Complicated Grief

When a death has occurred that was violent in nature (murder, suicide, murder/suicide, car accident, etc.), an individual may experience complicated or traumatic grief. Complicated grief may trigger intense feelings of fear and anxiety, especially when experienced within close proximity to oneself, either in the form of the relationship (brother, mother, sister, father, spouse), or physical location (i.e.- we experience another’s death before our very eyes). The mind is put on high alert and becomes hyper-vigilant in its’ attempt to protect itself from any “seeming” danger. The effects of this, often labeled as Generalized Anxiety Disorder, Post-Traumatic Stress, or even Post Traumatic Stress Disorder (PTSD) are deep and far-reaching. In this heightened state, fear and anxiety may persist for months following the death and can be completely debilitating. If you have experienced a traumatic loss and are experiencing complicated grief, seek the help of a psychotherapist as soon as possible.

When one has experienced a traumatic, violent, loss the symptoms are greatly pronounced:

-A Severely prolonged grief response lasting longer than two years post-event

– PTSD surrounding certain aspects of the loss

-Anxiety/panic attacks when emotional/mental/sensory triggers occur

-Separation Anxiety

-Night terrors

-Prolonged depression

-Suicidal ideation; obsession with suicide and formulating real plans of how to carry it out


-Great difficulty moving on

-Severe anger over the loss lasting more than 6 months

-A marked inability to adjust to life with the “loved one”

a. Feeling emotionally numb

b. Feeling emotionally stunned

c. Feeling that life is meaningless

d. Experiencing mistrust

e. Bitterness over the loss

f. Difficulty accepting the loss

g. Identity confusion

h. Avoidance of the reality of the loss

i. Difficulty moving on with life.

In 2009, Holly G. Prigerson published a study of two hundred and ninety-one bereaved individuals over a two year period and devised criteria for what she coined “Complicated Grief Disorder” (CGD)  which is now called Persistent Complex-Bereavement Related Disorder in the Diagnostics Statistics Manual V. The Criteria proposed for the new Persistent Complex Bereavement Disorder, are as follows:

  1. Death of a close other
  2. Since the death, at least one of the following on most days to a clinically significant degree for at least 12 months after the death:
    1. Persistent yearning for the deceased
    2. Intense sorrow and emotional pain in response to the death
    3. Preoccupation with the deceased
    4. Preoccupation with the circumstances of the death
  3. Since the death, at least 6 of the following symptoms are experienced on most days to a clinically significant degree for at least 12 months after the death:
    1. Marked difficulty accepting the death
    2. Disbelief or emotional numbness over the loss
    3. A difficulty with positive reminiscing about the deceased
    4. Bitterness or anger related to the loss
    5. Self Blame
    6. Excessive avoidance of reminders of the loss
    7. A desire to die to be with the deceased
    8. Difficulty trusting other people since the death
    9. Feeling alone or detached from other people since the death
    10. Feeling that life is meaningless or empty without the deceased or the belief that one cannot function without the deceased
    11. Confusion about one’s role in life or a diminished sense of one’s identity
    12. Difficulty or reluctance to pursue interests or to plan for the future (e.g.,
      friendships, activities) since the loss
    13. The disturbance causes clinically significant distress or impairment in social,
      occupational, or other important areas of functioning
    14. The bereavement reaction must be out of proportion or inconsistent with
      cultural or religious norms

The conclusion of the study stated:  “The criteria set for the PGD appear able to identify bereaved persons at heightened risk for enduring distress and dysfunction.” As the DSMV accepts this new classification it will empower both clinicians to develop new treatment protocols for patients with PGD  and those suffering from PGD to have greater treatment options available to them in the future so they may return to normal functioning experienced prior to the death. To see the full article, go to:

2014, Vol. 45, No. 3, 180-187. Prolonged Grief Disorder: Diagnostic Assessment and Treatment Considerations. Jordan and Litz et al. from theJournal of the American Psychology Association 

Complicated Grief can be extremely difficult, as the brain has suffered severe emotional trauma. In the same way that one may need to learn to walk again after a stroke, one must learn to trust life again after a violent loss. This may require a hard re-wiring of the brain around the emotional trauma, around the fear triggers, with the help of Eye Movement Desensitization and Reprocessing (EMDR) Therapy and Neuro-linguistic Programming. For information about EMDR go to

For information about the National Association of Crime Victim Compensation Boards, go to:

For information about How to file a Victim Impact Statement, the Purpose of a Victim Impact Statement, and how to Write a Victim Impact Statement go to:

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