. This is a loss that society has deemed inappropriate to grieve because some element of the death or loss was related to an “unacceptable” behavior. An example might be when a lung cancer patient dies from a smoking-related illness. Family members of former smokers may receive criticism for grieving openly because their loved one made a decision to smoke.
  2. Traumatic loss. Losing a loved one unexpectedly or in a horrific way causes a reaction beyond that of normal expected losses. Discovering the body of a loved one whether they died by accident or intention is traumatic. Enduring a traumatic event such as a devastating fire or weather event might cause a traumatic response as well. Traumatic loss is recognized by the vivid re-experiencing of aspects of the trauma. Dealing with this professionally early after they happen can prevent a more chronic problem.
  3. Multiple losses. Sometimes people suffer a series of losses in a short period of time. While the loss of one loved one might take two years, if you’ve lost four people in six months you may (or may not) be overwhelmed by the grief.
  4. Indeterminate loss. Sometimes grief cannot begin because there is an enduring quality to the loss. Parents whose children have been abducted cannot grieve the loss, even when there is suspicion of death, because there is no actual proof of the loss. Divorce and an affair within the context of a marriage can also be hard to grieve because there is no funeral for this loss.

Seeing a counselor can put your fears and concerns to rest or help you to find help when you need it. Book a free consultation today to learn more about what you are experiencing and find the help you need.

Karen Hildreth, LMHC