How Long Does Grief Last Before It’s a Mental Disorder?

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As a psychotherapist, I’ve often worked with clients who struggled with grief. At such times, it felt like my primary role was to just listen with empathy and compassion. The point is that no one can magically erase our pain. But sharing helps and is often the first step to healing and moving forward again.

Interestingly, the latest DSM—The Diagnostic and Statistical Manual of Mental Disorders—was updated with a new condition for grief that lasts longer than one year. Called “prolonged grief disorder,” it stigmatizes grief.
I was flabbergasted. After all, who’s to say that some grief won’t last a lifetime? Is that necessarily a pathological problem? Even with my Buddhist background and training in the monastery, where we were taught that grasping anything was the root of suffering—I believe that the grieving of a human heart and soul can make us more understanding and compassionate.

Grief expert David Kessler says, “For me, grief is love—it’s a love letter to those who have died, and it lasts the rest of our lives.” How beautiful.
It’s OK to have a heart that hurts. The healing power of grief is found in its ability to help us recognize the preciousness of each moment. It teaches us gratitude and recalls the beauty of life.

Of course, we need to function in the world and not let grief keep us from experiencing joy. But today’s grief may actually plant the seeds for tomorrow’s experience of joyfulness.
When Grief Overwhelms
Have you ever been so overwhelmed by grief that it became like a veil that darkened all aspects of your life?

The idea of family grief is one of the themes in my novel Travelers. The story’s protagonist, psychiatrist Dr. Ben Banks, is struggling with the agonizing loss of his daughter Melissa, and he is unable to heal. The year after Melissa’s death, Ben and his wife Beth have grown apart. Here’s a short excerpt, illustrating how loss can turn inward, causing blame and shame:

Certainly, Mel was fearless in the face of death. Right up to the end. Her tender and understanding eyes comforted all of us, especially her fiancée Samuel, who somehow kept it together despite leaving her hospital room every few minutes to “breathe.” Over the last five years of Mel’s life I learned more about acute lymphoblastic leukemia, or ALL, than I ever wanted to know. Mostly, I chastised myself for how I had missed the early onset of her symptoms. I don’t think I’ll ever forgive myself, no matter what anyone says.

While Ben lost his faith, there’s always hope. In Travelers, hope comes to Dr. Banks in the form of a mysterious Traveler, a sentient canine, and a psychotic patient. Slowly, Ben’s skepticism and cynicism give way to a new understanding. He undergoes a spiritual breakthrough—or initiation—that enables him to work through his grief and heal.

Finding Hope, Healing, and Renewal
If you’re grieving, perhaps the most important thing is not to isolate and to know that you are not alone. In my workshops, I often make the point that “If you have a human body and a human mind, then you will experience loss. You will lose relationships, even health due to aging.”

When you think about it, there is no one on the planet who is immune to these conditions. It doesn’t matter if you’re a king, queen, Jeff Bezos, or Mark Zuckerberg. One thing, however, does make a difference: Your understanding and acceptance of loss can help you recover. No, it will never bring back to loved one, but it can help you to grow seeds of compassion and appreciation for the wonder and miracle that is life.

At the end of Travelers, Dr. Banks’s journey leaves him with a realization that helps him heal and become whole:
That’s when I knew we were all seekers, all stardust Travelers on this small blue planet, trying to make sense of this deliciously implausible existence. And if we couldn’t solve anything, the least we could do was to help other Travelers who we met on this fleeting journey.

Practices and Reflections for a New Understanding of Grief
Grief is a natural process. For that reason, this practice is not a solution or a fix for grief. Rather, see it as opening new doorways for understanding grief.
Find a soothing, peaceful place where you can reflect on these questions. Set the intention to be open and curious and tender. Even if you do not gain new insights, you will have begun the process of healing and acceptance. As you sit with each question, breathe in peace and compassion for yourself.

How is my grief like a love letter for my beloved?
What is my “love letter” saying to the one I lost?
How has the grief changed me?
How can this grief serve to enrich my appreciation for the precious, impermanent things of life?
What does this grief teach me about loving myself?
How does grief make my heart more tender and open to all others who have also lost someone?
Write your own reflections here: ________________.

Above all, remember to embrace life, for grief is also a reminder of what it means to love and live fully.

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