Understanding Complicated Grief

In our model complicated grief has two components:

1. Prolonged Acute Grief including the response to separation from a loved one and elements of reaction to a trauma

2. Grief Complications including troubling thoughts, problematic behaviors or inability to adequately regulate emotions

Examples of prolonged acute grief

Some typical reactions to separation from a loved one:

  • Strong feelings of yearning or longing for the person; it’s almost like the death just happened
  • Frequent intense loneliness or feeling like life is empty or meaningless
  • Thoughts of the person seem to fill your mind or intrude on your thoughts when you are doing other things so that it might be difficult to concentrate

Some typical reactions to the trauma of the loss:

  • Troubling feelings of being shocked, stunned, dazed or numb
  • Feelings of disbelief or inability to accept what happened even though you know it’s true; e.g. you know the person died but it doesn’t seem possible

Examples of grief complications

Troubling Thoughts

It’s very common to second-guess ourselves after someone we love dies. We may think about missed opportunities to be helpful to them. Sometimes we focus on what others did not do. If you get caught up in troubling thoughts this makes it difficult to cope with the loss.


Unending emotional pain

If you have complicated grief you may feel the world is defined by absence: your life is infused with the sense of an unfillable void and pain is inescapable. People around you may have difficulty understanding this. Natural support systems dwindle as others begin to feel frustrated and helpless and withdraw their companionship, adding to the pain.
Trying to avoid the pain

When we lose someone we love, the pain can be so strong that any respite from it is welcome and merciful. Yet, over reliance on avoidance undermines the coping process and interferes with your ability to honor the loss.