Symptoms of Unresolved Grief
(Note: there are problems with use of the word “unresolved”)
These symptoms are considered normal during the acute stages of grief.
However the more symptoms that persist
, the stronger the likelihood of unresolved grief.
- Over-activity without a sense of loss
- Emulating mannerisms or symptoms of the person who died
- Psychosomatic medical illness
- Changes in relationships with friends and relatives
- Furious hostility
- Lack of emotion
- Acts detrimental to social and economic existence
- Agitated depression with tension, insomnia, feelings of worthlessness, bitter self-accusation, need for self-punishment
- Continued daily searching—years later
- Inability to discuss the deceased without crying or having the voice crack
- Continued panic attacks, fear of choking, shortness of breath
- Minor event triggers full-blown grief reaction
- Preservation of the environment just as it was when the person was alive
Types of Unresolved Grief
Two Basic Reasons for Failure to Grieve
- Absent Grief -- as if the death never occurred—complete denial or shock
- Inhibited Grief -- somatic complaints in place of grief reactions
- Delayed Grief -- grief reactions are minimal or absent at first; later there are full-blown reactions following a subsequent loss
- Conflicted Grief -- exaggeration of some aspects of the loss, while others are suppressed, e.g., extreme anger and extreme guilt
- Chronic Grief -- the bereaved person continuously exhibits intense grief reactions which aremore appropriate for early bereavement. The bereaved person keeps the deceased person alive with his/her grief.
- Unanticipated Grief -- occurs after sudden loss and is so disruptive that recovery is usually complicated.
- Abbreviated Grief -- a short-lived, but genuine form of grief. It may occur because of immediate replacement of the deceased or insufficient attachment to the deceased person, anticipatory grief may be a contributing factor.
Examples of Reasons for Failing to Grieve
- The person is unable to tolerate the pain of grief.
- The person has an excessive need to maintain interaction with the person who died.
How Does Society Contribute to the Failure of Some People to Grieve?
- Guilt—reviewing the relationship with the person who died brings up guilt
- Loss of extension of self—grief is avoided because it also means acknowledging the loss of a part of self
- Reawakening of an old loss
- Multiple loss
- Inadequate Ego Development—the bereaved person cannot handle overwhelming feelings of rage, frustration, depression, anxiety
- Miscellaneous: Belief that grieving = weakness. Belief that once crying starts = never stop. Letting go of the pain = letting go of my loved one
- Fear of “prolonged” grief: wallow, incessant, clinging, stuck, never letting go
- Expectation of brief grief: CHARGE
- Disenfranchised loss
- Unspeakable loss
- Ascribed status of “the rock”
- Lack of social/community support
- The media’s presentation of the “perfect griever”
Two Ways that a Therapist Can Diagnose Complicated Grief 2
What Society Needs to Realize
- The person will come with a self-diagnosis
- The person will come with a medical or psychiatric problem quite unaware that grief issues are at the heart of it.
- There are thousands of individual differences in grieving
- Some people do well without griefwork
- Continuing bonds are normal
- For many people grief reactions never entirely go away
- Our job in supporting bereaved parents and siblings is to put up with “brain pain” by allowing people to be in pain (APTBIP).
What You Can Do to Help
- Tolerate individual differences = Grieving Style.
- Recognize the symptoms of unhealthy grief.
- Practice your approach.
- Contact community resources, find what they offer, get phone numbers, emails, fees.
- Meet one-on-one.
- Be gentle, low key, present your observations, say little, don’t argue, listen, listen, listen, listen.
- Finish with concern and referral information—then drop it.
1 - From Rando, T.A. (Ed.) (1986). Parental Loss of a Child. Champaign, IL: Research Press Company.
2 - Worden, J.W. (1991). Grief counseling and therapy: A handbook for the mental health practitioner. NY: Springer Publisher.