The memoir Spare explores the young prince’s prolonged grief over the death of his mother, Princess Diana, and his fervent belief that she was still alive. It has sparked new interest in the treatment of traumatic loss.
Little wonder that Prince Harry is haunted. Twenty-six years on, an indelible image is seared in our psyches: Two young British boys walk behind their mother’s casket, heads bowed in anguish, as the world watches in sadness, shock and disbelief. Princess Diana – the people’s princess and the princes’ mum — was dead, killed in a horrific high-speed car crash in a Paris tunnel while being pursued by paparazzi. Public mourning for her spanned the globe.
Prince Harry was then only 12 years old. Prior to losing his beloved mother, he was considered the carefree child, with his mum’s keen sense of adventure and fun. Profound grief put an end to his impish, happy-go-lucky ways. He’d lost his emotional anchor, and his adolescence was marked by sorrow, anger and loneliness. He struggled in school and found it challenging to participate in public life. He blamed the British tabloid press, whom he loathes with a passion, for his mother’s death.
Joining the British Army at age 21 provided much-needed structure and a sense of community and purpose. But after two combat tours, he writes, he felt “hopeless” and “lost” and reportedly faced crippling panic attacks and post-traumatic stress. Not until his late 20s, at the urging of his brother (aka The Heir) and others, did Harry seek professional help. It was, he notes in his bestselling memoir Spare, a chaotic but transformative time.
Prince Harry doesn’t label it, but experts say he likely suffered with what’s known as prolonged grief disorder. There’s debate within the profession on its definition, but the diagnosis is considered warranted if debilitating grief – that is, severe, persistent and pervasive distress over the death of a loved one – endures beyond 6 months in children and a year in adults. People who experience such intense grief struggle to engage in everyday life and are preoccupied by their loss and a constant yearning. The Duke of Sussex reveals in his ghost-written book that for more than a decade he held on to “magical thinking” – a fervent belief that his mum wasn’t dead at all.
“With nothing to do but roam the castle and talk to myself, a suspicion took hold, which then became a firm belief. This was all a trick,” he wrote in Spare. Princess Diana was alive, he was certain of it; she had simply escaped her untenable life and hounding by the tabloid press, was in hiding and would summon her sons to join her when it was safe to do so. This kind of fantastical belief – a psychological coping or avoidance strategy – is not uncommon among the bereaved, say therapists, particularly among those dealing with trauma from the sudden, unexpected death of a loved one.
“I can safely say that losing my mum at the age of 12, and therefore shutting down all of my emotions for the last 20 years, has had a quite serious effect on not only my personal life but my work as well,” Prince Harry said in a 2017 interview with a British reporter. “My way of dealing with it was sticking my head in the sand, refusing to ever think about my mum, because why would that help? It’s only going to make you sad; it’s not going to bring her back.”
In the same interview, Prince Harry said that he had begun having conversations he previously avoided and realized “‘there’s actually a lot of stuff here I need to deal with.” He admitted that he was very close to a complete breakdown on numerous occasions. “I just couldn’t put my finger on it. I just didn’t know what was wrong with me.”
Regardless of how one feels about the monarchy in general or Prince Harry in particular, the royal second son has offered up a lot of food for thought on the mental health front with the release of Spare, which sold a record-breaking 3.2 million copies in its first week and has become the fastest-selling non-fiction book of all time. (“Spare” itself refers to being the remaining heir to the throne should something happen to the first in line.) He wrote about how he tried psychedelics, including hallucinogenic mushrooms and ayahuasca, to help cope with crippling grief. He also acknowledges self-medicating with other substances, legal and otherwise.
“I would never recommend people to do this recreationally,” Harry said about psychedelics in a 2023 interview on CBS’ “60 Minutes” with Anderson Cooper. (Cooper himself knows a thing or two about grief, which he explores on his podcast All There Is.) “But doing it with the right people, if you are suffering from a huge amount of loss, grief or trauma, then these things have a way of working as a medicine.”
