Don't Mourn Alone – Treating Complicated Grief in a Pandemic

No-one gets through life without experiencing grief. In most cases, it's intense and devastating at first but the dark feelings gradually give way to a kind of peace. Sufferers come to terms with their loss and eventually find themselves moving forward—making a space in their heart for their lost loved ones while planning for a future without them.

For some, the grieving process feels less like a linear path and more like an endless, tortured, merry-go-round. They get stuck. For those people, grief is a living nightmare that they never seem to wake from. This is what's known as ‘complicated grief,’ and it's particularly relevant when trying to get by during a pandemic.

Covid-19 has claimed over half a million lives across the globe. Researchers estimate that in the US alone, every Covid death leaves around nine people bereaved. That's a lot of people mourning lost loved ones during traumatic circumstances, which is leading some experts to conclude that we're on the cusp of an epidemic of complicated grief.

What is Complicated Grief?

There is some confusion over the official definition of complicated grief. The accepted authority for psychiatric terminology, the Diagnostic and Statistical Manual of Mental Disorders (DSM), identifies it as 'persistent complex bereavement disorder' while the World Health Organisation (WHO) refers to it as 'prolonged grief disorder'.

Whatever it’s called, the characteristics are generally the same—the grief is long-lasting, the bereaved cannot adapt to their loss and may experience secondary physical symptoms such as insomnia, depression, or anxiety. They are usually debilitated because their grief severely disrupts all aspects of their life.

Grief counsellor Kim O'Leary says she looks for tell-tale clues with her bereaved clients to know if their grief has moved from standard, to sinister. If a client is experiencing loss of appetite, nausea, severe exhaustion, disrupted sleep, and feels disconnected, or is obsessively dwelling on the person they've lost, they may fit the diagnosis of ‘complicated grief’.

All the above symptoms can be a normal part of the mourning process, and O'Leary is quick to point out the importance of giving clients space to feel before labelling and pathologizing their emotions— “We live in a grief impaired society. Sometimes we talk about complicated grief, because our grief is not fitting a timeline that works with our society [but] it's a process. Grief is not pretty, it's messy.”

So how can people identify between normal grief, and complicated grief?

“In a normal grief process you get hit by this wave and then it subsides a bit and you can breathe. When a person feels like they can never catch a breath, and it has been happening for a while, I would listen to that [and consider getting help],” says O'Leary  

Traumatic Loss in a Traumatic Time

Losing someone suddenly, without a chance to say goodbye... 

Becoming bereaved when you're already dealing with mental health issues, or external stresses like divorce or unemployment... 

Finding out that a loved one suffered a violent or painful death... 

There are many reasons why some losses hit harder than others, and put sufferers at risk of complicated grief. Being bereaved in traumatic circumstances is a prime indicator and now, during a pandemic, trauma is everywhere.

Complicated grief occurs in about 7 percent of mourners, but that number is expected to rise sharply as the impact of Coronavirus-related fatalities becomes more apparent.

It's been a heart-wrenching pandemic with devastating stories of loss, and for families who are suffering from the death of loved ones, those stories hit hard. People are unable to visit their sick parents or partners in the hospital for a final goodbye. Families are unable to hold funerals due to the need to socially distance. This means that traditional methods of working through the grieving process are no longer available. Even little things like not being able to get a hug from a friend, or worrying about the next pay cheque, adds to the pain of loss.

It’s a recipe for complicated grief. O'Leary says—

“In the midst of a crisis we tend to gather, we want to be with the people we love. The challenge now is finding how we can create a ritual or a memorial as a family or a community, and acknowledge that loss.

“We are in a collective state of grief at the moment, even though we are all experiencing it differently. There have been so many micro-losses, and the accumulation of those losses. We need to acknowledge that to be able to normalise them.”

Treating Complicated Grief

When O'Leary comes across a case of complicated grief in her practice at Awakening Heart Counselling, her first instinct is to treat the body as well as the brain. She says grief has a physical component that needs to be resolved before people can truly heal.

“Being in a state of prolonged grief affects our adrenalin and cortisol levels. It has an impact on inflammation in the body. When our heart is blown open we are going to feel intense feelings and that will create an intense response in our body. Our emotions, our thinking, and our physiology—it is all interconnected.”

She says somatic therapy can help, and describes it as “objection without contraction”—guiding the client to identify what they are objecting to. They might say, “I hate that I can't hug my friends”, “I am angry that I've lost this person,” and then notice how their body is contracting and restricting in response to that feeling.

This kind of emotional and physical mindfulness encourages people to let go of what they're holding onto, and become “unstuck.” O'Leary adds—“Your emotions can begin to move. You can start building capacity to bear the unbearable.”

By using somatic therapy, and other therapies like imagery and behavioural therapy, O'Leary says it's very possible to heal from grief, no matter how overwhelming it seems. She's seen clients come out the other side and believes it can be a restorative and even joyful experience.

“When we really connect with our grief, and allow it to move through us, it makes room for our creativity and vitality. There is anger and sadness but there's also a deep joy as we move through the process. Grief can really transform us. There is a loss of innocence, but in a good way. You know something more about yourself from the experience.”

If you're struggling with loss and want to talk to someone, Which Doctor can connect you with grief therapists, counsellors and coaches to give you the tools you need to move forward. 

Catherine Morris

Writer

Catherine Morris is an award-winning journalist with a bad case of wanderlust and a passion for all things health and wellness. Originally from Northern Ireland, she worked as a news and feature writer for media outlets in the UK, South Africa, France and the Caribbean before settling in Canada. Catherine now lives in Alberta with her husband and rescue mutt and spends her time happily exploring the great outdoors with both.