Grief/Loss

There are times when the normal feelings of grief become even more difficult to cope with. This may be because of previous life experiences, the nature of the relationship and family dynamics, current mental state, or the way the loved one died or is dying. Whatever the reason, grief can sometimes take a turn for the worse and may require the help of a professional therapist. The four most common variations of the grief experience are disenfranchised grief, complicated grief, compounded (or cumulative) grief, and anticipatory grief. Let’s look at compounded grief so that you have a better understanding of why this type of grief may be more difficult for the mourner.

First, Let’s Define Normal Grief

Before we dive into compounded grief, it’s important that you understand what normal grief looks like. Put simply, grief is your natural human response to the loss of someone or something you love. The emotions of grief vary greatly – sadness, anger, guilt, relief, shock – but these are all normal responses to loss. As much as you may prefer not to feel or deal with these types of emotions, they are actually a healthy part of the grieving process. When these emotions of grief become overwhelming, trigger deep depression, substance abuse, or suicidal thoughts, or are extreme or prolonged to the point that the mourner cannot care for themselves, we all understand that something more than normal grief is at work.

Grief is often accompanied by age-old rituals that bring people together to mourn. We hold hands, offer words of support and love, send cards and flowers, make donations, and deliver hot meals to the grieving family. We stand together to support those who are grieving and give them emotional and physical support as they come to terms with the loss. But what happens if one loss after another keeps piling up without giving you time to process what you think or feel?

Enter Compounded Grief

As we move forward, we’re going to review several key aspects of compounded grief. We’ll start off with a definition before moving into who’s susceptible, the complications compounded grief can bring, and a few tips for processing through compounded grief.

A Quick Definition

In short, compounded grief, also known as cumulative grief, is a pile-on effect of grief or “grief overload.” It may mean losing several loved ones in a short period of time. It may mean losing a loved one, then a relationship, then a job, then a pet, then a natural disaster hits and damages your home, etc. The losses can come from various sectors, but put together, it’s a big pile of grief and loss to deal with.

Additionally, losses you have not been able to process or face yet (even if they are from years ago) can add to the compounded nature of your grief. This is one reason why it’s so important to deal with your thoughts and emotions surrounding every type of loss, so they don’t create a tangled web of emotion that’s difficult to unravel.

Who’s Susceptible?

It’s possible for anyone to encounter compounded grief, but there are certain groups that have an increased likelihood: the elderly, healthcare professionals, and trauma survivors. Let’s break this down a little.

With the elderly, advanced age makes it more likely that they will have more friends and family die in a shorter period of time. For healthcare professionals, especially those in hospice care, the ER, or ICU, death may be a regular occurrence. As they see patients die, the losses and the emotions can pile up. And finally, trauma survivors who may be dealing with years of pent-up grief over past pain may feel unequipped to deal with new losses.

Now, remember, anyone can encounter compounded grief. These three groups are just at increased risk. No matter your age, you can experience a cascade of losses – loved one, friendship, job, pet, relationship, etc. – and you can begin to feel an overload of grief.

Complications that Arise from Compounded Grief

As with disenfranchised grief and complicated grief, there are certain complications that are unique to compounded grief. Let’s review them.

1. A tendency toward avoidance

When experiencing multiple losses in a relatively short period of time, your natural inclination may be to shut down emotionally and  avoid thinking about or dealing with the pain. You may feel extreme fatigue for a prolonged time. Yet another loss piled on to existing losses may trigger depression or suicidal thoughts. You may not know what to do or how to get out of the rut, so you avoid your feelings altogether. However, this is the last thing you need to do. Avoidance prolongs your grief, and as more losses occur down the line (and they will), your grief is only compounded more.

2. Watch out for numbing activities

Because avoidance is common with compounded grief, be on the lookout for numbing activities. In other words, things you do to avoid dealing with the grief directly. Common numbing activities include excessive alcohol consumption, binge-watching TV, online gaming (even the ones on your smartphone), and substance abuse. Additionally, outbursts of misplaced anger, blame, and overreactions to others’ comments or actions can become more common. While these coping mechanisms may seem to ease the pain in the moment, they can be harmful to yourself and others. It is important to ask yourself if your coping mechanism is helping you or hurting you even more in the long run.

