“Als je van iemand houdt
en je bent door de dood van elkaar gescheiden,
dan is er op de wereld niets en niemand,
die de leegte van de afwezigheid kan vullen.
Probeer het maar niet, want het zal je nooit lukken.
Aanvaard liever het gemis dat je is overkomen.
Dat klinkt hard, maar het is ook een grote troost,
want zolang de leegte werkelijk leeg blijft,
blijf je daardoor met elkaar verbonden”.
– Dietrich Bonhoeffer

Everyone processes the loss of a loved one differently. Some things are the same and other aspects are completely different when it comes to coping with loss and grief. Some of you may recognize the thoughts that are described in the poem above. Sometimes these kinds of thoughts can make you gloomy for a long time and prevent you from continuing with life. When do we speak of a normal grieving reaction to loss? And when do we speak of grief that has taken on a form that needs help from the outside, also know as complicate grief?

Complicated grief

In general, we talk of complicated grief in the event of serious problems with adaptation to someone’s death, after twelve months have already passed. For example, there may be separation anxiety. This is expressed in an intense desire to be with the deceased, “searching” for the deceased and intense suffering. The desire can be so strong that someone even wants to die so that they are reunited with their beloved ones. It feels like a part of them has died on the inside and the loss is too hard to accept. Life can feel meaningless. The reality of someone’s death is often avoided. As a result, someone can remain bitter and angry, have difficulty trusting others, and they cannot continue life. Anesthesia and flattening of emotions are another way how grief is expressed. Sometimes people can be obsessed with the deceased loved one or events that led to his or her death.

Different forms of grief

With chronic grief, there are clear observable symptoms, which do not diminish over time after a loss. If a grieving reaction is not expressed due to prolonged denial or the strong suppression of emotions, someone is in the stage of denial. Sometimes there is no place for a mourning reaction in the period following the loss. This is called delayed grief. Delayed grief can occur when the priority is to take care of other relatives or to deal with traumatic circumstances surrounding the death (traumatic grief). Delayed grief can occur if (unspoken) family rules about processing the loss of a beloved prevent someone in the family from mourning in their own way.

A small group of people, around 30%, suffer from these kinds of symptoms for a year, but then recover naturally. Less than 10% of the population suffer from complicated grief for a long time and need help from the outside.

Help

Do you recognize yourself in this story? Tell your practitioner or doctor. Complicated grief can be treated well. In my next blog I will give more tips to process your loss based on cognitive behavioral therapy.