Grief and Bereavement

Understanding Grief and Loss

Grief is personal and won’t ever be experienced by two individuals in exactly the same way. That person alone knows the depth of their grief and they need to listen to their own inner coping strategies. There are some people who get stuck at a certain point in their grieving journey and find they cannot move on.

If emotions are just as painful and have the same level of intensity after a considerable lapse in time, it is advisable to seek professional help. Such a decision takes courage and strength but can save unnecessary isolation in reaching a place of resolution and acceptance.

Common grief reactions

Reactions to loss, called grief reactions, vary widely from person to person and vary in the same person over time. Not every person has the same set of reactions, but there are some common ones. Grief reactions include difficult feelings, thoughts, physical sensations, and behaviour.

Feelings: People who have experienced loss may experience a range of feelings, including shock, numbness, sadness, despair, anxiety, anger, guilt, loneliness, helplessness, relief, and yearning. A grieving person may start crying after hearing a song or comment that makes them think of the person who has died. Sometimes, though, someone who is grieving may suddenly start crying for no reason.

Thoughts: Common thought patterns include disbelief, confusion, disorientation, difficulty concentrating, preoccupation, and hallucinations (briefly thinking that you see or hear the deceased person).

Physical sensations: It is common for grief to cause physical sensations, such as tightness or heaviness in the chest or throat, nausea or an upset stomach, dizziness, headaches, physical numbness, muscle weakness or tension, and fatigue. It may also cause vulnerability to illness.

Behaviors: When a person is grieving, it may be difficult to fall asleep or stay asleep, and he or she may lose energy for enjoyable activities or lose interest in eating or interacting socially. A grieving person may also become more irritable or aggressive. Other common behaviors include restlessness, hyperactivity, and listlessness (lack of interest, energy, or spirit).

Religion and spirituality:

Grief may also have religious and spiritual effects on a person's life. Loss may cause a person to question his or her faith or view of the world, or it may strengthen the person's faith by providing a new understanding of the meaning of life.

Stages of grief

Grief is often felt in waves or cycles, with periods of intense and painful feelings that come and go. People who are grieving may feel they are making progress but then suddenly face renewed, overwhelming grief. These renewed periods of grief may occur at significant dates, such as holidays or birthdays, or they may occur without reason. Over time, these periods of intense grieving typically become less frequent and less intense as the person adjusts to his or her loss.

Immediately after a loss, a person may experience shock, feelings of numbness, and disbelief or denial that the loss has occurred. The grieving person may feel disconnected from the world around them while going through mourning rituals, such as wakes or funerals. These initial grief reactions may last up to six weeks or more and may help to distance the person who is grieving from the pain of loss and protect him or her from feeling overwhelmed.

Another common reaction that comes after the initial feelings of numbness and disbelief fade is called confrontation. This reaction can be intensely painful as the grieving person comes to accept the reality of the loss. This reaction can last months or longer and is characterized by waves of distress, despair, and emotional upheaval with conflicting and difficult feelings. The person who is grieving may feel angry with the person who has died or feel guilty for still being alive. The grieving person may cry often, feel disorganized, have difficulty sleeping or getting up in the morning, and have trouble concentrating.

During the acceptance phase of grieving, the grieving person adapts to a new life without his or her loved one. Acceptance of the loss of a close person often occurs slowly over the course of a year or more. Life does not return to normal, but the grieving person may be able to create a new life with new goals and identity, often including unfamiliar roles. For example, a remaining spouse or partner may start taking care of the car for the first time or learn how to cook.

Grief reactions often do not occur in order, and a person may react with the same set of feelings more than once. Reactions may overlap and people may find that their feelings go back and forth. However, understanding the basic grief process can help people know what to expect and help reassure them that their experiences are normal and that the intense pain of grief likely will not last forever.

Five stages of grief - elisabeth kübler ross

EKR stage

Interpretation

1 - Denial

Denial is a conscious or unconscious refusal to accept facts, information, reality, etc., relating to the situation concerned. It's a defence mechanism and perfectly natural. Some people can become locked in this stage when dealing with a traumatic change that can be ignored. Death of course is not particularly easy to avoid or evade indefinitely.

2 - Anger

Anger can manifest in different ways. People dealing with emotional upset can be angry with themselves, and/or with others, especially those close to them. Knowing this helps keep detached and non-judgemental when experiencing the anger of someone who is very upset.

3 - Bargaining

Traditionally the bargaining stage for people facing death can involve attempting to bargain with whatever God the person believes in. People facing less serious trauma can bargain or seek to negotiate a compromise. For example "Can we still be friends?.." when facing a break-up. Bargaining rarely provides a sustainable solution, especially if it's a matter of life or death.

4 - Depression

Also referred to as preparatory grieving. In a way it's the dress rehearsal or the practice run for the 'aftermath' although this stage means different things depending on whom it involves. It's a sort of acceptance with emotional attachment. It's natural to feel sadness and regret, fear, uncertainty, etc. It shows that the person has at least begun to accept the reality.

5 - Acceptance

Again this stage definitely varies according to the person's situation, although broadly it is an indication that there is some emotional detachment and objectivity. People dying can enter this stage a long time before the people they leave behind, who must necessarily pass through their own individual stages of dealing with the grief.

(Based on the Grief Cycle model first published in On Death & Dying, Elisabeth Kübler-Ross, 1969. Interpretation by Alan Chapman 2006-2013.)

Tasks of mourning

Researchers have also described the grief process as a series of tasks that the grieving person may work through to resolve the grief. One model describes four tasks of mourning:

Task one: Accept the reality of the loss

Task two: Experience the pain of grief

Task three: Adjust to an environment in which the deceased individual is missing

Task four: Withdraw emotional energy and reinvest in other activities

Factors affecting grief

Throughout the stages of grief, the nature and intensity of grief reactions and the length of time a person grieves are affected by a variety of factors:

  • The nature of the person's relationship with the deceased (The intensity of grieving over the death of a spouse or parent may be different than the intensity of grieving over the death of a neighbor or coworker.)
  • The cause of death (The grieving process may differ depending on whether the person died suddenly or was ill for an extended time.)
  • The age and gender of the person who is grieving
  • The life history of the person who is grieving, including previous experiences with loss
  • The personality and coping style of the person who is grieving
  • The support available from friends and family, in addition to the family's customs and beliefs surrounding death
  • The religious and spiritual beliefs of the person who is grieving

Grieving is often more difficult and complicated when there are unresolved feelings or conflicts with the person who has died. Sometimes people who are struggling with complicated grief can get help by talking with a counsellor, such as a clinical social worker, psychologist, or spiritual counsellor. People who feel complete and good about their relationship with the person who has died may find that, although they are sad, their grieving experience is quite different than it would be if their relationship with the person had been strained.

 

Grief in different cultures

While each person's grief is unique, the experience is shaped by his or her society and culture. Each culture has its own set of rituals and beliefs surrounding death and bereavement that affect the ways one experiences and expresses grief. Funerals and memorial services help people who are grieving connect with their community and share their grief. However, the way a person expresses or experiences grief may be at odds with cultural expectations for bereavement. Someone who is feeling numbness or disbelief may not cry as might be expected at a funeral. Another person may experience a level of despair that feels out of step with cultural values or beliefs. It is important to allow people to grieve in ways that feel right to them

 

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