Sandra was estranged from her mother after experiencing childhood trauma. The grief when she died was complicated | Ahona Guha

For some of us, the death of a parent brings a period of bereavement and deep grief which slowly abates with the passing of time. For others, the story is more complicated.

Some find themselves unable to move past this loss and may continue grieving intensely for years and be unable to function because of the depth of the grief. Others find that they experience persistent difficult feelings such as anger or guilt. When the relationship with the deceased parent has been strained, these negative feelings may take over.

These are all forms of complicated grief.

This is a form of grief where the grieving is unusually intense or prolonged, or when there is marked disbelief about the death and poor processing, or other forms of intense emotional pain elated to the death, such as anger or guilt. Many clinicians, including me, prefer not to pathologise a normal human emotional experience such as grief and instead work to understand the phenomenology of the experience, and what this form of arrested grieving might mean to a person or say about their experiences and history.

*Sandra was in her 40s and had just lost her mother. She’d been seeing me for treatment for childhood trauma for a few months. She experienced sexual abuse perpetrated by her stepfather, who was now deceased. She told her mother about the abuse as an adult after his death, and her mother refused to believe her and told her not to disrespect her stepfather’s memory in that manner. Sandra was very distressed by this and decided to cease contact with her mother while she resolved some of her feelings and post-traumatic experiences.

A year after the estrangement, Sandra’s mother unexpectedly died.

Sandra was grief-stricken and surprised by the strength of her anguish. She wasn’t able to function or go to work and plunged into a deep depressive episode. She struggled to identify what she felt, and kept ruminating about whether her mother’s death was caused by the estrangement, and switching between this guilt and her anger at her mother.

We spent many sessions talking about her complicated relationship with her mother. Sandra was racked with confusion as she explored a relationship she had historically thought was a reasonable one, especially when contrasted with the abuse she received from her step-father.

As she reflected on this now, she started to develop a new narrative, one of a mother who would often leave her alone with her stepfather despite her frequent pleas to not be left alone. We spoke of ways to construct a new narrative to understand her childhood, and while we could never know whether Sandra’s mother knew about the abuse, we could still help Sandra own and express her rage and devastation.

She found the concept of complicated grief provided a helpful framework to help her understand her competing and intense emotions, and recognised that the core of her difficulties stemmed from the idea that she would never be able to express any of this to her mother, or to have a do-over or find rapprochement. The finality of death was difficult to stomach because it left so many questions.

Did her mother know about the abuse and turn a blind eye? Could her mother have found a way to support Sandra?

Despite this anger, Sandra felt very guilty about her decision to become estranged from her mother. We spoke about the concept of regrets and hind-sight bias (the tendency to perceive past events as having been more predictable than they really were) and the reasons Sandra had made the decision she did – to allow herself some space and time to sort through difficult emotions and experiences. It was important for Sandra to experience and allow her sadness but to disentangle this sadness from concepts of guilt (I did something bad), shame (I am bad) and responsibility (I could have stopped this).

It was important for her to learn to grieve her mother and to name and allow the other difficult feelings she held; difficult as it was to hold all these competing emotions. We noticed that as we labelled and explored this wide range of losses, her depression was slowly lifting and she was regaining a sense of optimism and hope.

*All clients are fictitious amalgams

Dr Ahona Guha is a clinical and forensic psychologist, trauma expert and author from Melbourne. She is the author of Reclaim: Understanding Complex Trauma and Those Who Abuse, and Life Skills for a Broken World