Healing from Complicated Bereavement Using Trauma-Focused Therapies

It was a car accident that, with sudden screeching violence, ended instantly a marriage of 30 years. They were driving, talking idly about a song on the radio, one conversation that would be unremarkable in their long lifetimes, no different than the millions that came before. No different, except it was the last. Another driver missed a red light, and Derrick never spoke to his wife Mandy again.

Their children were devastated. The week was spent in shock and mourning, in anger and teary laughter, in fits of sobbing and spells of numbness. But they got through it together. The funeral came and went, they returned to work, the days turned into weeks, and the children began to process their grief.

But Derrick was always at that intersection. He was still in that conversation. He was unable to move on.

His children didn’t know it, but he was suffering from complicated bereavement, which is the inability to healthily process a loss. This is different than missing someone. We all miss people, as the terrible finality of death is almost impossible to comprehend. But most people are able to understand and deal with their loss, in one way or the other. They can grieve productively. But people suffering from complicated bereavement can’t move on. They fixate on the loss, to the detriment of their health, their job, their social lives, and their mental facilities. Their suffering becomes a black hole, and they can slowly or quickly throw away their own lives.

They don’t have to be stuck forever, though. With proper mental health treatment, including trauma-focused therapies, people suffering from complicated bereavement can process their loss and move forward. That doesn’t mean forgetting. It just means taking that next step. It means leaving the intersection and moving towards a place of greater wellness and peace.

The symptoms of complex bereavement are at first hard to tell. After all, when faced with a loss, most grief looks similar. It doesn’t matter if it is sudden and unexpected or follows a prolonged illness and is met with slight relief, or anywhere in between. Loss is loss. It creates a line between realities, one in which you have years of more words and moments to exchange, and the one in which you don’t.

People suffering complicated bereavement hold onto that first reality, even though it is no longer a possibility. They focus intensely on that, even after everyone has moved forward. That’s the key difference. Some of the symptoms of complex bereavement are:

• Difficulty accepting the death. Nobody wants someone to be gone. But most people understand it is the reality. Acceptance is an important stage of grief because it leads you further away from anger and denial and lets you remember with some peace. Not accepting means never having a healthy relationship with the new reality.
• Overwhelming sorrow. Humans have an innate gift for compartmentalizing emotions. We can mourn, but put it out of our minds to go to the store or go to work or put one foot in front of the other and walk. Someone suffering complicated bereavement cannot do that. Sorrow overwhelms them, and floods every compartment.
• Longing. Nostalgia is the bittersweet wish for something that is gone. We all have it; it might be the most human of all emotions. But the sadness of nostalgia rarely overtakes our ability to live in the present. For someone with intense complicated grief, this longing for the person they lost is consuming.
• Bitterness. We live with the knowledge of death. That never makes it easy, but it is a condition of life. Someone suffering complicated bereavement become embittered toward that tragic reality, and bitter about life. They can become angry, ill-tempered, and fatalistic.
• Detached and numb. This seems like the opposite of bitter, but it isn’t. It is a culmination of these symptoms. It is the feeling that, without the lost loved one, their life has no purpose. They stop caring.

There is no one way to grieve, and there is no timetable on it. It is natural to miss someone you loved and is now gone; it is natural to be hit suddenly by your loss, and how much you miss them, even years after your loved one’s passing.

Complicated bereavement is different. It is not the reality of sadness, but the absence of acceptance. It’s when sorrow overtakes everything. And it can wreak havoc on a person’s life and wellbeing, just as surely as a car crash.

Complicated bereavement disrupts a person’s life by not letting them become comfortable in their new reality. It traps them between the past and the future, in a “between” place with (seemingly) no escape. More straightforwardly, it can create serious mental and physical health outcomes. Because the sufferer has a different outlook on their own life and their own purpose, they can stop taking care of their needs, whether those are social, physical, emotional, or economic.

Some of the possible outcomes of untreated complicated bereavement include:

• Deep isolation, a leading cause of depression
• Unhealthy eating habits (overeating, undereating, eating without concern for nutrition)
• Inability to carry out routines (including hygiene, exercise)
• Inability to continue working
• Depression
• Suicidal thoughts or actions

Obviously, any of these can spiral into and bounce against any other, and can lead to a host of other issues. Poor eating can lead to cardiovascular disease; lack of exercise can lead to all sorts of problems. Not working or not seeing friends can increase depression, sense of worthlessness, sense of isolation.

So what can be done? It starts by understanding the relationship of complicated grief to trauma, and getting the help that is needed.

The relationship between grief and trauma is complex. There are very different symptoms and outward appearances, and a person with complicated grief doesn’t have to have PTSD (although they certainly can), and vice-versa.

But there are similarities. PTSD alters neurochemicals, and functions in roughly the same way that addiction does, in the sense that it colonizes the brain and demands a certain response. Grief can act the same way. It triggers sensors in the brain which the brain can sometimes perceive as pleasure, even if they don’t feel that way. It starts to crave the sorrow.

All that’s abstract, of course, to the lived reality of grief. What isn’t abstract is how you feel, or what can be done. And there are ways to treat complicated grief, often using trauma-focused therapies. Trauma therapy exists not to mask the symptoms but to help the sufferer understand the cause, identify it, and understand how to live with it. By recognizing the source of trauma, we can understand triggers and dangers, and understand how to not live in the reality of trauma but the experience of the moment.

WIth grief, we understand the root cause. But we don’t always understand our reaction to it, or why we have to live there. But by diving into the source, we can understand how our unique case affects us, and how our life to that moment impacts our life after it.

This takes time. It isn’t easy, and it has to be done by compassionate and trained mental health experts, often in long-term care facilities. It can be partnered with traditional grief and loss groups, where people suffering similar issues can talk in a mediated setting and realize they aren’t alone. Moving forward doesn’t mean letting go of your love. It just means accepting that your love has entered a new stage. It means understanding that your life can go on.

We are so often at a crossroads in life. Sometimes, we’re stuck there, unable to see that the path we thought we were taking is blocked forever. We don’t like it, but with help, with love, with care, and with determination and care, we can accept our new road. We can move forward.

Bridges to Recovery offers comprehensive treatment for mental health disorders as well as process addictions and phase of life issues. Contact us to learn more about our renowned Los Angeles programs and how we can help you or your loved one start on the path to healing.