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Unresolved Grief

Unresolved grief, or complex grief, is different from normal grief in various ways. First, it lasts much longer, at times for many years. Second, it’s much more severe and intense, not lessening with time but instead often worsening. Third, it interferes with a person’s ability to function normally in daily life.

While there are no definite risk factors, it tends to be more common in people who have low self-esteem, feel guilty about the loss, or struggle with their feelings about the deceased. It also tends to affect those experiencing an unexpected and perhaps violent death of a loved one or those suffering from a loss that others don’t readily recognize, such as a miscarriage. Other risk factors include high stress, poor social support, trauma or traumatic grief, and serving as a caregiver to the deceased person. 

Whatever the circumstances of the loss, the common thread is that the sufferer tries to deny or avoid the normal aspects of their grief. Most often, they tend to hold on to their loved one and refuse to accept the loss. And this tendency to avoid grief is exactly what hinders the healing process and leads to an unresolved grief reaction. 

What are the Signs of Unresolved Grief?

At least at the start, unresolved grief is difficult to tell apart from the normal grieving process. However, in time, certain symptoms emerge that can help you determine if you or someone you know is dealing with unresolved grief. Unresolved grief is an experience of being “incomplete” with a loss. 

Symptoms of unresolved grief in adults and teenagers may include:

  • Intense sadness that doesn’t improve with time

  • Fond memories turn painful

  • Avoid getting close to people (relationship fears)

  • Numbness, emptiness, fatigue, digestive issues

  • Avoidance of reminders about the loss

  • Keeping same routines out of fear of forgetting

  • Unwillingness to speak about the loss or acknowledge it

  • Obsession and preoccupation and yearning for the person they lost

  • Isolation and avoiding contact with other people; feeling detached

  • Phobias and anxiety (for adults often about their health)

  • Overactivity and intense occupation with a hobby or work or the opposite – lack of interest

  • Self-destructive behavior, such as drug or alcohol abuse

  • Risky or criminal behavior (most often in teens)

  • Guilt, self-reproach, self-blame, panic attacks

  • Acquisition of physical symptoms representing identification with the deceased

  • Depression with tension, intense bitterness, feelings of worthlessness, and self-accusation

  • Suicidal thoughts


What is the Treatment for Unresolved Grief?

Grief counseling can help you heal no matter what type of grief you’re experiencing. It can help you move through the stages of grief with supportive guidance vs. getting stuck. But for those with unresolved grief, it is especially helpful.

Grief therapy usually encompasses:

  • Understanding grief reactions and unresolved/complicated grief symptoms

  • Cognitive behavioral techniques that explore and process obsessive thoughts and emotions and address trauma and stress symptoms

  • Role playing imagined conversations with the deceased and explaining the circumstances of their death and possible feelings of guilt

  • Exploring happy memories about the loved one and reducing avoidance of the topic

  • Adjusting to the loss by improving coping skills, reducing feelings of guilt and blame, and eventually redefining life goals

  • Learning skills to safely process emotional reactions vs. stuffing them

  • Re-establishing relationships and connection with valued life goals


Coping Skills that Help

  • Join a support group

  • Add self-care behaviors: nutritious eating, movement, getting enough rest

  • Stay connected with family and friends

  • Plan ahead for anniversaries and reminders of the loss

  • Get involved in spiritual activities

  • Process emotional pain (with a therapist, spiritual advisor, journal) vs stuffing it

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