Therapy for Grief After a Parent’s Death. What Driven Women Need That Grief Groups Don’t Offer

SANDWICH GENERATION • May 26, 2026

Last updated: July 2026 by Annie Wright, LMFT

The Stone Was the Color of Her Father’s Favorite Glass

Wednesday afternoon in Portland, Maine. Yulanda sat on the therapy couch, turning a small amber-colored stone over in her palm. It was the color of her father’s favorite rocks glass, the one he’d used every evening for thirty years, a detail she hadn’t thought about in months until it surfaced in session three. The light through the window was flat and gray. It was March.

“What didn’t work about the grief group?” I asked her.

Yulanda looked at the box of tissues on the side table. Untouched, same as the last two sessions. “They asked me to share my feelings with seven strangers in a circle on Tuesday nights,” she said. “I run a supply chain division. Forty-one direct reports. I don’t share my feelings with strangers on a schedule. I came here because I needed someone who’d know that about me without my having to explain it first.”

In my work with driven women grieving a parent’s death, over more than fifteen years and several thousand clinical hours, I’ve noticed a specific mismatch again and again. It’s not that these women don’t want to be witnessed in their grief. It’s that the format most available to them, the drop-in circle, the eight-week community group, the format built for the general population, asks for a kind of public unfolding that collides directly with the exact skill set that made them successful enough to be reading an article like this one. Not every driven woman struggles with group grief support. But often enough that I now ask about it directly in intake, because the women who struggle with it are usually the ones who blame themselves for struggling with it.

Yulanda’s fingers kept moving over the stone. Here, unlike the group, nobody was waiting for her to cry on cue.

Why Grief Groups Often Don’t Fit Driven Women, and Why That Isn’t a Character Flaw

Grief groups can be truly useful. I want to say that plainly before I say anything else, because this article isn’t an argument against peer support. It’s an argument for fit. Community grief support has real evidence behind it, particularly for people who feel isolated in their loss or who benefit from knowing their reaction isn’t unusual. That’s not nothing. For a lot of people, it’s everything.

But driven women carrying professional leadership roles, caregiving loads, or both, often bring an internal architecture built around control, composure, and efficient emotional labor. That architecture didn’t appear out of nowhere. It’s the same architecture that got her promoted, that keeps a household of four running on a shared calendar, that makes her the person colleagues call when a project is falling apart. Asking her to set all of that aside on command, in a circle, in front of seven people she just met, isn’t a small ask. It’s asking her to override the exact skill that has kept her functional.

Grief groups typically structure themselves around verbal sharing within a set window of time. For a woman who has spent two decades mastering efficient communication and invisible emotional management, being asked to produce grief on cue can feel less like relief and more like a performance review she didn’t sign up for. The Sandwich Generation Resource Hub covers this pattern in more depth: women managing eldercare and career simultaneously are at real risk of emotional overload, and a format that asks for more visible vulnerability on somebody else’s timeline can add to that load instead of relieving it.

None of this means something is wrong with her. It means the format and the woman are mismatched, and that mismatch is worth naming instead of white-knuckling through.

I recently sat with the 2005 JAMA trial that put Complicated Grief Treatment on the map, and I haven’t stopped thinking about one detail. Katherine Shear, MD, psychiatrist at Columbia University and one of the field’s most consistent voices on prolonged grief, ran a randomized controlled trial comparing her structured Complicated Grief Treatment against standard interpersonal psychotherapy in adults with clinically significant grief symptoms. The structured protocol outperformed standard talk therapy on response rate. That single finding is the reason I tell clients that “just process it in general talk therapy” isn’t always the right first move when grief has become truly stuck (Shear et al., 2005).

Grief, Complicated Grief, and Prolonged Grief Disorder. What the Difference Actually Is

I want to be careful here, because this is the section where a well-meaning article can accidentally hand a grieving woman a new way to worry about herself. So let’s start with what’s normal, because most of what you’re feeling probably is.

Grief after a parent’s death isn’t a disorder. It’s not a problem to be solved on a timeline. Waves of intense sadness, disrupted sleep, trouble concentrating, moments of disbelief, all of that is a completely ordinary part of mourning someone who mattered, and for most people, the intensity gradually eases over the months following the loss, even though the loss itself never fully goes away and doesn’t need to.

Prolonged Grief Disorder, or PGD, is different, and it’s a real diagnostic category, added to the DSM-5-TR in 2022. It’s not simply “grief that lasts a long time.” The clinical picture requires that at least twelve months have passed since the death, and that the person is experiencing intense yearning or preoccupation with the deceased nearly every day, along with at least three additional symptoms, things like identity disruption, marked disbelief about the death, avoidance of reminders, emotional pain, difficulty reengaging with life, emotional numbness, or a sense that life is meaningless without the person, all occurring to a degree that’s clinically significant and out of step with cultural and religious norms. A 2026 systematic review and meta-analysis estimated the global prevalence of prolonged grief disorder under standardized diagnostic frameworks, and even the higher-end pandemic-era estimates put it at a minority of bereaved adults, not the majority (Li et al., 2026).

