Several years ago I noticed a posting on Facebook of a woman telling a friend that she had been grieving “too long” and telling her to “just get over it already.” How long is too long to be grieving?

“At the temple, there is a poem called ‘Loss’, carved into the stone. It has three words ... but the poet has scratched them out. You cannot read ‘Loss’ ... Only feel it.” from “Memoirs of a Geisha”

Most of my adult life I’ve heard about the five stages of grief described by Elisabeth Kubler Ross: denial, anger, bargaining, depression and acceptance. They can occur in any order and one can revisit any of the stages again. Many people believe it’s like being in school, you do one step at a time and then you graduate. Except, what if you never graduate? My grandmother had nine children. Her second son died in childhood. My dad was her youngest son, so my grandmother was on the high side of middle age when I was born, and she lived to be 72 years old. She never “got over” the fact that she had lost a son. Most people who knew her probably didn’t know about her lost child. She was a very private person.

However: She. Never. Got. Over. It.

My favorite article about dealing with grief is “Getting Grief Right,” By Patrick O’Malley, a psychotherapist in Fort Worth, Texas. O’Malley states about the five stages of grief and healing:

“THAT model is still deeply and rigidly embedded in our cultural consciousness and psychological language. It inspires much self-diagnosis and self-criticism among the aggrieved. This is compounded by the often subtle and well-meaning judgment of the surrounding community. A person is to grieve for only so long and with so much intensity.

"To be sure, some people who come to see me exhibit serious, diagnosable symptoms that require treatment. Many, however, seek help only because they and the people around them believe that time is up on their grief. The truth is that grief is as unique as a fingerprint, conforms to no timetable or societal expectation.”

No doubt the stages of grief have helped a lot of people through a terrible ordeal. But, what if they don’t? What is the definition of prolonged grief?

Although the previous Diagnostic and Statistical Manual of Mental Disorders, (DSM-IV) excludes prolonged grief as a mental illness, stating that “it is an expected and culturally sanctioned response to a particular event;” the most recent DSM-V has included it as a potential disorder mainly to raise awareness that should a person show symptoms of “persistent complex bereavement disorder” as it is named, they are at a higher risk of having long term problems. They state that normal grief usually only lasts six months or less. A prolonged grief reaction lasts longer than six months and includes intrusive thoughts related to the loss of the person, intense feeling of emotional pain, or yearning for the lost person. It also must include five or more of the following: 1. Confusion about self identity/role. 2. Difficulty accepting the loss. 3. Avoidance of reminders of the reality of the loss (denial). 4. Difficulty trusting others. 5. Bitterness and anger. 6. Difficulty moving on. 7. Numbness (absence of emotion). 8. Feeling that life is empty. 9. Feeling stunned, dazed or shocked. If you or someone you know is experiencing any of these symptoms, it may be time to seek help.

Remember though, not everyone who has grief, even long term will have a disorder. However, the dangers of abnormal or prolonged grief that are not taken care of could be depression, anxiety and ultimately suicide.

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