What Complicated Grief Actually Means (And It Is Not What You Think)

When people hear the term complicated grief, they often think it means grief that is particularly painful or confusing. Sometimes therapists use it loosely to mean grief that feels hard to manage. But complicated grief is actually a clinical term, and understanding what it really means can be the difference between getting the right help and spinning your wheels in the wrong kind of treatment.

Complicated grief, now also called Prolonged Grief Disorder in the DSM-5, is a condition in which the normal grieving process gets stuck. Instead of gradually integrating the loss, the bereaved person remains trapped in acute grief for an extended period, typically beyond twelve months for adults. The grief does not diminish. It does not find a place to settle. It stays at the forefront of every day.

Complicated grief looks different from typical grief in specific ways. People with complicated grief often experience intense longing for the person who is gone that does not ease over time. They may have difficulty accepting that the loss is real. They may feel that a part of them died along with the person they lost. They often struggle to engage in daily life, relationships, or future planning.

Risk factors for complicated grief include: sudden or traumatic losses, losses involving ambivalence or conflict in the relationship, losses of primary attachment figures, a history of trauma or previous loss, and limited social support. This is why complicated grief is so common in people who had a complicated or painful relationship with the person they lost.

Complicated grief responds to specific, evidence-based treatment, not just general support or talk therapy. If you have been grieving in a way that feels like it is not moving, not changing, not easing with time, I encourage you to ask specifically whether you might be experiencing prolonged grief, and to look for a therapist who has specific training in grief treatment.

Angela Schellenberg is a grief and trauma therapist in LA County, specializing in attachment trauma, complicated grief, and the Grief, Trauma & Your Mama framework.