3. A strain on your faith

For some, experiencing loss after loss can lead to questioning faith in God. You may feel like you are being punished or find yourself asking how God could allow this much struggle and pain. If you feel shaken in your faith, it’s okay. God is not surprised by your feelings, and He’s not offended by them. Be honest about how you feel–don’t sugar coat it. Read through the Psalms to find prayers that express how you feel. Stay connected through the stress and grief and feelings of betrayal. Lean on Him in the days to come as you start to work through your grief.

Tips for Processing through Compounded Grief

As with every type of grief, you can process through what you feel and begin to find healing and reconciliation on the other side. But it will take hard work and perseverance on your side. Here are a few tips to help you get started as you work through your compounded grief and begin to feel the burden of grief overload lighten.

Take Your Time & Grieve Each Loss Individually

While it’s important not to avoid your grief, that doesn’t mean you should rush through the grieving process and lump all of your losses together into one big grief session. Instead, take time to honor each loss individually. While this process will take you longer, it will be much more effective in actually helping you mourn the losses. Each loss is distinct and unique, deserving of specific attention. Perhaps you start with the smallest grief and work your way through it. Then, choose another one, and work through it. By breaking your grief into bite-size pieces, you will feel less overwhelmed and be able to give each loss the focus it needs.

If you are grieving multiple people, consider writing down their names, your memories, their strengths, what you would say to them today, or what you miss about them. As you move into your memories and bring them to the surface, you will begin to release the emotions that have been pent up inside.

Find Ways to Express Your Grief

We all process grief a little differently than each other, so what works for your friend may not work for you. You can make some educated guesses on what will work for you but remain open to options that may make you feel uncomfortable. It may be exactly what you need. A few examples of ways to express your grief include talking with a friend, journaling, participating in a creative endeavor like painting, woodworking, or sculpting, joining a support group, or engaging in physical exercise like runs or walks.

Or, if your feelings are more intense, you may feel the need to expend yourself. You could use a punching bag, go on vigorous runs, go to a batting cage, shout at the sky, or whatever else will bring you release. As long as you aren’t hurting yourself or others (or breaking the law), find something that will help you release your emotions.

If you decide to talk with others about your grief, you might choose an understanding friend or family member who won’t try to minimize your grief. You might also consider whether attending a grief support group would be helpful, especially if other people in the group have experienced a similar loss. Finally, don’t be afraid to seek out a professional. With so many losses to sort through, a professional therapist can help you come up with a plan, establish a routine, and start addressing your grief in a healthy way.

Don’t Be Afraid of Your Emotions

As you find ways to express your grief, you may find some unsettling emotions below the surface. That’s okay. Grief brings out a wide range of emotions, like sadness, anger, shock, despair, fear, relief, or even guilt. No matter what you’re feeling, don’t be afraid of it. It’s normal, and you just need to take that extra time to process through and nurture yourself as you do the work of grief.

Practice Self-Care

Compounded grief takes a mental, emotional, and physical toll on the body. That’s why you should take extra steps to take care of yourself. You need adequate rest and nutrition to give your body the fuel it needs to get through the grieving process.

Here are a few suggestions for self-care:

• Spend time with friends and family
• Get a massage to release any tension or stress you may feel
• Create art – painting, drawing, writing, making crafts, woodworking, etc.
• Sing or listen to music
• Get outside for walks and hikes
• Journal about your feelings
• Read
• Meditate or pray

Honor Your Losses

Lastly, search out meaningful ways to honor each specific loss in your life. Take time to think about the loss that hurts the most and try to put words to the pain or start a healing ritual. For instance, with the death of a person, you might write a tribute poem, watch their favorite movie every year, or bake their favorite dessert on their birthday. With the loss of a pet, you could put a memorial stone in your yard or walk your pet’s favorite path. Or, for the loss of a relationship, you could place a keepsake in a memory box, or you could box up all your keepsakes and either donate or throw them away. What you do isn’t as important as honoring your feelings and your needs. As you honor your losses, you can begin to release your emotions and find a way to move forward.

We can’t necessarily plan and prepare for compounded grief because we don’t know when it will happen. However, we can cultivate good grief habits and actively engage with our feelings. If you are currently dealing with compounded grief, don’t give up. Take one day at a time, one loss at a time. As you work through each event that has caused you pain, you will move forward and find renewed meaning and purpose in life. Your grief doesn’t have to control you; you can take back your life.

