Grief – the deep, wrenching sorrow of loss - usually abates with the passage of time. Human beings, says psychologist Assoc Prof Dr Anasuya Jegathevi Jegathesan, have over time developed an innate ability to cope with grief. The passage of time usually helps, as do rituals that give the bereaved a sense of closure to their relationship with a loved one they’ve lost.
But for some, the grief is unending and all-consuming. So is the feeling of guilt. This, she says, is complicated grief or grief-plus and those who suffer from it might need help navigating themselves out of it.
“With normal grief, people accept the loss and believe that life still holds meaning. They can sustain a coherent sense of self and can still maintain their daily routines and take care of themselves and still find pleasure in things.
“With complicated grief, people are stuck in their grief and are unable to process their loss. They remain frozen, depressed and fearful for a prolonged period. And the symptoms of grief intensify over time instead of abating.
In pandemic times, for those who have lost a loved one to Covid-19, there is the potential for complicated guilt, particular if some members of a family have survived and others have not.
“This is complicated and family members may experience survivor’s guilt which can lead to depression and anxiety for the long term. Questions like ‘Why did I live when my loved one didn’t?’ may arise and this is hard to deal with on your own.
“It’s a hard load to carry and they need to talk to counsellors or therapists on their loss. Try to see people who are aware of and can help you deal with complicated grief, ” says Dr Anasuya who is the programme director of Taylors University psychology programme.
Survivor’s guilt leaves the living with the feeling that they shouldn’t enjoy their life because they’ve lost a loved one.
Researchers estimate that complicated grief affects approximately 2-3% of the population worldwide. According to an article in The Independent, “The People Who Can’t Stop Grieving”, complicated grief affects 10-20% of people who have lost a spouse or romantic partner or when the death of a loved one is sudden or violent. It is even more common in parents who have lost a child.
“It’s hard to say exactly how many people suffer from complicated grief because in times of tragedy or disaster, the numbers spike. For example, after the MH370 disappearance, we saw many cases of complicated grief. Also, some people can find their way out of it without seeking help, but some can’t, ” she points out.
The symptoms of complicated grief, says Dr Anasuya, include an intense longing and pining for the deceased, having problems accepting the death that is manifested in a feeling of numbness or detachment, bitterness about the loss, extreme guilt and depression with deep sadness, the inability to carry on daily routines, being easily overwhelmed, the inability to enjoy life or difficulty moving on with one’s own life, withdrawal from social activity or people who are connected with the deceased and even experiencing physical symptoms similar to those experienced by the deceased prior to death.
“Complicated grief can be debilitating, but it can be treated, ” says Dr Anasuya. “If you don’t allow yourself to get the help you need, you think you are going through depression when it is actually complicated grief that has an identifiable source that can be managed and overcome. If it is not addressed, it might develop into massive depressive disorder which will bring on other issues, ” she adds.
Because grief is a very personal thing, though family and friends may want to help, they may end up doing more harm if they do not understand the situation well, she points out.
“The way people grieve, too, may vary. For example, a person may need to have many photos of the deceased put up while another cannot bear to have a single photo as it reminds them of their pain.
“Even things like this can cause misunderstandings so before we can help someone overcome their grief, we need to understand and accept how they cope, ” she says.
Sharing feelings and having conversations are important.
“Families must come together and not fall apart. So bear in mind that the words you use can hurt a lot - don’t ask someone why they are taking so long to ‘get over’ their grief. Understand that we all cope differently, ” she says.