Complicated bereavement is unfortunately not uncommon. Factors that can complicate the grieving process include an unanticipated loss, sudden, random or violent circumstances, multiple losses, the death of a child, or an angry, ambivalent or dependent relationship with the deceased. The mourner’s history of losses, personality style, and pre-morbid mental health adjustment also impact the grief process (Rando, 1993). Clearly, the traumatic circumstances that surrounded the events of September 11th added an unprecedented degree of complexity to the grief of those who experienced losses that day. While it appears reasonable that issues related to the trauma itself must be resolved before there is sufficient intrapsychic energy to deal with the loss per se, parsing out the differences between the symptoms of post-traumatic stress and those of complicated grief can be challenging (Figley, Bride, amp. Mazza, 1997). Depressive symptoms may also be confusing and interfere with the recognition of and response to the symptoms of complicated grief (Rando, 1993). Especially in the initial phases of recovery from a traumatic loss, individual interventions are an appropriate modality of treatment. The process of assessment for the variety of co-morbid risks that can accompany traumatic loss is facilitated in individual sessions. There is also the opportunity to provide support and problem solving that specifically address the challenges that have been generated by both the loss itself, the circumstances surrounding it, and its intrapsychic concomitants. But because of the sense of emotional isolation that commonly accompanies both trauma and the loss of a significant other, support groups are an excellent adjunct to individual treatment (Figley et al., 1997).
Grief and Bereavement Support Groups as a Supportive Intervention for People Who Are Facing the Experience of Loss and Grief