When the Storm Doesn’t Run Out of Rain:
Understanding Complex Persistent Bereavement Disorder
By Gillian Rodriguez, MA, LPC
Grief, in all its forms, is deeply human. It’s how we honor what we’ve lost and adapt to a world that feels changed. But sometimes, grief doesn’t soften over time. Sometimes it gets heavier, more consuming — like it’s frozen in place, refusing to let life move forward. When that happens, we may be looking at something more than typical grief.
As a therapist, I’ve seen many people carry loss in ways that are intense, ongoing, and deeply disruptive to daily life — months and even years after a loved one has passed. This is what we call Complex Persistent Bereavement Disorder (CPBD), also sometimes referred to as Prolonged Grief Disorder in newer diagnostic language.
Let’s talk about what makes this form of grief different, why it matters, and how culture plays a role in what “normal” grieving even looks like.
What Is Complex Persistent Bereavement Disorder?
At its core, CPBD is grief that doesn’t follow a typical healing path. It’s not just that the person is still mourning — it's that the mourning is so intense, pervasive, and disruptive that it interferes with the person’s ability to function.
Someone with CPBD may:
Feel emotionally “stuck” in the loss, even long after it happened.
Experience persistent yearning, sorrow, or emotional pain.
Avoid reminders of the deceased — or become entirely preoccupied by them.
Feel that life has no purpose or meaning without the person who died.
Struggle to form or maintain relationships, or feel disconnected from others.
Have intense guilt or anger about the death, often cycling endlessly.
Experience difficulty engaging with life — as if moving forward feels like betrayal.
These symptoms usually last at least 12 months (or 6 months in children), but the intensity is what truly sets CPBD apart. This isn’t just grief that lingers — it’s grief that dominates.
Typical Grief vs. Complex Bereavement
Grief is not linear. It doesn’t follow neat stages or a tidy timeline. But over time, most people find that grief softens — that the pain becomes more manageable, even if the loss is never forgotten.
With typical grief, people still experience sadness, longing, or triggers. But they also begin to:
Reconnect with others.
Re-engage with work, hobbies, or self-care.
Create space for joy and meaning alongside their loss.
With complex grief, that healing process doesn’t really begin. The world stays dim. The loss feels as raw as ever, and time doesn’t seem to help. Instead of adapting, the person remains emotionally anchored to the moment of loss.
When Grief Becomes Trauma
Sometimes CPBD overlaps with trauma — especially when the loss was sudden, violent, or involved complicated relationships. If someone loses a loved one to suicide, homicide, or overdose, or if the relationship was marked by abuse or estrangement, the grief often comes with layers of pain that don’t resolve easily.
Grief becomes more than sadness. It becomes entangled with shock, guilt, shame, regret, and sometimes even PTSD-like symptoms. In those cases, grief work must also become trauma work.
Cultural Context Matters
One of the most important — and often overlooked — aspects of grief is culture. Grief doesn’t look the same everywhere, and what one culture considers “prolonged,” another might view as completely appropriate or even expected.
For example:
In some Latinx and Asian cultures, it's common to honor deceased loved ones regularly, even years after death, through altars, rituals, and ongoing conversation with ancestors.
In many African and Caribbean cultures, expressive mourning — including visible emotion, community gatherings, and music — is an integral part of healing.
In the U.S., there's often an unspoken pressure to “move on” or return to productivity quickly — which can pathologize normal emotional expression.
Because of this, diagnosing CPBD requires cultural sensitivity. We must ask: Is this grief truly impairing the person’s life, or are they grieving in a way that’s consistent with their community’s values and practices?
What Healing Can Look Like
Complex grief can feel endless — but it is treatable. Therapy can help create a safe, supportive space to:
Gently process the pain of the loss.
Explore the meanings attached to the death and the relationship.
Reduce avoidance and reconnect with life.
Address any underlying trauma, guilt, or depression.
Build new ways to honor the loved one — without becoming trapped in the loss.
Sometimes we use Complicated Grief Therapy, a structured approach that includes both grief-focused work and behavioral strategies. Other times, we integrate EMDR, Internal Family Systems, or trauma-informed practices to meet the client where they are.
If You Recognize Yourself Here
If you're reading this and thinking, “This sounds like me,” I want you to know: there is nothing wrong with you. Your grief is not a failure. You are not “too sensitive” or “not strong enough.” You are carrying something unbearably heavy — and you deserve support.
Therapy can’t rewrite what happened. Therapy doesn’t erase your memories, — it just helps you learn how to carry it all.
