When the grief is not gone

Ann Murray Mozingo of York, ME, was a new mother who was still breastfeeding her 17-month-old son in the spring of 2000 when she woke up one morning to find her husband Bill on the bathroom floor. He died at the age of 42 in the early morning from a brain aneurysm. That’s how her best friend and life partner disappeared and she was left alone to raise her child.

Emotional, Mozingo tried to protect his young child from his grief. She would wait until he fell asleep and pour out her pain in private, screaming, crying, and hitting pillows.

“I remember midnight was my time,” she said. “I would do this thing – I would lock myself in the bathroom and pretend to cut down trees. It was a way to get really desperate, depressed energy out of my body. “

But after eight months, members of Mozingo’s family began to wonder if she had not been in mourning for too long.

“It was the first time culture came in and said, ‘You have to be better,'” Mozingo said.

Roadblocks to help

For a small but significant number of people, the grief can be so deep that surviving one day seems impossible. They remain in the initial phase of shock and disbelief a year or more after their loss. This is especially true when there are complicating factors around death.

Although hurt by her family’s comments, Mozingo sought advice. To her surprise, she had difficulty convincing future therapists that there was a problem. The first three were contemptuous.

“One man said, ‘You’re fine. You arrived on time, your blouse was ironed and you got here. And I said, “My mother ironed this blouse and she drove me, so they (swears).”

One therapist told her she just had to find a job and leave the house.

“Wyatt was 2. It was a really big slap in the face because I thought I had the most important job in the world, to raise him.”

The fourth counselor realized how hard Mozingo was fighting. She diagnosed Mozingo with a condition called complex grief. The grueling demands of single parenthood left Mozingo little time to process his sudden widowhood.

“I’ve been on deck all day with a man,” says Mozingo. “I could not slip a little in my work. I couldn’t take a break. I couldn’t grieve every hour, every day, willingly. “

A new diagnosis for the bereaved

Complex grief was first identified by researchers in 1993. Seven years later, the condition – now called long-term grief disorder (PGD) – was added to the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Prolonged grief disorder is when a person’s extreme longing or concern for the dead prevents them from continuing their daily lives. The other eight symptoms are emotional numbness, severe loneliness and isolation, identity breakdown (feeling that part of oneself is dead), feelings of disbelief about death, avoiding reminders of death, severe emotional pain (anger, bitterness, grief), difficulty reintegrating into everyday life and feeling that life is meaningless. PGD ​​is diagnosed in adults if the functional impairment persists with at least three additional symptoms for more than a year. It is 6 months for children.

Some mental health practitioners were initially wary of the new DSM classification out of concern that it condemned the natural response. But Amy McCarthy, a clinical social worker at Boston Children’s Hospital, believes it offers a framework for health care providers and family members to talk about grief. The clinical diagnosis also paves the way for insurance coverage.

“To sue for insurance, you have to prove that there is a medical need,” McCarthy said. “There is an argument that, of course, people who are grieving can benefit from therapeutic support. But if we don’t have a language to support that, then it’s much harder for these people to get access to help, and it’s already so hard to get access to mental health support. ”

Not every grief is the same

Natalia Skritskaya, a researcher and grief therapist who co-founded the Center for Prolonged Grief at Columbia University in 2013, said prolonged grief can be “very disabling” and requires treatment.

“Grief is universal and natural, I agree, but not prolonged grief,” says Skritskaya. “In a sense, you could think of this argument that applies to, say, an infection. It is very natural to get a cold or flu. It’s human everywhere to get sick, but don’t we have to do anything about it?

Based on three separate 5-year clinical trials, the center has developed a treatment approach based on a combination of cognitive-behavioral therapy, long-term exposure therapy used for post-traumatic stress disorder, attachment theory, attention and many other techniques. This is a short-term, focused intervention that usually takes 4 months of weekly psychotherapy sessions.

Complex grief

You can’t know how you will react to the death of a loved one until it happens. Donna George, a retired counselor in Ithaca, New York, knows from experience that the single most important determinant may be the state of the relationship you had, or some unusual circumstances behind your death.

Life after loss

After the death of her husband, Mozingo fears that her grief may destroy her. Eventually, she regained her emotional balance through medication, supplements, therapies, support groups, and a year of immersion in an interdisciplinary spiritual practice curriculum. And Mozingo harnessed his hard-earned coping skills as a facilitator for a group of grieving young widows.

Today, Mozingo is happily remarried. In 2021, her son graduated from Hofstra University with a degree in international finance. Gone are the days when he locked himself in the bathroom, pretending to chop wood to relieve his grief. But Bill is never far from her thoughts. She recently sent a message to a friend of theirs at their wedding reception. This would be their 27th anniversary. Mozingo appreciated the bitter memory, but he didn’t stop there.

“Grief is not something you overcome. Grief is something you learn to live with, “said George, the heavy loss counselor. But support and therapy “can give them permission to move forward and find joy in their lives again.”