Grief while natural can go many different directions and become in some cases pathological. There are many unique singularities that can make one loss different than another and transverse normal and healthy trajectories into abnormal and pathological trajectories. Grief Counselors can play a key role in guiding clients and helping identify possible clues that can lead to complications in grief. While pastoral counselors who are grief certified can help those along normal trajectories, only licensed and clinical counselors can help those with complications.
Grief can become pathological. Please also review AIHCP’s Grief Counseling Certification
Please also review AIHCP’s Grief Counseling Certification and see if it matches your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification in grief counseling. AIHCP certifies both clinical as well as pastoral professionals within the Human Service professions. as well as others within the healthcare fields.
One’s faith is a critical component to self identity. It is a world view that acts like a compass when times of trouble occur. It is an anchor that keeps the person in place as the various “isms” of the world alter society. Hence, when loss challenges world view or spiritual belief, the person can find him/herself in an existential crisis. Many with spiritual and religious background respond strong to loss with certainty and faith, but when faith is misplaced, or when the loss is traumatic, there can be mild, moderate or even severe faith challenges to the individual.
Christianity as a faith plays the same psychological basis as any faith for a person with a world view. A Muslim, Jew, or Hindu can weather the storm of loss and grief from a psychological standpoint if their faith plays a key role in identity of the person. Likewise, spiritual individuals who may have no religious affiliation can also have strong roots in facing adversity. In addition, even atheists or agnostics, although subject to possible turmoil more than spiritually based individuals, can also have world views that allow them to show resilience in loss. Obviously, family and communal support plays a key role as well, so to merely judge one’s resilience on faith alone without considering support can lead to disparities.
Faith is a powerful tool in helping grievers find peace and healing. Healthy faith gives connection to God, beliefs and others within the community and helps one readjust and find meaning in the loss
In conclusion, for most, faith and ritual play critical roles in helping individuals understand the loss and its suffering. Rituals help heal wounds and find closure but also understanding and hope. Religion offers hope and reunion beyond the temporal world. It gives a sense of meaning to why we suffer or what we must do. Faith also gives individuals the sense of being loved by a Divine Being who cares and hopes to heal them. These are critical aspects of resiliency due the connection with God, meaning and a community of believers. However, when spirituality is unhealthy, things can go drastically wrong.
A Healthy Faith and Loss
There is also discussion in loss how much a role spirituality plays versus religious. This stems from healthy versus sick faith. A devout religious person or a devout spiritual person both have strong views that can help them through loss but also those views can become more adversely challenged when bad things happen. We hear many definitions of individuals who are spiritual but not religious, or we see on the other hand, individuals who are only outwardly religious but have no spiritual personal life. I find both imbalances unhealthy and more open to potential pitfalls during loss (if looking at faith and loss alone without any other factors).
The spiritual but religious motif is usually a response to anger towards organized religion. One is suspect to it or has had a unhealthy encounter with it. This prevents communal, ritualistic and dogmatic tenets to emerge in the person’s world view. The person becomes his/her own existential religious guide in determining faith world views. The person is deeply committed but not held to an objective standard in many cases. The person is usually also more isolated from communal religious bonds.
The purely overt religious but lacking spirituality is an equally dangerous road. The person is more concerned with show and communal approval. The dogmas are more about identity than true motivating source to act. It creates a proudful and pharisaical image that dominates unfortunately American politics and Christian nationalism. It is faith without love, but also faith without true foundation.
The proper balance is the personal and communal that incorporates the individual’s piety with the collective dogmatic creed and ritual of the religion. It balances the arrogance of religious identity but also prevents the subjectivity of wandering spirituality that self serves one’s own desires. It is religion in public and private worship perfectly balanced. An individual who preaches and who also practices one’s faith is a far more healthy spiritual person and one more adept at handling loss and grief. They have identity, ritual and communal support but also deep spiritual understanding of the ritual and faith and it nourishes the soul. It is not a subjective self chosen diet of faith but one that rests upon the tenets of a faith handed down for generations.
Hence healthy faith is critical in responding to loss. Religious and spiritual individuals may respond to loss in very positive ways due to their faith but when faith is not healthy, it can derail the grieving process in mild, moderate or more serious ways.
