In an audio presentation for Psychiatric Times, Katherine Shear, an expert on complicated grief, delivers a talk on the topic that provides listeners with a concise and comprehensive primer. She gives -- in about 15 minutes -- a complete overview of the malady, noting that it affects as many as 10% of bereaved people. Shear begins by characterizing grief -- and even intense grief reactions -- as a normal response to the death of someone with whom the bereaved person has a close relationship, then differentiates complicated grief by clearly summarizing its causes, symptoms, assessment, and treatment.
One of many useful ingredients in Shear's presentation is her "five simple questions" to help a clinician assess whether a person who is having continuing, intense grief symptoms a year or more after the death might be suffering from complicated grief:
- How much are they having trouble accepting the death of this person?
- How much does grief still interfere with their life?
- How much are they having images or thoughts about the person who died? These thoughts are often intrusive kinds of thoughts.
- Are there things they used to do when this person was alive that they don't feel comfortable doing anymore, that they avoid? [Or are they] avoiding looking at pictures of the person or talking about the person?
- How much are they feeling cut off or distant from other people, even people they generally feel close to, like family or friends? Do they have intense feelings of loneliness even when they're with people who they're close to?