Complicated and Complex Grief

Dear Dr. Leary:

My older son, age 46, died 7 months ago; my younger son died 8 years ago when he was 36.  Both deaths were unexpected and related to heart for the older and subarachnoid hemorrhage for my younger son.  My husband died 1 yr. & 2 months ago from CHF and my Mother 2 yrs. ago just before Thanksgiving from intestinal blockage.  My Dad passed in 1991, 24 years ago (incredible).

I am sort of going downhill since a week before Thanksgiving.  I’m back to work these past 5 months as a Nurse Practitioner in Women’s Health and I can be caught off-guard as I walk with a woman through her emotions and concerns.  I’m also having a hard time coordinating my thoughts, setting boundaries, i.e. saying a clear yes or no), eating well (I’m overeating sweets and carbs and drinking lots of coffee with creamer and eating very little protein) I even have a hard time making time to be with my grandchildren who are suffering the loss of their Dad, my oldest son. Everything is so different the past year or two and I’m lost in a maze.  Please don’t stop sending me encouraging letters and things.  Linda

Dear Linda:

You are describing your very unique and personal journey of grief.  The intensity of grief has surfaced during this holiday time, and it is not uncommon for the holidays to remind you of all the loved ones you have lost.  That your sons’ deaths were unexpected, and out of the normal “course” of nature (i.e. our expectation that parents “should” die before their children) makes your grief complicated and complex.

One of the ways to understand your “downhill slide” during this time is to take the perspective that all of the symptoms and signs you describe such as having a difficult time with focus, boundaries, nutrition, and energy, are your body’s way to communicate with you.  What might your heart, mind, and body be telling you?  What is that you need to not feel as though your focus and self-care was in decline? 

It seems important at this time, when your body is asking for self-care and attention, to begin first by validating what you are feeling and experiencing.  You have done that with this letter.  The second step is to identify what you need; this is unique and individual for each person.  The third step is to reach out and ask for the support you need and deserve in order to pass through this challenging time; choose personal friends, family, and professionals who will listen to you as often as you need to express yourself.  Ask them to listen without judgment or advice (unless you ask for it); who will hold a “safe place” for you to explore and express your feelings; and who will remember and talk about your loved ones with you.

This time asks you to focus on your own needs; to put yourself first and nourish yourself in ways that soothe and provide you energy.  For some people, work provides a way to “compartmentalize” and rest from the onslaught of grief; for others, work feels too demanding and depleting. In your case, it sounds as though the demands and reminders of others’ grief at work is adding another layer of difficulty to your grief. I hope you will take time off from work if you are able in order to give yourself whatever your mind, heart, and body is asking for.  Grief is extremely exhausting work, and when it arises, we are called to respond to the needs that are being communicated.

Please be gentle and selfish with yourself whenever your grief surges, and your body expresses its sorrow.  Grief knows no timeline, and the journey is extremely personal.

Thinking of you,

Lani Leary


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