Issues in Faith and Loss
Christian Counselors, Pastoral Counselors or Grief Counselors when dealing with faith based individuals and loss should always tread easy when first discussing God and loss with a distressed individual. Individuals experiencing loss are no longer intellectual at first. They are in a state of shock and numbness. This follows with denial and an array of emotions, which include sadness, anger and even guilt. Incorporating a comment as “Your child is now with God” or “Your husband is now in Heaven” can cause a very angry reaction towards God. This is not unnatural to have anger towards God. It is not unnatural to doubt God or question God even. Within the first days of emotional distress, this mild adverse reaction which occurs with some believers, even with the most profound faith is not something to be overtly concerned with.
Individuals may only briefly question, or this questioning may persist through the depressive stage of grief as one tries to understand loss and organize it with life’s narrative. This is especially true in more traumatic incidents, when a parent loses a child, or an entire town is destroyed by a tornado. It becomes quite difficult through the depressive and mourning stage to understand God’s presence. Not everyone can show patience like Job and that is OK.
When the loss challenges the faith and doubt emerges, complications within the grieving process can occur. Usually unhealthy faith is more vulnerable to spiritual complications in grieving but it can occur to anyone
Obviously as pointed out, those with an imbalanced faith, poor foundation of faith, or no faith are more subject to negative spiritual reactions about God and the loss. Obviously, one has to take into account support systems and the level of the loss in regards to reactions that are mild, moderate or severe but for most part, those with kinks in the armor of faith are more subject to moderate or severe negative spiritual reactions when dealing with a loss.
In addition to imbalance of spirituality and religious, a lack of understanding of faith can play a key role in negative experiences. Individuals who see prayer as a magic bean and God as a genie willing to grant wishes face a far more difficult grief reaction that an individual who recognizes prayer as communion with God. Likewise, individuals who consider their power of prayer as a sign of their faith and a correlation of their relationship with God are also more subject to negative spiritual reactions in loss. Prayer when it is seen as a contract and not a covenant with God creates a distortion of faith. Instead of seeing God as a genie that grants or does not grant, individuals need to see God as a Father who walks and comforts us. Can God grant our prayers? Yes, but does He always, no!.
Faith that has a strong understanding of the human condition and suffering is key. Within Christianity especially, suffering is seen as part of a fallen existence due to sin. In Christianity, God becomes human and suffers with humanity. Jesus Christ shows individuals that God’s will is not always the easiest or least painful but one that is necessary. If Christ Himself suffered, what can we expect? In the Christian faith, Christian Counselors can utilize the motif of Christ as “Suffering Servant” who suffered first as an excellent coping example when loss and grief occur. Christ suffered first. However, with that suffering and death came also victory. Christ conquered death and rose. So shall all who suffer in Christ, shall rise in Christ.
So while many individuals may feel abandoned or betrayed by God, like Job, like Christ, one can find light at the end of the tunnel. Even Christ, felt abandoned on the cross. It is OK to feel this and important to express it, as Christ Himself expressed. In the Garden and on the cross, Christ felt completely alone and abandoned, but pushed forward in faith. Hence, when we feel alone or abandoned in loss, we must realize that Christ is with us and it is important to emphasize this in Christian Counseling when dealing with loss. Christ is not always here to take away the cross, but He is definitely here to help one carry it.
Finally, in addition to misunderstanding of suffering, those with an unhealthy faith have key misunderstandings of the essence of God Himself. They can easily fall prey to the philosophical traps of the atheistic world which challenges God. The famous query, “How can a Good and All Powerful God permit suffering?” is all too used in atheistic and agnostic circles without rebuttal. If God is good then suffering should not exist, but if suffering exists, then He must not be all powerful, for a good being would never permit suffering. So the atheist or agnostic leaves the suffering individual with only two false options. Either God is not all good and a sadist being, or He is not God and not powerful enough to stop evil and suffering. This two answer only option is the trap. The fact remains, God is both good and all-powerful, but suffering and evil exists because He created intelligent beings in His image with the ability to do good or evil. Evil and suffering is a result of free choice not God. God does not wish to prevent freedom to love or hate because that would be the ultimate rejection of human and angelic freedom. The source of evil is choice, not a good God and God’s power is not in question as He permits the consequences to carry out in a fallen world.
