Every person experiences grief differently. You may even experience different losses in different ways. There can be a wide variation in intensity and duration, often proceeding in fits and starts. It is a process, not a state. A clinician needs to make a judgement about whether a person’s grief is progressing adaptively in order to determine whether or not to intervene.
There are two easily distinguishable forms of grief.
- Acute grief occurs in the immediate aftermath of loss, can be very painful, and may include behaviors that are not normally acceptable in daily life.
- Integrated or abiding grief follows (and perhaps never fully dissipates) wherein the person finds their way back to a normal fulfilling life.
Uncomplicated (normal) grief does not require formal treatment or intervention, though empathetic support and validation of a person’s feelings are appropriate whether grief is normal or complicated. Complicated grief is a syndrome of prolonged and intense (acute) grief associated with substantial impairment in work, health and social functioning, resulting from the inability to transition from acute to integrated grief.
Complicated Grief Treatment (CGT) combines cognitive behavioral techniques with interpersonal psychotherapy and motivational interviewing, and has demonstrated significantly better outcomes than standard psychotherapy. Psychotropic medications and standard grief-focused supportive psychotherapies do not work as well to treat this syndrome.