- Hey everybody today
we're gonna talk about complicated grief and how it differs from regular grief, but
before we jump into that, are you new to my channel? Welcome. I am a licensed therapist
making mental health videos on Mondays and on Thursdays so make sure you have your
notifications turned on so that you don't miss out. But now let's hop in to today's topic. And it's important, as
always I wanna define things so it's important to first
know that grief itself is the natural reaction to loss. It's the body and mind's
way of healing wounds caused by loss of something precious. We tend to think of it
mostly as intense sorry, but it can present itself as
a lot of different emotions or thoughts or even physical symptoms. The important thing to know about grief is that while it can feel awful, it is a healthy and
adaptive process of healing. It's just your brain's way
of making sense of the loss and it helps us to learn what we value and leads us to reach out
for comfort and relationship. So in a way, grief is really just a helpful tool for
processing the loss. Now complicated grief, on the other hand, can feel very similar to grief, but it is in fact very different from it. While grief is an adaptive process of making sense of a loss, complicated grief is actually a disruption of the grieving process. It keeps you from processing a loss. It's like a complete roadblock. Grief involves positive
feelings and memories and complicated grief
generally makes it tough to be able to access the memory or loss in a way that enables you to have a positive or honoring feeling. Also grief is a reaction to
losing something you value. Complicated grief is a reaction to like the negative thoughts
or feelings that we have about some element of the loss, almost like the loss stirred
something up inside of us and it feels icky and the thoughts that we have about it are all negative. That's where complicated
grief comes out of. And overall, if that doesn't make sense just know that complicated
grief is really borne out of a negative belief or experience that we've attached to the loss. It could be a negative belief
that we have about ourselves or possibly the relationship that we had with the person who's passed away or is no longer in our lives. Instead of processing the loss, complicated grief keeps
us stuck in the process, unable to do the healing work of grieving. A better way of explaining this is if we talk about the loss
like it's a physical wound. Grieving is the healthy
process of that wound healing. It's the cleaning out of the wound through experiencing and processing the different losses
associated with that wound. It feels painful at first, you know. If you like have a cut on your leg, you put rubbing alcohol
or hydrogen peroxide on it and you're like, oo, it really hurts and then if we're processing it, it can get kind of confusing and it can be hard at times, but this whole grief process is necessary if we want the wound to heal fully. Does that kinda make sense? In complicated grief, on the other hand, is when that wound becomes infected or you kind of keep
tearing out the sutures. I love the band The Postal Service and I just couldn't help
myself, had to add that in. But anyways, during complicated grief you are still feeling pain and confusion, but it's caused, not by the wound itself, but by the infection that
has gotten into the wound. For example, let's say you have suffered the loss of a person or relationship that is really important to you. The grieving process would be
the emotions and the thoughts and the physical responses,
they can often be uncomfortable, that come as your mind works
to make sense of that loss. Complicated grief is the
interruption of that process. So instead of being
able to honor the person or thing that was lost, some narrative, like I was talking about, all those negative thoughts or beliefs
we maybe have about ourselves is going to distract and stop that. And so instead of the grief narratives which are rooted in the
loss and might sound like, why did this happen to me or I miss the way that they cared for me or I don't wanna do this without them. Instead a complicated grief narrative might be something like
people who cry are babies or this is all my fault, I
deserved this, I'm so weak. Or even narratives caused
by other losses in our life, like everyone is always leaving me or is this is always happening. Does that make sense? It's like instead of
having a healthy thought and belief and story, we tell
ourselves about the grief, complicated grief prevents it and almost makes it personal, where we did something to cause it. And so of course we're not gonna be able to process it and move forward. Now as far as the emotions side, they may feel very similar,
especially in the beginning. When you lose someone or you're grieving, you feel sad, angry, hopeless, maybe even depressed, but these emotions are not rooted in working through the loss and over time, it'll become clear that you're just stuck in a cycle. You're responding to that
maladaptive narrative you had, which maladaptive narrative's
just a therapisty way of saying that unhealthy story
