Mental Health Matters: Feeling “Stuck” in Grief


M. Regina Asaro, MS, RN, CT

Grief is hard for most people to get through; it does take time and “grief work” but there is no timetable to provide guidance for the process. Often, the only way mourners can mark their progress is to look back and see whether they are feeling and coping differently than when their grief was new. This column will look at some of the issues and concerns which might cause the mourner to feel “stuck” and need help to move forward.

Dr. Therese Rando (1993) described a number of issues which might place the mourner at risk for complications: whether the death is sudden and traumatic; a relationship with the deceased which was marked by anger or dependence; what she termed as “mourner liabilities,” including prior losses or stresses that were not resolved and/or prior mental health problems; and, lastly, the mourner’s perceived lack of social support (p. 453). There are, additionally, many variations and individual factors which may also promote or interfere with the grief process.

Good friends may serve as a sounding board for dealing with loss-related issues; however, when one is feeling “stuck,” it can be more useful to talk with a counselor trained in traumatic loss issues, someone who can help you to understand the convergence and/or overlapping of all the feelings, emotions and issues that often surround a traumatic loss. Following are some of the ways in which counseling can be helpful:

  • to assist one to find acceptable ways of expressing anger or frustration with those who are perceived to have caused the death;
  • to help one resolve unfinished business, anger and/or guilt over some aspect of the relationship with the deceased, themselves. There are “ups and downs” as part of the normal course of any relationship; however, when a loved one dies before it is possible to resolve conflict or to give or receive forgiveness for angry words or disagreements, it can be hard afterwards.
  • to explore the differing levels of dependence and interdependence that one shared with deceased loved ones. People often feel abandoned by loved ones, especially when they die suddenly. After the death, survivors must make adjustments so that they can meet needs previously taken care of by the deceased; they may either take them on themselves or have them met by other sources. This is not an uncommon issue but one which must be resolved.
  • to deal with the “resurrection” of other past losses, which may need to be “re-grieved.” Counseling can be very helpful in teasing these losses apart so that one can determine which issues and feelings belong to the old loss and which to the new. The bereaved can then express the feelings and mourn the losses as needed.
  • to promote mental health and help lessen the impact that the stress of the death may have had on pre-existing psychiatric symptoms. Mental health is not just an absence of mental illness but includes one’s ability to cope and solve problems as well as self-esteem issues and one’s belief system. Just as the symptoms of many physical illnesses may be re-triggered by a high level of stress, the aftermath of a traumatic loss can also challenge one’s ability to cope with symptoms of depression, anxiety, thought disorders and substance abuse. Additionally, the use of illegal drugs or alcohol to deal with anxiety and stress and depression following the death should also be addressed.
  • to provide a sense of being supported emotionally through a difficult process. This may be especially needed in families where all are mourning the same loss and are either at different places in their grief or who are feeling so overwhelmed that they are unable to allow each other an expression of these feelings.

    • Conclusions

    If you see yourself in the above, know that there is much you can do to help yourself. While it is true that we need to do the grief work described in the last column, sometimes extra help is needed to get “unstuck” or to express some of the most difficult feelings associated with a traumatic loss. If so, I urge you to consider making an appointment with a counselor who is trained in traumatic loss issues. While there are no miracle cures, reaching out for help to get you through the rough parts of grief is a positive coping strategy which will, hopefully, save you a great deal of pain and frustration.

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    Rando, T. A. (1993). Treatment of Complicated Mourning. Champagne, IL:
    Research Press.
    M. Regina Asaro, MS, RN, CT of Newport News, VA, a consultant on traumatic loss issues,
    may be contacted at rasaro68@peoplepc.com

    Copyright 2004, M. Regina Asaro, MS, RN, CT. The above may be copied in part or in its entirety with acknowledgement of the author and its source.