Grief is one of the most universal human experiences, and one of the least well supported. We lose people we love, relationships we depended on, futures we had imagined, and versions of ourselves that were bound up with what we’ve lost. The expectation that grief will follow a recognisable course and ease within a predictable timeframe is rarely matched by the reality of how it actually feels.

I work with adults navigating grief in its many forms, including bereavement by suicide, for which I have specialist training.

What Grief Can Look Like

Grief doesn’t always look the way we expect it to. It can arrive as sadness, but also as anger, numbness, guilt, relief, or a disorienting flatness. It can surface months or years after a loss, triggered by something that seems unrelated. It can feel manageable one day and completely unmanageable the next. It can also be complicated by the nature of the relationship with the person who died, particularly when that relationship was ambivalent, estranged, or involved harm alongside love.

Not all grief is about death. People also grieve the end of significant relationships, the loss of health, the loss of a role or identity, parents who were present but emotionally absent, and the futures they had hoped for. These losses are real and they deserve the same attention as bereavement.

Complicated Grief

For most people, grief is painful but gradually eases over time as they adjust to a life that has changed. For some, grief doesn’t follow that course. The intensity remains or worsens rather than softening. Daily functioning becomes difficult to sustain. The loss remains as present and acute as it was in the early weeks, sometimes for months or years.

This is sometimes called complicated grief or prolonged grief disorder, and it is more common than is often recognised. It isn’t a sign of weakness or of grieving wrongly. It often reflects something about the particular loss, the relationship, the circumstances of the death, or earlier experiences that the current grief has touched.

Signs that grief may have become complicated include:

• Intense and persistent longing for the person who died that doesn’t soften over time
• Difficulty accepting the reality of the loss, even months or years later
• Bitterness or anger about the death that feels stuck rather than moving
• A sense that life has no meaning or purpose without the person who died
• Withdrawing from relationships or activities that previously mattered
• Significant guilt about things said or unsaid, done or left undone
• A feeling that part of your own identity died alongside the person you lost
• Worsening of pre-existing difficulties including depression, anxiety, or PTSD
• Thoughts of suicide or self-harm

These responses are understandable in the immediate aftermath of loss. It is when they persist beyond six months, or show little sign of easing, that professional support is likely to be helpful.

Factors That Can Make Grief More Complex

Research identifies several circumstances that increase the likelihood of complicated grief developing. These include:

• A death that was sudden, traumatic, or unexpected, including death by suicide, accident, or violence
• A loss where the death feels preventable
• A relationship that was complicated, ambivalent, or involved abuse alongside care
• Experiencing multiple losses in a short period
• A strong dependency on the person who died
• Circumstances that prevented normal mourning, including deaths during the pandemic, deaths in geographically distant locations, or estrangement that meant there was no opportunity to say goodbye
• Previous experiences of loss, trauma, or depression that the current grief has reactivated

Bereavement by Suicide

Losing someone to suicide brings its own particular grief. Alongside the loss itself, there is often profound shock, guilt, unanswerable questions, and a sense of stigma that can make it harder to talk about openly. The grief can feel entangled in a way that ordinary bereavement doesn’t always prepare you for. I have specialist training in supporting people bereaved by suicide and am experienced in working with the specific dimensions this kind of loss involves.

How I Work With Grief

My approach to grief is relational and psychodynamic. That means I’m interested not only in the loss itself but in your inner world, your memories and your relationship with the person who died, the grief that may have been present before this loss, and the ways the past is shaping how you experience the present.

Grief doesn’t need to be fixed or resolved on a timetable. What therapy offers is a space where the full weight of a loss can be brought without managing it for someone else’s comfort, where grief that has become stuck or complicated can receive careful attention, and where you don’t have to carry it alone.

If you’d like to explore whether working together might help, I’d be glad to have an initial conversation. Get in touch at samanthamerry.co.uk/contacts.

References

Eisma, M. C., Boelen, P. A., & Lenferink, L. (2020). Prolonged grief disorder following the Coronavirus (COVID-19) pandemic. Psychiatry Research, 288, 113031.

Shear, M. K. (2012). Grief and mourning gone awry: Pathway and course of complicated grief. Dialogues in Clinical Neuroscience, 14(2), 119–128.

Simon, N. M. (2013). Treating complicated grief. JAMA, 310(4), 416–423.

Herman, J. L. (1992). Trauma and Recovery. Basic Books.