you keep telling yourself about the loss, like all those beliefs that we're having, right? So we can respond to that rather than ever being able to respond to the actual loss we're facing, which is really why we can't process it. Does this all makes sense? I hope so. So if we think this is happening to us, what could have caused it? Why would we have complicated
grief versus regular grief? Now there are a lot of
things that can cause it. It could be, number
one, and the most common is unresolved past grief or trauma, especially from childhood. When you're a kid, sometimes
you experience injuries that you don't yet have the language or cognition to even process. These things can be triggered or resurface when something happens in your life. And the second cause is loss
you feel responsible for, like you did something to cause this. Like I said some of those maladaptive or negative thoughts that we can have can be like, people always leave me, this is all my fault, I did something. So that can obviously lead
to complicated grief as well. And number three it could
be from invalidated loss. And invalidated loss occurs when you feel your grief
is disproportionate to the situation, meaning you really think you're overreacting and
you're judging your grief instead of allowing yourself to feel it and validating the experience. And this could be because
of the circumstances surrounding the loss or the
ways others react to your loss or the culture in your family about grief. It can happen when you compare losses or when certain emotions
in the grief process feel off-limits to you in your mind. For example, you feel guilty about anger or have a belief system
that makes you feel weak for really feeling sad
and missing someone. And complicated grief can also occur when you find yourself in a situation involving delayed grief, so
this is the fourth cause, fourth potential cause
of complicated grief. And delayed grief is when circumstances make it difficult to process
the loss as it happens. Maybe you're busy planning a funeral or you have to care for
someone else's experience of the same loss, so you aren't able to fully process your own. And I remember, honestly,
when my dad passed away my mom was sort of in this weird trance during the whole process,
because she had to make sure that all the
finances were in order, and she had to plan the funeral, and she was also consoling me and being there for other
members of the family, and there was just so much to do that I think it almost just distracted her from her own loss. Another source might be
ambiguous or hidden loss. Some losses are invisible, like losing a child to miscarriage. When loss isn't seen or
acknowledged by others, you can end up experiencing complications. Or the sixth cause is compounded losses. When multiple losses occur
around the same time, it can make it challenging
to process each one. And number seven, sudden
lingering or violent loss. Essentially these kinds of injuries are often being experienced as what we would call a traumatic loss. Recurring losses or losses
that are a disruption of some sort of a central
belief or thought you have about yourself can create trauma and essentially, in the end,
create complicated grief, meaning that if the
loss seems to go against what you feel you truly are, it could be as simple as always believing that you are strong and independent. But if our grief makes us feel weak and lost without someone, it goes against what we
believe about ourselves. Do you know what I mean? And that can lead to complicated grief. Okay, enough about that and the causes, let's move into how we can know if we're struggling
with complicated grief. So identifying complicated
grief can be tricky, because at times it can look
very similar to regular grief, not to mention that we don't
just wanna start thinking we have a mental illness when
we're just doing something as normal and healthy as a grieving. Now since complicated grief is in the DSM, remember it's not the end-all be-all, but it just gives us
a way to better define and diagnose and treat
certain mental illnesses, but in the DSM it's called persistent complex bereavement disorder, or PCBD, and it's included in
the DSM as a condition that needs further study precisely because it is so complicated. And if you remember, I did
a video a long time ago about non-suicidal self-injury and that was in that
same portion of the DSM, under conditions that
need further research. And so what that means is
is that we might find it in the next update of the DSM. Now in order for someone
to struggle with PCBD, we must have experienced
the death of a loved one at least six months previous and at least one of the following symptoms has to be happening longer than expected, okay, so that has to be going on. And then we have to have at
least one of these things, okay. And obviously when we're assessing this, we have to take into consideration a person's social or cultural environment because different people of religions and backgrounds and cultures have different grieving processes and what's considered
quote unquote normal. Okay, but they have to
have at least one of these. Number one, intense and persistent yearning for the deceased. Number two, frequent
preoccupation with the deceased. Three, intense feelings of
