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Mitchell A. Levick Ph.D.


Attachment, Grief, and Complicated Grief

A Thought or Two on Loss and Recovery

We recently buried my grandmother.

People say she lived a good life; she did. People say she was fortunate to live a long life, especially without tremendously debilitating ailments; that's true, too. People say how fortunate my family and I have been to have had such a vital addition in our lives for so long. True, true, true: it's all true.

I just thought that she could live longer - like for the rest of my life. It is wishful thinking, but she was there for my birth, upbringing, marriage, children's births, children's B'nai Mitzvah, divorce, and the multiple deaths of other family members including my father and grandfather, her husband of 78 years. The writing was on the wall for her demise at 98 years of age, but I neglected to see that. I just came to expect my Nana's love, warmth, humor, and intelligence would always be there. She was a constant person, from my birth to now, her death.

Why does loss hurt so much, especially this one? Others have died under considerably more tragic circumstances, and the grief was much less. How is it that we respond so differently to loss? Few other topics are as familiar to us as loss, yet it is one that we rarely readily embrace. Have you written your will? No, I don't want to deal with it. Have you given thought to your long term health care? No, I don't want to deal with it. Have you gone through your deceased family member's belongings yet? No, I don't want to deal with it. From the loss of our baby teeth, to misplacing cherished keepsakes, to breaking up with a first love, we do not like the inevitability of loss.

Our responses to loss depend in large measure on the type and the intensity of our attachments to the person or thing that is lost. Attachment makes life worth living, and attachment makes sure we are in pain when we face loss. Attachment is simply an affectional tie between one's self and another person or thing. We have all sorts of attachments to people (like Nana) and objects (e.g., souvenirs) and ideas (such as expectations and hopes). And, the more we feel attached, the more it affects us when we lose that person or thing. Think: The higher you go, the harder you fall. Yet, there are a lot of differences in how we progress through the pain of loss. Most of us are able to get through the process of loss, or mourning, without major complications or need of psychiatric help. Perhaps most painful, is getting stuck in loss.

Typically, mourning involves going through various grieving phases and feelings including numbness, sadness, anger, remorse, emptiness, and all-around emotional pain. We mourn in unique ways depending upon different factors such as personality and culture. Sometimes, however, the mourning process can go awry, and we are unable to make it out the other side. In general, this happens when we get stuck in one of two types of denial: (1) we fail to fully accept or acknowledge the loss has occurred, or (2) we remain incessantly yearning for that lost person or thing. In the former, we might see an inhibition or delay of grief reactions. In the latter, we might see the bereaved try to keep the deceased present by referring to the deceased in the present tense, by cherishing the deceased's personal effects, or by frequently manifesting the deceased in (typically frustrated) dreams.

If after a significant loss, one does not proceed along a natural course of mourning, various physical and psychological conditions can arise. A prominent sign of trouble is chronic physical health complaints such as insomnia, achiness, and physical pain. Of course, there are a host of emotional symptoms too that are also associated with what is called "complicated grieving," things like prolonged guilt, self-blame, misdirected hostility, self-sabotage, isolation, and an absence of pleasure. Not uncommonly, it is the bereaved who is the last to know that he or she may be experiencing a complicated grief reaction. Researchers are starting to learn more about complicated grief and how to help people suffering from it. For more information, check out

At this point, I have to say that I just simply miss my grandmother. I am sad and achy and blue. I hate that I can no longer go visit her and hear her lament about her impending death as she has done for the last 15 years. I guess, begrudgingly, that she had to be right about it, eventually. I also know that pain will subside, just as I know my attachment to her memory will endure.