When a child dies, our thoughts immediately turn to the parents and the deep grief they must be feeling. And while this reaction is good, right, and warranted, we often forget that there are also deeply grieving grandparents who need our support and sympathy, too. Because they are often overlooked, grandparents face several unique challenges on the way to healing.

Often called “neglected mourners,” grandparents take a back seat to the primary mourners – the parents and siblings of the child who has died. But Dr. Alan Wolfelt, a nationally respected grief counselor and educator, tells us not to forget grandparents. He says: “When a grandchild dies, grandparents grieve twice. They mourn the loss of the child and they feel the pain of their own child’s suffering. Sometimes we forget about the grandparents when a child dies. You can help by not forgetting, by offering the grandparents your love, support and presence in the weeks and months to come.”

Because they are often overlooked, grandparents face some extra challenges. Let’s review those challenges so you can better understand what a grieving grandparent may be feeling and can determine how best to love and support them through this terrible loss.

10 Challenges Grieving Grandparents Face

 1. Their grief is often unacknowledged

As mentioned above, grandparent grief is often overlooked or unacknowledged. This tendency is not intentional or malicious, but it does make the grief journey harder for grandparents. Grief that is unacknowledged or overlooked by society or groups of people is called disenfranchised grief. Often those whose grief is disenfranchised have a hard time sharing their thoughts and emotions because they feel that their grief is out of place or doesn’t help the situation. While grandparents often feel helpless, angry, and heartbroken over the loss of a grandchild, they may feel less able to openly express their feelings because they are not the primary mourners.

2. They may not receive the support they need

Because grandparents are not the primary mourners, they don’t often receive the support they need during a time of loss. Friends may rally around the child’s immediate family and bring casseroles and condolences, but is anyone offering the same type of support to the grandparents? Unfortunately, the answer is commonly no. And while there are generalized grief support groups, it’s hard to find a support group that specifically addresses grandparent grief.

3. They may feel unable to share their feelings

As a matriarch or patriarch of the family, it’s natural to want to show a strong, loving face to family, especially to a grieving adult child and their spouse and children. Because a grandparent may feel the need to offer support to their grieving child and doesn’t want to add any additional burden, they may push aside their own feelings of grief in favor of offering support and assistance. While offering practical help to their grieving child is good, it can sometimes be at the expense of their own grief journey. There’s a delicate balance to find between helping and healing.

4. They may deal with family splintering

The death of a child can put a lot of stress and strain on a marriage. While it doesn’t happen often, there are cases when a marriage is unable to survive the death of a child and a whole new set of challenges are introduced. Not only is the immediate family adjusting to separated life, the grandparents must also learn how to adjust to this new lifestyle. They may not be able to see their living grandchildren as often as they did before, which may complicate the grief they feel over the grandchild who has died. Instead of being able to enjoy their living grandchildren, they are pushed even further to the outskirts, their grief and needs overlooked and unacknowledged.

5. They may have to take on a parenting role

Depending on proximity and the closeness of relationship, grandparents may be asked to step in to help with siblings while the parents deal with the effects of losing a child. In some ways, this is a blessing. Grandparents can spend time with their living grandchildren and further cement those precious relationships. On the other hand, with less energy reserves, grandparents may have difficulty finding the time and mental/emotional energy to process through their own emotions of grief. Every bit of energy goes toward keeping the family afloat.

It’s important to note that parents will also feel this strain as they grieve the loss of their child. They will be torn between responsibilities to living children, jobs, friends, family, extracurricular activities, and more. A hybrid option is likely best – parents and grandparents (with other friends and family) helping each other along the way and alternating babysitting to give each person the breaks they need.

6. They may feel helpless in the face of their child’s pain

First and foremost, a grandparent is a parent themselves. Their own child is in deep pain, and there’s nothing they can do about it. They want to help, to fix, to prevent pain, but in this case, there’s often a sense of helplessness. Some grandparents may feel depressed at their lack of ability to help and may experience additional stress because they are concerned about the mental and emotional well-being of their child.

7. Their health may suffer

For particularly elderly grandparents, health and wellness are a concern during times of grief. Because young people are often physically healthy, they don’t think too much about the physical difficulties of grief. However, for elderly grandparents, deep grief can lead to not eating, sleeping poorly, socializing less, and not functioning as well. It’s best to keep a loving eye on grandparents whose health is not the best and keep a lookout for potential declines.

