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Traumatic and Complicated Grief

Living Donor Grief          Coping With Grief


In the case of disenfranchisement, of if a person's defense and/or coping mechanisms are depleted, feelings associated with grief can become intense and persistent, preventing a person from moving through the grieving process. This can be known as Traumatic Grief.  

As discussed elsewhere, living kidney and liver donors can and do experience grief. This grief is perfectly normal. Sometimes, however, it can become pathological.


Traumatic Grief Inventory (101):

-I feel that life is empty or meaningless
-I feel myself longing and yearning for [life prior to kidney or liver donation]
-I feel like the future holds no meaning or purpose 
-I feel unable to imagine life being fulfilling 
-I feel like I have become numb since...
-I feel lonely ever since...
-I feel stunned, dazed, or shocked 
-I think about [the situation/event] so much that it can be hard for me to do the things I normally do
-The [situation/event] feels overwhelming or devastating
-I feel that I have trouble accepting the [situation/event]

One study found that those who scored high for Traumatic Grief at the six-month mark were at a higher risk of cancer, high blood pressure, and heart trouble 13 and 25 months after the inciting event. (103)


Disenfranchising grief can intensify feelings of anger, guilt and powerlessness. Often, grief is accompanied by other crises, such as financial constraints, legal difficulties, or ambivalent feelings toward the recipient, family or loved ones, etc.  These concurrent events can complicate the grief process, exacerbating and lengthening its severity and manifestations. 

Complicated Grief symptoms include (100):

-Strong yearnings for lost person (or loss of self, or loss of whole two-kidney body)
-Trouble accepting the loss
-Inability to trust others
-Bitterness or anger related to the loss
-Feeling that life is empty or meaningless
-Feeling that future is bleak
-Feeling agitated


Another set of researchers (102) suggests the following diagnostic criteria for Complicated Grief Disorder, the loss occurring at least 14 months earlier.

In the last month, any three of the following seven symptoms with a severity that interferes with daily functioning:

Intrusive symptoms
1. Unbidden memories or intrusive fantasies related to the loss
2. Strong spells or pangs of severe emotion related to the loss
3. Distressingly strong yearnings or wishes that the deceased (or lost) were there

Signs of avoidance and failure to adapt
4. Feelings of being far too much alone or personally empty
5. Excessively staying away from people, places, or activities that remind the subject of the [traumatic event; in this case, the kidney or liver donation]
6. Unusual levels of sleep interference
7. Loss of interest in work, social, caretaking, or recreational activities to a maladaptive degree


Bereavement has been linked to immune suppression, increased doctors' visits, poorer physical health, sleep pattern disturbances, change in eating habits, headaches, suicide and death (103).


Consider seeking professional help if:

  • the intense yearning does not diminish over time.
  • substantial feelings of guilt or uncontrolled rage
  • severe depression and hopelessness about the future
  • abuse or alcohol, tobacco or other drugs
  • engaging in risky sexual activity, self-injury, or other self-destructive behavior



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Last Updated: February 20, 2012