Complicated Grief

Losing a loved one is always hard. Feelings like sadness, numbness, or anger are a crucial part of the healing process. But when these emotions don’t resolve on their own, they can prevent you from leading a full life. Fortunately, there are ways to break through your grief.
 

Please note that it is not recommended to use this course without a therapist who has training and experience in the treatment of complicated grief.

Kelty’s Key recognizes the work of the Center for Complicated Grief, Columbia University, New York, NY, which was a resource for this course.

What is Complicated Grief?

5min
When grief does not pass naturally over time, it can stop you from enjoying life.
What is Complicated Grief Unit Guide

When someone we love dies, we experience a sense of loss. This grieving period is a normal process of life. But sometimes, grief does not resolve on its own over time. Complicated grief can affect your ability to function. Intense longings and unwanted thoughts can stop you from living fully. But there are ways to move forward. You can learn new skills that can help you resolve your grief.

  • The Facts
  • Understanding Complicated Grief
  • The Symptoms
  • Recovery
Audio Tip
Sandy Patola-Moosmann, MA, RCC, explains why grief is a necessary process.
1:22

The Facts

It is natural to feel pain after a significant loss. Grief is a sign that we have lost someone important. Without it, a person can’t come to terms with the massive change that death brings to their life. These feelings can bubble to the surface later on, or come out in other ways. If you lose more than one person in your life, unresolved grief can accumulate. You can end up grieving multiple deaths at once. In this situation, processing loss is even more difficult. Although grief is painful and disruptive, we need it. It is healthy and a natural process.

For some people, grief does not resolve on its own. Instead, you might find that you get stuck in feelings of yearning and hopelessness. If these emotions continue for more than 6 months, you may have complicated grief. About 7-10 percent of people will experience complicated grief. While you may feel isolated, you are not alone.

Audio Tip
Hilda Fernandez, MA, RCC, describes the difference between grief and complicated grief.
2:12

Understanding Complicated Grief

You may wonder why complicated grief has affected you and not someone else. Most likely, you were very attached to the person who died. Your connection was probably deep and long-lasting. They may have given you a sense of safety and meaning. When a bond like this gets shaken by death, it can feel like your world has been turned upside-down. You might think that your life has no purpose without the person who died. If your sense of self-worth is attached to your loved one, you may be unable to accept the death and let go.

While complicated grief can happen anytime, some deaths are more likely to bring it about. These include unexpected tragedies, suicides, or the death of a child. Untimely deaths often take longer to process and resolve. For this reason, complicated grief becomes more likely in these cases.

Symptoms of Complicated Grief

Complicated grief can affect you in many ways. It can change how you think, what you feel, and what you do.

Thoughts

It might feel like you can't stop thinking about your loved one or how they died. Life might not seem worth living without them. You may not be able to accept the reality of your loss. Thoughts about yourself and the world might become more and more negative over time. You might question who you are or how you'll survive without your loved one.

0:41
Andrea Sierralta, MA, RCC
Emotional

It is common to feel an intense longing or yearning for the person that passed. You might feel overwhelmed, shocked, or numb. Reminders of your loved one, in life or death, can cause powerful emotional reactions.

0:42
Dr. Margaret Drewlo
Behavioral

Difficulty adapting to your new life is a significant challenge in complicated grief. You may start avoiding things that remind you of your loved one. You might write off certain situations, places, or even people. Withdrawing yourself from activities and choosing to be alone is also common. Some people find it hard to get out of bed, take care of themselves, or get things done at work or school.

0:34
Andrea Sierralta, MA, RCC
Physical

Complicated grief does not have any specific physical symptoms associated with it. But many people do find they suffer from an ache in the area of their heart. When you are at your limit emotionally, you may feel nauseous or exhausted.

Note that physical changes to your body may not be from grief itself. After losing a loved one, we recommend seeing your family doctor for a checkup. It's important to make sure your symptoms are from grieving and not something else.

0:31
Dr. Francois Botha

Recovering From Grief

While you may feel eternally stuck in grief, all is not lost. There are ways to help you manage complicated grief and move past it.

Psychotherapy

There are many types of therapy to help you through complicated grief. Kelty's Key uses cognitive behavioral therapy. This approach teaches you how to face your grief and work towards resolving it. You'll learn skills to help you move forward and re-engage with life.

