How those who grieve feel pressured to 'move on' — and why that makes the loss hurt even more

Maya Thompson’s son Ronan was just a few days shy of turning 4 when he died of the childhood cancer neuroblastoma in 2011.

The devastating loss flattened Thompson. But about a year in, a relative decided it was time for her to stop grieving.

“She told me that she and her family were extremely disappointed in the way I was handling everything,” recalls Thompson, who'd been pointedly sharing her grief in a blog at the time. “She told me my heart was black and ugly, and it was going to remain that way until I found some peace around what had happened to Ronan because he was where he belongs, and they’re all at peace with it, and I have to find peace with it, too.”

While she believes the relative was coming from a concerned place, it was “pretty horrific to hear,” Thompson tells Yahoo Life. “I walked away from that situation.”

But there were others — commenters on her blog and, later, in person and on her Instagram, where she often posts about Ronan and her three other children.

“I felt a ton of pressure,” she says. “I got it all: ‘Move on,’ ‘Get over it,’ ‘At least you have other children,’ ‘You shouldn’t be grieving this long.’ … I think they want to try to fix it and make it better, because it’s probably hard to watch people suffering so much,” she surmises. “But my grief is my love for him.”

Thompson’s experience with being pressured to move on is not rare.

“I do think there’s a push for us to get over grief,” says Arizona State University professor and psychologist Joanne Cacciatore. The grief scholar and counselor, who still grieves a daughter she lost during childbirth in 1994, tells Yahoo Life that the pressure to move on quickly “is common enough that I spend a significant amount of time reassuring people that you don’t have to be done grieving in two months when your child or partner or parent died.”

Kara Thieleman, a psychology researcher at ASU, tells Yahoo Life that this sort of pressure, which she describes as “prevalent,” is “one of the things that really complicates the grief experience,” and is more problematic than looking at the intensity of the grief itself.

“When you internalize other people’s expectations,” she says, “which then leads you to judge yourself negatively, ‘I’m not over it’ turns into shame and hopelessness and helplessness and … feeling like you’re ‘doing it wrong,’ because so many people are telling you that you’re doing it wrong.”

She adds, “I think, in general, our culture is not very tolerant of suffering.”

But why is society this way?

Sociologist Nancy Berns, author of Closure: The Rush to End Grief and What It Costs Us and professor of sociology at Drake University, has focused much of her research around the pressure to “move on” and find “closure” — popular concepts in Western society and particularly in the U.S., she notes, because they “tap into our fast-paced culture and our desire to have steps to figure everything out."

“Closure,” in regards to loss, she tells Yahoo Life, “grew in popularity particularly in the ’90s, but has roots in the ’60s and ’70s, with the rise of pop psychology and victim survivor movements.” The “made-up concept” has been exploited by groups including politicians pushing the death penalty and those in the funeral industry, she says.

“It carries a lot of baggage and can create more harm than help for those who are grieving,” says Berns, who notes, “We grieve because we love. Even as it changes over time and people learn how to carry it, it’s still going to be part of our lives in many ways.”

But when people receive messages about closure, she adds, “What it sounds like is, ‘You don’t want to listen to my pain,’ and it shuts them down and isolates them further.”

That’s how Jenna Pratt of Georgia, who now supports others through Lionheart Grief Coaching, has often felt since her son died at 2, in 2020, of a congenital heart defect. She describes grief as being “like a backpack that you put on when your loved one dies. The weight of that backpack is always the same. … You get stronger, but the backpack is there.”

That's true whether it’s five years or 20 or more, say those who have lived it.

Says Thompson of the past 12 years, “In my day-to-day life, the pain has dissipated, and while I’m able to have pretty OK days, he’s always with me. But I never know: Yesterday I had such a heavy day of grief I couldn’t even go to the grocery store.”

Similarly, it has been almost 11 years since Barbara Kempe’s husband, Robert, died unexpectedly of complications from chemotherapy for lymphoma. While those around her might have been patient in the beginning, the New York mom of two (and Yahoo employee) tells Yahoo Life, now “some seem to have discomfort around why I want to talk about him so much.” But keeping his memory alive is something she’s made a point of doing, particularly for her kids, despite others' reactions.

“A lot of times they’ll change the subject — or say these kind of ‘uplifting’ things, like, ‘Well, it’s been a long time,’ she says. ‘And usually that turns into, ‘So, are you seeing anyone?’ It's like, ‘Move along.’”

Adds Kempe, “There isn’t a great structure for talking about loss … and there does seem to be an encouragement to be done with it quickly so you don’t bother people.” But, she says, “I’m really OK with it not being OK, which confuses people.”

Berns believes the push for “closure” is often self-serving. “We’re not very good at sitting with other people’s pain. It can make us very uncomfortable. That’s one part of this,” she says. But also, she adds, “People often have good intentions: They want someone to be better, and their thought is that they need to wrap up this pain and grief to get there. But that’s a false assumption about how emotions work — that we can only have one emotion at a time. … We carry complicated experiences and emotions, and that’s OK.”

