What’s Pathological Grief? Definition + Examples

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The process of grieving for most individuals is considered a mild form of grief-related traumatic stress. When a bereaved person experiences more complicated or severe forms of stress, it's known as an acute stress disorder. A suffering individual may also experience post-traumatic stress disorder, otherwise known as PTSD.

These grief-related responses usually occur after exposure to severe or traumatic losses or events in a person's life, including violent death, combat experience, or other life-threatening experiences.

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Although most grief experiences tend to fall into the “mild” category (even though they may be related to profound sorrow), pathological grief is experienced in more traumatic ways and can be challenging to resolve. The term “pathological grief” stems from an individual's inability to work through their grief despite their best efforts or how much time has elapsed from the event.

Definition of Pathological Grief

There isn't a timeline for grief, but both abbreviated grief and pathological grief focus on the time elapsed from the date of a loss or occurrence and the severity of a person's suffering.

The amount of time it takes an individual to move forward from despair is one way of defining pathological grief. There's no indicator of how long grief lasts. However, an individual can expect to feel the most profound effects of grief for up to twelve months after suffering a significant loss. 

Pathological grief can last for several years before a grieving individual gets past a severe loss. Generally, a person who's suffering beyond the initial twelve months of suffering has the potential to develop this type of grief.

A pathological grief reaction is usually defined as lasting beyond the initial first year where a grieving person isn't healing or improving from their loss. There's a significant delay in the grieving process with pathological grief, although there's no absolute time frame for suffering to be considered pathological.

A typical grieving time frame is anywhere from six to twelve months from the death of a loved one or a significant loss. A person who's still actively grieving beyond that time frame may be considered “stuck” in their grief.

Differences Between Pathological Grief and Normal Grief

A person suffering from pathological grief tends to have difficulty coping with the grief-related emotions following a significant loss. Although grief is a natural response to the loss of a loved one or another type of traumatic event, some people experience a more severe and prolonged course of grieving. 

When a person experiences high levels of acute symptoms, their grief shifts from average to complicated, and they’re at a higher risk of long-term mental health impairments, declines in physical health, and suicidal behaviors. When this occurs, a pathological state of grief emerges, requiring clinical intervention and treatment.

Persistent complex bereavement is considered a psychiatric disorder similar to complicated grief that requires outside professional treatment in most cases. Pathological grief is a trauma- and stress-related disorder that responds to grief counseling or clinical therapy specifically targeted for complicated grief.  

In comparison, normal grief is a natural response to grieving when a person suffers the death of a loved one or another significant loss. In almost all examples of loss, individuals affected by the loss of a loved one will suffer through some level of bereavement that leads to severe psychological pain. Even though this suffering can result in profound changes to an individual's way of living or thinking, these intensely painful experiences are considered a normal part of human grieving.

Although most people acknowledge that death is an unavoidable process, many people cannot withstand the feeling of profound sadness and have difficulty living with it. In most instances, though, a grieving individual will never require help from a professional therapist. Most people suffering from normal grief will recover on their own after a period of mourning and bereavement.

Mourning is similar to grief in that it's also a normal reaction to the death of a loved one. It affects a person both psychologically and physiologically. During normal grief and mourning, the average time to move past the most severe suffering is 6 to 12 months. The time grief takes to lessen or resolve depends on the nature of the relationship to the deceased and the severity of the loss experience.

What Are the Signs That Someone Is Experiencing Pathological Grief?

The death of a loved one is one of the most distressing experiences a person can undergo during their lifetime. Unfortunately, it's also one of the most common types of loss humans experience. Most people will usually experience grief that follows a projected path of shock and disbelief, profound pain and sorrow, and a general numbness for several months. These are all common signs and symptoms of normal grief. Normal grief gradually lessens or goes away on its own without the need for professional intervention.

A few people will experience a more complicated grief response beyond the usual feelings of pain and suffering. In this minority of people, the feelings of loss are so debilitating that they affect all areas of their life and living. People suffering from pathological grief will find it difficult to move forward in life and return to their regular routines. 

The standard progression through grief is to follow a specific expected trajectory. Although everyone's grief experience is unique, some commonalities or shared experiences exist with people who suffer through loss. A person experiencing normal grief is expected to share some or all of these stages of grief:

  • Acceptance of the reality of their loss
  • Allowance of the natural grief reactions to emerge
  • Adjustment to a new life and reality
  • Moving on in life and forging new relationships

Pathological grief holds back a person from moving forward in all aspects of healing. Their grieving process becomes complicated and starts to distort the grieving individual's perception of reality. They may not understand or accept that their loved one is gone or refuse to let go of what they once had. 

Recognizing that the initial stages of normal grief mimic the signs and symptoms of prolonged grief is essential to understanding when someone is experiencing pathological grief. With normal grief, these signs and symptoms begin to disappear gradually. At the same time, complicated grief keeps a person in the heightened stages of grief without ebbs and flows. The following are some things to look for in spotting pathological grief: 

  • Intense sorrow, pain, and going over the loss
  • Inability to focus on things other than their loss
  • Avoidance of reminders of their loved one
  • Intense yearning 
  • Failure to accept the death
  • Withdrawal from life and others
  • Bitterness resulting from loss
  • Lost hope and purpose
  • Distrust of others
  • Inability to look at the positives in life

Examples of Pathological Grief

A person dealing with pathological grief will undergo a psychological process that includes testing reality from time to time. This process is susceptible to interference from conditions outside of the suffering individual's mind and thought processes. These internal and external factors combined can create an entirely different reality than what exists.

These external conditions might include extreme situations like the violent death of a family member or a hostile relationship with the deceased. Various psychological defense mechanisms can emerge that include suppressing emotions and the disbelief that their loved one has died to avoid the stressors linked to these events.

A person going through this might have a negative view of themselves and the world around them. They may demonstrate an avoidance of emotional problems, distorted perceptions of reality, or feeling that their grief will go on forever. 

How to Deal With Pathological Grief

Responding to a loved one who's dealing with pathological grief may seem overwhelming and a bit challenging. An initial reaction might be to step back and allow your loved ones time to process their grief without interference. 

Withdrawal away from grieving loved ones is a common response because, often, our society fails to teach us how to interact with someone suffering through loss. Many of us don't know what to say in these situations. A person dealing with exaggerated, grief-related emotions such as yearning, anger, and depression may not be easy to console or interact with. The following tips might help you reconnect with your loved one to start rebuilding your relationship.

Recognize the symptoms

Dealing with pathological grief comes down to recognizing the symptoms of the bereaved. When confronted with the negative aspects of the grieving individual’s changed behaviors, interacting with them becomes challenging and often stressful. Take the time to look for and recognize the deeper meaning behind their actions and reactions without allowing yourself to take things personally.

Refrain from comparing

Everyone grieves differently, even when suffering through the same types of loss. In situations where you have experienced the same loss as the bereaved individual suffering through pathological grief, it's easy to compare your grief process to theirs. But people have different biological makeups and coping skills.

Your loved one may have an incredibly challenging time dealing with their loss, while you may have higher resilience to stress.

Recognizing Pathological Grief 

Suffering through loss is an inevitable part of life. The understanding of pathological grief is comparable to complicated grief and is characterized by an extended mourning period. Pathological grief is an acute type of grief that physically, psychologically, and socially impairs a grieving individual.

Many people suffer from pathological grief, especially when suffering through disaster or the violent and unexpected death of a loved one. Once you recognize the signs and symptoms, dealing with the aftermath of grief becomes less challenging.

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