1:33
Jerry Stochansky, RCAT
Medications

You can't cure grief with medicine. Still, medication can help you get past some of the depressive symptoms that may get in the way. They may be the stepping stone you need to better engage in and complete therapy.

1:05
Sandy Patola-Moosmann, MA, RCC

Well Done. You’re on Your Way.

You’ve taken the first step and learned about complicated grief. Knowledge is important. Understanding what grief is and how it works will help you moving forward.

I’m using the self-help:
I’ve got an online therapist:
I’m working on my own:

Understanding Your Grief

20min
Believing that you are always in pain can keep you stuck in grief.
Understanding Your Grief Unit Guide

Complicated grief can take over your life. It might seem like there is nothing but darkness and terrible imagery. To resolve your grief, you need to believe that you can get through this. Understanding your day-to-day lows and noticing your highs is a great first step.

  • Supports
  • Grief Records
  • Triggers
  • Responses
Audio Tip
Dr. Francois Botha explains why social support is important in recovery from complicated grief.
1:09

Don’t Go It Alone

Moving through complicated grief is hard work. It can be emotionally and physically exhausting. With so many challenges ahead, it is essential to have people around you for support.

Who we turn to for help changes throughout our lives. After a loss, you may be surprised by sudden shifts. Were you shocked when the people you thought you could depend on disappeared from your life? Perhaps they didn't understand what's taking you "so long" to "get over it." Maybe they didn't know what to say or do. Sometimes conflict or blame can surface after a death.

Did people you had not expected step-up to offer their support? Have you found any groups or meet-ups helpful? Finding people who can be there for you, without being critical, is crucial at this time. You shouldn't have to go it alone. Supportive people will help you benefit from what you are learning and make it through.

Who can you currently reach out to for support? Try to name 3 people or groups:

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Audio Tip
Dr. Francois Botha describes how social support may change after a significant loss.
1:22

Reach Out

You may have experienced friends or family pulling away from you after your loss. They might not know what to say or misunderstand your actions. However, it is also possible that you are distancing yourself. You might find it hard to interact with your loved ones now that your life has changed so much.

It's important to recognize this behavior and try to reverse it. Isolating yourself will only make you feel more alone than you already do.

Reaching out might be as simple as letting certain people know that you need them. Of course, just because it's simple doesn't mean it's easy. Reaching out takes a lot of effort when you are in grief. When you manage to ask for help, give yourself credit. It's an accomplishment.

Accepting help can also be hard. It can be particularly challenging if you have been independent and self-reliant. Try to be open. It's ok to need support at this time.

Here are your 3 supports. How can you reach out to them this week?

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Audio Tip
Dr. Margaret Drewlo explains why it’s important to monitor the intensity of grief throughout the day.
1:00

Always Hurting

Grief is overwhelming. You probably feel like you are in anguish every minute of every day. Does it feel like you’ll never be happy? As though your body and mind are no longer able to be at peace? Many people start to believe that life will never get better. If you think this way, you’ll feel hopeless. It will be hard to stay motivated and work through your grief.

The power of grief is intense, but it’s not at full blast all the time. It ebbs and flows throughout the day. Moments of distress probably jump out at you. But times of neutrality or happiness might pass unnoticed. To believe that you can make it out of grief, you must pay attention to the fluctuations in your emotions. When you notice that you can feel neutral, or even half-decent, you’ll become more confident. You’ll feel more assured that you can move forward and embrace life again.

Grief Records

An excellent tool to track changes in your emotions is a grief record. Take a few minutes several times a day to write down what was happening and how distressed you felt. Rate the distress from 0 (none) to 10 (high). Different people experience the pain of grief in different ways. A 10 on your scale might be overwhelming panic or rage. On the other hand, it might be a feeling of numbness like you’re on autopilot.

It’s also helpful to track what made your pain change. Did an image come to you that made your panic even worse? Maybe a thought gave you some comfort and helped calm you.

A grief record is most beneficial when you use it several times a day for about a month. It will help you see a fuller picture of your grief and its intensity. You’ll start to collect evidence that you can feel emotions other than pain. What makes your grief more or less intense will also become apparent.