Interventions in Spiritual Complications with Grief
The stages of grief are outlines of human experience with the grieving process. They obviously are not always linear. They can skip steps, revert back to former steps and oscillate between each other in intensity. Different individuals, depending on a variety of subjective circumstances react differently to different losses, but we can form a basis for understanding of the universal reaction to grief and draw a blue print of what is healthy and what is not healthy. When spiritual complications arise, it can derail the grieving process. Spirituality as something that is usually a anchor and help in healing can, as stated, create mild, moderate or even severe complicated grief reactions.
In the first stage, individuals respond with shock, disbelief and denial. Even the most devout and spiritual person will feel the shock and pain of the loss. How could this happen? With emotion swirling, intellect and what one consciously believes can sometimes be swept to the side. The individual may question God, or become angry with God.
For many, mild complications of grief and spirituality can lead the person back to God with more strength realizing their dependence upon God
As grief and the reality of the loss sets in, the individual enters into the dark night of sadness and pain. Some will find consolation in faith, while others may feel a desolation. Some may feel abandoned by God. This is not necessarily a complication but a natural reaction to loss. In this desolation, is there a merely a feeling of “Where are you God”, or is a more intense belief that God does not exist at all, or even a reaction of hatred towards God. While it is still too early, especially considering the varying natures of loss to consider anger towards God or disbelief in God as a severe reaction, it still nonetheless a mild reaction that could complicate spiritual readjustment later. It should be closely monitored to see how it develops in the spiritual life of the person.
In the despair and pain of loss, individuals go through three phases of spiritual reconnection. McCall, in her text, “Bereavement Counseling: Pastoral Care for Complicated Grieving” points out the trials of despair, discernment and conversion during the process of mild, moderate or severe estrangement from God. She mentions that during the despair moment, some individuals never reclaim the peace and joy of God, but instead remain haunted by the loss and a emptiness with God. They are unable to reconcile from the depression and pain, a logical bridge between the loss and their worldview.
It is following this phase, that discernment occurs. The individual either continues breaking down his/her worldview and its incompatibility with the loss, or finally finds guidance from grace or the aid of others to connect the loss with faith and the world view. This leads to renewed energy to seek forgiveness from God. Others discover how much they need God in the loss and despair. Sometimes in the darkest days, we discover how much we need God by our side. We realize that we cannot stand alone but need God. This recognition can lead to a deeper and stronger faith. However, sometimes, it can complicate things with guilt for how one behaved or create a pseudo response where one accepts one’s world view but still nonetheless with less energy and commitment as before. If not, this continues to lead further breaking down of the worldview and faith. When answered it leads to the renewal of faith and rituals, but if does not occur, then the person is unable to reintegrate the faith into one’s life at this point.
These steps are clearly seen in C.S. Lewis’ “Grief Observed” where Lewis experiences the spiritual battle between his faith and the pain and loss of his wife. He writes about his despair and depression and journals his anger and sense of abandonment. (Clearly exhibiting a mild spiritual existential crisis in his life) He however in later chapters discerns the loss, reconnects it with God, and finds meaning. He then reintegrates his faith with the loss.
After suffering, individuals enter the final stages of grief which involve acceptance of the loss. McCall lists a two fold process that involves re-organization as well as recovery itself, albeit recovery is a false word in grieving. Adjustment seems to be a far better word in grieving because no person truly recovers from loss but only learns to adjust to it in healthy ways with meaning. In the case of spirituality, one is able to connect the meaning of loss with their faith and incorporate again a healthy relationship with God via former spiritual practices. However, complications in spiritual grief become severe when this stage is unattainable. The individual does not recover his/her faith in God but instead either hates God or completely denies His existence. In even more adverse reactions, removal of all memories of the faith before, including images or statues occur, as well as a bellicose attitude towards religion or anyone who holds a religious view. The person refuses to attend rituals or pray and has completely removed their previous held worldview. The ability to tie the loss with their previous worldview is impossible. This causes a complication in the grieving process that prevents the person from finding peace or readjusting to the new narrative in a healthy fashion.
