“The world is a crazy, beautiful, ugly complicated place, and it keeps moving on from crisis to strangeness to beauty to weirdness to tragedy. The caravan keeps moving on…" ~David Remnick
We all like to be reassured that we are normal when we are going through something for the first time. Like that rash is a normal response to your eating something you are allergic to. Good to know.
When you are going through a time of grieving, it can be so helpful to know what physical, cognitive, emotional, and behavioral experiences are considered normal. Grief counselors do a lot of work in “normalizing” the experiences of someone in deep grief. You relax when you hear the words, “It’s perfectly understandable that you are feeling/thinking/behaving in this way. It's normal.” Whew.
Grief is the normal and natural reaction to loss. In most instances, people adapt to their loss and recover from the most debilitating effects of grief over the course of time.
And yet, even two people grieving the same loss will not experience it in the same way. Your ability to adapt to loss of a significant relationship is dependent upon many factors. Let’s narrow this down and consider the nature of the relationship between the people involved and the circumstances of the loss.
Attachment Theory, as brought forward by psychiatrist, John Bowlby, explains how humans form attachments to each other, and what happens when these bonds are broken. The nature of the grieving process for that loss depends a great deal upon the type of attachment between the people involved. People experiencing anxious or ambivalent attachments with the person who dies can sometimes experience complications in the grieving process that create even more difficulty than those with secure attachments.
Also, J. William Worden discusses what he calls the “mediators of mourning” in his book, Grief Counseling and Grief Therapy. These determine the effect that a lost relationship will have you. Two of the most important mediators are: 1) who the person was to you and 2) the circumstances under which they died (whether there was a trauma associated with the loss, if it was sudden or expected, etc.)
There are times when grieving goes outside the spectrum of what is considered “normal.” As with most psychological diagnoses, there is a continuum of mental health from what is normal on one end to psychopathology on the other. For instance, Obsessive Compulsive Disorder is on one end of the continuum. Having a focused attention to detail might be in the normal range.
Once grieving has left the bounds of what is considered normal, it is referred to as complicated grief.
“Complicated grief is a disruption in the normal grief process which prohibits healthy closure and healing for the affected person. It manifests itself as a response or reaction which may be prolonged, delayed, distorted, absent, concomitant, excessive, unresolved/layered, or trauma-related. Studies indicate that 14-30% of grieving people will develop complicated grief.”
~ Linda J. Schupp, Ph.D. Grief: Normal, Complicated, Traumatic
14-30% is a staggering statistic. This is a large number of people who will probably need some kind of therapeutic help with their grieving process to have a chance of adapting to and rebuilding their lives after loss. Some of these manifestations cited above occupy a very gray area of interpretation. Also, different cultural norms can cloud the issue over what is considered a normal grief response and a complicated one.
Complicated grief can be incapacitating and people experiencing it are at high risk. The reason I am writing about this today is to educate and inform rather than to create undue concern. Each of the adjectives above are on a spectrum of meaning. What does prolonged mean? According to the Diagnostic and Statistical Manual of Mental Disorders, bereavement symptoms that last more than two months after the time of loss might be considered a Major Depressive Episode. Of course, there are other factors that need to be taken into account. However, in my experience, two months is a relatively short time for an expectation of the completion of the acute grieving phase and the most troubling of symptoms to subside.
I have my own yardsticks for each of these features that I use when assessing if it is appropriate to work with a particular client. If the person meets the criteria for complicated grief, they are better served in the care and treatment of a therapist than a grief coach or counselor.
One assessment tool is my intuition. And, I ask a potential client about their mental health history prior to their loss. If they share that they have been under treatment by a mental health professional for Depression or Bipolar Disorder, I will usually ask them to check back in with their therapist and work with them for the first six months or so of the grieving process. People who have a history of depression are at a greater risk for experiencing complicated grief.
It is very important that all coaches understand the scope of practice of coaching and work only with people who are in the bounds of normal psychological functioning. This is completely for the sake of the client’s health and wellbeing.
Normal grief is well supported by grief coaches and counselors. Also, there are many wonderful books that help you understand and heal your grieving heart and adapt to your loss. Find a support system, people who will listen and “walk with” you on your journey. Alan Wolfelt, who has written many wonderful books on this subject, calls this “companioning” with a grieving person. Normal grief is not a disease and does not require fixing or treatment.
And, if you are wondering if the grief you are experiencing is “normal” or complicated, I would encourage you to find a reputable therapist or grief counselor to talk to. They have the training in this area to assess and guide you towards the appropriate resources.
Even if it's complicated, know that the caravan of life does move on, carrying you through the desert of your grief and into the oasis of loving. There, all manner of healing is possible.
Love and Blessings on Your Journey,