Take a minute and plan how you’ll use a grief record. Do you have a small notebook? Some people use their phone as it’s always on hand. Below is an example of what your grief record might look like:

Date / Time Situation Level of Distress What changed distress? Increased or decreased distress?
March 26
10:30 PM
Trying to fall asleep and the thought of my son in the ground came into my mind. 8 The more I thought about him being cold the worse it got. Could not sleep for another six hours.
March 26
11:00 PM
Trying to fall asleep and the thought of my son in the ground came into my mind. 7 Thought of him being with my Dad and my sister and they were comforting him. Distress went down a little.
March 27th
8:00 AM
Saw TV news item with happy child my son’s age. 6 Sharp emotional pain at first which subsided a bit when I called my friend Jill and talked to her for 15 minutes.
March 27th
5:30 PM
My neighbor came by to introduce me to her new puppy. 0 I noticed after my neighbor left I started to feel some distress again but felt none while I was holding the puppy. I wasn’t aware I had breaks in my emotional pain.
March 28th
9:30 AM
I saw a parent with her son and I got very angry. It is unfair! 7 I remembered that I had my son for longer than some parents get and I felt a small amount better. Later I started to think that it is unfair again and I got angrier and angrier.
Audio Tip
Dr. Margaret Drewlo discusses how therapists help clients work with triggers.
1:13

Triggers

As you use your grief record, you might notice some patterns. There may be places, situations, or even people that open the floodgates to your grief. These are called triggers. A trigger might be something closely tied to your loved one, like a birthday, or something more abstract, like a smell. Either way, triggers are linked to memories and feelings about the person who has died. They can interrupt your day and send you into a tailspin of pain.

You'll know something is a trigger because you'll have a strong reaction to it. For example, you might feel deep sorrow, anger, or nausea. Triggers make you feel terrible. Worrying about whether you'll come across a trigger can be draining. Naturally, many people deal with triggers by trying to avoid them.

But it's useful to take note of your triggers. They can help you pinpoint sensitive issues or emotions that are keeping you stuck in grief. Recognizing these problematic areas is the first step to moving past them. You can find ways to cope.

Take a minute to think of 3 triggers. As you continue working on your grief record, you may notice more.

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Responses to Triggers

It can also be helpful to write down how you react to different triggers. A trigger might cause you to experience intense emotions. Other times you might feel a physical reaction in your body.

Here are some examples:

Trigger My Response
The anniversary of my son’s death. Shortness of breath all day. Non-stop sobbing. I thought I was going crazy.
Seeing a group of school children. My stomach grabbed and I got a pain in my chest.
Mother’s Day talked about in a group of my friends. I felt like I was in a pit. Like a sense of doom. So alone. I wanted to run out of there.
Pancake smell. Tearful.
Walking into the hospital to visit my Mom. I smelled blood. I lost my way even though I knew the building layout. I got dizzy and had to sit down.
Emergency vehicle siren. The first time I heard a siren I vomited. Now I freeze.

What are some responses you have experienced when triggered?

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William's Story

William's son David died while competing in a sporting activity 9 months ago. Since then, William has felt like he is consumed by grief every day, all day. The pain seems like it is never-ending. He feels it at work, at home, in the morning, and at night. William is not sure how much more of this he can take. He's starting to question whether he'll ever feel anything but pain ever again.

William's therapist suggested he try keeping track of his daily emotions in a grief record. William thought this sounded like a waste of time. He already knew how he was feeling and why. As a favor to his wife, he decided to give it a go. The record doesn't take much time, so why not?

After a few days of tracking his grief, William noticed that his level of distress actually varied in the day. At times the pain was intense and long-lasting. Other times it felt duller and was short-lived. Surprisingly, there were also moments when he felt neutral or even a little happy. He felt best during several evenings he spent with his brother. On the other hand, William noticed that watching sports on TV always made him really upset.

William kept up his grief record for 4 weeks. He saw that his grief came and went. Sometimes it was very intense, and sometimes not. William felt a bit of relief, knowing that his body was still able to feel something aside from pain. He felt less afraid of his grief and a little more confident that he could work through it.