emptiness or loneliness. Four, recurrent thoughts
that life is meaningless or unfair without the deceased. And five, a frequent urge to
join the deceased in death. And in conjunction with those, we also have to have at
least two of the following, and these must have been occurring and been recorded for at
least one month, okay. And the first one is
feeling shocked, stunned, or numb since the loved one's death. Number two, feelings of disbelief or inability to accept the loss. Number three, rumination
about the circumstances or consequences of the death. Number four, anger or
bitterness about the death. Number five, experiencing pain that the deceased suffered or hearing and seeing the deceased. Number six, trouble trusting
or caring about others. Number seven, intense reactions to memories or reminders of the deceased. And number eight and finally, avoidance of the reminders of the deceased or the opposite where we'll
seek out such reminders so we can feel closer to them. Now in order to diagnose, symptoms would need to create substantial
distress for the sufferer or impact significantly
on areas of functioning and cannot be attributed to other causes. Just like all other diagnosis, in order for them to be a real issue they have to impair our
ability to function. I've talked about that a lot in all of my other DSM diagnosis videos. But also know that grieving can still involve complicated emotions
that you may not like, but they are about the loss and not about you, and not
about the grief itself. What I mean is, don't think
it's complicated grief just because it's extremely painful and there are mixed emotions. Trust me, I feel like
everything I've had to grieve, every person I've lost in my life has created mixed emotions and it's been really uncomfortable. And these complications
that we're talking about when it comes to complicated grief are the things that are keeping you from healing and grieving, so
the question to consider is is what you're experiencing
helping you mourn the loss? Or is it keeping you from
even thinking about the loss? And if you think you might be dealing with complicated grief, please reach out to a therapist or other mental health
professional in your area. They can really help you figure out what's interrupting the
grief process for you and help you move past it so you're able to process the grief you're feeling. And one type of therapy
that's known to help with this is CBT, or cognitive behavioral therapy. In CBT, your therapist will work with you to identify the narratives. Remember those faulty beliefs or guilt? Anyways, they'll help
you identify the ones that are interrupting
your grieving process. Then they will help you identify what these faulty beliefs are rooted in and either help you work through them or separating them out from the loss so that it can be processed separately, because let's say it was a trauma that's causing your complicated grief, we'd wanna process
through that trauma first and then get into the grieving process. But overall, the important thing to know is that complicated grief
is very, very common and it can and will get better. So please reach out because
if its left untreated, complicated grief can lead
to other mental health issues that would need their own treatment, such as depression or anxiety. And finally, I wanna
just get into something that you can use today to
help you begin this process. And one way to do that is to start working through past losses. I offer this up as an option because it can be easier
to start with something you aren't currently struggling with. Just like when we go to
process through trauma, we may start off with a smaller less emotionally charged
portion of that first. So take a few minutes and think through some of the losses you've
experienced in your life. Do you feel like you've done all the work of working through those losses? If not, maybe carve
out some time this week to journal through those losses and see what emotions or narratives, you know, those nasty
stories we tell ourselves about it, see what comes up for you. And remember to be
compassionate about this process and ensure you're talking
kindly to yourself as you work through it. Loss is really hard,
so try to pay attention to the thoughts you have when you start thinking about your loss. Are these thoughts about the loss or are they things that
might be about yourself and what's keeping you from
actually facing the loss? Then take some time to
think about the loss itself. What do you miss about that person? What do you think feel about that loss? As you process, just try
to notice any thoughts that arise when you think about the loss. Those can be clues to
what may be preventing you from grieving fully. Even identifying these will help you make more space in the
process for your loss and resolve the complications. I hope you found this video helpful. If you want to know more you can check out the links below and let us know in the comments if you've ever experienced
complicated grief. And if so, how did you
know that's what it was? Or how did you work through it? Leave those in the comments below because you never know
who you're gonna help and I will see you next time, bye. (gentle music)