Here’s what I want you to take from this section, and I’ll say it as directly as I can. If you’re eight months out from your father’s death and you still cry in the car, still reach for the phone to call him before you remember, still feel a wave of disbelief some mornings, that’s not a red flag. That’s grief doing what grief does. What I’d want you paying attention to is different: whether the intensity has stayed completely flat rather than softening at all over many months, whether you’ve become unable to function at work or in relationships in a sustained way, or whether you’re avoiding anything connected to the loss so thoroughly that your life has started shrinking around the avoidance. Those are the signals that warrant a conversation with a clinician, not a self-diagnosis from an article.

I’ll also say the thing I say to almost every driven woman who arrives with a spreadsheet of her own symptoms. You don’t need to determine, on your own, whether what you have is grief or Prolonged Grief Disorder. That’s a clinical determination, made collaboratively, over time, by someone trained to make it. Your job right now is simpler. Notice how you’re doing. If something in you says this has stopped moving at all, trust that instinct enough to ask a professional, not a search engine.

What a Grief Therapist Actually Does Differently for a Driven Woman

A grief therapist working with driven women isn’t running a script. The work is built around the specific shape of this woman’s loss, her particular resilience, and the pace she can actually tolerate, not the pace a workbook assumes she should be on.

In a one-on-one setting, I can adjust pace, modality, and emotional attunement session by session in a way a group format simply can’t accommodate. Grief isn’t linear for anyone, but it’s especially non-linear for women who’ve spent years managing their outward presentation. I’m not expecting tears on cue. I’m watching for the subtler signals: a pause that lasts a beat too long, the mental load she’s still carrying for her father’s unfinished paperwork, the sentence she starts three times and doesn’t finish.

This therapeutic relationship becomes a place for what I think of as witnessed grief, a holding of the experience that’s attuned to her actual professional and relational context, not a generic template. I might mirror her need for structure in one session and gently invite more emotional exploration in the next, and the choice of which to do isn’t mine alone. It’s something we build together, week by week, based on what her nervous system can actually hold that day.

This kind of work also has to make room for relational history. Grief for a parent rarely arrives uncomplicated. It usually drags family dynamics and old attachment wounds along with it. Pauline Boss, PhD, the psychologist who coined the term ambiguous loss, has spent decades documenting how loss without full resolution, a parent who was physically present but emotionally absent for years, a relationship that ended before it ever really got repaired, complicates straightforward grief. I think about her framework often with clients whose fathers were, in some sense, gone long before the funeral.

The therapist’s job in this setup isn’t to manufacture vulnerability. It’s to build enough safety that vulnerability stops feeling dangerous, on whatever timeline that actually takes for her, not for the client in the workbook example.

The Modalities That Work. Complicated Grief Therapy, IFS, Somatic Work, and Meaning Reconstruction

Grief therapy for driven women often blends several evidence-informed approaches rather than relying on just one, because grief itself isn’t a single-mechanism problem.

Complicated Grief Therapy, the structured protocol Katherine Shear, MD, built and tested, is the one with the clearest randomized-trial evidence specifically for grief that’s become prolonged or disabling. It’s not a general talk-therapy approach retrofitted for grief. It was built for grief specifically, and that specificity is part of why it works well for people whose grief has truly stalled.

Internal Family Systems, or IFS, works differently. It treats the mind as made up of different “parts,” and it gives a woman a way to access and integrate the parts of her that feel vulnerable or hidden underneath a professional exterior she’s maintained for years. For a client who has one part that wants to fall apart and another part that’s terrified of what falling apart would cost her at work, IFS gives both parts a seat at the table instead of forcing a winner.

Somatic approaches attend to where grief lives in the body, not only the mind. Grief that gets intellectualized without ever being felt physically tends to show up eventually as exhaustion, headaches, or digestive trouble that doesn’t respond to anything else. Bessel van der Kolk, MD, psychiatrist and trauma researcher, has spent decades documenting how the body holds what the narrative mind hasn’t processed, and in my clinical experience, driven women, who are often skilled at narrating their experience clearly while remaining physically disconnected from it, are exactly the population where this gap shows up most (van der Kolk et al., 2024).

Meaning Reconstruction, the approach pioneered by Robert Neimeyer, PhD, focuses on something different again: helping a person rebuild a coherent sense of narrative and identity after a loss that’s reorganized everything. It doesn’t ask her to “let go.” It asks her to figure out who she’s now, in relationship to a parent who’s gone but not erased.