Good Job! You’re Ready to Start a Grief Record

Download Your Worksheet

Continue working on your grief record over the next week. It should only take a few minutes a day. Track your emotions and keep your eyes open for new triggers. As you gain evidence that your pain is not always at full blast, you'll become more assured that you can work through this.

Download

Congratulations! You're Tracking Your Grief

Keep working on your grief record and exploring the ups and downs of your grief. Remember to reach out for support, even if it’s hard.

I’m using the self-help:
I’ve got an online therapist:
I’m working on my own:

Re-Telling Your Story

10min
Facing a painful memory can help you move through grief.
Re-Telling Your Story Unit Guide

The memory of how your loved one died might be a traumatic one. You might be afraid to think about it or see the images that come with the story. But processing this memory is an essential step in resolving your grief. Repetition of the story can help you come to terms with the death of your loved one.

  • Recording the Story
  • Listening to the Story
  • Rewards
  • Fears and Expectations
Audio Tip
Dr. Francois Botha describes how revisiting the story of a loved one’s death can lower the intensity of your emotions.
1:02

Emotional Memories

As you begin to notice the daily ups and downs of your grief, it is also important to process your memories.

For many people, remembering the moment you found out your loved one died is traumatic. This memory is one of the hardest to process in grief. Thinking about how your loved one died might bring up intense emotions. They might feel just as strong as when you first learned of the death. While time has passed, and you may know that the death occurred, emotionally, you haven’t accepted it. You are stuck in the shock that hit when the death took place. It is tough to move through grief when you are still in this state of emotional trauma.

Re-telling your story can help you process things on an emotional level. This exercise involves recording your story and listening to it over several weeks. With time, the emotions surrounding your memory will soften. In a sense, you get used to the story. You can become more comfortable talking and thinking about that time in your life. Re-telling the story is a gentle way of coming to terms with the death of your loved one.

Rewards for Hard Work

Before you set out to retell your story, you should know that this is not easy. It may be one of the hardest things you ever do. For this reason, it’s essential to reward yourself every time you listen to your story. Balancing the difficult work you are doing with some positivity or comfort can help grief to move along.

It’s best to have a list of rewards ready to go before starting the exercise. You can write them down or even put them on pieces of paper in a jar where you can see them.

Try to think of 5 to 10 possible rewards. They should be things you value and find uplifting or comforting. You don’t have to go big. Small things that help you feel a little bit better are perfect rewards. Everyone’s list will be unique. A cup of tea, a walk in the woods, or your favorite TV show might work. Others might prefer soft sheets, hiring a cleaning company, or a warm dessert.

Take a moment and think of some rewards. What might give you some comfort after a tough exercise?

Fears and Expectations

We know that re-telling your story can be painful and might be scary. You might worry that you can’t handle the intense emotions that come with revisiting. Perhaps you’re anxious that the feelings will never go away once you let them out. It may surprise you to learn that the opposite is true. If you keep using the exercise regularly, the emotions will soften. Reach out to your support network if you need more confidence to try the activity.

Re-telling your story will get less painful the more you listen and repeat it. However, no one expects that this story will ever be easy for you to tell. As you process your loss, your feelings will ease, but your connection to your loved one will remain.

Audio Tip
Dr. Margaret Drewlo goes through the steps of re-telling your story.
5:13

How to Tell Your Story

Re-telling the story of your loved one’s death takes about 5 to 10 minutes a day.

It’s best to make your recording using your computer, an old phone, or a tape recorder. If your phone is the easiest option, that’s alright too. Just try to imagine setting a password on the file after you finish. You don’t want to feel like you are carrying the story around with you at all times.

Choose how and where you’d like to record yourself and follow these steps:

  1. Set your device to record. Set a timer for 10 minutes.
  2. Rate your level of distress from 0 (none) to 10 (high).
  3. Answer the question:
      What is the story of the moment you found out that (name) died?
      Where were you? Who was around you? What time of the day or night was it?
      Close your eyes as you tell the story. Create a vivid image in your mind. Your re-telling should last about 5 to 10 minutes. Stop when you have finished or when the timer goes off.
  4. Open your eyes and rate from 0 to 10 how distressed you felt with the re-telling.
  5. Close your eyes and imagine that you are rewinding the story on your device. Visualize yourself clicking rewind and see the recording going back to the beginning. Now imagine storing your recording somewhere safe. A secure folder on your computer could work. This step gives your mind a break from the intense feelings that may have come up during the re-telling.
  6. Pick a reward from your list and give it to yourself. Try to open yourself to feelings of enjoyment.
  7. Listen to the story you recorded each day for the next week. Record your level of distress before and after you listen. Reward yourself after each time.

