When Anne Schomaker lost her husband in 2002, she did everything you’re supposed to do to heal from grief. She went to therapy, she volunteered, she traveled, she took up new hobbies, and she dated. To the outside world, she looked like she was moving on. To the outside world, it looked like she was healing the “right” way. But inside, she was frozen in mourning, unable to move forward emotionally. Nine years after the death of her husband, nightmares still haunted her in her sleep and she avoided reminders that would push her further into despair, such as the arias from the operas they had enjoyed. “I wasn’t really doing well. I had terrible pangs of sadness and despondency. I was missing my husband so badly. The pain just didn’t go away.”
Complicated bereavement is a disruption of the normal grieving process after a loss. While the loss of a loved one can be expected to be deeply painful and elicit emotional distress long after the loss has occurred, the symptoms of grief usually dissipate over time. Sometimes, however, healing does not occur. Instead, you become locked in a state of ongoing mourning; the emotional wound of your loss remains wide open and you are unable to move on. You may be preoccupied with constant thoughts of your loved one, experience intense longing, and be overwhelmed with feelings of sorrow, numbness, or anger. You may feel intense loneliness, even when you are surrounded by others, and may go out of your way to avoid reminders of the person you have lost. Or you may do the opposite—you may surround yourself with objects that make you feel close to your loved one, continuously return to the places that elicit memories of your time together, and live as if you are constantly waiting for their return. You are especially likely to experience complicated bereavement if you lost a loved one suddenly and unexpectedly, without the opportunity to emotionally prepare yourself for their death.
Many people with complicated bereavement are encouraged by well-meaning friends and family to move on, and you may feel that your emotional state is nothing more than a personal shortcoming. You’re told that you’re not grieving the right way. However, research indicates that complicated grief is actually a complex psychological illness with a neurological basis. A study by Mary-Frances O’Connor, published in NeuroImage, examined the effect of grief on brain function via functional magnetic resonance imaging. When people with complicated bereavement were shown pictures of their loved ones, “the nucleus accumbens – the part of the brain associated with rewards or longing – lighted up.” Those who experienced “normal patterns of grieving” exhibited markedly less nucleus accumbens activity.
This area of the brain is also associated with the longing for alcohol and drugs, suggesting that memories of loved ones may actually have an addictive effect on those with complicated bereavement, providing a new understanding of why you are unable to move beyond acute grief. As Dr. O’Connor says, “It’s as if the brain were saying, ‘Yes I’m anticipating seeing this person’ and yet ‘I am not getting to see this person.’ The mismatch is very painful.” Recognizing the neurological underpinnings of complicated bereavement may help researchers and clinicians develop more effective treatment protocols. More importantly, it may help you better understand your experience and reduce the feelings of self-blame and shame you may feel.
Unfortunately, the addictive qualities of your memories may also lead you to develop other addictions. In your attempt to cope with the overwhelming pain of your loss, you may have turned to drugs or alcohol or even food, compounding your emotional distress and presenting new dangers to your well-being. While using substances to escape psychological suffering is common among people experiencing grief, people with complicated bereavement are particularly vulnerable to developing substance addiction issues as they seek to soothe themselves from severe and ongoing mourning. However, any relief you find is only temporary and once the effects of the alcohol or drugs wear off, you’re back where you started or even worse off, as the effects of the substances themselves exacerbate your distress. The resulting cycle of grief and addiction can have serious implications for your ability to function, your physical health, and your fragile psychological state.
If you are suffering from complicated bereavement and a co-occurring substance addiction, healing is within reach. However, effective treatment requires specialized care designed around your unique needs to address the full scope of your emotional and behavioral health issues. In practice, this means that both your grief and addiction must be treated simultaneously to ensure that you process your state of bereavement while attending to the physical and psychological effects of your substance use.
Through comprehensive clinical care, you can develop the skills you need to move forward with your grieving process, cope with your pain in healthy, productive ways, and regain your sense of joy and possibility. Meanwhile, you will learn how to gain control over your addictive drive toward harmful substances as well as safely exploring the complex relationship between your use and your grief to give you a complete picture of your psychological state within an environment of hope and support.
The goal of treatment is never to minimize the loss of your loved one, but to discover ways of expressing, understanding, and coping with that loss in ways that are nourishing, revitalizing, and restorative. With the right therapies delivered with compassion and respect, you can begin the process of meaningful recovery to reawaken your spirit and enhance your quality of life.
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