Rethinking Grief Narratives: Is it Time to Normalise the Outlier?
Complicated/Prolonged Griefs – Global Story of New Normal

Grief can be described as series of responses to an unexplainable hole in one’s emotional self as a result of loss by death, through ill health, part of ourselves, or something valuable
Over centuries, scholars have tried to understand the responses that should be ‘normal’ processes of grieving. In order to understand these ‘normal’ processes, theorists have propounded a number of theories. Based on the ‘normal process’ concept, scholars generally agree that
- Grief is a process that run at its own pace but time-limited.
- Everybody’s grief is unique and different.
- There is no right way to grieve.
- Strong emotions and thoughts are part of grief.
Most grief theories tend to focus on the ‘ normal’ and ‘individualised’ griefs. Situations like the recent COVID-19 pandemic makes us question our grief models and their normality and individualistic constructs. The grief of the pandemic cut across global, international, national, cultural, belief boundaries. It goes beyond the ‘normal’ and time-limited framework originally believed. If humanity in itself is complex, how then do we try to understand grief in a simple stage or phase process as proposed by prominent theorists such as Bowlby’s (1996) four phases of grief, or Kubler-Ross’ (1969) five stages of grief?
Just like the established binary response-stands of either ‘letting go’ or ‘continuing bond’. How about ‘ embracing the uncertainty’ ? Many people often try to make sense of the grief and tend to put pressure on themselves to accept either to ‘let go’ or ‘continue the bond’. It is also okay to just ‘ embrac e the uncertainty’ of the situation. It can also be okay not to know or have answers to the whys of the situations. I am aware that the fundamental reason why we feel the urge to make the either/or decisions is because we interpret uncertainty as threatening. The interpretation is what ends up causing or exacerbating anxiety, PTSD depression, etc. that people experience during bereavement and grief period.
Hence
·rather than focusing on the probabilities of the unknown, we could focus on the beliefs about uncertainty .
·rather than classifying grief into ‘normal’ or ‘abnormal’, we could focus on the uniqueness of individual’s grief
·rather than grouping grief into simple/linear process or complicated/prolonged grief, we could focus on the underpinning factors of grief
COMPLICATED/PROLONGED GRIEF: A NEW NORMAL
Before now, complicated/prolonged grief is said to occur in a small percentage (10%) of the population. One wonders if this is the case because we were measuring grief with the wrong scores. With the current global grief, we have seen various human expression of grief in ways that have not been documented. People are easily triggered into
·mob actions,
·rebellious behaviours,
·dismissal of reality,
·engagement in risky behaviours, and
·exaggerated fear of the unknown.
These expressions seem to be a new normal ways expressing global or group grief – the aftermath of the Pandemic. Before now, these behaviours would have been classed as abnormal. The pandemic loss and the consequent grief expressions seem to be telling us that there are still a lot to be learnt about grief especially from the ‘group grief’ perspectives.
Grief is often explained in terms of time-limited, severity, ability to accept the situation, and moving on with life. Scholars holds that during the first few months after a loss, many signs and symptoms of ‘normal grief’ are the same as those of ‘complicated grief’. However, while normal grief symptoms gradually start to fade over time, those of complicated grief linger or get worse. One wonders if we have organised the grieving process in this binary way so that we can have a clean resolution to the chaos or uncertainty often faced during grief.
Signs and symptoms of complicated grief may include:
1.Intense sorrow, pain and rumination over the loss of your loved one
2.Focus on little else but your loved one's death
3.Extreme focus on reminders of the loved one or excessive avoidance of reminders
4.Intense and persistent longing or pining for the deceased
5.Problems accepting the death
6.Numbness or detachment
7.Bitterness about your loss
8.Feeling that life holds no meaning or purpose
9.Lack of trust in others
10.Inability to enjoy life or think back on positive experiences with your loved one
Complicated grief also may be indicated if the person continues to:
1.Have trouble carrying out normal routines
2.Isolate from others and withdraw from social activities
3.Experience depression, deep sadness, guilt or self-blame
4.Believe that you did something wrong or could have prevented the death
5.Feel life is not worth living without your loved one
6.Wish you had died along with your loved one
LEVELS OF GRIEF SUPPORT
Just as it is the individual that can truly assess the nature or severity of grief, they are the central person to decide the kind of help they want and need. Generally, there are three main levels of grief support:
LEVEL 1: GENERAL SUPPORT & INFORMATION
The first level of grief support involves offering general support and information. Most people who experience loss will only require first-level support, which involves providing people with information on the grieving process, practical help with tasks, and social support. Family, friends, and colleagues are often able to provide much of this support. The person needs to feel adequately supported for it to be appropriate
LEVEL 2: EXTRA SUPPORT
Some people may need extra support through their grief. Extra support might be needed if:
- The grieving person feels that they are still not coping well with the first level support.
- There are not enough network support (friend and family) for the grieving person.
- The grieving person is unable to discuss their feelings with family and friend because they do not wish to upset them.
This level of support provides the opportunity for the person to reflect in a focused way on their experience of loss. This support can be provided as 1-2-1 or in groups and is used for both adults and children. The providers may be: self-help groups, faith groups, and community groups. The providers are trained to provide a listening ear, to help people talk about their experience, and to support them in finding their way through their grief.
LEVEL 3: THERAPY SUPPORT
This level of support is provided by specialised professionals (Psychologists, Psychotherapists, Counsellors, and Doctors with psychotherapy training).
No experience of grief is easy and the circumstances surrounding certain deaths (e.g. devastated effects of COVID-19 pandemic) can cause additional difficulties for those left behind. People do not have to go through the first two level of support to access professional help. If they feel that they wish to be managed by professional, then they need to access such support.
In a global grief as we have seen with the COVID-19 pandemic, it is important that we, as health professionals, have a group as well as individualised perspective of grief symptoms and the help we offer our patients/clients. We may also have to lean towards an integrated approach to therapeutic support because no one model will be able to fit all nuances of current grief presentation.
If you need professional help, please contact us at dr.oby@fcc-clinics.com / www.fcc-clinics.com
Stay Safe and Psychologically Connected
Dr.Oby@FCC Clinics - Global Healthcare