After a week has passed, create a new recording using steps 1 to 7 again. You’ll continue this exercise for several weeks.

Miriam's Story

Miriam's husband Jake died tragically a year ago. Since then, she has felt stuck in grief. She yearns for Jake. Miriam still feels intense emotions about his death, and can't bear to think about it. But sometimes, she can't get it out of her mind either. Miriam does not want to kill herself but desperately wants to be with Jake.

Miriam's therapist explains that she needs to come to terms with the death of her husband emotionally. Processing the memory of when she learned of Jake's death will help. To begin, Miriam will work on re-telling the story. This exercise involves recording the story of Jake's death and listening to it once a day.

The thought of talking about her husband's death scares Miriam to the core. But with the support of her best friend, Miriam gives it a try. The first recording is quite painful. Miriam talks about the phone call she received. How the person on the other end described the accident and the numbness she felt. Miriam had never spoken of these events out loud before. A phone call the next day from her therapist helped her to feel supported.

Miriam listened to her recording each day for a week. She felt reassured that while the emotions were intense, they did calm down after a while. After 5 weeks of recording and listening to her story, Miriam found that talking about Jake's death was more comfortable. She knew it would never be an easy topic, but in some ways, Miriam felt some distance now. The story of Jake's death no longer caused the emotional reaction it did before.

Good Work! You're Ready to Start Re-Telling Your Story

Download Your Worksheet

Re-telling your story is one of the hardest things you may ever take on. We've included a worksheet with the steps to help you keep going over the upcoming weeks. You are working hard. Remember to reward yourself.

Download

Well Done! You're Ready to Face a Difficult Memory

Keep listening to your recording every day for the next week. At the start of a new week, re-record your story and start again. Work with a trained professional to continue processing your memories on an emotional level.

I’m using the self-help:
I’ve got an online therapist:
I’m working on my own:

Facing Your Grief

20min
Trying to avoid pain can keep you stuck in a cycle of grief.
Facing Your Grief Unit Guide

Grief can hit you emotionally and physically. A reminder of your loved one or their death can cause a lot of suffering. It’s natural to want to avoid this pain. You may have started to dodge places, people, or things that trigger your grief. The difficulty with this plan is that avoidance tends to grow. You can become more isolated, making your grief harder to work through. An important part of your healing is learning to expose yourself gently to your triggers. Facing distressing situations will allow you to reconnect with the world around you.

  • Avoidance
  • Exposure
  • A Series of Goals
  • Reward Yourself
Audio Tip
Dr. Francois Botha discusses which situations people with complicated grief tend to avoid and why.
1:04

Understanding Avoidance

Grief can be incredibly painful. Reminders of your loved one might make you feel like you are in agony. The suffering and hurt can feel like more than you can bear. Grief can also hit you physically. You might feel heavy, achy, or like someone punched you in the gut.

It’s human nature to try to avoid things that feel bad or uncomfortable. While in grief, your pain may be brought about by anything that makes you think of your loved one. To avoid this pain, you may start to hide away from certain people, places, or events. These triggers, which make you think of your loved one, can be anything. It might be your loved one’s favorite restaurant, their family members, their birthday, or the place where they died.

Avoiding triggers can seem like a good strategy. But in the long run, it does more harm than good. Over time, you can become more and more sensitive to any reminders of your loss. For example, if you initially avoided the graveyard, you may find that now you steer clear of that entire neighborhood. You may start to avoid more and more situations, as your world becomes smaller and smaller. In this way, you can end up spending most of your time alone, physically and emotionally. This loneliness will only perpetuate your grief.

Dr. Margaret Drewlo
1:18

Exposure

One of the big problems with avoidance is that it plays up the thought that “I can’t.” You might feel like you can’t handle going to a place where you have memories with your loved one. Or that you can’t function out in the “normal” world. Exposure is a gentle way to start showing yourself that you can. The idea is to ease yourself back into situations you’ve been avoiding. With time, you can gain confidence that you will be able to face reminders of your loved one without becoming overwhelmed.

