Grief Therapy in Frederick, MD

We work with grief in the many forms it takes, including the ones that do not always get named as grief. The work is not to fix what cannot be undone. It is to make room for what is real, help the parts that have gotten stuck loosen, and build the capacity to hold the loss alongside the rest of your life.

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What grief is

Grief is the human response to loss. It is not a disorder, not a problem to be fixed, and not something most people get over. It is a process the body and mind move through when something or someone significant is gone. Most grieving people are not clinically ill. They are responding to loss the way humans respond to loss.

The shape of grief varies. Some people experience it as waves of intense pain that pass and return. Some experience it as a steady undertone running through everything else. Some experience it physically before they experience it as a feeling. The popular five-stages model is well known but not strictly evidence-based as a sequence; modern grief research describes grief more like an oscillation between facing the loss and stepping back from it, with both movements being part of how integration happens.

Grief is not the same as depression, although the two can travel together. Grief tends to come in waves and to hold love and longing alongside the pain. Depression tends to be more steady, more pervasive, and more closed off. Some grief evolves into depression, particularly when the loss was sudden, traumatic, or complicated by other unresolved feelings. A consultation can help you tell them apart.

Therapy is not required to grieve. Most people grieve with the support of family, community, time, and ritual. Therapy becomes useful when grief is heavier than the rest of life can hold, when it has stayed acute for a long time, when the loss is complicated by trauma or by a complicated relationship, or when there is no one in your life who can hold the conversation with you.

The many forms grief takes

Grief is often pictured as the response to a death. It is also the response to many other losses, some of which our culture does not readily recognize as losses. The categories below are not diagnostic. They are ways of naming experience that often go without a name.

Bereavement: the death of someone close

Death of a parent, partner, child, sibling, friend, mentor, or other significant person. The form of the loss matters: a long expected death sits differently from a sudden one, and a violent or traumatic death adds layers that need their own attention. Suicide loss in particular often carries grief, trauma, and complicated feelings braided together.

Anticipatory grief

Grieving a loss that has not yet happened. Common with terminal illness, late-stage dementia, or any situation where you are losing someone in stages while they are still here. Anticipatory grief is real grief and deserves real attention. It is not "early" grief or a substitute; it is its own experience and often does not lessen the grief that follows the death.

Ambiguous loss

Loss without clear closure. The estranged family member who is alive but unreachable. The loved one with dementia who is here in body but not as themselves. The relationship that ended without explanation. Ambiguous loss is uniquely hard because there is no event to grieve around and no permission from the world to grieve at all.

Disenfranchised grief

Grief for losses that society does not fully recognize. Pet loss, miscarriage, infertility, the end of a relationship that wasn't legally or publicly acknowledged, the loss of a friendship, the loss of a former version of yourself. The grief is real even when no one offers condolences. People carrying disenfranchised grief sometimes feel they have to grieve in private or apologize for grieving at all.

Non-death losses that still need grieving

Divorce. Job loss. Loss of health or physical function. The end of a stage of life that mattered. Becoming an empty-nester. Retirement, when work was identity. Immigration, when a whole world is left behind. Religious or community departures. Identity shifts after illness, transition, or major change. These are all losses, and the grief that follows is grief.

Cumulative grief

Multiple losses stacked too closely together to grieve one at a time. A year that takes too much. A profession (medical, military, hospice, ministry) that asks you to absorb other people's losses on top of your own. Cumulative grief sometimes shows up as numbness or as a sense that you cannot feel any of it because you would not know where to start.

Grief inside a complicated relationship

Grief for someone who hurt you. Grief that holds love and anger and relief at once. Grief for what the relationship could have been but wasn't. This kind of grief is common and often the hardest to talk about because the feelings don't sit neatly. Therapy can hold the whole picture, including the parts that feel taboo to say out loud.

When grief gets stuck

Most grief integrates over time. People do not stop loving or longing for what was lost; they grow a life that holds the loss alongside everything else. When that integration does not happen, when grief stays as raw and impairing months or years after a loss as it was at the start, that is sometimes called complicated, prolonged, or stuck grief.

The DSM-5-TR added Prolonged Grief Disorder as a clinical diagnosis in 2022, defined by persistent yearning and preoccupation with the deceased, intense emotional pain, and significant disruption to daily life that continues for at least 12 months after a death (six months for children and adolescents). The diagnosis is meant to identify the relatively small percentage of bereaved people whose grief is impairing enough that targeted treatment helps. Most grief does not become prolonged grief disorder. When it does, evidence-based therapy can change the trajectory.

