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Key points
- Guilt, self-reproach, anxiety, fatigue, helplessness, and shock are all components of a normal grief reaction.
- Grief reactions are influenced by manner of death as well as relationship to the deceased.
- Complicated grief describes an unusually extreme or persistent reaction to loss.
- Complicated grief can also be masked—reflected in a number of vague physical complaints.
There are many different kinds of grief. Uncomplicated or normal grief is characterized by a number of feelings, beliefs, and behaviors that most people experience after a significant loss.
Those who suffer the loss of a loved one usually experience sadness and often guilt and self-reproach. Anxiety, fatigue, helplessness, and shock are also common components of a normal grief reaction. The intensity and extent of these reactions may vary, but none is viewed as pathological.
People grieve in many different ways and with varying levels of intensity.
Differences in grief reactions are determined by a number of factors. Who the person was in relation to the griever is a major determinant of a grief response. The strength of the attachment is another influential factor, as is the mode of death. Grieving the sudden death of a young child, for example, will most likely be very different from grieving an elderly relative who succumbed after a lengthy illness.
Problems occur when grief becomes excessive in intensity or persists for an abnormally long time. This is known as "complicated grief," and it can occur in a variety of ways. A chronic grief reaction is one that lasts for an exceptionally long time and never appears to come to a satisfactory resolution. The grieving individual responds to a loss from long ago with the full intensity and sadness one might anticipate from a much more recent loss.
Delayed grief is a response to loss that gets postponed to a later time. The person suffering may be so overwhelmed by their feelings that they react in a way that seems insufficient at the time of the loss. This form of grief is often recognizable when we see someone have an extreme reaction to someone else's loss or to a movie or play in which a character in the story experiences a loss like theirs. It is as though their own grief catches up with them, and they react in a manner that would have been expected at the time of the actual loss.
Another example of complicated grief is a masked grief reaction. Many people experience physical symptoms that are vague, have no identifiable cause, and are not recognized as related to the loss. For some reason, their grief at the time of the loss was absent, or its expression was inhibited. As a result, their grieving process was never completed and caused complications that later surface in the form of physical symptoms or maladaptive behavior. Most often, symptoms like these abate after their feelings about the loss are dealt with in a more satisfactory way. Unexplained depression, for example, is often related to a loss experience from which someone has not adequately recovered.
For normal grief reactions, time and one's own resources are most often sufficient for us to recover from a loss. For complicated grief reactions, reaching out for help may be necessary to achieve a satisfactory resolution.