None of these four modalities is “the right one” in isolation. What I see in practice, across several hundred bereaved clients, is that most driven women end up needing some blend, usually starting with stabilization work before moving into whichever of CGT, IFS, or meaning reconstruction fits the specific texture of what’s stuck. Not every client needs all four. But almost none of them need only one.

How a therapist sequences these approaches matters as much as which ones get used. Early sessions, in my experience, are rarely the place for deep exposure work or intensive parts-based dialogue, even when a client is eager to get to the hard material quickly, which driven women often are. Stabilization comes first: naming what’s safe to feel here, establishing that the pace belongs to her, and building enough trust that the nervous system stops treating the therapy room itself as one more place requiring vigilance. Only once that foundation is in place does it make sense to move into the more structured protocols, and even then, the order isn’t fixed. Some clients need somatic grounding before they can tolerate CGT’s exposure elements. Others need the narrative coherence of meaning reconstruction before their body will let down its guard at all. A therapist who insists on one sequence regardless of the client sitting in front of her isn’t practicing evidence-based care. She’s practicing a checklist.

Both/And: You Need Witnessed Grief AND You Need a Container That Matches Your Architecture

Grief is relational by nature. It asks to be witnessed, seen and held by someone without judgment or rush. For driven women, that need for witnessed grief doesn’t disappear just because the standard container doesn’t fit. It just needs a different shape: one that respects her need for discretion, for autonomy, for an emotional unfolding that happens on her actual timeline rather than a group’s fixed schedule.

Individual therapy can offer exactly that kind of tailored container. But I want to be honest about the limit of that Both/And, because I don’t think it’s helpful to pretend individual therapy is simply superior to community grief support in every case. It isn’t. What individual therapy does well is privacy, pacing, and structural flexibility. What a well-run grief group does well, and does better than individual work, is normalization: sitting in a room with six other people who also lost a parent and realizing your reaction isn’t strange. Individual therapy can talk about that normalization. A group lets you feel it in real time, from people who aren’t being paid to understand you.

Julia, a 47-year-old attorney I worked with several years ago, came in certain that group work was categorically wrong for her, the same way Yulanda had assumed. Six months into individual therapy, once her acute grief had softened enough that she had bandwidth left over, she asked me about adding a monthly bereaved-adult-child group alongside our individual sessions. Not instead of. Alongside. “I don’t need it every week,” she told me. “But once a month, hearing other people say the exact strange thing I’ve been thinking, that’s doing something the individual work doesn’t do.” She kept both for the better part of a year.

Understanding the sandwich generation’s specific pressures matters here too. A woman juggling eldercare, a career, and her own grief often has less flexibility to attend a weekly group at a fixed time, which is one more practical reason individual work, with its scheduling flexibility, tends to be the entry point even for women who eventually add group support back in.

The honest version of Both/And is this: witnessed grief and a well-fitting container aren’t competing needs. They’re the same need, described from two directions. The mistake isn’t choosing individual therapy over a group, or a group over individual therapy. The mistake is assuming the format that works for most people is the format that has to work for you.

The Systemic Lens: Why Composure Got Built Into Her Grief in the First Place

The mismatch we’ve been describing, the driven woman whose grief doesn’t fit the group format, isn’t a personal quirk. It’s a pattern, and the pattern has a structural origin worth naming directly.

Women who’ve climbed into leadership, who’ve built careers in male-dominated fields, who’ve become the person everyone calls when something’s falling apart, have typically done so inside workplace cultures that reward emotional restraint and punish visible distress, especially in women, whose emotional expression is more likely than men’s to be read as unprofessional or unstable rather than simply human. That’s not a personal preference she developed in a vacuum. It’s an adaptation to decades of watching what happens to women who cry at work versus what happens to men who do.

The mechanism is specific. Professional environments train a narrow range of acceptable emotional display, calm, measured, solution-oriented, and women in leadership often internalize that narrow range more thoroughly than their male peers because the cost of violating it lands harder on them. By the time grief arrives, the nervous system has had years of practice keeping big feelings contained in professional settings. That containment doesn’t have an off switch just because the setting is a grief group instead of a boardroom.

You’re not broken for finding the circle unbearable. You built the exact skill that circle is asking you to override, and you built it because the world rewarded you for building it. That’s not a flaw in you. That’s a structural inheritance, and it should be named as one instead of quietly blamed on your personality.

Here’s how that inheritance shows up on an ordinary Tuesday. It’s the reflexive glance at your phone during the group’s designated sharing time, checking whether a work email needs a response. It’s the internal countdown running under every minute you’re expected to speak. It’s driving home afterward, replaying what you said, wondering if you shared too much or too little, running a kind of post-mortem on your own grief the way you’d run one on a missed deadline. None of that is dysfunction. It’s the same competence that built your career, applied to a situation where competence isn’t actually what’s being asked of you.