Going out of your way to expose yourself to the pain of grief might sound crazy. You might remember being told in the early days of your loss to focus on self-care. Don’t overwhelm yourself. Get help from others and concentrate on the basics like eating healthy, getting rest, and personal hygiene. This advice works well if your grief resolves on its own. You’d naturally start to sleep and function better and re-enter your social, work, or school life.

Things change when grief holds on for a long time. Self-protection and avoidance behaviors start to become a barrier. They prevent healing rather than help it move along. When you find yourself in this situation, exposure is the best solution. It can help you break the cycle of avoidance, isolation, and grief.

Your Difficult Situation

The first step of exposure is to identify something you avoid. It could be an activity you used to do with your loved one. Perhaps you've found that your grief erupts when you spend time with a particular person.

You probably avoid more than one thing that triggers your grief. In that case, start with the one that feels the easiest. For example, you might want to work on looking at a photograph of your loved one before visiting the graveyard.

Name a situation, place, person, or thing you'd like to stop avoiding:

300 characters remaining
Feeling Stuck?
Situations:PartiesGoing to the doctorSporting events
Places:RestaurantsBedroom of the deceasedGraveyard
People:Friend of the deceasedFamily of the deceasedOther parents

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Dr. Margaret Drewlo
0:49

Breaking Up the Challenge

Exposure doesn't mean you have to jump into the deep end. It's better to go slow and ease your way towards your ultimate goal. You have already survived your loss and have been through a lot. Exposure isn't meant to overwhelm you more. It's important to break up your goal into pieces that feel manageable. While you may not always complete your task, having a step-wise plan will help boost your chances. Small successes will motivate you to continue onwards.

If you are unsure how to break your goal down, think about how you could change the conditions to feel better. Consider who you'll do your exercise with, how long you'll do it for, and what time you'll do it. Say your main goal is to attend your daughter's graduation. The ceremony will be at the school you've been avoiding since your son died. You might start building towards this event by:

Difficulty Step
Easiest Looking at a photograph of the school.
Easier Drive past the school with a friend in the car.
Middle Visit the school after the students have left for the day.
Harder Revisit as school lets out, and things are busy with students and parents.
Hardest Attend the graduation ceremony.

Your Goals

My Ultimate Goal:

Write out a few different ways that you can expose yourself to your situation, person, or thing. Start with your most manageable goal and gradually work up to the hardest. If you think your ultimate goal is very hard, then your first step should be at a 1 or 2 level of difficulty. Some challenges may require more than 5 steps.

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Audio Tip
Dr. Francois Botha explains why rewards are important for people engaged in treatment for complicated grief.
1:40

Reward Yourself

As you work through your exposure, it's essential to reward yourself. Don't downplay how hard it can be to face your grief. Acknowledge the hard work you are doing and give yourself credit for taking it on.

Rewarding yourself can also help you through your grief. Many people stop doing pleasurable things after a loss. You might feel guilty -- like you don't deserve to feel good or have fun. Avoiding pleasure can hold you back and keep you stuck in your grief. For this reason, giving yourself small rewards can be doubly helpful.

Think about some rewards you can give yourself as you start to tackle your first challenge. It should be something you'll appreciate. It doesn't matter if other people wouldn't consider it rewarding.

How will you reward yourself for completing your challenge?
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Feeling Stuck?
Doing craftsWatch sportsWear favorite clothes
Listen to new musicBuy new cosmeticsAn hour of me-time
Go to the beachBuy a small gadgetApply cream to hands

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Your First Challenge

Good job. You're ready to start planning your first exercise:

Think about trying this task. How much grief do you feel?

5

When will you do your exercise?

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For how long will you do your exercise?

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Keep Going

Grief comes in waves. You may try to face some of your triggers and then find it too tough. A bad couple of weeks might discourage you and make you want to give up. Life, in general, might get in the way. A nasty cold or other obstacles may put a stop to your exposure. These events should be no surprise. Life rarely occurs on a straight course. Be easy on yourself when things come up that interfere with your goals.

