Grieving is difficult.
In early grief, many people experience strong emotions and feelings of loneliness, worry and upset. This grieving is sometimes called acute grief. Most people find their own way through their grief with the support of friends and family.
Some people benefit from talking to trained listeners who can provide some space and time for the bereaved person to process all that has happened.
The purpose of grieving is to find a way to stay connected to that person you loved, while being able to pick up the pieces of your life again.
We don’t get over loss, but grief naturally changes and reshapes in time and finds its rightful place in our hearts. When this happens, it’s called integrated grief. We still miss the person, we may still get upset at reminders of them or as certain significant dates approach, but we are functioning and have again found meaning in our lives.
However, the work of grief doesn’t always progress, and we now know people can get stuck in their grief.
When the symptoms of grief remain very intense and get in the way of everyday life, this is called prolonged grief. It’s sometimes known as complicated grief or persistent complex bereavement disorder. It’s a red flag that some more specialised help may be needed.
If we use the metaphor of the journey of grief being like a train journey, then prolonged grief would be the train overturning with its wheels spinning.
Prolonged Grief is a recognised difficulty, but it’s not well understood, and bereaved people with prolonged grief can be left feeling they’re not trying hard enough to get on with life or they are looking for attention or sympathy. The truth is dealing with unrelenting grief is very challenging and no one would choose to feel like this.
Who is likely to get stuck in grief?
We don’t know for sure who is going to get stuck in their grief, but we do know some of the factors that can make someone vulnerable to developing prolonged grief.
These include: an unexpected or violent death, a death that you feel could have been prevented and the death of a child. Other aspects also plan a role.
What are the signs of prolonged grief?
Prolonged Grief resembles the early acute stage of grief. Rather than changing, the grief remains as intense as it was in the early days of grief. The table below explains the difference between a grief that’s integrating and a grief that’s stuck.
Intergrated vs. prolonged grief
| Integrated grief | When grief gets stuck |
| Pangs of grief lessen over time | Pangs of grief are persistent, prolonged or very intense |
| Acceptance of the death | Difficulty accepting the finality of the death |
| Feelings of longing & yearning are still there, but not constantly | Intense yearning/longing |
| Still having thoughts of the loved one, but able to think about other things too | Preoccupation with thoughts of the person who died |
| Able to enjoy the company of others | Avoiding or having difficulty in social situations |
| Able to experience moments of joy | Feeling numb, empty, no joyful moments |
The International classification of diseases (ICD 11) lists prolonged grief disorder as a recognised difficulty.
What to do if you suspect you, or someone you care about, might be stuck in grief?
Talk to someone who is trained in prolonged grief. These therapists use a way of working that has been shown in several studies to be more effective for people struggling with prolonged grief than traditional therapy, but it’s not the only way to work with it. You can access a list online through www.bereaved.ie or call us (01) 679 3188 for the name of trained therapists in your area.
Before beginning any therapy, it’s important to have a thorough consultation to make sure that prolonged grief is the difficulty (prolonged grief is sometimes confused with depression). It’s also important to feel comfortable with the therapist. Ask for a clear outline of how you’ll work together and what the cost will be.
Grief never goes away, but you can heal from grief, even when it gets stuck. You can get to a place where you remember loved ones with love rather than with pain.
Further Resources
There is also a lot of helpful information on the Columbia University Center for complicated grief website. Click the For the Public tab
Watch Dr. Susan Delaney discussing the many misperceptions around grief on this TED talk
We don’t move on from grief talk. We move forward with it, by Nora McInerny TED talk
Further suggested reading is available through our Thérèse Brady Library, email [email protected]
