Case Record 07 · Prolonged Grief: Completing an Unfinished Bereavement Process

Overview

This case record documents an adult individual presenting with prolonged grief following the loss of a close family member. The presentation was characterised by sustained emotional constriction, physiological sensitivity to loss-related cues, and reduced functional vitality.

The record is situated within a regulation-informed mindfulness-based counselling approach. The focus is on patterns of nervous system regulation and emotional stabilisation rather than diagnostic or treatment claims.

Support was non-contact and regulation-oriented, with the aim of restoring autonomic flexibility, present-time orientation, and emotional tolerance capacity. The process did not replace psychological, psychiatric, or medical care.

Presenting Pattern

The individual demonstrated:

• Persistent grief reactions extending beyond the initial bereavement period

• Alternation between emotional numbness and sudden waves of sadness

• Physiological distress when recalling the loss

• Chronic fatigue and reduced motivation

• A sense of being internally “stalled” despite cognitive insight

Although the individual understood the nature of the loss, emotional processing appeared constrained, and daily functioning remained limited.

Regulation-Based Formulation

Within a regulation-informed framework, this presentation was conceptualised as a constricted regulatory response around loss related cues rather than incomplete psychological insight.

From a nervous system perspective, features were consistent with:

• Prolonged activation of loss-related stress responses

• Reduced autonomic oscillation between activation and recovery

• Defensive conservation patterns limiting emotional mobility

Psychologically, the individual demonstrated:

• Heightened sensitivity to memory triggers

• Protective emotional suppression to maintain functioning

• Concern that emotional activation might overwhelm stability

The grief response appeared neurologically constrained rather than fully integrated within present-time regulation.

Therapeutic Perspective

Within this regulation-informed approach, support prioritised:

• Nervous system stabilisation before emotional exploration

• Gradual expansion of tolerance for loss related cues

• Strengthening present-time safety signals

• Increasing regulatory flexibility across activation states

Descriptive language regarding activation and constriction refers to observable regulatory patterns and does not imply diagnostic or energetic claims.

Supportive Process and Observed Shifts

Support emphasised gradual nervous system settling, attentional grounding, and paced exposure to loss related memory within regulated states.

Observed shifts included:

• Reduced physiological activation when recalling the deceased

• Increased capacity to remain present during emotional activation

• Periods of spontaneous affect release followed by stabilisation

• Improved sleep and overall energy

• Renewed engagement with daily routines and relationships

Over time, the individual described grief as less dominant in present experience and more integrated within personal history.

Integrative Summary

From a regulation-informed perspective, the observed shift reflected:

• Increased autonomic flexibility around loss related cues

• Movement from constricted defensive states toward regulated presence

• Greater integration of grief within ongoing life functioning

The aim was not to remove grief, but to restore regulatory capacity so that loss could be held without overwhelming the nervous system.

Ethics and Scope

This case record is provided for educational and service description purposes only. It does not constitute psychological diagnosis, treatment, or outcome claims. All mental health decisions remained under appropriate professional care. Individual responses vary and outcomes are not guaranteed.