Understanding Complicated Grief

Life is beautiful, but it can also be painful. As we age, we experience events that cause us to grieve what we’ve lost. Whether it’s the sudden death of a loved one or the end of a marriage, we all face obstacles that negatively impact our mental health. While most people work through these crises in time, some find themselves stuck in the grieving process. This is a phenomenon called complicated grief.

At Cumberland Heights, we have identified a trend among those in treatment for substance use disorder: often, they have unresolved feelings about a loss. Today, we’ll discuss our facility’s theory of complicated grief, authored by our very own Michelle Morris, M.Div., LPC-MHSP.

When Grief Won’t Die

First, we want to clarify that bereavement isn’t an experience tied solely to death – it’s our natural response to a loss of any kind. We mourn the loss of relationships, jobs and our health. However, we also grieve the loss of the status quo when good things happen to us. If you have a hard time adjusting to a new home, the completion of a college degree or a promotion, you’re actually dealing with a kind of grief. The point is that strong emotions are commonly associated with change and loss. A majority of the time, people are able to work through these feelings and move on. Unfortunately, that’s not always the case.

According to research published in Dialogues in Clinical Neuroscience, an estimated 7% of the bereaved will experience complicated grief. This intense, ongoing state of mourning occupies most of a person’s mental energy, preventing them from healing. They cannot process the finality of what has happened and will take extreme measures to avoid confronting the event in question. They may become completely absorbed by what happened, ignoring other obligations or becoming too depressed to meet them.

Symptoms of complicated grief include:

  • Intense sorrow and rumination
  • Hopelessness and loss of purpose
  • Excessively avoiding (or seeking out) reminders of what they’ve lost
  • Difficulty accepting what has happened
  • Intrusive memories about the person or event
  • Numbing or detaching from reality
  • Becoming bitter about one’s loss
  • Inability to reflect on “the good times”
  • Struggling to function normally
  • Blaming themselves for what happened
  • Believing that they could have changed the outcome
  • Thinking about suicide or wishing they had died, too

What Causes Complicated Grief?

Over the years, the Cumberland Heights team has dealt with countless cases of complicated grief. Our Spiritual Director, Michelle Morris, M.Div., LPC-MHSP, has identified a formula for understanding what corrupts the typical grieving process. She has summarized this in the Cumberland-Morris Model. Below is an outline of her findings.

Put simply, loss leads to a mixture of negative emotions. Healthy grieving allows people to find safe coping mechanisms, process their loss, make meaning of it and carry on. However, there are many pitfalls awaiting the bereaved at each stage of this cycle, including denial, unhealthy coping mechanisms and trauma.

Denial prevents a person from naming their loss as a loss. It occurs when a person is aware of what has happened but is unwilling to deal with the emotions that bubble up as a result. People in denial don’t recognize their despair; they refuse to respond to it and stifle their emotional response.

Unhealthy coping makes someone feel better in the moment, but can have destructive consequences. Often, short-term relief is found through substance abuse, overworking, sexual promiscuity and other behaviors rooted in excess. These choices complicate a person’s grieving process and prevent them from working through what has happened.

Trauma interferes with one’s ability to see the full picture of the loss. Traumatic memories are stored dysfunctionally, preventing victims from accessing and understanding them. The result is an overwhelmingly negative experience that cannot be processed.

There are evidence-based interventions to address each of these catalysts for complicated grief, including education, process groups, coping skills education, grounding, 12 Step groups, journaling, spiritual practices and trauma-specific therapy. All of these are offered at Cumberland Heights. However, to completely heal, the Cumberland-Morris Model asserts that the task of “meaning-making” must be undertaken.

Overcoming Complicate Grief: Finding Meaning in Loss

Stories are exceptionally important to human beings. They help us to build social bonds, express ourselves and understand events. They also serve as our primary approach to learning. Meaning-making challenges us to tell a story about our grief that ends with a life-shaping takeaway.

Loss often feels senseless and unjustified, especially if it’s associated with the tragic, sudden death of a loved one. Choosing to find a deeper significance creates a sense of purpose in the bereaved; they have a reason to move forward with their own lives.

This process is different for everyone. Meaning-making may look like:

  • Learning a lesson from the experience
  • Gaining insight into one’s own personality or strength
  • Feeling inspired to change, grow or embrace sobriety
  • Telling this story to help others in a similar situation
  • Motivating the creation of a charity, memorial, annual event or other worthy cause

Once a person has found meaning, they have a chance to move on and begin again. While completely “letting go” isn’t likely for those who have experienced the death of a spouse, child or parent, these individuals can find solace and purpose behind their loss. With support, patience and meaning-making, it is possible for those in the grip of complicated grief to find happiness again.

Meet Michelle Morris

To gain a complete picture of the Cumberland-Morris Model, we interviewed the Spiritual Director behind its creation. Michelle Morris, M.Div., LPC-MHSP, began her career as a chaplain for hospitals and jails. Inspired by her experiences, she returned to school and earned two master’s degrees. Her three years at Cumberland Heights have made the most of her passion for both spirituality and mental health. In this time, Morris has identified suffering as a natural part of life – and a necessary, inherently spiritual experience.

“You can’t process what you can’t feel,” she said. “At some point, sobriety forces us to confront [our loss] and learn how to deal with it. Substance use disorder turns the volume down on our emotions, but it doesn’t teach us to tolerate or process them. Healthy skills do.”

When asked about Cumberland Heights’ approach to treatment for complicated grief, Morris emphasized the importance of this programming. “Our goal is for everyone to participate in grief education – especially young men. We need to help people understand that it isn’t one thing like sadness; it’s a mix of emotions. Getting sober itself is a grieving process: letting go of that primary relationship. We spend most of our time and money on it. Some people call it their lover or best friend, and if we don’t grieve properly, we tend to go back… it’s like a toxic relationship. The only way I’ve seen people truly move forward with loss is to make something meaningful out of their experience.”

Through meaning-making, therapy and community support, those who come to Cumberland Heights find freedom from complicated grief and substance use disorder. To learn more about our treatment protocols or the Cumberland-Morris model, we invite you to contact our admissions team.

References

Horowitz, M. J., Siegel, B., Holen, A., Bonanno, G. A., Milbrath, C., & Stinson, C. H. (2003). Diagnostic criteria for complicated grief disorder. FOCUS: The Journal of Lifelong Learning in Psychiatry, 1(3), 290–298. https://doi.org/10.1176/foc.1.3.290

Shear M. K. (2012). Grief and mourning gone awry: pathway and course of complicated grief. Dialogues in clinical neuroscience, 14(2), 119–128. https://doi.org/10.31887/DCNS.2012.14.2/mshear

Why is it so meaningful to give to Cumberland Heights?

Your gift to Cumberland Heights through our annual and capital initiates gives immediate support to patients and their families. To make a longer term impact a gift to the endowment fund will provide patient assistance funding for years to come.

×