GLOSSARY (Complicated Grief)

In recognition of the fact that acronyms and abbreviations can be confusing, sometimes misleading, the following is an A-Z of complementary terms and references:


A


Absent Grief 


Experiencing a death in absentia i.e. not being present at the moment of death and/or not seeing the body afterwards. This may also involve not attending the funeral and/or not visiting the final resting place. 


Acceptance 


A desirable outcome of grief, normally achieved in the short-term in cases that are uncomplicated. Designated as a phase/stage in certain bereavement models. 


Acute Grief 


Otherwise referred to as 'normal' grief, indicating symptoms that are present for up to six months. Some of the manifestations of normal grief are shock, denial, numbness, sadness, anger, mourning and eventual recovery.


Ambiguous Grief 


An ambiguous loss can be physical or psychological in nature. In the former case the physical body of the loved one is no longer present, in the latter case a loved one is still physically present but is psychologically absent.


Anger 


A common manifestation of grief in both the short- and long-term. Designated as a phase/stage in certain bereavement models. 


Anticipatory Grief 


Often experienced during the long (terminal) illness of a loved one and/or old-age, the death is anticipated. Feelings of grief extend towards looking forward to the death, rather than the actual death itself.


Anxiety


A feeling of uneasiness and worry, usually generalised and unfocused as an over-reaction to a situation that is subjectively unpleasant. It may involve tension, restlessness, fatigue, rumination and problems with focus and concentration. Can become a manifestation of grief in both the short- and long-term. 


Art Therapy 


A therapeutic intervention that focuses on exploration of grief through engaging in various art-forms and practices. 


Avoidance 


A coping mechanism that involves a person disengaging with the process of grieving as well as avoiding various aspects of the death, bereavement and loss that are difficult and painful to deal with. 


B 


Bereavement 


The affectation of a death, manifest in symptoms that are broadly commensurate with the nature of loss.


C


Chronic Grief/Chronic Sorrow 


A term used to describe a range of atypical mourning styles. 


Cognitive Behavioural Therapy (CBT)


A type of psychological therapeutic intervention that involves psycho-social interventions with the overall aim of improving mental health. Focuses on developing and improving personal coping strategies by focusing on thoughts, feelings, attitudes and behaviours that are problematic. 


Complicated Grief (CG) 


Currently the accepted medical nomenclature for describing a clinical condition characterised by prolonged and excessive responses to the death of a loved one. Defined medically as prolonged grief symptoms that last for at least 6 months following the death of a loved one this has become a common term used to describe a range of complex, atypical mourning styles. 


Complicated Grief Treatment (CGT)


A type of psychological therapeutic intervention drawn from Attachment Theory and with roots in both Inter-personal Therapy (IPT) and Cognitive-Behavioural Therapy (CBT), CGT includes techniques similar to prolonged exposure (repeatedly telling the story of the death and in vivo exposure activities). The treatment also involves focusing on personal goals and relationships in the context of long-term bereavement. 


Complicated Mourning 


A term used to describe a range of atypical mourning styles. 


Concomitant Grief 


Any number of deaths, bereavements and losses that occur over a relatively short space of time. The compound effects of these may be experienced with respect to different types of losses. 


D


Delayed Grief 


Characterised by late arrival accompanied by intense emotions. No symptoms of grief present themselves for weeks or months, sometimes due to initial shock and/or denial of the death event. 


Denial 


A common manifestation of grief in both the short- and long-term. Designated as a phase/stage in certain bereavement models. May comprise part of an avoidant strategy. 


Depression 


A common manifestation of grief in both the short- and long-term. Designated as a phase/stage in certain bereavement models. For medical disambiguation refer to 'Major Depressive Disorder'.


Diagnostic and Statistical Manual of Mental Disorders (DSM)


Now in it's fifth edition (DSM-V/DSM-5), published in 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM) offers a common language and standard criteria for the classification of mental disorders. 


Diary Keeping 


A record with any number of entries over a given period of time, arranged by date that reports on personal events. Usually used in relation to private documents, however, can refer to printed publications and electronic formats. Involves personal commentary on experiences, thoughts, feelings and observations, including events outside of the writer's first-hand experience. 


Disenfranchised Grief 


There is no overt expression of grief despite it being warranted due to the nature of the relationship with the deceased. May involve the suppression of painful emotions and problems with expression of feelings. Grief may be inhibited i.e. sorrow internalised rather than externalised, possibly due to societal/cultural norms. 


Distorted Grief 


A rare occurrence, predominantly affecting those with an underlying pathology. Usually involves bizarre behaviours associated with the death and the loss that have their own particular meaning(s) for the bereaved. 


Drama Therapy 


A therapeutic intervention that focuses on exploration of grief through engaging in 'acting out', 'rôle play' and 'story-telling', often involving musical movement, dance, mime and other aspects of performance art. 


E


Exaggerated Grief 


See 'Distorted Grief'. 


Excessive Grief 


A type of grief that manifests itself with very intense emotions that are often overwhelming. The individual may be very traumatised and exhibit suicidal tendencies. 


G


Generalised Anxiety Disorder (GAD)


A recognised mental disorder that involves excessive, uncontrollable and often irrational worry regarding activities and events. Considered to be a 'diagnostic neighbour' to Complicated Grief and Persistent Complex Bereavement Disorder. 


I


Imagined Grief 


Grief that a person imagines will be related to an incident of death that is yet to happen, more common in cases of terminal illness (as opposed to 'Real Grief'). 


