Differences Between Normal, Absent and Complicated Grief

Grief is a broad human emotion that will affect all of us at some point in life. Some people have to handle grief more often than others. And while some people seem to handle it well, others seem to have a tougher time coping with loss.

Grief is not only about death. Grief can happen as the result of losing your job, moving to a new place, ending a relationship, or falling out with a friend. Any time that you have to make a considerable adjustment in your life, this could be considered an act of grieving.

When we talk about grief, most people are comfortable talking about the stages of grief. But the different types of grief are also important to be aware of. Whether you are going through the grieving process, or you are helping someone to navigate this, it’s very helpful to be able to offer constructive advice

There are three main types of grief that we will explore in more detail today: normal grief, absent grief and complicated grief. It’s important to remember that there is no wrong way to grieve, and even normal grief can become complicated if the individual is ill-equipped to handle it.

Normal simply means that it is more common and it doesn’t imply that the other types of grief are abnormal. As we have mentioned, there is no right or wrong way to grieve, and everyone has to do what is right for them. Understanding the type of grief you or a loved one may be experiencing might help to make it easier to manage these feelings and move forward.

What is grief?

Grief is one of the most powerful human emotions. But it impacts more than just your emotional health, it can also impact you physically and spiritually. It is commonly described as an intense feeling that is too overwhelming to handle.

Grief is most commonly associated with losing a loved one, but it can also be triggered by:

• Losing your job
• A change in lifestyle or financial security
• After a stillbirth or miscarriage
• Ending a friendship, relationship or marriage
• After serious illness or disease
• After losing your independence due to loss of mobility
• Following a break-in, if you now feel unsafe
• Following a near-death experience

Grief is not a singular emotion. It can change and evolve. And if you grieve once, it might not feel the same if you go through the process again. And everyone is affected by grief in different ways. There is no template for grief that everyone goes through.

This is why categorising and understanding grief is so important for being able to move forward. Understanding grief makes it easier to handle, as individuals can more easily recognise that their feelings are not unique. When you know that everyone goes through these emotions, it becomes much easier to handle adversity.

What is normal grief?

Normal grief is the name given to a typical grieving process. While unpleasant, traumatic and painful, there is nothing abnormal about this type of journey through grief. And while it might be different for everyone, the general pathway and emotions are similar. Normal grief typically follows the following pattern, also known as the stages of grief:

1. Shock and disbelief
2. Disorganisation, chaos and numbness
3. Anger
4. Bargaining
5. Depression
6. Acceptance

The duration of these stages can vary from person to person, and might not follow this order exactly. You might experience all of these emotions or just a few. Grief also isn't a linear journey, and individuals might cycle between stages of grief, feeling unable to move forward.

Common experiences of grief include:

• Crying or weeping
• Feeling overwhelmed
• Lack of appetite or overeating
• Insomnia or hypersomnia
• Loss of energy or fatigue
• Feeling guilty, sad, empty or depressed
• Anxiety or panic attacks
• Isolating oneself from friends and family

Grieving is a process, and when it is normal grief, the only thing a person can do is give it time. As the weeks and months pass, you will return to a new normal. We call it a new normal because the grief will have altered you in some way. As you adjust to your new life without the thing or person you are grieving, you might find that you have to adjust to the changes.

Normal grief is characterised by the fact that it is manageable. Individuals can still go on with their life and participate in activities, even if they might be unpleasant or painful. However, when grief gets too much to handle, this is known as complicated grief.

What is complicated grief?

Complicated grief is a more severe form of bereavement. It is when the grieving process does not follow the typical path, or when the individual experiences excessive and intense grief that gets in the way of their life. This type of grief often leads to mental health problems such as depression and anxiety.

The symptoms of complicated grief can be categorised as those that get in the way of a normal life. This could include:

• Excessive thoughts about the person who has died
• Intense longing for the deceased
• Suffering from intrusive images or thoughts
• Having difficulty accepting the death
• Feeling like life is not worth living without the person who has died
• Experiencing guilt over things that were said or done before the death
• Neglecting personal hygiene or appearance
• Suicidal thoughts or actions
• Reckless behaviour

It's difficult to categorise when normal grief spills over into complicated grief, but in general, if the grief is preventing you from moving forward, it might be categorised as absent.

If you feel trapped by your grief and unable to move forward, this would likely be categorised as complicated grief. Those experiencing complicated grief might need closer supervision and professional intervention in the form of medication or grief counselling.

What is absent grief?

Absent grief occurs when the person has already grieved the loss extensively before the person has passed away. This can lead to complicated and complex feelings of guilt, anger and denial. When the grief is absent, it can leave individuals feeling that there is something wrong with them.

There can be several reasons why an individual might experience absent grief. This includes, but is not limited to:

• anticipating the death of a loved one and preparing for it;
• being unable to attend or participate in funeral rituals;
• being estranged from the loved one
• avoiding thinking about death because it is too difficult to deal with, otherwise known as denial
• you realise you weren't that close with the person who passed away
• other things are happening in your life that take priority

Common symptoms of absent grief include:

• Feeling numb or disconnected from your emotions
• Having difficulty remembering the person who has died
• Having physical symptoms such as headaches, nausea or chest pain
• Feeling like you are going crazy
• Experiencing flashbacks or hallucinations of the deceased
• Dreaming about the person who has died
• Trying to avoid talking or thinking about death altogether

You might become obsessed with the idea that you should be feeling more than you are. This can be all-consuming and leave you feeling abnormal for not having a typical reaction to loss.

Remember that denial is one of the stages of normal grief, so you may simply be stuck in this stage. Once you pass through this and accept that the person has gone, you may feel differently.

Absent grief can be a defence mechanism to help you avoid feeling the extent of your emotions. So, before you start wondering if you are cold and absent for not feeling grief, remember that you might simply be protecting yourself in some way. If you are experiencing some of the symptoms listed above, it's best to seek professional help from your GP or a grief counsellor.

How long does it take to grieve?

There is no right or wrong answer to this question, as everyone experiences grief in their way and at their own pace. Some people feel intense grief for a short time but can move on quickly. Others might be in denial for a long time, and then their grief hits them further down the line. And some might feel low-level grief for an extended period.

The stages of grief don't always follow a neat order and you may skip or revisit certain steps. If at any point you feel that you are "stuck" in your grief, reach out to those around you for help. You don't have to cope with this on your own.

It helps a lot of people to remember that grief never really leaves us, but it does change us. You won't be the same person you were before you were grieving, so part of the grieving process is all about coming to terms with who this new person is. It's a journey of discovery as you get to know yourself again and learn all about yourself in the wake of grief.

It's also helpful to think of your grief as staying the same size, and you are growing around it. So, you aren't waiting for it to shrink or diminish, but you are waiting for your strength to take over and grow around the grief to make it more manageable. This analogy can help those who are stuck in their grief as they fear letting go.