What Eight Months of Weekly Grief Therapy Actually Looked Like for One Driven Woman

Yulanda’s process unfolded slowly, in layers, over eight months of weekly sessions. The early weeks were mostly about safety. She brought the amber stone to nearly every session without ever mentioning why until week six, when she finally said her father used to let her hold his rocks glass when she was small, “just to feel the weight of it,” and that the stone was the closest thing she had to that weight now.

Around month three, we started doing more somatic work alongside the talking, tracking where grief actually lived in her body rather than only in her account of it. She noticed, with some surprise, that her jaw ached most days and that she’d been clenching it since the funeral without realizing.

By month five, she’d started experimenting with small, private acts of vulnerability outside our sessions, telling one colleague the real reason she’d left early on a Thursday, instead of the vague excuse she’d have given six months earlier. “I didn’t fall apart,” she told me. “I just told the truth and nothing bad happened.” That surprised her more than it probably should’ve.

That image stayed with me while I worked with Yulanda, because so much of her inherited grief pattern, the instinct to grieve invisibly, efficiently, on nobody’s schedule but her own, had been handed down the same way: unspoken, unexamined, worn without ever being chosen.

By month eight, Yulanda wasn’t “done grieving.” Nobody is, eight months out from losing a parent, and I’d be worried if she were. What had changed was smaller and more specific. She could talk about her father without immediately redirecting the conversation to something manageable. She still kept the amber stone in her desk drawer at work, not on display, not hidden, just there. Some Tuesdays she still cried in her car before a client meeting. She’d stopped being ashamed of that particular Tuesday ritual, which, in my experience, is usually the actual marker of movement, not the absence of tears but the absence of shame about them.

When to Seek Professional Support Sooner, Not Later

Most grief, even intense grief, doesn’t require crisis-level intervention. But there are specific signals worth taking seriously, and I’d rather name them plainly than bury them in caveats.

Seek professional support promptly, rather than waiting to see if things improve on their own, if you’re having thoughts of suicide or of not wanting to be alive, if you’re unable to care for yourself or dependents in basic ways, if you’re using alcohol or other substances to get through most days, or if grief has been completely flat and unchanging, with zero softening, for many months in a row. Those aren’t signs you’re grieving wrong. They’re signs it’s time to bring in more support than a blog post, a support group, or self-management can provide.

This article is for information and support. It is not a substitute for therapy, diagnosis or treatment from a licensed clinician who knows you. If you are in immediate danger, call or text 988 in the United States to reach the Suicide and Crisis Lifeline, or call 911. See the full medical disclaimer.

If you or someone you love is in crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988 in the United States, available 24 hours a day. This isn’t a substitute for ongoing care, but it’s an immediate resource, and using it’s not an overreaction.

For everything short of crisis, the guidance is gentler. If you’ve read the Prolonged Grief Disorder criteria above and found yourself thinking “some of this sounds like me,” that’s worth bringing to a licensed clinician for an actual evaluation, not something to self-diagnose from a table of symptoms. Grief this significant calls for a real assessment, not a checklist you run against yourself alone at midnight.

Of course you’re tired. Grief this deep, held alongside a job and a family and everyone else’s needs, is exhausting in a way that doesn’t always show on the outside. That exhaustion isn’t a sign you’re doing it wrong. It’s a sign you’re doing something truly hard, on top of everything else you were already doing.

References

Peer-Reviewed Research (Vancouver)

1. Shear K, Frank E, Houck PR, Reynolds CF 3rd. Treatment of complicated grief: a randomized controlled trial. JAMA. 2005;293(21):2601-2608. doi:10.1001/jama.293.21.2601. PMID: 15928281.
2. Li S, et al. Global prevalence of prolonged grief disorder during the COVID-19 pandemic under standardized diagnostic frameworks: a systematic review and meta-analysis. Psychol Med. 2026 May 21. PMID: 42165098.
3. van der Kolk BA, Wang JB, Yehuda R, Bedrosian L, Coker AR, Harrison C, et al. Effects of MDMA-assisted therapy for PTSD on self-experience. PLoS One. 2024;19(1):e0295926. doi:10.1371/journal.pone.0295926. PMID: 38198456.

Books, Clinical Frameworks & Cultural Sources (Chicago Author-Date)

• American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: American Psychiatric Association Publishing, 2022.
• Boss, Pauline. Ambiguous Loss: Learning to Live with Unresolved Grief. Cambridge, MA: Harvard University Press, 1999.
• Neimeyer, Robert A. Meaning Reconstruction and the Experience of Loss. Washington, DC: American Psychological Association, 2001.
• Oliver, Mary. Devotions. Little, Brown Book Group Limited, 2017.
• Sexton, Anne. The Complete Poems. Houghton Mifflin, 1981.

Warmly, Annie

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