Grief gets stuck most often when something other than grief is also at work. Trauma is the most common one: a sudden or violent death, witnessing a loved one's last moments, the discovery scene after a suicide, a close call that ended differently. The loss is real, but a piece of the experience around the loss is also unprocessed in a way that makes the rest of the grieving harder. The same can happen with non-death losses that included violence, betrayal, or abuse.

Grief can also stay stuck when the relationship was complicated, when the loss was disenfranchised and never named, when it happened in a context that did not allow for grieving, or when prior trauma was already loaded into the system. Trauma-informed therapy works at both the trauma level and the grief level, which is part of why this kind of work tends to help with grief that has not moved.

Does this sound like you?

Some of the felt experiences that bring people to grief therapy:

The world keeps moving and you cannot, and people around you seem to expect you to be further along than you are
Waves of grief that arrive without warning and knock the wind out of an ordinary day
A specific moment from before, during, or after the loss that you cannot stop replaying
Anger, guilt, relief, or numbness that you didn't expect and don't know what to do with
A relationship that ended (by death or otherwise) where the unfinished pieces are louder than what was finished
An anniversary, a holiday, or a sensory cue that pulls you back into the rawness
A loss that nobody around you treats as a loss, and a quiet sense that you don't have permission to grieve
A heaviness that has been there for more than a year and is not lifting on its own
The sense that you cannot grieve and live your life at the same time

If any of that resonated, you are in a reasonable place to consider therapy. And if you're not sure yet, that's fine too. A consultation can help you sort through what you're carrying.

How we work with grief

Grief work is not the same as fixing grief. The work is to make space for what is real, help the parts that have gotten stuck loosen, and build the capacity to hold what cannot be undone alongside the rest of your life. The right approach depends on what kind of loss you are carrying and what is happening in the carrying.

Talk-based grief work

Most grief work involves making room to feel what is there, talk about what was lost, and slowly find words for an experience that often resists language. The therapist's role is steady, attuned, and unhurried. The work draws on grief research, including the body of work on continuing bonds (the finding that maintaining an internal relationship with what was lost is part of healthy grieving, not a sign of being stuck) and on meaning-making approaches that help people reconstruct a sense of the world that the loss disrupted.

EMDR for traumatic and stuck grief

When grief is complicated by trauma or has stayed stuck for months or years, EMDR can help process the specific moments that are not settling. A sudden death, the moment of a diagnosis, the call that brought the news, an image at a hospital or a scene, the last conversation: EMDR helps reduce the intensity of those moments so they stop hijacking the present, while leaving the love and the memory intact. EMDR is not used to remove the relationship with what was lost. It is used to help the difficult pieces of the loss settle so the rest can move.

Art therapy for what words cannot reach

Grief often lives in places that words alone do not fully reach: in body sensations, in fragmented imagery, in feelings that don't fit into neat sentences. Our art therapist Whitney Dahlberg works with grief as a primary specialty, integrating creative process with EMDR when that fits the work. Art therapy is particularly useful when narrating a loss feels overwhelming, when complicated feelings are hard to admit out loud, or when the loss touched parts of you that did not have language at the time. It can also give shape to a continuing bond with who or what was lost, one of the ways people grow through grief rather than leaving it behind.

Coordinated care when more is needed

Some grief sits inside a larger picture: a depression that has set in, an anxiety that has tightened, a body that is not sleeping or eating, a family that is grieving differently than you are. We coordinate across our team and with outside providers when the work calls for it. Medication management through our practice or through an outside prescriber is one option for clients whose grief has become entangled with depressive symptoms heavy enough to interfere with the work. We also refer to bereavement groups and community resources when group support fits a client's needs better than (or alongside) individual therapy.

When to reach out

Most grief does not need therapy. Time, ritual, community, and the slow work of daily life carry many people through. Therapy becomes useful when one or more of the following is true.

Grief is heavier than the rest of your life can hold and is interfering with sleep, work, relationships, or basic functioning
The grief has stayed acute for a long time without integrating, particularly past 12 months for adults or six months for children and teens
The loss was traumatic (sudden, violent, suicide, witnessed) and a specific moment around it keeps replaying
The relationship was complicated, and the feelings do not sit neatly
You have lost more than you can grieve one at a time
You do not have a person in your life who can hold this conversation with you
The grief is for a loss your community does not fully recognize, and you have been grieving alone

If reaching out feels right, we would be glad to help. If it doesn't yet, that's fine too, and the door stays open.

If you are having thoughts of harming yourself

Outpatient therapy is meant for ongoing work and is not the right tool for an active crisis. Grief sometimes brings thoughts of wanting to be with the person you lost or thoughts of not wanting to be here. If those thoughts feel close, please call or text the 988 Suicide and Crisis Lifeline, available 24/7. If you are in immediate danger, call 911 or go to your nearest emergency room. Once you are stable, ongoing therapy can be part of how you carry this.

Frequently Asked Questions

What's the difference between grief and depression?

Grief is the human response to a specific loss. It comes in waves, holds memories of what was lost alongside the pain, and tends to integrate over time even when it never fully ends. Depression is more pervasive and persistent, often without a clear trigger, marked by a steady loss of interest and pleasure across most areas of life and persistent thoughts of worthlessness or hopelessness. Grief and depression can overlap, and grief sometimes evolves into depression, particularly when a loss was sudden, traumatic, or complicated by unresolved feelings. A consultation can help you tell them apart.

How long does grief last?

Grief does not run on a timeline and does not fully end. What changes over time is how it sits with you and how much capacity you have to carry on alongside it. Most people find that the rawness of acute grief softens over months and years, while love and longing for what was lost often remain as a quieter presence. If grief stays as intense and impairing as it was at the start for more than a year, that is sometimes a sign of prolonged grief, and therapy can help with that.

Can EMDR help with grief?

Often yes, particularly when grief is complicated by trauma: a sudden or violent loss, a suicide loss, witnessing a loved one's death, or grief that keeps replaying a specific moment that won't process. EMDR can help reduce the intensity of those moments so they stop hijacking the present, while leaving the love and the memory intact. EMDR is not used to remove the relationship with what was lost. It is used to help the difficult parts of the loss settle so you can carry the rest.

I haven't lost anyone to death. Can I still come for grief therapy?

Yes. Grief is the response to loss, and many losses are not death losses. Divorce, miscarriage, infertility, estrangement, the loss of a relationship that mattered, the loss of a job or a role, the loss of health or function, the loss of a community after a move, the loss of who you used to be after a major life change. These are real losses and they deserve real grieving. Many of our clients are working with non-death loss, sometimes alongside other concerns.

How is art therapy useful for grief?

Grief often lives in places that words alone do not fully reach: in body sensations, in fragmented imagery, in feelings that don't fit into neat sentences. Art therapy provides another channel for expression and processing. It can be particularly useful when narrating a loss feels overwhelming, when complicated feelings (relief, anger, guilt) are hard to admit out loud, or when the loss happened before language could fully hold it. It can also give form to a continuing bond with what was lost, which is part of how people grow through grief rather than leaving it behind. Our art therapist Whitney Dahlberg works with grief regularly and integrates EMDR when that fits the work.

What if my grief is for a complicated relationship?

Grief for a complicated relationship is among the harder kinds of grief and one of the most common reasons people seek therapy. You may be grieving someone who hurt you, someone you also loved, someone whose loss changes your life and your inner world in mixed ways. Anger, relief, guilt, and longing can sit side by side. None of those feelings make your grief less real or less worth attention. Therapy can hold the whole picture, including the parts that feel taboo to say out loud.

Is grief therapy covered by insurance?

Often yes, when grief is part of a clinical picture (such as depression, anxiety, adjustment disorder, or prolonged grief disorder). Coverage depends on your specific plan and on the diagnosis used. We accept CareFirst BCBS and offer self-pay options. Contact your insurance provider to verify your mental health benefits, and let us know if you'd like guidance on the questions to ask.

What is prolonged grief disorder?

Prolonged grief disorder is a clinical diagnosis added to the DSM-5-TR in 2022 for grief that remains intense, persistent, and impairing for at least 12 months after a death (six months for children and adolescents). It involves persistent yearning, preoccupation with the deceased, intense emotional pain, and significant disruption to daily functioning. Most grief does not become prolonged grief disorder. When it does, evidence-based treatment exists and can help. A consultation can help you figure out whether what you're experiencing fits this picture.

Clinically reviewed by

Sarah Martin, LCPC, NCC

Clinical Director, Trauma Specialists of Maryland

Sarah is a Licensed Clinical Professional Counselor and Board Certified Counselor with over 8 years in the mental health field. She is trained in EMDR and works with clients across the spectrum of grief, including loss complicated by trauma, ambiguous loss, and grief that has not integrated on its own.

Read full bio

Also reviewed by

Whitney Dahlberg, LCPAT, ATR-BC Board Certified Art Therapist

If you'd like to talk about what you're carrying

A consultation can help you figure out whether therapy is the right next step and, if it is, who on our team would be a good fit. Reaching out is its own kind of brave, especially after a loss.

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If a form doesn't feel right, you can also email us at info@traumaspecialistsofmd.com. We're here either way.