A 2021 Apple TV+ documentary series on mental health the prince made with Oprah Winfrey, “The Me You Can’t See,” includes video of Harry undergoing EMDR, or eye movement desensitization and reprocessing therapy, which can help people with PTSD manage triggering memories. Earlier, he had helped launch a UK mental health campaign, Heads Together, with his brother Prince William and his brother’s wife (then Duchess, now Princess) Kate.
For more than a decade after Diana’s death, Prince Harry was unable to talk about the loss of his mother – even with his bereft brother. He was unable to cry. He describes a weight on his chest that prevented him from doing so. When his father woke him to tell him the tragic news, Harry told Cooper, “I never shed a single tear. I was in shock. I couldn’t believe it.” It wasn’t until her casket was lowered into the ground that Prince Harry was finally able to sob, even as he refused to accept that his mum was gone.
“She would never do this to us,” he remembers thinking. “I thought it was part of a plan: She would call us and we would join her – I thought this for years. William thought so too. I never gave up hope that maybe this was the day she will reappear,” he said, of a wait that lasted into his early 20s.
Harry’s candor has helped put prolonged grief on the map, say mental health professionals, and by being open about his struggles with grief, he may also help to destigmatize the disorder. His journey shows that even someone with wealth, resources and access to the best care can struggle with complex grief. Equally important, say grief experts, it shows how one can seek professional help and find a way to manage it.
Seven years ago, the now 38-year-old started intensive therapy. In February 2021, Harry relinquished his royal roles and responsibilities after moving from London to Montecito in Santa Barbara County with wife Meghan Markle and their two children. His goal: to live a more “normal” life in California away from the prying eyes of the British press. Now, he says, he is content with many aspects of his new life, though his estrangement from his brother and father, King Charles, remains a source of torment. As for his mother: “I’ve made peace with losing her. I’m now very much focused on turning that pain into purpose.”
Former royal, current mental health advocate
Grief, of course, is a natural human emotion, not a mental disorder. Losing a loved one is a staggering blow, but one all of us face at some point. Shock, horror, numbness, sadness, denial, anger, guilt, helplessness, depression and longing: All are part of grieving and the human condition. Prolonged grief, which affects about 10% of the bereaved, causes sustained emotional pain and desolation that leads the bereaved to isolate and impacts their ability to function, pursue their own interests or plan for the future.
When, exactly, “typical” grieving abates or morphs into prolonged grief is the subject of controversy. Grief is universal, but every person’s grief is unique, including their timeline to traverse the process. Still, in March 2022, the latest edition of psychiatry’s “bible” – the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) – included prolonged grief as a new diagnosis.
Magical thinking like Harry’s can be a protective armor for people overwhelmed by grief. And it isn’t only the realm of the young. When the late author Joan Didion’s husband, fellow writer John Gregory Dunne, died, she couldn’t give away all his shoes, just in case he returned.
“We might expect if the death is sudden to feel shock. We do not expect this shock to be obliterative, dislocating to both body and mind,” she wrote in The Year of Magical Thinking. “We might expect we will be prostrate, inconsolable, crazy with loss. We do not expect to be literally crazy, cool customers who believe their husband is about to return and need his shoes.”
Some adults hold onto the belief that a deceased child will walk through the door again, says Danielle Glorioso, a San Diego social worker in private practice who specializes in treating clients experiencing acute grief, prolonged grief, and suicide bereavement. The “earth-shattering” suicide in 2006 of her younger brother at age 26 had a profound impact on Glorioso, then a graduate student. She decided to change paths and focus on helping people heal from grief.
“Grief is lifelong”
“After my loss I struggled to find a trained grief therapist to help me deal with and process the sadness associated with my loss,” Glorioso said in an interview with MindSite News. Her clients find comfort in knowing that their therapist has professional and personal experience in navigating this emotion, she says.
“Grief is not something to be resolved; it’s not something you get rid of,” adds Glorioso. “It’s about finding ways to adapt, manage and come to terms with grief, which is lifelong.” For her, counseling grieving clients gives meaning to her brother’s life and helps her continue to connect with him.
Prince Harry’s decade-long battle with prolonged grief may be something of an outlier, but there is no set schedule for addressing it, experts make clear.
