Prolonged and Complicated Grief Therapy
What Is Prolonged Grief Disorder?
Prolonged Grief Disorder (PGD), sometimes called Complicated Grief, occurs when grief remains intense and continues to significantly impair daily life long after a bereavement. A person may feel emotionally stuck, unable to accept the loss, disconnected from life, or unable to move forward. The longing, yearning, and emotional pain remain so overwhelming that relationships, work, wellbeing, and everyday functioning are affected. Prolonged Grief Disorder can develop after the death of a partner, child, parent, sibling, friend, or other significant attachment figure. It is more common following sudden, traumatic, unexpected, or highly significant losses.
What Is Complicated or Prolonged Grief Disorder?
Complicated grief, also known as Prolonged Grief Disorder (PGD), occurs when the emotional pain of a loss remains persistently intense and continues to significantly affect daily life over time. Symptoms may include ongoing yearning for the person who died, emotional distress, intrusive thoughts, guilt, numbness, difficulty accepting the loss, and difficulty reconnecting with life after bereavement. The grief feels stuck, making it difficult to adapt to a world without the person who has died.
Can Prolonged Grief Disorder and Traumatic Grief Be Healed?
Yes. Healing from prolonged grief disorder and traumatic grief is possible. When grief becomes overwhelming or the loss itself was traumatic, the natural grieving process can become interrupted or blocked.
Trauma-informed therapies such as EMDR, Deep Brain Reorienting (DBR), Internal Family Systems (IFS), and somatic approaches can help process the trauma surrounding the loss, reduce emotional overwhelm, and create the safety needed for healthy mourning.
Healing does not mean forgetting the person who died. It means finding a different way of carrying the relationship, processing the pain of the loss, and gradually reconnecting with life, meaning, and inner safety.
Complicated Grief: Key Insights
- Complicated grief is more than sorrow. It can affect identity, relationships, daily functioning, and a person’s ability to engage fully with life.
- Traumatic loss can trigger PTSD. Intrusive memories, nightmares, avoidance, hypervigilance, and emotional numbness may occur alongside grief.
- Attachment patterns influence grief. Unresolved conflict, dependency, abandonment fears, and complex relationships may make adaptation to loss more difficult.
- Grief can reactivate earlier wounds. Previous losses, attachment injuries, childhood trauma, and feelings of loneliness may resurface following bereavement.
- Healing is possible. EMDR, DBR, Internal Family Systems (IFS), and somatic therapies can help people process loss safely and restore connection, meaning, and wellbeing.
What Does Complicated Grief Feel Like?
People experiencing Complex Grief or Prolonged Grief Disorder often describe feeling as though life stopped at the moment of the loss while everyone else continued moving forward.
Although they know intellectually that the person has died, emotionally it can feel impossible to fully accept the reality of the loss or adapt to a life without them.
- Persistent yearning or longing for the person who died
- Difficulty accepting the loss
- Feeling emotionally numb, disconnected, or detached
- Intense sadness, guilt, regret, anger, or loneliness
- Avoiding reminders of the loss
- Feeling unable to imagine a meaningful future
- Loss of purpose, identity, or direction
- Difficulty reconnecting with relationships and everyday life
Many people describe feeling caught between wanting to hold on to the person they lost and wanting relief from the pain of the loss. This inner conflict can leave grief feeling stuck, overwhelming, and difficult to move through naturally.
Normal grief, Prolonged Grief Disorder (PGD), and PTSD following a traumatic loss can overlap. Shock, sadness, yearning, and emotional pain may be present in all three, but the grieving process differs.
| Normal Grief | Prolonged Grief Disorder | PTSD Following Loss |
|---|---|---|
| Natural response to losing someone important | The attachment pain of the loss remains overwhelming and difficult to integrate | Shock and trauma disrupt the normal grieving process |
| Grief comes in waves | Persistent preoccupation with the person who died and difficulty shifting attention away from the loss | Avoidance of reminders alongside intrusive memories of the circumstances of the death |
| Sadness and longing gradually soften over time | Persistent yearning and difficulty accepting the loss | Flashbacks, nightmares, hypervigilance, and distress linked to the traumatic event |
| Gradual adaptation to life after the loss | Feeling emotionally stuck and unable to move forward | Nervous system remains organised around threat, danger, and survival |
| Memories bring sadness and comfort (bittersweet) | Memories trigger intense longing, pain, and difficulty accepting reality | Memories trigger fear, distress, shock, or traumatic re-experiencing. The distress is also from not being able to access heart-felt memories of connection. |
Key Takeaway: Prolonged Grief Disorder is primarily centered on persistent longing, attachment pain, and difficulty adapting to life after the loss. PTSD following a traumatic loss is primarily centered on unresolved shock, threat, fear, and traumatic memories surrounding how the loss occurred.
Many people experience both Prolonged Grief Disorder and PTSD at the same time. In these situations, therapy may need to address both the attachment pain of the loss and the unresolved shock or trauma associated with how the loss occurred.
Common Triggers in Complicated Grief
Complicated grief can be reactivated by reminders of the person who died, the relationship, or the circumstances surrounding the loss.
