Acknowledging Grief and Its Complexities: Finding Ways to Co-Exist and Reconnect

By: Catherine Tamayo, LPCC

When loss enters your life, it can often bring questions that are difficult to say out loud: “Will I always feel this empty?”, “Why do I feel angry one moment and numb the next?” or “Does it mean something if I also feel relief?”

Grief is rarely just one emotion. It can bring sadness, longing, regret, guilt, anger, and sometimes even moments of peace or relief. For some, the relationship with the person who died was loving; for others, it was layered, complicated, or unfinished. All of these experiences are part of grief.

At Mind Matters Collective (MMC), grief is not viewed as something to fix or move past. Therapy is about supporting you in learning to co-exist with loss — honoring memories, processing the layers of emotions and thoughts, followed by gradually re-engaging in purposeful activities and relationships that align with your values.

Grief as a Natural Process

Grief can touch every part of life — emotions, thoughts, physical health, routines, and relationships. It may feel like:

• Waves of sadness or emptiness

• Guilt, regret, or anger

• Relief if suffering has ended or if the relationship was conflicted

• Numbness or disconnection from daily life

• A longing that comes and goes without warning

These experiences are part of the natural process of adapting to loss. Grief does not move in a straight line. It shifts, softens, intensifies, and can change over time.

When Grief Gets Stuck

For many, grief gradually becomes something you learn to co-exist with while finding ways to re-engage in life. But sometimes grief does not ease. Instead, it remains intense and persistent, making daily life feel heavier and difficult to navigate.

The DSM-5-TR defines Prolonged Grief Disorder (PGD) as grief lasting 12 months or more in adults (6 months for children) with persistent, disruptive symptoms such as:

• Ongoing yearning or preoccupation with the deceased

• Difficulty accepting the death

• Avoidance of reminders of the loss

• Intense loneliness or a sense that life has lost meaning

• Identity disruption (feeling like part of you died)

• Difficulty re-engaging in daily life or relationships

For a diagnosis, these symptoms must cause significant distress or impairment in functioning.

This does not mean that grief itself is a disorder. Grief is a natural response to loss. PGD simply describes when grief gets stuck in ways that impacts daily functioning for a prolonged period of time.

How Therapy Can Assist

Therapy does not take grief away. Instead, each of these evidence-based approaches are designed to honor your grief while creating space to re-engage in purposeful activities, relationships, and daily life.

• Acknowledge and process emotions — sadness, anger, guilt, ambivalence, or relief — without judgment

• Honor memories in ways that continue bonds with the person who died

• Re-engage in purposeful activities and relationships that reflect your values

• Modify roles and routines to fit life as it is now, not as it once was

Acceptance and Commitment Therapy (ACT)

ACT emphasizes making space for painful emotions while still moving toward what matters most. It supports you in:

• Relating differently to painful thoughts like “I’ll never feel whole again”

• Living with grief while gradually re-engaging in daily life in a way that reflects your values, relationships and the places where you choose to be present

Exposure-Based Practices

Grief can often prompt avoidance or rumination. Avoidance might look like staying away from certain photos, places, conversations, or belongings. Rumination can sound like going over the “what ifs,” “should haves,” or “if onlys” on repeat. While these responses are natural in the short term, research shows that persistent avoidance and rumination are two strong indicators for developing prolonged or complicated grief. These coping responses can make your world smaller over time and keep your nervous system stuck in survival mode.

Exposure-based practices, introduced gradually and respectfully, support you in approaching reminders of loss differently. This might include looking at photos, visiting meaningful places, or having conversations you’ve been avoiding. For rumination, it may involve setting aside intentional, time-limited space to revisit looping thoughts, then practicing shifting attention back to the present. Over time, this process can assist in:

• Restoring nervous system balance and grounding your body in the present

• Softening the intensity of internal physical cues (like tightness in the chest or stomach)

• Expanding your quality of life instead of narrowing your world around avoidance

For some, avoidance comes with painful self-beliefs such as: “I can’t allow myself to go there or else I’ll never stop crying,” or “I should be strong enough not to keep feeling this.” For others, rumination may sound like: “I deserve to feel this pain,” or “If this person died, then I don’t deserve to…” Therapy can assist in noticing and gently shifting these kinds of narratives so that grief is honored without becoming a disruptive negative belief.

Common Questions—Answered

Will this emptiness always feel the same?
Grief may not fully go away, but it changes. The emptiness can soften, allowing grief to be present while also making space for moments of connection with people, places, and activities that also matter.

What if my emotions feel messy — like anger, regret, or relief?
Grief rarely shows up as just sadness. Emotions are valid. Therapy can provide a space to acknowledge them, understand their roots, and find ways to carry them without shame.

Support From MMC and Local Resources

At Mind Matters Collective, providers use evidence-based therapy approaches across many areas of concern, including grief and loss. Some clinicians have experience supporting people through the many layers of grief — whether that involves profound longing, conflicted relationships, or the challenges of prolonged grief.

Click here to request an appointment with an MMC provider

Here are also a few community-based grief resources in Minnesota:

• Brighter Days Family Grief Center – Free grief support services for children, teens, and families. Programs are child-focused, trauma-aware, and community-driven.

• The Grief Club of Minnesota – No-cost grief counseling from licensed professionals, with tailored programming for youth and families navigating loss.

• FamilyMeans – Center for Grief & Loss – Individual, family, and group therapy, plus critical incident response and community education.

You do not have to face loss alone. With compassionate support and evidence-based care, it is possible to honor your grief while re-engaging in a life that may still hold purpose and connection.

References & Resources

• American Psychiatric Association. (2022). DSM-5-TR: Diagnostic and Statistical Manual of Mental Disorders (5th ed., text revision).

• Lundorff, M., et al. (2017). Prevalence of prolonged grief disorder in adult bereavement: A systematic review and meta-analysis. Journal of Affective Disorders.

• Shear, M. K., et al. (2016). Treatment of complicated grief: A randomized clinical trial. JAMA Psychiatry.

• Neff, K. D. (2023). Self-compassion: Theory, method, research, and intervention. Annual Review of Psychology.