Take the time you need and then come back to your exposure. The important thing is to keep trying. And don’t forget to reward yourself.

Daisy's Story

Daisy's partner Blair died suddenly last year. Since then, Daisy has not been able to work. She's gradually stopped seeing friends altogether and avoids anything that reminds her of Blair. Daisy can't handle any reminders of their former life together. She spends most of her time alone at home. Daisy wonders if she will ever "get better."

Daisy decided to try to deal with her grief, even if feeling better did not seem possible. Her therapist recommended she start doing exposure exercises. Daisy wanted to work towards hanging a picture of Blair in her living room. She wondered if she'd be able to handle the pain that came when she looked at pictures of Blair. Daisy was sure it would be too overwhelming. Nonetheless, she dug out the box of photos that she'd been avoiding.

Later that night, Daisy opened the box. The next day, she put her hand in and took out a picture of Blair from before they met. She held it in her hand. It hurt, but it didn't overwhelm her. Next, Daisy held a photo of the 2 of them working on their garden together. Another day, Daisy found a picture from their last holiday. She held it and showed it to a friend. It wasn't easy, but it was not as painful as Daisy assumed. It felt good to share her love for her partner.

Daisy practiced holding Blair's picture about 20 times before it got easier. She was able to honor her love for Blair by putting her favorite photo in a new frame she bought for this purpose. Daisy was proud to see Blair's picture in her living room. It warmed her heart to see the face she loved as she moved through her home.

Well Done! You're Ready to Start Facing Your Grief

Download Your Worksheet

It takes courage to face things that trigger your grief. Take it slow and break down your goals into more manageable steps. Don’t forget to give yourself the credit you have earned. Taking on your grief is extremely hard, and you deserve to be rewarded.

Download

Well Done! You're Ready to Try Exposure

Keep practicing your exposure. With time you can stop avoiding reminders of your loved one and reconnect with life.

I’m using the self-help:
I’ve got an online therapist:
I’m working on my own:

Resolving and Reinvesting

15min
When intense grief lingers, resolution and finding a way to reinvest in your life might seem impossible
Resolving and Reinvesting Unit Guide

It is possible to integrate your losses into your life and to find ways to reinvest or new ways to invest in your life. Several things can help. First of all, identifying your values as they are now will help you to reimagine and reinvest in the life that lays ahead. Second, when you know what your values are, you can develop new goals. Third, coming to a point of resolution involves accepting that your loved one had both positive and negative qualities to them. Finally, having an imaginary conversation can help you to resolve the loss.

An important part of the treatment for complicated grief is to gently and gradually move towards experiences that have been distressing or painful. In this unit, you’ll learn tools that will help you master these challenges.

  • Identify Your Values
  • New Goals
  • Both Sides
  • Having a Conversation

Life Can Be Worthwhile Again

When someone important to you dies, you think that life will never be the same. This is real. Life cannot go back to the way it was before your loved one died. But you might also think that life can never be good again. That is where treatment comes in to help you recognize that your loved one is gone, to help you remove the blocks in your natural grieving process and then to come to a resolution about your loss. In this treatment for complicated grief another goal is to have your remembrances of your loved one become “bittersweet”. You may never feel happy that they have died. But you can come to a state of being able to hold pain and regret for your loss and also positive emotions about your relationship with them.

How you get there from where you are now is let go of the relationship that was, creatively resolve remaining issues in the relationship if you can, and orient yourself to your new future with new goals.

Identifying your Values

Finding meaning in life is best found in our values. Our values give us a direction to how we want to spend our time and energy. Death teaches us that our life is finite. Experiencing a big loss can motivate you to decide how you want to spend your time and resources. Determining the values that are most important to you can help you gain clarity about your goals.

Identify the five values that are most important to you.

Feeling Stuck?
BeautyCommitmentContributionCompassionForgivenessFun
GenerosityHopeInner PeaceKnowledgeOpennessSafety
Self KnowledgePassionPleasurePurposeSuccessSpirituality

Done

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Audio Tip
Dr. Francois Botha discusses how establishing longer term goals and clarifying values help clients with complicated grief.
1:21

Discover New Goals

If a miracle happened right now and you were at peace with the death, what goals would you have for your life? It is understandable that in grief you may have given up your goals and dreams. This exercise helps you discover what your goals are now that your life is very different. It might take a while for you to come up with new goals. There are no wrong answers.

