Each year millions of bereaved people worldwide develop CG

Most people experience intense grief when someone they love dies. Grief remains intense until they adapt to the loss and their grief finds a place in their life. For an estimated 12-15% of bereaved people this does not happen. These people have complicated grief and often don’t know what’s wrong. Millions of people suffer this way. They don’t know that help is available.

Most people with CG had a rewarding relationship with their loved one

You might think that complicated grief is more likely if there was a difficult or ambivalent relationship with the person who died. However, this is not the case.  Sometimes what a person yearns for is a relationship they badly wanted but couldn’t have. However, this is a misconception. It is not the case that complicated grief is usually related to underlying problems in the relationship with the deceased. In fact, most people struggling with complicated grief have had an especially strong and rewarding relationship with the person who died. This means yearning and sorrow are especially strong and acute grief is especially painful.

Certain thoughts can make it hard to adapt

It’s natural to wish for a different outcome when someone we love dies. It’s natural to wish that we (or someone) could have done something to prevent the death. However, people with complicated grief often get caught up in second guessing or in thinking “if only…” it can be a problem.  Here are some examples: thinking you failed your loved one or that someone else did; imagining how things might have been different; thinking someone could have prevented the death or made it easier. Thinking you should have expressed your love and appreciation more or made your loved one happier.

A person with CG might be thinking that grief is their main tie to their loved one or believe that grieving less means they are forgetting the person. At the same time, they may think they are grieving too much and should be over this by now. They might think that life is unbearable without their loved one. Maybe they can’t stop wishing that the person who died was still here or think it’s unfair that this person died. These are the kinds of thoughts that are often on the minds of people with complicated grief.

Avoiding reminders can make it hard to adapt to the loss

Painful emotions are a hallmark of acute grief. Grief emotions are often more intense and more difficult to manage than anything else we experience as an adult. Avoidance of reminders is a way to manage the pain – at least in the beginning. However, for a person with complicated grief, avoidance can seem like the only way to manage, and this makes it difficult to move forward after a loss. Here are some examples of the kinds of things people might avoid: the deceased person’s favorite places, places where the person who died spent time, places they went together, or places that remind them of the death.

Another way to manage painful emotions is to try to escape from the reality and focus on ways to feel close to the person who died. A person with CG may spend many hours daydreaming about being with the person, or they may do things to try to recreate  feelings of closeness. Examples are looking at photo albums, listening to recordings of their voice or smelling the clothes they wore.

Some people have a such strong desire to escape from the pain that they do self-destructive things. They may use drugs or alcohol to try to do this. They may try to sleep as much as possible. They may neglect their health or do risky things in order to hasten death or leave death to chance. Sadly, some people with CG don’t realize that it is possible to get help and to feel much better.

Having a hard time managing emotions can make it difficult to adapt to the loss

Most people find a way to balance emotional pain with respite by doing a range of different things, including being with other people or distracting themselves. People with complicated grief are often unable to do this. They may be caught up in thinking about how things could have been rather than how they are now.  Instead of lessening, their grief emotions get stronger and harder to manage. It’s hard to get respite and it’s hard to manage the pain.

A person with complicated grief might not give themselves permission to set the grief aside; they may feel it is wrong to have any joy or satisfaction in life because their loved one can’t have that anymore.

People with complicated grief may have trouble sleeping, eating regular meals, getting regular exercise or having a regular schedule; these are things that can help keep a person on an even keel. Emotions are harder to manage when these routines are disrupted.

Support from other people is important in grief. Most of us don’t grieve well alone, but a person with complicated grief may hide their feelings because they are afraid of being too emotional in front of others.