Sub-module 4.7 – Identifying and Supporting Individuals at Risk of Complicated Grief
Grief is a natural and unique process that can follow different trajectories, as we have seen with the Bonanno model. However, for some people, grief can become complicated, that is, it can significantly and lastly impede their daily functioning and well-being. Complicated grief is characterized by an intensity and persistence of grief symptoms beyond what is culturally expected, as well as difficulties adapting to the loss and reinvesting in one’s life. It is essential for the GRIEF COACH to know how to identify people at risk of complicated grief and to offer them appropriate support, in order to prevent the worsening of their distress and to promote their healing process.
Several risk factors can increase the likelihood of developing complicated grief. Among these factors are the nature of the relationship with the deceased (for example, the loss of a child or spouse), the circumstances of death (for example, a sudden, violent or traumatic death), a history of mental disorders (for example, pre-existing depression or anxiety disorder), lack of social support, or concurrent stressors (for example, financial difficulties or family conflicts). Certain individual vulnerability factors, such as insecure attachment style, low self-esteem or maladaptive coping strategies, may also increase the risk of complicated grief. For example, a person who has lost their spouse suddenly, has little family support, and has a history of depression may be particularly at risk of developing complicated grief.
The GRIEF COACH can identify those at risk of complicated grief by looking for certain signs and symptoms. People with complicated grief may exhibit intense, persistent distress that does not lessen over time and pervades all areas of their life. They may have difficulty accepting the reality of the loss, recalling positive memories of the deceased, finding meaning in their life without them, or engaging in new activities. They also may suffer from severe depressive symptoms, suicidal thoughts, sleep or appetite disorders, or somatic complaints. Behaviorally, they may isolate themselves socially, neglect their responsibilities, or adopt risky behaviors. For example, a person with complicated grief may cry every day for months, sleep with the deceased’s clothes, refuse to attend family gatherings, or put themselves in danger through impulsive behaviors.
When faced with a person at risk or showing signs of complicated grief, the GRIEF COACH must provide specific support and guide towards appropriate care. He/she can propose more intensive, regular therapeutic follow-up, in order to offer a safe space to express painful emotions and explore the factors maintaining the distress. They can also teach emotional regulation techniques, such as relaxation, mindfulness or cognitive restructuring, to help the person better manage their symptoms. The GRIEF COACH can also work on problematic cognitions and beliefs that hinder the grieving process, such as excessive guilt, chronic anger, or a sense of loss. The grieving person can be encouraged to recall positive memories of the deceased, to honor their memory symbolically and to gradually reinvest in meaningful activities and relationships. For example, the GRIEF COACH can suggest to a person with complicated grief to keep a journal of their emotions, create a commemorative ritual, join a support group, or engage in a cause that is close to their heart.
In cases of severe complicated grief, the GRIEF COACH must collaborate with other mental health professionals, such as psychologists or psychiatrists, to provide comprehensive and coordinated care. It may be necessary to combine medication with therapy to alleviate the most disabling depressive or anxious symptoms. The GRIEF COACH can also involve the grieving person’s entourage in the support process, educating them about the issues surrounding complicated grief and guiding them on how to offer a caring and helpful presence. The aim is to create a solid, empathetic support network around the person with complicated grief, in order to break their isolation and promote their recovery.
It is important to note that complicated grief is not a weakness or failure, but a normal response to a particularly difficult loss or unfavorable life circumstances. People with complicated grief do not choose to suffer and need compassionate, non-judgmental support. The role of the GRIEF COACH is to welcome them in their distress, value their resources, and guide them towards a healing trajectory, at their pace and according to their needs. By providing adjusted support and collaborating with other professionals, the GRIEF COACH can help people with complicated grief navigate this ordeal and find a meaningful balance in life.
Finally, it is essential to keep in mind that complicated grief is not a fatality and that people who suffer from it have the ability to recover, provided they receive appropriate and compassionate support. The GRIEF COACH can be a key player in this healing process, offering a stable, empathic and enlightened presence, and helping the bereaved to mobilize their internal and external resources. By relying on scientific knowledge and practical tools of grief coaching, the GRIEF COACH can help prevent and alleviate the suffering associated with complicated grief, promoting trajectories of resilience and personal growth.
Key points:
– Complicated grief is characterized by an intensity and persistence of grief symptoms beyond what is culturally expected, significantly impeding the daily functioning and well-being of the bereaved person.
– Several risk factors can increase the likelihood of developing complicated grief, such as the nature of the relationship with the deceased, the circumstances of the death, a history of mental disorders, lack of social support, and certain individual vulnerability factors.
– The GRIEF COACH can identify people at risk of complicated grief by looking out for signs such as intense, persistent distress, difficulties in accepting the reality of the loss, severe depressive symptoms, sleep or appetite disorders, and isolating or risky behaviors.
– Faced with a person at risk or showing signs of complicated grief, the GRIEF COACH must provide specific support and guide towards appropriate care, offering intensive therapeutic follow-up, teaching emotional regulation techniques, and working on problematic cognitions and beliefs.
– In cases of severe complicated grief, the GRIEF COACH must work in collaboration with other mental health professionals to provide comprehensive and coordinated care and involve the bereaved person’s entourage in the support process.
– Complicated grief is not weakness but a normal response to a particularly difficult loss, and people who suffer from it need compassionate and non-judgmental support to navigate this ordeal and find a meaningful balance in life.
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