As the parable of Christ states, sometimes the seed of faith falls in fertile ground and can overcome all adversity while seeds that fall in thorny ground are never able to produce fruit. This is sometimes the sad reality but as Grief and Christian Counselors, we can try to help individuals in the infant stages of loss with support and love. During the later phases of searching and yearning, we can emphasize the true nature of suffering, its meaning, and how Christ suffers with us. It is important to help and encourage healthy grieving practices that are adaptive and not maladaptive. Support and care can prevent further despair and help the person find gratitude and hope in others and again in God. It can help individuals realize that God is still present despite the loss.
Conclusion
Faith is usually an important anchor in grief adjustment but sometimes due to a variety of reasons it can complicate the grieving process. Faith that is healthy gives connection and meaning to the grieving person to a Deity or Higher Power, as well as worldviews and a communal support system. However, sometimes faith and the loss cannot find meaning and when this occurs an existential crisis can complicate grieving. When previous held beliefs are no longer integrated and tied to the loss, then readjustment into life can become difficult and complications in grief can arise. It is important to identify issues that may arise in spiritual and religious people at the earliest phases and help not only counsel and educate but give them hope that life continues. Christian and pastoral counselors as well as grief counselors can help spiritual individuals find hope in loss.
Christ is the ultimate examples for Christians when dealing with loss and pain. Please also review AIHCP’s Christian Counseling Certification
Please also review AIHCP’s Christian Counseling Certification and see if it meets your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification in Christian Counseling.
For certified grief counselors, please also review AIHCP’s Christian Grief Counselor Program. The program explores grief, loss and suffering from a Christian perspective.
References
C.S Lewis. (1961). “Grief Observed”
McCall, Junietta. (2012). “Bereavement Counseling: Pastoral Care for Complicated Grieving”. Routledge
Additional Resources
Mendoza, M. (2020). “Complicated Spiritual Grief”. Psychology Today. Access here
Williams. L. (2022). “The Missing Link: Spirituality and Grief”. What’s Your Grief. Access here
Feldman, D. (2019). “The Power of Rituals to Heal Grief”. Psychology Today. Access here
“Easing grief through religion and spirituality”. (2015). Harvard Health Publishing. Access here
Grief is a natural reaction to loss. Grief is the price of love and as long as love survives, the bond will never be broken. Even though one may never see the other, the bond remains. How that bond exists is important. If the bond remains and the person is again able to reintegrate into society, then it is a healthy bond, if however, the bond prevents one from living again, then the bond is existing at an unhealthy state. Also bear in mind, whether the loss is death, or any type of loss, complications can occur where one does fully readjust and adapt to the new situation. In all these cases, the grieving process, while natural, became unhealthy due to a variety of issues. In Grief Counseling, we refer to unhealthy adjustment in loss as Complicated Grief.
Complications in grief prevent individuals from successfully navigating the grieving process. Grief Counseling can help
Complicated Grief can be seen as an extreme grief reaction beyond what is defined as normal, or as an absent grief reaction all together. It can also be seen by its manifestations upon the mental, emotional, physical and social aspects of the person, as well as its duration. It can occur at any point within the grieving process and keep a person at a particular stage of his/her grief.
Some cases of grief are more susceptible to complications in grieving, albeit not guarantees of complications. Such losses that are extremely traumatic as found in war, natural disaster, rape, grotesque displays of death, and acts of terrorism can have more serious imprints upon the brain and cause PTSD and grief complications that prevent the evil from being processed. In addition, extremely painful losses such as the loss of a child or parent, or suicide can have a more impactful sting to a person’s recovery. Finally, sudden losses can also shock the system. If a loved one is murdered, dies in a car crash, or one is suddenly faced with a personal loss or injury, then grief responses can be become complicated
Grief Counselors have a special role in monitoring grief trajectories to ensure they remain steady and on normal pace. While everyone grieves uniquely, there are general human responses to loss that involve stages of denial, anger, bargaining, emotional distress, restructuring and re-adjusting to the loss itself. Within this, individuals may bounce back and forth between stages, or oscillate in extremity of emotion from day to day, but there is a general measurement that is not equated as pathological. Grief Counselors who are not licensed counselors need to spot complications in grief and refer patients to licensed counselors when depression or complicated grief appears. Licensed Counselors with expertise in grief can then help the person unblock the impasse that permits the person to continue the grieving journey.
