Grief is an inevitable part of life, but that doesn't make it any easier to go through. Even so, grief often resolves itself. It may never entirely fade, and the loss that caused it certainly won't be forgotten, but it almost always changes and becomes incorporated into life, so the grieving person can move on.
There are times, however, when grief doesn't take this relatively straightforward path toward resolution. What we call complicated grief typically results from complex and often ambivalent relationships, leaving in the survivor unresolved feelings of guilt, shame, anger, and regret that can fester, sometimes for many years. For therapists, negotiating the troubled waters of complicated grief can be difficult because one partner in a complicated relationship has died or is unavailable for some other reason. In effect, were challenged to find a solution to an equation with only half the factors at our disposal.
Tracy and John comprised such a difficult equation. I first met Tracy while she was in the hospital receiving an intense form of chemotherapy for her metastatic melanoma. She was a 58-year-old woman, the cornerstone of her family and community, who'd risen from being a waitress to being the manager of a popular local restaurant. Her husband, John, visited her in the hospital regularly, while her children and grandchildren, who all lived at a considerable distance, came to see her as often as they could, and gave her their unflinching…