‘Doing the same puzzle over and over again’: a qualitative analysis of feeling stuck in grief

Abstract

2022 has witnessed a crescendo of controversial debate in grief and bereavement research, surrounding the inclusion of prolonged grief disorder (PGD) in the revised Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V-TR). Criticisms of the inclusion of PGD focus on the potential for diagnosis narrowing the range of healthy functioning and any treatment gains associated with a PGD diagnosis being outweighed by the risk of pathologising individual differences and diversity in human behaviour (Ben-Zeev et al, 2010). This qualitative research approaches ‘stuckness’ in grief from a non-pathologising, inductive and curious position that embodies the core, humanistic values of counselling psychology (Cooper, 2009). Four participants who reported feeling stuck in grief were interviewed and the resultant transcripts were analysed using interpretative phenomenological analysis (IPA). The four superordinate themes: (eclipsed by the deceased; the power in powerlessness; the double-edged sword of coping behaviours, and living in purgatory) reveal novel insights into the significance and consequences of living with unresolved dilemmas of grieving. Findings support a meaning reconstruction approach to grief therapy and highlight the negative implications of holding a pathologising, time-limited, stage-based conceptualisation of grief. Implications for practice include combining person-centred therapy with targeted cognitive-behavioral grief interventions that can help to reduce dissonance and address a dependence on avoidance and polarised thinking.