- Anniversaries, birthdays, and holidays
- Family gatherings and important life milestones
- Songs, smells, places, photographs, or personal belongings
- Seeing others experience what has been lost
- Dreams, memories, or reminders of the person
- Unfinished conversations, regrets, or unresolved conflict
- Major life transitions that highlight the person’s absence
Clinical Insight: Triggers are a normal part of grieving. However, if reminders of the loss repeatedly lead to overwhelming distress, depression, anxiety, panic attacks, emotional numbness, or significant difficulties in daily functioning, it may be helpful to seek a professional assessment.
Concerned that grief may have become stuck or overwhelming?
Book a Confidential Consultation with Dr. MilliaCoping Patterns in Complicated Grief
To survive the pain of loss, people often develop coping strategies that help them manage overwhelming emotions, loneliness, shock, or the reality of what has happened.
- Avoiding reminders of the loss
- Staying constantly busy
- Emotional numbing or shutdown
- Withdrawing or isolating from others
- Using food, alcohol, work, exercise, or screens to cope
- Feeling unable to speak about the person who died
- Avoiding people, places, or activities linked to the loss
These coping patterns are often attempts to protect against overwhelming emotional pain. The unbearable pain may be hard to turn to without numbing or soothing it.
Need Support? It is not always easy to speak openly about grief with family or friends. A compassionate and confidential therapeutic space can help you understand your responses to loss and process grief safely.
Can Unresolved Grief Be Helped?
Yes. Working through grief does not mean forgetting the person who died or “moving on” as though the loss did not matter. It means gradually finding a way to carry the relationship differently, reduce emotional pain, process traumatic aspects of the loss, and reconnect with life, meaning, and inner safety.
How Different Therapies Help With Traumatic Grief
Traumatic grief can involve shock, attachment pain, intrusive memories, guilt, emotional overwhelm, and difficulty adapting to life after a loss. Different therapies work at different levels of the grief experience.
Therapy | How It Understands Grief | Focus of Healing |
|---|---|---|
EMDR (Eye Movement Desensitization and Reprocessing) Therapy for grief | Traumatic grief occurs when distressing memories of the loss remain emotionally and physically overwhelming. The nervous system becomes stuck in shock, guilt, intrusive memories, or traumatic aspects of the loss. | Helps the brain reprocess traumatic memories, reduce emotional distress, and allow grief to integrate more naturally over time. |
IFS (Internal Family Systems) Therapy | Helps to soften up the protective parts of the system holding the pain of loss and grief. Parts that organize themselves to cope and prevent emotional flooding and overwhelm. | Helps build compassionate relationships with the protective parts, reducing the system’s internal conflicts that may have come from differing needs and fears and supporting emotional healing. |
DBR (Deep Brain Reorienting) Therapy for PTSD | Traumatic grief often begins with shock. The nervous system may become frozen at the moment the loss was discovered or realized, preventing the grief from fully unfolding. | Works with the brain’s earliest orienting and shock responses, helping process attachment pain and grief that feels deeply held, stuck, or difficult to access. |
Key Takeaway: EMDR primarily helps process traumatic memories, IFS helps heal the emotional and relational impact of the loss, and DBR helps resolve the shock and attachment pain that may keep grief feeling stuck. These approaches can also be integrated depending on the individual’s needs.
When Should Someone Seek Help for Grief?
Grief therapy may be helpful when the emotional pain of a loss remains persistently overwhelming or begins to affect daily functioning, relationships, sleep, concentration, or emotional well-being.
People may benefit from support if they experience ongoing guilt, intrusive memories, rumination, emotional numbness, anxiety, panic attacks, isolation, or difficulty coping following a loss.
Trauma-informed grief therapy provides a safe and compassionate space to process grief, traumatic distress, and unresolved emotional pain while supporting healing and emotional integration over time.
🔗 Related Trauma & Therapy Resources
Explore related trauma, grief, attachment, and therapy resources.
Healing shock, attachment wounds, and traumatic grief. EMDR Therapy
Processing distressing and overwhelming memories. IFS Therapy
Working with wounded and protective parts. Complex PTSD
Understanding developmental and prolonged trauma. PTSD Therapy
Trauma-focused treatment and recovery. Attachment Trauma
How early relationships shape emotional well-being.
Need support for grief, trauma, PTSD, or attachment wounds?
Book a Confidential Consultation with Dr. MilliaFAQs — Grief & Therapy
These are some of the most common questions people ask when navigating grief, loss, and the fear of beginning therapy.
Will I ever overcome the loss of my loved one?
Can grief get better?
How long does it take to come to terms with grief?
I still feel traumatised by my loss — will I ever heal?
Will therapy make me relive my painful loss?
I am afraid to go to a therapist for my grief — is that normal?
Will therapy make me forget the person I lost?
How does therapy help with grief?
About Dr. Millia
Dr. Millia Begum
is a trained trauma specialist with over 25 years of clinical experience in psychiatry and therapy. She trained in the UK’s NHS system and served the NHS in various senior roles.
She is an EMDR International Approved Consultant, an EMDR researcher, and a board member of the EMDR Association UK. She integrates Deep Brain Reorientation Therapy in her practice. Dr. Millia is a Certified Internal Family Systems (IFS) Therapist, bringing a compassionate, parts-informed approach to her work with clients in Dubai.