Bereavement & Complex Bereavement
Losing someone close to us is one of life's most painful challenges.
Grief is a natural response to the loss of a loved one, and the process can feel overwhelming.
However, it’s important to recognize that grief is a personal journey, and with the right support and care, healing is possible.
Whether you're grieving a loss or supporting someone through their grief, it’s essential to remember that there is no “right” way to mourn.
Grief can feel all-consuming, but with time, support, and the right interventions, peace and healing can be found.
In this blog post, we'll explore bereavement and complex bereavement, helping you understand the grieving process, the differences between normal and complicated grief, and how support and treatment can guide you toward healing.
What Is Bereavement?
Bereavement is the period of grief and mourning that follows the death of someone close.
During this time, individuals often experience deep sadness, loneliness, and emotional pain as they process their loss.
Grieving is unique to every person, and reactions can vary greatly—some may cry, others may withdraw, and some may even feel angry or frustrated. All of these responses are normal during the grieving process.
Common symptoms of bereavement include:
Deep sadness and longing for the deceased
Difficulty accepting the loss, accompanied by disbelief or denial
Exhaustion or fatigue
Loss of interest in activities once enjoyed
Irritability, anger, or frustration, especially toward others
Intrusive thoughts or memories of the deceased
Changes in sleep patterns or appetite
These emotional and physical reactions are completely normal, and with time, most individuals find ways to accept the loss and adjust to life without their loved ones.
The journey through grief is personal and doesn't follow a specific timeline—it's important to give yourself and others grace during this time of emotional adjustment.
What Is Complex Bereavement?
While grief is a natural response to loss, for some individuals, the grieving process can become prolonged or more intense, leading to what is called complex bereavement (also known as complicated grief).
This occurs when the grief does not lessen over time and may worsen, preventing an individual from moving forward.
It can feel like being "stuck" in grief, where the pain of the loss becomes overwhelming and prevents daily functioning.
Complex bereavement can cause long-lasting emotional distress, and individuals may have trouble accepting the death, often feeling like they are trapped in their grief.
This type of grief may be more likely after a traumatic or unresolved loss, or when the relationship with the deceased person was especially close or intense.
Symptoms of complex bereavement include:
Persistent sadness and preoccupation with the loss
Difficulty accepting the death, often feeling disbelief or shock long after the event
Inability to find joy or engage in activities once enjoyed
Feeling emotionally numb or disconnected from reality
Intense guilt or regret, often about things left unsaid or undone
Intrusive thoughts or vivid memories of the deceased
Avoidance of places, people, or activities that remind the person of their loss
Difficulty forming new connections, as the individual remains emotionally “stuck”
Persistent Complex Bereavement Disorder
According to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), complicated grief, often referred to as Persistent Complex Bereavement Disorder (PCBD), is characterized by severe and prolonged grief symptoms that hinder an individual’s ability to function.
In addition to the symptoms listed above, this condition may include:
Intense yearning for the deceased, along with intrusive thoughts or images of the deceased
Difficulty accepting the death or a sense of disbelief that persists for an extended period
Emotional numbness or avoidance of reminders related to the deceased person
A sense of detachment or difficulty forming new relationships
Symptoms that persist for at least 12 months following the loss (DSM-5, 2013).
Similarly, the ICD-10 (International Classification of Diseases, 10th Edition) provides a diagnosis for prolonged grief disorder, which includes symptoms similar to those outlined in the DSM-5 criteria.
It is essential to note that these diagnostic criteria are used to identify when grief has become more complex and when intervention is necessary for healing (World Health Organization, 2016).
If these symptoms persist for more than six months and interfere with daily life, professional intervention and support are highly recommended.
How Bereavement Affects Your Life
Grief can affect many aspects of your life, including your emotional well-being, physical health, and social interactions.
It can be emotionally exhausting, and for some, the pain can interfere with functioning at work or in social situations.
It's not uncommon for people to experience symptoms of depression or anxiety during the grieving process, as the mind and body struggle to cope with the overwhelming emotions of loss.
While grief is often associated with sadness, it can also lead to irritability, mood swings, and difficulty concentrating.
Physical symptoms like changes in appetite, disrupted sleep, or fatigue are common as well.
Effective Treatments for Bereavement and Complex Bereavement
The good news is that there are effective treatments available for both bereavement and complex bereavement.
While grieving is a natural process that takes time, some individuals may need extra support if their grief becomes prolonged or overwhelming.
Here are some treatments that can help:
Grief Counseling: Talking to a grief counselor or therapist provides a safe space to express feelings of pain, fear, and sadness.
Therapy can help individuals process their emotions and work through feelings of guilt, anger, or sadness.
Studies have shown that grief counseling can be beneficial for many, offering emotional support and healing (Holland, 2017).
Cognitive Behavioral Therapy (CBT): CBT is a highly effective therapeutic approach for complex bereavement.
It helps individuals identify negative thought patterns and beliefs that may be preventing them from moving forward. CBT teaches coping strategies and helps people reframe their grief, enabling them to find hope and begin the process of acceptance (Shear & Shair, 2005).
Research supports the effectiveness of CBT for individuals experiencing complicated grief, with many studies showing improvement in emotional well-being and a reduced sense of being "stuck" (Boelen & van den Bout, 2005).
Support Groups: Grief support groups can offer a sense of community and understanding, where individuals can connect with others who have experienced similar losses.
Sharing your story and listening to others can help reduce isolation and provide comfort. Support groups foster a sense of solidarity during the grieving process.
Mindfulness and Relaxation Techniques: Practices like mindfulness, meditation, and deep breathing exercises can help manage the emotional intensity of grief.
Mindfulness encourages individuals to stay present with their feelings, reduce stress, and process grief in a more grounded way (Kabat-Zinn, 2005).
These techniques can help you navigate grief in a healthy and manageable way.
Medication: For some individuals, antidepressants or anti-anxiety medication may be necessary, particularly if depression or anxiety is overwhelming.
These medications can provide relief from intense emotional distress and help individuals focus on the healing process.
If you're considering medication, It’s important to consult your GP or psychiatrist to find the right medication for you. They can help determine the best course of treatment based on your individual needs and circumstances.
How Shenwise Can Help
If you or someone you know is struggling with bereavement or complex bereavement, it's important to remember that there is no "right" timeline for healing. Everyone’s grief journey is different.
Healing doesn’t mean forgetting; it means finding ways to carry the love and memories of your loved one forward in a healthy way.
At Shenwise, we understand the emotional toll of grief, and we are here to support you as you navigate this difficult time.
Our compassionate, nonjudgmental therapists specialize in helping individuals process their grief, whether they are experiencing the normal grieving process or struggling with complicated bereavement.
We offer evidence-based therapies, including Cognitive Behavioral Therapy (CBT), to help individuals work through the emotional challenges of loss and begin to heal.
You don’t have to go through this alone.
Reach out to us today for a free 15-minute consultation, and let us help guide you toward emotional peace and healing.
Additional Resources for Support
If you or someone you know is experiencing grief, here are some helpful resources that offer support:
Cruse Bereavement Care: Offers support for people affected by bereavement in the UK. www.cruse.org.uk
The Grief Recovery Method: Provides resources for individuals and families coping with loss. www.griefrecoverymethod.com
Mind: Offers mental health support and information about managing emotional well-being. www.mind.org.uk
References
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Boelen, P. A., & van den Bout, J. (2005). Complicated grief and related disorders. Journal of Clinical Psychology, 61(10), 1289-1299.
World Health Organization (WHO). (2016). International Classification of Diseases (ICD-10). Retrieved from https://www.who.int/classifications/icd/en/
Holland, J. C. (2017). The Human Experience of Grief: What It Teaches Us About Life. Oxford University Press.
Kabat-Zinn, J. (2005). Wherever You Go, There You Are: Mindfulness Meditation in Everyday Life. Hyperion.
Shear, M. K., & Shair, H. (2005). Attachment, loss, and complicated grief. Developmental Psychobiology, 47(3), 253-267. https://doi.org/10.1002/dev.20070