8. They don’t have as much energy

As mentioned earlier, grandparents may not have as much energy as they used to. Their pace of life is already slowing down a little and energy levels are decreasing. Grief is hard mentally, physically, and emotionally, so it may take grandparents a little more time and effort to grieve. While they do have more life experience and have likely lost loved ones before, the loss of a child is especially difficult at any age.

9. They deal with a loss of legacy

Both parents and grandparents expect a child to outlive them, so when that doesn’t happen, there’s a sense that a legacy has been lost. This feeling can be especially potent if the grandparents only have one grandchild. Whether the grandchild is two, ten, or 25, they must deal with the loss of what could have been – what should have been.

10. They may deal with feelings of guilt

Some grandparents may feel guilty after the loss of a grandchild. Having lived a long life themselves, they may struggle to make sense of what has happened. Questions like, “Why couldn’t it have been me?” may pass through their minds. While this feeling is natural and normal following a loss, guilt is often misplaced and can lead to grieving complications.

Now that you understand several of the challenges that grieving grandparents face, let’s talk about a few things you (and they) can do to grieve well after the loss of a grandchild.

Tips for Grieving Well

As the grandparent:

• Find ways to express your feelings
• Talk to friends or relatives about your loss
• Don’t compare your grief to that of your child or son or daughter-in-law; everyone’s grief is unique and different
• Take care of yourself physically so you have the mental and emotional energy you need
• Honor your grandchild’s life and memory in meaningful ways

As the supportive friend or family member:

• Offer a listening ear
• Help with household chores and must-do activities to give grandparents more time and energy to work through their grief
• Express your condolences and acknowledge their loss
• Look for ways to include them in healing rituals and meaningful moments

The loss of a grandchild is a severe blow – to both the parents and grandparents. None of them will ever truly “get over” the loss, and really, that’s not the goal. The goal of healthy grieving is to find a way to reconcile yourself to the loss and begin to move forward with meaning and purpose. The child that has died will always be missed – that’s a fact. Though life has changed irreversibly, it can be good again as you do the work of grief and meaningfully and personally grieve.

You are likely familiar with feelings of grief, but did you know that there are different variations of grief? Of course, the experience of grief is different from person to person, but sometimes “normal grief” can take a turn and become something a little different. The four most common variations are disenfranchised grief, complicated grief, compounded grief, and anticipatory grief. Today, let’s unpack complicated grief so that you have a better understanding of this potentially serious detour in the grieving process.

First, Let’s Define Normal Grief

Before we dive into complicated grief (also known as prolonged grief), it’s important that you understand what normal grief looks like. Put simply, grief is your natural human response to the loss of someone or something you love. The emotions of grief vary greatly – sadness, anger, guilt, relief, shock – but these are all normal responses to loss. As much as you may prefer not to feel or deal with these types of emotions, they are actually a healthy part of the grieving process.

Grief is often accompanied by age-old rituals that bring people together to grieve. We hold hands, offer words of support and love, send cards and flowers, make donations, and deliver hot meals to the grieving family. We stand together to support those who are grieving and give them emotional and physical support as they mourn. But what happens if nothing helps and you feel stuck in a downward spiral of grief and despair?

Enter Complicated Grief

As we move forward, we’re going to review several key aspects of complicated grief. We’ll start off with a definition before moving into the symptoms, who is susceptible, and how to get help.

A Quick Definition

When you lose someone or something you love, you’re going to experience grief. The initial period of time just after a loss, when your emotions are unpredictable and you can’t concentrate on anything but the loss, is called acute grief. It’s the hard beginning of loss. However, in most cases, after a period of time, you are able to move into integrated grief. This means that you have learned to accept the reality of the death, have found ways to cope and adapt to your new way of life, and have begun to hope again, finding renewed meaning and purpose in life. Moving from acute grief (initial feelings of loss) to integrated grief (a reconciliation to the loss) is a natural progression through the grief journey.

This movement or reconciliation takes time, but it’s characterized by a lessening of your grief feelings. You may bounce back and forth between sadness, shock, and anger for a little while, but then, your grief feelings gradually lessen until they become an ache that occasionally comes back to visit you (normally around special days and events).

