Persistent Complex Bereavement Disorder Treatment Scottsdale | Phoenix

Psychologists and psychiatrists at Shier Private Practice in Scottsdale, AZ specialize in the treatment of persistent complex bereavement disorder/complicated grief. Our private outpatient clinic offers a comprehensive psychiatric/medical assessment and treatment plan. Treatment may include medications, behavioral therapies or a combination of treatments.

What Is Persistent Complex Bereavement Disorder/Complicated Grief?

Grief is the standard reaction to loss whereas bereavement is the process of one recovering from the death of a loved one. Grief and Bereavement may both be expressed by a range of emotions from sadness to denial or anger. The process of recovering from the death of a loved one may vary significantly from one person to another depending on the relationship with the deceased, time since the loss, as well as the bereaved individual’s background and beliefs. Most bereaved adults report distress, yearning, intense grief, intrusive thoughts somatic distress and interpersonal disconnection in the weeks and months following a loss. In normal grieving, it is expected that symptoms of grief and bereavement will reduce over time. For most, the intensity of these thoughts and emotions diminish within 6-18 months after the loss. As time progresses, individuals are more likely to feel more contentment surrounding the loss, and are better able to reminisce on good memories with the deceased.

Persistent complex bereavement disorder, otherwise known as complicated grief, describes bereavement in which feelings of loss interfere with daily functioning and do not improve after time passes. The risk of developing persistent complex bereavement disorder is heightened by an increased dependency on the deceased prior to the death and by the death of a child. Those with complicated grief experience more severe symptoms that are distressing and persistent; these individuals have more trouble in coming to accept the loss and resuming their daily activities/lifestyle. Persistent complex bereavement disorder is often associated with deficits in social and occupational functioning, increased drug and alcohol use, and increases in risks for serious medical conditions such as hypertension, cancer, and immunological deficiency, overall affecting quality of life. Individuals with persistent complex bereavement disorder frequently report suicidal ideation.

The approximate prevalence of persistent complex bereavement disorder is 2.4%-4.8% and is more common in females than in males.

What are the symptoms of Persistent Complex Bereavement Disorder?

The proposed DSM-5 criteria for persistent complex bereavement disorder are as follows:

The individual experienced the death of someone with whom he or she had a close relationship

Since the death, at least one of the following symptoms is experienced on more days than not and to a clinically significant degree and has persisted for at least 12 months after the death in the case of bereaved adults and 6 months for bereaved children:

    1. Persistent yearning/longing for the deceased.
    2. Intense sorrow and emotional pain in response to the death
    3. Preoccupation with the deceased

Preoccupation with the circumstances of the death. Since the death, at least six of the following symptoms are experienced on more days than not and to a clinically significant degree, and have persisted for at least 12 months after the death in the case of bereaved adults and 6 months for bereaved children:

Reactive distress to the death

  1. Marked difficulty accepting the death.
  2. Experiencing disbelief or emotional numbness over the loss
  3. Difficulty with positive reminiscing about the deceased
  4. Bitterness or anger related to the loss
  5. Maladaptive appraisals about oneself in relation to the deceased or the death (self-blame)
  6. Excessive avoidance of reminders of the loss

Social/identity disruption

  1. A desire to die in order to be with the deceased
  2. Difficulty trusting other individuals since the death
  3. Feeling alone or detached from other individuals since the death
  4. Feeling that life is meaningless or empty without the deceased or belief that one cannot function without the deceased
  5. Confusion about one’s role in life, or a diminished sense of one’s identity
  6. Difficulty or reluctance to pursue interests since the loss or to plan for the future

The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

The bereavement reaction is out of proportion to or inconsistent with cultural, religious, or age-appropriate norms.

Persistent Complex Bereavement Disorder Treatment

Grief-targeted psychotherapy is most effective in learning to cope with loss. In grief counseling, therapists help individuals work through bereavement through memories, dialogue, and reflections about the deceased. Group therapy may be beneficial for the bereaved to connect with individuals who have experienced similar loss. Family therapy may be helpful for family units adapting to the loss of their family member.

How to Cope

  1. Self-care – Eat well and get plenty of rest. Maintaining a healthy lifestyle is key in managing symptoms of bereavement.
  2. Exercise – 30 minutes of aerobic exercise each day may decrease symptoms of anxiety and depression, helping with the bereavement process.
  3. Seek out support – Surround yourself with individuals who understand your loss. Seek out relatives, friends and support groups that will allow you to connect with individuals experiencing similar loss.
  4. Postpone major life changes – Give yourself time to adapt and adjust to your loss. It may be helpful to maintain some consistency while grieving.
  5. Avoid drugs and alcohol – Avoid self-medicating as this may worsen symptoms of anxiety and depression and will increase your risk for physical health issues.
  6. Relaxation techniques – Participating in mindfulness meditation and deep breathing exercises can reduce stress levels and can be used as a healthy tool for grieving.

For children grieving:

  1. Talk about how she is feeling as much as she would like.  Do not shy away from the subject.
  2. Give space for crying when tears arise. Do not try to “fix it” by distraction or other means, rather sit near her, hug her if that’s what she wants and listen to anything she might wish to say.  If it seems like there is a need to say something you can say things like “This is really hard”, “I feel so sad too”, “I’m so sorry you’re going through this, I also feel really sad about it”, “It’s scary when things like this happen”.  The goal is to validate her feelings.
  3. Ask the child if they wish to go to the funeral.  If the answer is yes, ensure that they know they can leave at any time and designate an adult they can go to who will take them out of the area as often as they need.   If a child says she is not ready to go tell her that is OK and that she can talk to you about how she is feeling when ever she’d like and if she changes her mind to just let you know.
  4. Role model expressing grief.  This means that when you as a parent need to cry, do not hide it from your child.  Ask your child for a hug because you’re feeling sad and show her that it is OK to express grief and to get support for it as needed.
  5. Allow for support for you and your child.  If there are groups meeting to talk about grieving the loss of the person be sure to attend to give memory and space for comforting and being comforted.

Last update: February 25, 2019

The content on this website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.