“We can help if grief persists for a long time or becomes more intense”

I use cognitive behavioural therapy to help people with complicated grief. It's a way of looking at the links between our thoughts, feelings and behaviours, and breaking the vicious circles we can become trapped in when grief is prolonged.

It's important to acknowledge that all grief is painful. But after allowing time for grief, which everyone needs, most people do start to find some joy and meaning again.

The difference when people have complicated grief (also called prolonged grief or prolonged grief disorder) is that the persistent sadness doesn't lift. The intensity grows. A year after the bereavement they may be feeling far worse, unable to cope with everyday life or maintain emotional connections.

The positive news is that there is support, and it can really make a difference. If you're feeling this way day after day, or you're supporting someone and worried about them, please get help. Informal support from friends or family is valuable for anyone who's bereaved, but in complicated grief people usually need more in-depth help.

Sadly, the support we provide at the Marie Curie Hospice, Newcastle isn't available everywhere, but I recommend reading our information page about complicated grief, and speaking to your GP about how you are feeling and about services in your area.

People often tell me that the person they've lost totally consumes their thoughts, but that they can't bear to talk about them, even to say their name, because it's too painful. They can't look at photos, recall happy memories. That's the saddest thing. They've lost someone that meant so much and they've lost everything to do with them as well. It means everything is focussed on the loss. I help them get to a point where they feel safe to talk about them, to enjoy memories and to think about everything they mean to them.

Flashbacks are common in complicated grief, often to moments when the person was very ill. These are very distressing, and they keep us "stuck" in the loss. It feels as if it's happening again and again. Therapy helps people to stay in the here and now.

One man couldn't go into shops because he was scared that a familiar song might come on, or that he might see a type of food his partner ate and trigger a flashback. He felt he had no control and it had become totally overwhelming.

Everyone experiences grief differently, so the support we give is very individual He and his partner had both loved music, and he hadn't felt able to pick up his guitar since she died. Being able to play again and rediscover that pleasure they had shared was one of the first things we worked on. The way we support people very much depends on the individual.

We look at how the person who died lived. Who they really were. That can start to replace upsetting images with memories from the loved one's life.

I worked with a young woman who was really struggling with trauma after her father's death. I helped her to write a happy memory 'flash card'. She would use it to help her to focus on specific character quirks she had loved about him. It meant she could engage with and enjoy those memories.

Bereavement counselling won't take the pain of grief away, because that pain is part of our love. But it allows people to move forwards, to talk about the person they have lost.

Grief is something we all experience. And complicated or prolonged grief affects around one in ten of us. So, there's clearly a real need for support, but we don't talk about grief enough. That means we don't normalise it, and people might not realise when they need extra support.

They often feel very isolated, and that society expects them to have moved on after a year. But you may need to give yourself more time. It's important not to suppress your feelings, to be able to release your emotions, to cry. That's a strength, not a weakness.

I've been with Marie Curie for over ten years. It's such fulfilling work. Being alongside people through dying, death and grief sounds like a sad job – and of course I do feel their pain – but it's also hopeful work. Because helping people to talk about their feelings can make such a difference for them. They can feel less alone, go through a process of grief, and start to live again.

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