Inhibited Grief 


See 'Disenfranchised Grief'.


Integrated Counselling 


A type of psychological therapeutic intervention that involves a range of inter-personal/counselling approaches. 


Integrated Grief 


Grief that is 'worked through' by the person bereaved to the point where the loss is eventually accepted and becomes a healthy aspect of their life. See also 'Processed Grief'. 


International Classification of Diseases (ICD) 


A diagnostic tool for epidemiology, health management and clinical purposes. Maintained by the World Health Organisation (WHO), the directing/co-ordinating authority within the United Nations (UN) system. 


Inter-personal Therapy (IPT)


A structured therapy for people with moderate to severe depression. Based on the theory that personality development and behaviours are related to and determined by relationships between persons. 


J


Journal Writing 


Often less frequent than diary entries, though similarly involves personal commentary on experiences, thoughts, feelings and observations, including events outside of the writer's first-hand experience. 


L


Layered Grief 


Related to bereavements experienced by a person in addition to former losses. May correspond to issues around bereavement/loss that parents and primary care-givers have experienced. 


Letter Writing 


A technique that involves writing letters to deceased loved ones and expressing thoughts and feelings that might otherwise remain non-verbalised. May also be used as a reconciliatory tool with estranged relatives, friends and other contacts. 


M


Major Depressive Disorder (MDD)


A recognised mental disorder, also known as 'depression', which involves low mood, present over time in most situations. Believed to be due to a combination of genetic, environmental and psychological factors. Symptoms including loss of self-esteem, loss of interest in a range of activities and low-energy and may be relatively constant over time or be intermittent. Considered to be a 'diagnostic neighbour' to Complicated Grief and Persistent Complex Bereavement Disorder. 


Maladaptive Grief 


A term used to describe a range of atypical mourning styles. 


Masked Grief 


See 'Disenfranchised Grief'.  


Meaning Reconstruction Theory 


A type of psychological therapeutic intervention that suggests the relevance of meaning‐orientation, narrative strategies and auto-biographical memory in adapting to bereavement. 


Meditation 


Practices that involve techniques for focusing the mind on a particular object, thought or activity with the aim of achieving a calm and clear mental state. 


Memorials 


Refers to any number of commemorative objects and practices that serve to preserve and maintain the living memory of those who have died. May correspond to both public and/or private dimensions. 


Multi-layered Grief 


See 'Concomitant Grief'.


Music Therapy 


A therapeutic intervention that focuses on engaging with grief through various aspects of music e.g. writing, listening and performing. It may also involve reminiscence using musical compositions e.g. songs, lyrics, acoustics. 


N


Narrative Therapy 


A therapeutic approach that involves engaging in various types of writing, both biographical and auto-biographical. May take the form of personal narratives, short stories, novels, poetry, play-writing, screen-writing, diary and journal keeping and letter writing. 


National Health Service (NHS)


The name used for each of the public health services in the United Kingdom. 


Normal Grief 


See 'Acute Grief'.


P


Pathological Grief/Mourning


A term used to describe a range of atypical mourning styles. 


Persistent Complex Bereavement Disorder (PCBD)


Defined medically as prolonged grief symptoms that last for at least 12 months following the death of a loved one, this condition denote atypical, pathological mourning styles and patterns that are inconsistent with those of acute/normal grief. Currently a 'Candidate Disorder' in the DSM-5.


Post Traumatic Stress Disorder (PTSD) 


A recognised mental disorder that can develop after an individual is exposed to a traumatic event(s). Symptoms may include disturbing thoughts, feelings and dreams related to the event(s), mental and physical distress to trauma-related cues and attempts to avoid such cues. Considered to be a 'diagnostic neighbour' to Complicated Grief and Persistent Complex Bereavement Disorder. 


Processed Grief 


Grief that is 'worked through' by the person bereaved to the point where the loss is eventually accepted and becomes a healthy aspect of their life. See also 'Integrated Grief'. 


Prolonged Grief 


A term used to describe a range of atypical mourning styles. 


Psycho-therapy 


The use of psychological methods in order to help a person change behaviour and overcome problems with the aim to improve mental health and well-being, mitigate troublesome behaviours and improve relationships and social skills. 


R


Real Grief 


Grief that is the consequence of an actual death (as opposed to 'Imagined Grief'). 


Repressors 


A term used to describe people who avoid any situation that might cause them anxiety or otherwise obsess about it (the former relates to avoidance, the latter to chronic levels of grieving). 


T


Traumatic/Trauma-Related Grief 


The death may be violent and is shocking and/or highly memorable. It is often unanticipated and as such allows the bereaved no time to prepare for the loss. Accompanied feelings of helplessness, powerlessness, lack of control and fear are common. 


U


Unanticipated Grief 


Grief that could not have otherwise been foreseen or pre-empted, signalling that the bereaved was in no way prepared for the death and the subsequent feelings and emotions associated with the loss. 


Uncomplicated Grief 


See 'Acute Grief' and 'Normal Grief'. 


Unresolved Grief 


A term that erroneously describes the problematic of grief not having been processed, integrated and accepted. Rather than grief being 'resolved' or 'unresolved' it's arguably more useful to consider this in terms of a bereaved person being 'reconciled' with a loss rather than having 'resolved' it. 


V


Visualisation 


A technique that involves the use of guided imagery and the use of imagination to relax, manage problems and relieve stress.