Understanding complex grief
Summary
Worden's Mourning Tasks
The grief tasks described by William Worden offer a useful framework for understanding the processes involved in working through loss, provided they are understood as flexible and non-linear processes .
The tasks of grief can thus be understood as possible paths of elaboration, which are especially tense when the bond has been very significant or the circumstances of the loss have been adverse, unlike the phases of grief, described as more linear or fixed. Grief does not work in phases, but as an irregular, deeply personal process that unfolds with advances, setbacks and oscillations.
Tasks are not stages that must be completed or indicators of whether grief is "progressing correctly", but rather psychological and emotional movements that can appear unevenly, oscillatingly or partially, especially in situations of complex grief.
This approach allows guidance and intervention without imposing rhythms or normative expectations, and helps identify work points within the process.
Accept the reality of loss
Accepting the reality of loss involves recognizing, both cognitively and emotionally, that the loved one has died and will not return. This process is not immediate or uniform: the mind may know this while the heart still resists it. In complex grief, this task can be made more difficult by sudden, traumatic, or ambiguous deaths, which make it difficult to gradually come to terms with the loss.
Acceptance is built through the daily experience of absence, small gestures and gradual confrontation with reality. Rituals and farewell spaces can facilitate this process, as long as they are adapted to the person's rhythm and needs.
Working through the pain of grief
Processing grief means allowing yourself to feel and express the emotions associated with loss—sadness, anger, guilt, fear, longing—without repressing them or getting stuck in them. In complex grief, this task can be blocked by both emotional avoidance and a constant immersion in suffering that prevents any reparative distance.
The goal is not to eliminate pain or intensify it, but to promote emotional regulation that allows us to move through it safely. Expressing pain, sharing it with other people, giving it symbolic or bodily form and respecting personal time are key elements so that suffering can be transformed.
Adapting to a world without your loved one
Loss forces practical, emotional, and identity adjustments. Adapting to a world without the loved one involves reorganizing daily life, taking on new roles, and redefining aspects of one's sense of self. In complex grief, this adaptation may be made more difficult by highly dependent attachments, losses that affect central roles, or lack of personal and social resources.
This process can awaken feelings of bewilderment, emptiness or guilt for continuing to live. The accompaniment in this task focuses on facilitating small movements of reconnection with life, without rushing or imposing, respecting the fact that adapting does not mean forgetting or stopping loving.
Emotionally relocating the deceased person and continuing to live
This task refers to the transformation of the bond with the loved one. It is not about erasing the memory or "closing" the relationship, but rather finding a way to integrate it internally that allows the affection to be maintained without preventing involvement in the present life.
In complex grief, this task can be blocked by an intense fixation on longing or by feelings of guilt associated with moving on. Support work can help build a symbolic relationship with the deceased that is compatible with growth, new projects, and openness to other bonds.
What is complex grief?
Stroebe and Shut's dual model of grief
The dual model of grief describes the grieving process as a dynamic movement that oscillates between two complementary orientations: the orientation towards loss and the orientation towards restoration . This model is based on the idea that grief is not a linear or stable process, but a fluctuating experience, in which the person alternates moments of intense contact with the pain of loss with moments of distancing and reconnection with everyday life.
Orientation towards loss
Orientation towards loss includes all those moments in which the person connects directly with the pain of absence. It is the space of remembrance, longing, crying, sadness, anger or guilt. It also includes the need to talk about the deceased person, to think about them and to give meaning to the relationship and the loss.
This orientation is an essential part of the grieving process, as it allows us to recognize the reality of the loss and emotionally process the bond. Persistently avoiding it can make it difficult to process grief and favor the chronicity of suffering.
Orientation towards restoration
Restoration orientation refers to the moments in which the person directs attention towards the present and future life. It includes the reorganization of daily life, the assumption of new roles, the resolution of practical problems, the recovery of activities, interests and relationships, as well as the construction of a new meaning of life in the absence of the loved one.
This orientation does not imply forgetting or denying the pain, but rather the ability to temporarily distance oneself from the suffering in order to continue living. When this orientation is blocked, the person may feel trapped in the past and experience a prolonged loss of functioning.