Write down any ideas you have, even if you don’t think they are possible or practical. The purpose of the exercise is to get you to start thinking of a meaningful future.

Next

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Audio Tip
Dr. Margaret Drewlo explains why developing a balanced view of the person who died is part of treatment for complicated grief.
0:59

Both Sides

We can forget that the person who died was a whole person like we all are. We can forget that our loved one had positive qualities and qualities that were not positive. Sometimes we only remember the good times we spent with them or only remember the hard times. An important part of the work you are doing is to be able to see your loved one in all their humanness. Have a balanced view.

You can use a picture and or a treasured object to help tell the balanced story of the person who died. It can help to have these items in front of you as you complete the following exercise.


What are some of the positive qualities of the person who died?

What are some qualities of the person who died which are not positive?

What are some of the pleasant memories you have of times you spent together?

What are some of the unpleasant memories of times you spent together?

What are your reflections about the Both Sides exercise you just completed?

If you are using this course for self-help you can connect with your supportive friends or family for encouragement.

Done

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Audio Tip
Dr. Margaret Drewlo describes how imaginal conversations with the person who died help people with complicated grief.
0:54

Having a Conversation

If you had a positive relationship with the person who died there is research suggesting it can be beneficial to have a conversation with them about the events surrounding their death and your relationship. If you did not have a positive relationship you may decide not to do this exercise now. You might want to do it in the future when your relationship with the person who died is more resolved. This practice is a two-sided imaginal conversation. You will do the talking for both of you.

You may have already been talking to your loved one but did not realize that it could be helping you to feel at peace with their death. You may have been telling them about your day or asking them why they had to die when they did. You might wonder what they really thought of you or another question you never got to ask. Being curious about them and their death is entirely to be expected. If you did not know before now, it is worth repeating. Entirely to be expected.

Here is an example of how a conversation might go.

You: Why did you die? Why couldn’t I have more time with you?

Them: I wanted to stay with you, but I was too sick.
I wanted to have more time with you too. That was my biggest wish.
I am so sorry to leave you. If I could change it, I would.

You: I REALLY miss you.

Them: I knew you would, and I am sorry you are hurting. You are going to be okay. I think you are a strong woman.

Your Conversation

The typical way this conversation starts is for you to imagine that death has just occurred but your loved one can still hear you and talk to you. You will know what kind of language is authentic to them and what they would likely say to you if you asked them a question.

Take five minutes to have a conversation with your loved one now.

What was that like? Make some notes and share your reflections with your Kelty’s Key psychotherapist or a friend or family member who is supporting you. You could also show your friend or family this section of the website so that they understand the exercise.

Done

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Martina's Story

After her sister died, Martina gave up her plans for her future. The goals she had for her life did not seem important anymore and she resigned herself to trying to make it through each day. She no longer expected that she’d have a bright future or that there was anything for her to look forward to.

In her psychotherapy, Martina was asked to think about what she would want for her future if she had been able to come to peace about her sister’s death. Martina had not thought about that for so long that she could not come up with anything. Between sessions, Martina considered this question.

Martina struggled to know what was important to her anymore. She was not sure of if she knew what was meaningful to her. She was not confident she knew her central values.

Martina did a values identification exercise and was able to come up with several core values. After becoming reacquainted with her values she was able to find a few causes that gave her meaning. Martina finally settled on volunteering for a cause her sister would have supported. Martina felt more connected to her home community and more connected to a positive memory of her sister.

Good Job! You have learned new strategies

Download Your Worksheet

Good Job! You have learned strategies to create new goals for your future and to resolve your relationship with your loved one who has died. You have done a lot of hard work to get to this point.

Download

Congratulations! You’ve learned new strategies to create new goals for your future

Your goals may change as you continue in your grieving process. That is as expected. If you have decided to have imaginal conversations with your loved one the conversations will also likely change over time.

I’m using the self-help:
I’ve got an online therapist:
I’m working on my own:
Useful Tools

 

Keep practicing. Download reusable worksheets and audio guides for Complicated Grief.

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