However, sometimes acute grief doesn’t progress as it should. Instead of lessening over time, your feelings of grief intensify until all you can think about is the loss you’ve gone through. This is complicated grief. In most cases, complicated grief occurs following the loss of a person, but it’s not necessarily confined to that.

With complicated grief, the death becomes center stage in your life. Many of those suffering from complicated grief are unable to resume normal life and are stuck in a state of intense mourning.

Symptoms of Complicated Grief

As we’ve talked about, complicated grief is an extended time of intense grief when you are unable to move through the grieving process. The grief begins to take over your life and the future seems bleak and lonely.

At first, many of the symptoms of complicated grief look like normal grief. However, if grief indicators worsen as time passes, then it could be a case of complicated grief. Here are a few symptoms to look out for months and even years following the loss:

• Intense sorrow, pain, or pining over the loss, focusing on little else
• Problems accepting the reality of the death
• Strong attachment to mementos/reminders or a strong avoidance of them
• Numbness, detachment, bitterness, and/or easily irritated
• Feeling that life holds no meaning or purpose
• Trouble carrying out normal routines, including personal hygiene
• Increasingly isolated and withdrawn
• Denial and defensiveness when asked about the grief
• Guilt over feeling that they did something wrong, could have prevented the death, or should have died along with the loved one

If six months or more have passed since the loss and grief feelings have only gotten worse, then it’s time to consider getting help. Six months is not a hard and fast rule as some losses will take years to recover from, but it is enough time to ascertain whether grief symptoms are lessening or worsening.

Who’s Susceptible?

While doctors and mental health professionals are still learning about complicated grief, it’s believed that as much as 20% of those who lose a loved one will experience complicated grief. Unfortunately, it’s not yet known exactly what causes complicated grief, though it’s considered another type of mental health disorder.

As with many mental health disorders, the cause may be related to your environment, personality, genetics, or chemical makeup. Complicated grief occurs more often in women and particularly those of an older age. Outside these factors, other circumstances may increase a person’s risk of experiencing complicated grief, including:

• The death was shocking, unexpected, violent, or premature
• There was more than one death in a short period of time
• You witnessed the death or suffering with the deceased (as with a long illness)
• You had a close or dependent relationship to the deceased person
• Social isolation or loss of a support system or friendships
• Past history of depression, separation anxiety, or post-traumatic stress disorder (PTSD)
• Traumatic childhood experiences, such as abuse or neglect
• Other major life stressors, such as major financial hardships

Seeking Help

Just as with any other mental health concern, it’s best to seek professional support and care when dealing with complicated grief. If you find that you or a loved one have been unable to make distinct progress toward integrated grief and that your grief feelings are intensifying (no matter how long it’s been), consider whether now is the time to seek help so that you can come to terms with your loss and reclaim a sense of acceptance and peace.

At first, you may think you can handle things, but over time, complicated grief can affect you physically, mentally, and socially. Without the proper treatment, complications could arise, including:

• Depression
• Suicidal thoughts or behaviors
• Anxiety, including PTSD
• Significant sleep disturbances
• Increased risk of physical illness, such as heart disease, cancer, or high blood pressure
• Long-term difficulty with daily living, relationships, or work activities
• Alcohol, nicotine use, or substance abuse

At this point in time, it’s not clear how to prevent complicated grief. However, counseling and grief therapy soon after the loss (especially for those in an at-risk group) is thought to help curb the severity of complicated grief and put you on the path to healing.

What Can Family and Friends Do to Help?

Because those suffering from complicated grief are susceptible to additional complications like depression, anxiety, or sleep issues, the best option is to speak with a professional, who can act as a guide through the entire journey toward recovery.

However, as family and friends, you can do something to help!

Offer your full and loving support to the person dealing with complicated grief. Be there to talk. Be encouraging. Bring small gifts or tokens of your love. Actively listen and don’t interrupt. Plan positive activities, like taking a walk or doing something they’ve always enjoyed.

They don’t need you to try to fix them; they need you to accept them where they are right now. Be there for them. Realize that complicated grief is difficult on both of you and the road to recovery may be long and difficult. But it is achievable! When we do the work of grief, we can find a way to reconcile ourselves to loss and find new hope and meaning for the future.