Oscillation as a central element
The key element of the dual model is the oscillation between both orientations.
Healthy grief involves being able to move between contact with loss and reconnection with life, without being rigidly fixed in either pole.
This oscillation allows pain to be regulated, avoiding both constant immersion in suffering and persistent emotional avoidance.
The back and forth movements do not follow a predictable or symmetrical rhythm: they can vary depending on the timing of the process, personal circumstances, and available support factors.
In complex grief, the oscillation can be disrupted. Some people become trapped in an almost exclusive orientation towards loss, with intense and persistent contact with pain that makes daily life difficult. Others, on the other hand, may take refuge rigidly in an orientation towards restoration, avoiding pain and blocking emotional processing of the loss.
The approach to complex grief focuses on restoring the capacity for oscillation, helping the person to tolerate contact with the loss and, at the same time, to recover spaces of life, meaning and connection. The clinical criterion is not to eliminate pain, but to facilitate a more flexible and adaptive movement between both orientations.
Neimeyer's model: grief as a process of reconstructing meaning
Robert Neimeyer's model understands grief as a process of reconstructing meaning in the face of the loss of a loved one. From this perspective, suffering does not come solely from physical absence, but from the profound rupture of the system of meanings with which the person organized their life, their identity, and their relationship with the world.
The death of someone significant can disrupt basic beliefs—about security, justice, the meaning of life, or one's own identity—and generate an experience of existential bewilderment.
Mourning thus appears as an attempt to reconstruct a vital narrative that can integrate the loss without denying it or becoming fixated on it.
Grief as a crisis of meaning
According to this model, loss can cause a crisis of meaning when previous schemas are not sufficient to explain or contain the lived experience. In these cases, the person may feel that "nothing makes sense," that the world is no longer recognizable, or that their identity has been profoundly altered.
In complex grief, this crisis can be particularly intense and persistent. It is not so much the emotional pain that is blocked, but the inability to make sense of the loss or integrate it into one's life story. This can manifest as a feeling of existential emptiness, constant rumination about the "why" of the death, or a marked difficulty in projecting oneself into the future.
Unfinished business as the core of suffering
A central element in Neimeyer's model is the role of unresolved issues in the intensification and chronicization of grief. These refer to everything that was left unsaid, undone, or unresolved in the relationship with the deceased: unspoken words, open conflicts, unspoken apologies, unrecognized affections, or decisions interrupted by death.
When these unresolved issues cannot be symbolically worked through, grief can become blocked. The person may feel trapped in persistent feelings of guilt, anger, sadness, or longing, with a constant need to “close” what reality no longer allows for literal resolution. In these cases, the suffering comes not only from the loss, but from the broken relationship.
Narrative and identity in the grieving process
A central element of Neimeyer's model is the importance of narrative. People make sense of our experience through stories: who we are, what has happened to us, what we have lost, and how it fits into our history. Loss disrupts this narrative and forces us to revise it.
Mourning therefore involves a work of identity reconstruction: redefining who I am without the loved one, what place they now occupy in my life, and how I can continue living without betraying the bond. This process does not consist of finding a definitive or consoling explanation, but of constructing a meaning that is habitable enough to allow me to move forward.
The continued bond with the deceased person
Unlike older models that posited the need to "let go" of the bond, Neimeyer's model recognizes the importance of continued bonds . Maintaining a symbolic relationship with the deceased—through memory, shared values, or internal dialogue—can be a source of comfort and coherence, as long as this bond does not prevent involvement in present life.
In complex grief, the problem is not the presence of the bond, but when it becomes fixed in rigid or painful forms that make it difficult to reconstruct meaning and be open to the future.
From this model, support for complex grief does not focus on eliminating symptoms, but rather on facilitating processes of meaning and resolution of pending issues. This includes:
- Create safe spaces to express and explore the story of loss.
- Accompany the review of beliefs broken or questioned by death.
- Facilitate the integration of the bond with the deceased person within a broader life narrative.
- Promote the construction of new meanings, roles and projects compatible with the loss.
The criterion of progress is not the absence of pain, but the ability to give loss an understandable place within one's own history, allowing life to continue with meaning, even if it is different from what one had imagined.
