The Long Goodbye: “Normal” vs. “Complicated” Grief

A death from a long illness is very different from a sudden death. It gives you time to say goodbye and time to adjust to the idea that the beloved will not be with you anymore. Some researchers have found that it is "easier" to experience a death if you know for at least six months that your loved one is terminally ill. But this fact is like orders of infinity: there in theory, hard to detect in practice. On my birthday, a month after my mother passed away, a friend mused out loud that my mom's death was surely easier to bear because I knew it was coming. I almost bit her head off: Easier to bear compared to what—the time she died of a heart attack? Instead, I bit my tongue.

What studies actually say is that I'll begin to "accept" my mother's death more quickly than I would have in the case of a sudden loss—possibly because I experienced what researchers call "anticipatory grief" while she was still alive. In the meantime, it sucks as much as any other death. You still feel like you're pacing in the chilly dark outside a house with lit-up windows, wishing you could go inside. You feel clueless about the rules of shelter and solace in this new environment you've been exiled to.

And that is why one afternoon, about three weeks after my mother died, I Googled "grief."

I was having a bad day. It was 2 p.m., and I was supposed to be doing something. Instead, I was sitting on my bed (which I had actually made, in compensation for everything else undone) wondering: Was it normal to feel everything was pointless? Would I always feel this way? I wanted to know more. I wanted to get a picture of this strange experience from the outside, instead of the melted inside. So I Googled—feeling a little like Lindsay in Freaks and Geeks, in the episode where she smokes a joint, gets way too high, and digs out an encyclopedia to learn more about "marijuana." Only information can prevent her from feeling that she's floating away.

The clinical literature on grief is extensive. Much of it reinforces what even the newish mourner has already begun to realize: Grief isn't rational; it isn't linear; it is experienced in waves. Joan Didion talks about this in The Year of Magical Thinking, her remarkable memoir about losing her husband while her daughter was ill: "[V]irtually everyone who has ever experienced grief mentions this phenomenon of waves," she writes. She quotes a 1944 description by Michael Lindemann, then chief of psychiatry at Massachusetts General Hospital. He defines grief as:

sensations of somatic distress occurring in waves lasting from twenty minutes to an hour at a time, a feeling of tightness in the throat, choking with shortness of breath, need for sighing, and an empty feeling in the abdomen, lack of muscular power, and an intensive subjective distress described as tension or mental pain.

Intensive subjective distress. Yes, exactly: That was the objective description I was looking for. The experience is, as Lindemann notes, brutally physiological: It literally takes your breath away. This is also what makes grief so hard to communicate to anyone who hasn't experienced it.

One thing I learned is that researchers believe there are two kinds of grief: "normal grief" and "complicated grief" (which is also called "prolonged grief"). Normal grief is a term for the feeling most bereaved people experience, which peaks within the first six months and then begins to dissipate. ("Complicated grief" does not—and evidence suggests that many parents who lose children are experiencing something more like complicated grief.) Calling grief "normal" makes it sound mundane, but, as one researcher underscored to me, its symptoms are extreme. They include insomnia or other sleep disorders, difficulty breathing, auditory or visual hallucinations, appetite problems, and dryness of mouth.