Reasons for Unresolved/Complicated Grief
In this post we explore psychological and social factors that may contribute to unresolved/complicated grief. Click here for a list of symptoms and behaviours of unresolved/complicated grief.
Anger and guilt can often be a key source of adjustment difficulties in the process of grief. Guilt can inhibit the grief process if mourners are unable to confront the guilt that arises when reflecting on their life with the person that died. Guilt may encourage the mourner to be anxious or afraid of their grief because it may surface negative feelings or acts they have directed to the bereaved. It is also common for individuals going through grief to experience feelings of anger. Anger may be due to feelings of frustration and a sense of helplessness that may end up being directed at either the deceased or deflected onto others. If the anger is not directed at the deceased and it is not displaced onto someone else, the anger may be turned inward and manifest as depression (Worden, 2005).
The difficulties associated with unresolved grief have also been attributed to a previous insecure attachment to the deceased. Insecure attachments of any kind can encourage distorted perspectives on the meaning of the relationship thereby complicating grief as the mourner grieves from a distorted perspective of the deceased and the meaning they have given to the relationship. Due to the insecure attachment, the mourner may be afraid to grieve in order to avoid the distorted perceptions of what has been lost and the accompanying feelings of intense helplessness, fear of loneliness and other related overwhelming feelings that can often surround the loss of an insecure attachment figure.
One overwhelming feeling often experienced with such cases is a deep sense of abandonment within those who have lost their insecure attachment figure. It is such feelings of abandonment that could have some individuals reluctant to grieve because the grieving reawakens the painful and very profound sense of being left all alone to fend for them selves in the world. Multiple losses can also hinder the normal grieving process. Those who experience multiple losses over a short period of time may experience difficulty in grieving because the combined losses are too overwhelming to contemplate and deal with all at once.
People with severe ego impairments (e.g. personality disorders) are often unable to adequately complete the grief process. Such people may have difficulty successfully engaging normal grief processes and instead experience feelings of intense hopelessness, frustration, anxiety and depression resulting in complicated grief (Williamson & Shneidman, 1995; Freeman, 2005) For example, individuals who suffer Borderline Personality Disorder may have difficulty in mastering the grieving tasks before them as they may not be able to fully understand and express their emotions accurately or appropriately.
It is common for some individuals to deny themselves the opportunity to grieve because of their beliefs about what it means to grieve. For example, some individuals may deny themselves the opportunity to experience the full extent of their grief because they may fear losing control or may perceive such intense emotional expression as “weak”. Others may not want to give up the pain of the loss because they believe it binds them closer to the deceased resulting in chronic grief. Those individuals with a history of depression are also at risk of developing complicated grief (Mitchell, 1999). Such issues, and others, that may interfere with the normal grief process need to be addressed for the individual to successfully work through it.
Social connections provide the bereaved with an opportunity to find support, comfort and encouragement in their grief. However, in some instances, these social connections can prohibit the mourner from experiencing and expressing their grief well. Previous literature has identified three social factors that contribute to complications in the grieving process. These factors are 1) When the loss is socially unspeakable; 2) When the loss is socially negated or 3) When there is no social support.
Socially unspeakable loss refers to the loss that is “unspeakable” thereby making members of the social system redundant in being of any assistance to the bereaved (e.g. when the loss is the result of suicide, drug overdose and other potentially ‘unspeakable’ things). In this type of loss, the social network tends to shy away from the bereaved out of ignorance of what to say to console the mourning person. The social negation of loss refers to when the loss is not socially defined as loss (e.g. abortion, miscarriage, loss of a very old parent, etc.). Although the mourner may experience grief, there is often inadequate or nonexistent social support.
No social support refers to when the individual is either away from their social support network at the time of mourning or there is no social support available, thereby making grieving difficult. Geographic distance is becoming increasingly common as individuals become more mobile therefore making the absence of social support in times of grief a very real factor contributing to complicated grief (Freeman 2005, Williamson & Shneidman, 1995).
Society norms and expectations also play a role in the grief work of an individual. Every society has rules regarding what is socially significant and what loss may be recognized. The rules almost dictate who, how long and to whom an individual has a recognized right to grieve. Often these social morays around grieving can overlook the nature of human attachment, the sense of loss and the personal experience and meaning of the grief.
Complicated grief can also be encouraged in the very young and the mentally disabled due to them being perceived as unable to comprehend death therefore are often excluded from the mourning rituals of their society. This often results in disenfranchised grief.
Having the role of the strong one has also been implicated in key social factors that can contribute to complicated grief. In some situations and families, there are certain people who are designated to be “strong” by those around them. They are usually called upon to make all the funeral arrangements, offer support to others and show no emotions. As a result, individuals in this social role could miss an opportunity to deal with their own grief resulting in delayed grief and other forms of complications (Freeman 2005, Williamson & Shneidman, 1995).