It is important to note that grief is not a pathology and individuals suffer from loss and the imbalance it causes for the rest of their lives, but what is pathological is inability to readjust to living life. It is also important to note that the degree of the loss and attachment play a key correlation with the time to normally recover from a loss. Time and duration are difficult assessments with deep emotional pain when grading it with a loss. The attachment and how the person is progressing sometimes needs to be evaluated to see if the person is stuck in complication or merely still progressing at a natural rate.
Key Signs of Complications
Acute grief is extremely painful. Someone in acute grief cannot function at first. They are emotionally unable to rationalize, they cannot interact with others, and have no meaning for the loss. One cannot find complications in acute grief because the grief is raw and new. In fact, the extreme pain in acute grief is natural and important in the grieving process itself. When someone is experiencing acute grief symptoms months or years later, depending on the loss, then one can better access if complications have occurred. If a person is still extremely emotional over the loss as if it just occurred and is unable to process it and feels depression to the point it is crippling to life, then this is a sure sign of a complication. These emotional intense pains will creep into every aspect of the person’s life. One’s physical health, stress levels, sleeping patterns and immune response can all take hard hits. In addition, one’s mental health can decline as a constant state of depression emerges over the person. Life will no longer have any meaning to the person. Happiness will be unattainable in any activity. One’s social life will become isolated. One may resign from past activities that gave oneself joy and completely disassociate from family and friends. This will negatively affect profession and career and academics. Finally, one will maladaptively cope with the issue through possible drug use. As pointed out, the absence of grief can also be a sign. Maladaptive coping that prevents the person from recognizing the loss can occur. Individuals may deny the grieving process by keeping oneself busy. One may avoid cleaning out a deceased’s closet after a year. These are also signs of not adjusting to the loss in a healthy way.
Complications within the Trajectory
When someone denies a terrible reality or loss, they are naturally protecting themselves. This is normal in grief reaction, however, if denial persists, then the processing of the loss can never take place. If a grief counselor discovers constant denial, avoidance of the subject, the person’s possessions, or areas where the person died, then there are chances of a complication in the grieving process that have prevented the person from moving forward in the denial phase. It is no longer healthy but has become a toxic maladaptive coping mechanism.
If someone experiencing extreme adverse emotions beyond the initial acute phase of grief, then there are also signs of complications within the grieving process. Individuals may be extremely angry, sad, or guilty even over a death. Complicated relationships with the deceased, how the deceased passed, a person’s role in the passing of the deceased, unresolved issues with the deceased, and not expressing emotion earlier in the loss can lead to a mass of untamed emotions. One needs to discuss these emotions and why they are exhibiting themselves later in the grieving process. Through grief counseling, one can better understand the source of the emotions and help individuals come to grips with how they felt about the person, the person’s death and their emotions in relationship to it.
Becoming stuck in grief is a sign of complicated grief. An individual is trapped in the grieving process and unable to adjust to the loss in a healthy way
Someone who is suffering over depression, or suffering from pro-longed grief have exceeded any normal time frame. Again time frames and duration of grief can vary, but a good grief counselor can calculate if someone is experiencing excessive duration and depression. When the person has lost meaning to life and is unable to find happiness over an extended period of time after the loss, then the person needs professional aid in fighting off the depression which may be chemically based as well.
Other individuals suffer from an inability to reorganize their lives and find meaning the loss. They are unable to live with the loss but still live from day to day. Individuals may not be able to make new connections or tie the loss of the past to the present and future. They remain stuck in the past and unable to proceed into new venues. They feel obligated to the past. They may utilize maladaptive practices such as drugs to cover feelings or ignore new events. They may not be able to visit a grave, or discuss the loss. The deceased’s past is only of pain, with no remembrance of happiness or smiles. Healthy grieving permits one to have both sad and happy memories. It allows one to make new connections with people without feeling a betrayal to the deceased. It permits one to find meaning in the deceased’s life and push forward with that meaning into other venues or social agendas.