“Grief has no distance. Grief comes in waves, paroxysms, sudden apprehensions that weaken the knees and blind the eyes and obliterate the dailiness of life,” Didion wrote. “We try to keep the [dead] alive in order to keep them with us. I also know that if we are to live ourselves there comes a point at which we must relinquish the dead, let them go.”
While prolonged grief is a major throughline of Harry’s memoir, he also offers hope for coming out the other side. Grief may remain his constant companion, but it is no longer an all-consuming fixation.
Thankfully, as Prince Harry found, therapy can help people process prolonged grief. That’s critical because complex grief can lead to or worsen depression and anxiety, make people emotionally numb, and create difficulty maintaining relationships. It’s also linked to elevated rates of substance use, suicidal thoughts and attempts.
Treatment for prolonged grief can include talk therapy, cognitive behavioral therapy and exposure therapy similar to that used with people who have experienced trauma. These therapies can help people start to move through the grief – rather than move on from it – and engage in meaningful activities again while they continue to cope with their sorrow.
Getting help is key. One need not be a regular viewer of “The Crown” to appreciate that Charles was woefully emotionally unprepared to help his sons navigate this terrain. In a review on the memoir for The New Yorker, Rebecca Mead calls the British royals “the nation’s most important, most privileged, most scrutinized, most publicly dysfunctional family.” Indeed, the English in general and the royal family in particular – sometimes known as “The Firm” – have a reputation for avoiding uncomfortable feelings and difficult psychological matters: Their “stiff upper lip” keeps them outwardly stoic, resolute and unemotional in the face of adversity.
There’s a difference between so-called normal grieving versus prolonged grief. Prolonged grief is entrenched, and “things look the same for this person today as they did the day after the death,“ Mary-Frances O’Connor, an associate professor of psychology and grief researcher at the University of Arizona and author of The Grieving Brain, explained to the New York Times. “For a person who’s adapting more typically, a year after a loss, they’re still going to have sadness. They’re still going to miss the person who’s gone. But you can see this trajectory of change where they have started to restore a life that feels meaningful to them.”
Indeed, grief experts say the idea of “time healing all wounds” or “moving on” from grief is a myth. The pain may become less intense, but grief remains. “It’s not about taking grief away,” O’Connor said. “It’s about learning how to live with the fact that you are a person who has waves of grief now.”
Glorioso found treatment and later became a certified grief therapy trainer with the Center for Prolonged Grief at the Columbia School of Social Work. The center champions short-term therapy to address the issues raised by complicated grief and helps strengthen a bereaved person’s adaptive capacity. A mix of techniques help people understand grief, manage strong emotions, strengthen close relationships and contemplate the future, while also getting more comfortable revisiting reminders of their loss.
Over the course of 16 weekly sessions, the center’s therapy has been shown to make a marked difference in the life of the bereaved, studies show. “It’s highly effective,” says Glorioso, “and has helped every single one of my clients…integrate grief, heal from their loss and improve their lives.”
Making meaning of profound loss
One challenge is that most therapists have little or no experience recognizing and treating prolonged grief, say experts in the field. Katherine Shear, a professor of psychiatry at Columbia University, founding director of the Center for Prolonged Grief, and a grief researcher, advocated for including prolonged grief in the DSM-5, partly in the hope it will encourage education, research and services – while also making it easier to get prolonged grief treatment covered by health insurance.
“It has been difficult to convince mental health professionals and the educational institutions that train them to prioritize understanding of grief,” Shear wrote in a blog post.
Other therapists are concerned that being diagnosed with a grief “disorder” pathologizes a universal human emotion and could lead to overprescribing of psychiatric medications. They also see the 6-to-12-month marker as arbitrary and say it’s completely normal for grief to extend beyond that time frame.
Therapy can help a grieving person make meaning of their loss. In his book and in interviews, Prince Harry shares memories of Princess Diana, remembers happy times and imagines her inclusion in his current life. These are all signs of healthy healing, writes social worker Sarah Wayland, an associate professor at the University of New England in New South Wales, Australia, in an article about Prince Harry and complex grief for the The Conversation, a nonprofit news site written for the general public by academic experts.
