Sub-module 3.4 – Recognising the Signs of Complicated or Pathological Grief
While grief is a painful and distressing experience, most bereaved individuals manage to navigate through this ordeal and regain a balance in life. However, for some individuals, the grieving process can become complicated or pathological, hindering their daily functioning and long-term well-being. It is essential for the GRIEF COACH to recognise the signs of complicated or pathological grief, in order to guide the concerned individuals towards suitable care.
One of the most characteristic signs of complicated grief is the persistence and intensity of grief symptoms exceeding a period considered as normal. In normal grief, symptoms tend to fade gradually over time, but in complicated grief, they persist with high intensity for months or even years. Individuals suffering from complicated grief may continue to experience intense sadness, a pervasive sense of loss, or persistent anger or guilt, long after the loss. For instance, an individual who lost their spouse may still cry each day, two years after the death, experiencing a constant sense of emptiness and finding no interest in activities they used to enjoy.
Another sign of complicated grief is the inability to accept the reality of the loss. Individuals suffering from complicated grief may struggle to believe that the person has truly passed away, continue to hope for their return, or nurture illusions about their presence. They may keep the belongings of the deceased intact as if they were coming back or keep talking about them in the present tense. For example, a parent who lost a child might continue to buy gifts for their birthday, speak to them as if they were present, or refuse to alter their room.
Excessive avoidance behaviours can also be an indication of complicated grief. Individuals suffering from complicated grief may overly avoid situations, places or people that remind them of the loss, to the point of socially isolating themselves and considerably restricting their activities. They may refuse to partake in family events, cease meeting common friends, or avoid anything associated with the deceased. For instance, an individual who lost a loved one in a car accident might refuse to drive, take public transportation, or even leave their home.
Complicated grief can also manifest through symptoms of intense and debilitating distress, interfering with daily functioning. Individuals suffering from complicated grief may exhibit severe depressive symptoms, suicidal thoughts, panic attacks, sleep or eating disorders, or excessive alcohol or drug consumption. These symptoms can jeopardise their ability to work, maintain social relationships, or take care of themselves. For example, a person suffering from complicated grief may lose their job due to repeated absences, neglect their personal hygiene or engage in risky behaviours.
It is important to note that the signs of complicated grief can vary from one person to another and that certain risk factors, such as previous trauma, an ambivalent relationship with the deceased, or a lack of social support may increase the likelihood of developing complicated grief. The role of the GRIEF COACH is to be attentive to these signs and assess their impact on the well-being and functioning of the bereaved individual.
When the GRIEF COACH suspects complicated or pathological grief, it is essential to guide the individual towards suitable resources, such as grief counselling specialised in complicated grief or a medical evaluation. The GRIEF COACH can also offer additional support, by helping the person develop healthy coping strategies, identify their resources, and maintain a social connection. However, it is crucial to acknowledge the limits of their expertise and not hesitate to refer the person to mental health professionals when needed.
By being attentive to the signs of complicated or pathological grief and pointing the concerned individuals towards suitable care, the GRIEF COACH can play a crucial role in preventing long-term complications and fostering a healthier, more enduring healing process. It is essential to remember that every bereaved individual is unique and the role of the GRIEF COACH is to provide tailored, empathetic support, respecting each individual’s pace.
KeyPoints to Remember :
1. Complicated or pathological grief is characterized by the persistence and intensity of grief symptoms beyond a period considered as normal.
2. The inability to accept the reality of the loss is a sign of complicated grief. Individuals may continue to hope for the deceased’s return or nurture illusions about their presence.
3. Excessive avoidance behaviours, such as social isolation and activity restriction, can indicate complicated grief.
4. Complicated grief can manifest through symptoms of intense, disabling distress, such as severe depressive symptoms, suicidal thoughts, sleep or eating disorders, or excessive alcohol or drug use.
5. The signs of complicated grief vary from one person to another and certain risk factors can increase the likelihood of developing complicated grief.
6. The role of the GRIEF COACH is to be attentive to the signs of complicated grief, assess their impact on the bereaved individual’s well-being and functioning, and guide toward suitable resources if necessary.
7. The GRIEF COACH can offer additional support by helping the individual develop healthy coping strategies, identify their resources, and maintain a social connection, while acknowledging the limits of their expertise.
8. The support provided by the GRIEF COACH should be personalised, empathetic, and respectful of the pace of each bereaved individual.
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