Resiliency
Most individuals who grieve losses face difficult acute phases but grieve naturally. They are able to process the loss and move forward in life despite the pain. For the percentage who does not grieve normally, one should not consider weak. Resiliency to loss has many factors. The nature of the loss itself has a large impact to the adjustment to it. Again, objective natures of loss can play a key role into how one recovers. Traumatic, stigmatic, sudden, or severe loss can play key role in preventing processing of a memory or loss. Others who face complications may have family history of depression and a natural serotonin imbalance, hence reducing resilient behavior. Still others without emotional support can face a difficult uphill battle in adjusting to the loss. Individuals with family and social support have an easier time healing from loss than those alone or with unsupportive friends and family. Others have proper guidance to avoid maladaptive coping mechanisms such as drinking and find guidance in support groups that offer other venues to cope with loss. Prayer, mediation, exercise and hobbies are ways they adjust to the pain and loss itself. Finally, individuals whether religious or not that hold to some world view to anchor them have a better chance of adjusting to loss over time.
Conclusion
Hence when grief is not processed properly, complications can occur within any point within the trajectory. Complications manifest in extreme emotions or lack of emotions well beyond the acute phase of grief and duration of these emotions exceed normal process ranges. They prevent the person from moving forward and adjusting to the loss in a healthy way. Grief Counselors play a key role in helping individuals remain on a healthy trajectory, with special care to the unique grieving situation. Licensed counselors who are also grief counselors can play a key role in helping those who fall off the healthy trajectory and help them again find the care they need to find adjustment to the loss.
Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals
Again it is important to note that grief is normal. It is natural and healthy process. Grief is not an imbalance that needs corrected. There is no true recovery but more so a process that leads to acceptance of the loss and finds meaning in the loss.
To better help others through the grieving process, the American Academy of Grief Counseling and AIHCP offers a four year Grief Counseling Certification for qualified professionals. The program is online and independent study and open to those interested in helping others navigate the murky waters of grief. Please review AIHCP’s Grief Counseling Program and see if it meets your academic and professional goals.
“Complicated Grief.” The Cleveland Clinic. Access here
Sutton, J. (2022). “How to Treat Complicated Grief in Therapy: 12 Examples”. Positive Psychology. Access here
Shear, K. et, al. (2013). “Bereavement and Complicated Grief”. Psychiatry Rep. 2013 Nov; 15(11): 10.1007/s11920-013-0406-z. National Library of Medicine. Access here
Talbbl, R. (2017). “Six Signs of Incomplete Grief”. Psychology Today. Access here
Complicated Grief is a result of not naturally processing through the grieving cycle. It can result in Prolonged Grief, or turn into a Clinical Depression. Complications in grief are due to the nature of the loss, the subjective uniqueness of the person experiencing grief, or other supporting factors or lack of. Please also review AIHCP’s Grief Counseling Certification
Grief is natural but sometimes it can go wrong during the adaptation process. Individuals can fall into grief complications. Prolonged Grief is one type. Usually complications to loss are due to a variety of reasons regarding the nature of the loss, a persons own coping abilities and support. Prolonged Grief can turn into Depression if not careful. When complications in the grieving process manifest beyond normal grieving, it is important for individuals to find help from a licensed counselor who is certified or well versed in grief counseling.
Prolonged Grief is a complication in the grieving process. Please also review AIHCP’s Grief Counseling Certification
The article, “What Is Complicated Grief?” by Markham Heid takes a closer look at the nature of Complicated Grief, its symptoms and how to deal with it. He states,
“Complicated grief is now called ‘prolonged grief disorder,’” says M. Katherine Shear, MD, the author of the study in The New England Journal of Medicine and the Marion E. Kenworthy professor of psychiatry at Columbia University in New York, who studies grief and bereavement. “The difference between normal or healthy grief and prolonged grief is related to whether certain defensive responses that are a normal part of early grief become persistent and overly influential in mental functioning.”
Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification as a Grief Counselor.