Accessing therapy soon after a loss can help keep grief from becoming prolonged and may be especially helpful for people with underlying mental health conditions or those who lost a loved one under sudden or traumatic circumstances.
As agonizing as it is, severe emotional pain will usually start to lift if a bereaved person is allowed to feel, to talk and to cry, grief experts say. Family, friends and faith communities can help people work through their anguish. A grief support group, especially one focused on a particular type of loss, such as the death of a spouse or a child or a parent, may also help.
Long-term studies in the U.S. have found that children who lose a parent are more likely to struggle academically, suffer from substance use disorders and endure depression. Eventually, however, most adapt, develop resilience and their risk of behavioral health challenges later in life is similar to their non-grieving peers. A grief program for children developed by an Australian nonprofit, Seasons for Growth, emphasizes the importance of allowing children to choose how they grieve.
“Personal agency is key,” notes Wayland. This means giving children the choice of whether to attend performative activities, such as funerals, she writes, and allowing them to share their experiences in a way that makes sense for them. It may also mean –and this is an acceptable emotional response under the circumstances–expressing anger.
The prince finds a separate peace – and purpose
Magical thinking like Harry’s is often motivated by the desire to understand an unimaginable world and can lead children to form inaccurate conclusions about a sudden death, including that they or someone else is somehow responsible for the loss. Experts agree that children dealing with a traumatic death need opportunities to speak openly to people close to them about their loss and their feelings – including guilt or concern that somehow a child is responsible for the death.
“With a 12-year-old like Harry, you would show tremendous respect for the rate and pace that the child was comfortable talking about the loss and help walk them through their fears,” explains Barbara Greenberg, a clinical psychologist who specializes in treating adolescents. “You want to offer tremendous support while helping them understand their own inner resources and resilience to adjust to their grief.”
Greenberg, an advice columnist for MindSite News, has weighed in on sibling relationships through the lens of Spare. She notes that in the age of COVID, many people have faced multiple losses in quick succession, including an uptick in suicides. She welcomes the discussions triggered by the wildly popular book, especially because too often, Greenberg says, dealing with grief is glossed over. “Harry’s done a wonderful thing, a service, by making his grief central to his memoir,” she says.
Prince Harry has said his father, whom he loves, wasn’t equipped to help his sons navigate their devastating loss. In his Netflix documentary series, “Harry & Meghan,” the prince said he didn’t receive the right support in the aftermath of his mother’s death. “I was trying to balance the whole experience of being a young boy who was trying to deal with the loss of his mum without much support or help or guidance,” he said. “It didn’t seem right, it didn’t seem fair.”
Instead, he suffered in silence and in pain. “The pain is also what drives me. Some days the pain is the only thing holding me together. …Without the pain, well she might think … I’ve forgotten her,” he told a therapist when he finally sought help. Harry’s honesty – that grief is a wound that time does not heal – is a message many grieving people can relate to.
In Spare, Harry writes that he misses his mother every day. Some days he still longs for her. But he also says his journey is about the eternal power of love over grief. His example, say experts, can offer hope to fellow sufferers of lasting despair over the loss of a loved one. He now understands that his mother – who longed for peace in the world and at home – would find solace in knowing her son is finally at ease with her passing.
“There was so much I didn’t remember, because I was so young when she died, but the greater miracle was all that I did,” he writes. “Her devastating smile, her vulnerable eyes, her childlike love of movies and music and clothes and sweets – and us. Oh how she loved my brother and me…Well, Mummy, vice versa.”
There is speculation that King Charles will respond to his son’s memoir prior to his May coronation, which Prince Harry and his family plan to attend. Whatever happens, it seems clear that Prince Harry will continue his mental health advocacy. As he said in a recent NPR interview, “If there’s something that I can do, or something that I can share, that is going to save a life, or make people’s lives better and encourage others, and empower others to come forward to share their own story as part of their own healing process, [I’m] kind of willing to do anything.”
Type of work: