The deaths of 49 members of the queer community at Orlando’s Pulse dance club (whether or not they were self-identified as gay, lesbian, bisexual, or transgender people) has evoked a variety of emotional responses, chief among them grief.

Grief is our personal or communal experience of loss. Although we typically think of loss in terms of the death of a loved one, other losses also produce grief. In most instances we have at our disposal socially sanctioned ways of externalizing our grief in rituals and other practices of mourning. Vigils, memorial services, funerals, memorials and shrines all provide opportunities for personal and communal expression of grief.

But what happens when something obstructs our  being able to acknowledge our loss, experience and express our grief, and publicly mourn?

• Consider the customers at Pulse who couldn’t tell their families, friends and co-workers about their trauma because they’re not out of the closet.
• Consider the parents and other family members who only learned of their loved ones’ sexuality by learning that they had been murdered and where.
• Consider the intimate partners who lost beloveds but, because they’ve not disclosed their sexualities to family and friends, cannot mourn.

Circumstances like these produced what is known as complicated grief.

According to Columbia University’s Center for Complicated Grief, “When grief is complicated the pain can be unrelenting and life seems empty of any possibility for happiness.”

Fortunately, complicated grief can be treated:

Complicated grief treatment (CGT) has been rigorously tested in three large studies funded by the National Institute of Mental Health (NIMH). The treatment is administered in 16 weekly sessions using techniques derived from interpersonal therapy, motivational interviewing, positive psychology and cognitive-behavioral therapy. If you are apprehensive about treatment that can last a long time you may be happy to hear that this treatment is short-term.

In addition to losing friends and other loved ones, queer people in Orlando and elsewhere lost a sacred space and a sense of trust and safety. Others who have lived under the shadow of abuse and violence have had old traumas triggered into fresh pain.

Complicated grief takes time and professional help to heal, but that treatment relies on our own innate capacities and resilience: “I will survive.”