Not to be underestimated for its part in the pressure to move on, Cacciatore says, is capitalism. "We want to focus on productivity and being a contributing member of society, and that’s what we prioritize as opposed to compassion," she says, pointing to a recent essay that states, "To demand the freedom to mourn — not on the employer’s schedule, but in our own time — is to reject the cruel rhythms of the capitalist status quo."

Enter ‘prolonged grief disorder’

Just over a year ago, the conversation around enduring grief entered a new chapter when it was given its own psychiatric diagnosis — prolonged grief disorder (PGD) — and added to the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official diagnostic guide of the American Psychiatric Association, allowing doctors to bill insurance companies for its treatment.

It has been controversial, to say the least.

Criteria for the diagnosis — persisting at "a disabling degree" for one year in adults and six months for children and adolescents — include a feeling of yearning, a sense of disbelief over the death, feeling like part of oneself has died, avoiding reminders of the death, intense emotional pain and difficulty moving on with life.

“It’s abnormal not to feel some anxiety or sadness, but extreme levels are what we’re talking about,” explains Weill Cornell Medicine psychosocial epidemiologist Holly Prigerson, the driving force behind getting the disorder into the DSM. “Like, really extreme levels where you don’t want to move on. You want to die. You don’t want to get out of bed. You’re sure the future is going to be bleak without this person and there’s no point in going on.” Further, she notes, studies have found grief associated with increased risk of heart attacks, and adverse health behaviors such as smoking.

“Any indicator of a health risk is worthy of knowing who's at risk, what are the features of it, and how to try to reduce that risk to improve quality of life," Prigerson says of the purpose behind the diagnosis.

Further, she's running a clinical trial to see if the drug Naltrexone — meant to help people fight addictions — is useful for prolonged grief disorder (as it’s already being used by some, off-label, she notes). It seemed worthy of study, she explains, after looking at how addiction causes “yearning and pining and craving, which is basically grief,” only with “a yearning for a particular person.”

Adds Katherine Shear, a Columbia University psychiatry professor who helped shepherd the new disorder into the DSM, “We’re not trying to tell people that they should move on or how they should feel. … I think to a large extent we approached it by listening to people who were coming and asking for our help, honestly."

Shear runs Columbia's Center for Prolonged Grief, and has developed a targeted, non-pharmaceutical treatment. "At the heart of the treatment," she says, "is understanding the grief is not the problem, but it’s how to live with grief and live with your loss.”

Further, she adds, her research has shown that antidepressants, when prescribed to grievers, "weren’t helping.”

Thompson can attest to that: When her son was sick, her doctor prescribed a collection of medications — an SSRI for depression, antianxiety pills, a stimulant, a sleep aid — and she says that she became dependent on them after Ronan died. “It became a vicious cycle,” Thompson says, sharing that, at the height of her drug use, she attempted suicide. She eventually stopped taking those medications, she says, explaining: “I just decided I would rather go through the acute pain than living like a zombie. … I wasn’t depressed, it’s just grief.”

Adds Pratt, who was put on the antidepressant Lexapro when her son died, “You can treat the symptoms with these drugs; you cannot treat the root cause. You’re just packing it away.”

It’s why, for many, the DSM-Naltrexone narrative has not landed well.

The criteria, says Cacciatore, who has been a vocal opponent, are "remarkably easy to meet," and don't take into account people experiencing unnatural, traumatic grief, such as over the death of a child, or a suicide, which typically "endures for more than one year."

Berns expresses concern that “grief is becoming intertwined with a mental illness ... and grieving is not a mental illness.”

Regarding the Naltrexone trial, “I think it’s insulting,” says Thieleman. “People’s relationships to their loved ones, to depict it as an addiction? It’s what makes us human, these social bonds we have with other people. And when someone dies, we naturally feel profound loss and grief and a yearning for that person. You risk great harm when you try to interrupt that bond.”

While Prigerson says only about 4% of grievers will actually meet the criteria for prolonged grief disorder, Thieleman and Cacciatore conducted a study of 1,100, still under review, that found a different reality: that upwards of 34% of the bereaved qualify.

“I agree wholeheartedly you want to help, but do we need to tell them there’s something wrong with their grief in order to do it?” Thieleman asks. “I don’t think we do.”

The heated discussion is all part of the complex and often divisive ways our culture views grief and how long is too long to grieve.

Cacciatore maintains that there is no such thing as “too long” when you're pining for those you love.

“There is no remedy for it, no pill, no scripture, no shortcut," she says. "I still identify as a grieving mom. Yeah, it’s been 29 years in July. So? I imagine, for me, I’ll grieve for a lifetime.”

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