Understanding Prolonged Grief

Why is this grief not leaving me?

The death of a loved one is one of life’s major stressors and can dramatically change a person’s life. About one in ten bereaved people struggles to adapt to such a loss and feels “stuck” in intense grief indefinitely – time goes on, but their yearning and pain do not diminish. This condition is now recognized as prolonged grief. 

Prolonged grief is a debilitating form of intense grief that can last for years or even decades, profoundly impacting a person’s life. It is characterized by intense longing for the deceased or insistent thoughts about them or the death, combined with sorrow and intense emotional pain. The pain is triggered by countless reminders of the loss, leading to extensive avoidance in order to cope. 

Sometimes the initial shock sets in, and the bereaved feels emotionally numb for a long time. People suffering from prolonged grief struggle to fully process and accept the death, despite knowing the facts or even witnessing the event. Unable to bridge the gap between their life before the death of a loved one and their current reality, they end up feeling disconnected from their own identity, sense of meaning, and purpose in life, as well as other people in their life.

We cannot predict who will develop prolonged grief and who will not; however, we do know about some risk factors. For example, certain circumstances of the loss make it more difficult to process and come to terms with, increasing the chances that the bereaved develops prolonged grief. For example, many cardiac arrest deaths are sudden and unexpected, might seem preventable, or involve a younger person. All these factors make dealing with the loss particularly hard.

How prolonged grief might feel

Adam’s wife Sarah died of a sudden cardiac arrest. It was such a complete shock; she was young and healthy. They had married only a few years ago and were happy building their life together. As devastated as Adam was, he did not feel like he could grieve, because he had their two small children to take care of. Thus, he walled off his grief and any thoughts about Sarah and focused on his job and providing for the family. 

 

Ten years after the loss, Adam still cannot believe that Sarah is gone and feels waves of intense sadness and longing when reminded of her. He tries to avoid such reminders, including many places they went together and even his children’s questions about their late mother. Although he continues to work and provide for the family, his life is devoid of much else. He does not have the energy for social activities and keeps to himself. His children are getting older, but he does not feel connected to them, as they remind him too much of his wife. He struggles to find enjoyment in things he used to love or to imagine a meaningful future. He is just going through the motions while his life is slipping by.

When we experience the death of a loved one, our initial instinct is to shield ourselves from the unwanted, painful new reality. This can take the form of protesting the reality of the loss, struggling to believe it’s true, daydreaming about alternative scenarios where the death did not happen, and trying to avoid the pain and discomfort associated with the loss. While these automatic reactions offer temporary relief, they can backfire in the long term and derail the process of adapting to the loss, leading to prolonged grief. 

Yet despite the persistence of prolonged grief, there are effective treatments, making it all the more important to identify. Prolonged Grief Treatment is one of the most researched treatments for prolonged grief, and there are many clinicians across the world trained in this approach. You can learn more about Prolonged Grief Treatment and other resources for prolonged grief at Columbia Center for Prolonged Grief, including searching for a grief therapist in your region.

Thank you to our contributors

Marisol Rosales & Natalia Skritskaya