Grief is the anguish experienced after a significant loss, usually the death of a beloved person. Bereavement is the objective situation one faces after losing an important person.
Although the terms are often used interchangeably, researchers use bereavement to refer to the ‘fact’ of having lost someone or something, while grief is the emotional response to the situation. But, grief has no singular pattern and everyone experiences it differently. Initially, it was used to signify the emotions experienced after the death of a loved one, but now the definition is broader and includes other losses like - losing a house or a pet.
Grief can be adopted in many forms depending on the situation.
Abrupt grief occurs with any sudden or unexpected loss - the sudden death of a relative or loved one. It is one of the most common types of grief.
Prolonged grief is when feelings of anguish stay with you for an extended period. DSM 5 defines prolonged grief disorder or complicated grief as an intense preoccupation with the feeling of loss for more than a year after the inciting incident. People with possible prolonged grief disorder should seek the help of a mental health professional.
Delayed grief is described as denial initially, followed by intense grief when the weight of the loss becomes a reality. This can be normal as the initial shock and numbness can occur after a devastating event.
Perhaps one of the least acknowledged forms of grief, disenfranchised grief is when society disregards your anguish owing to a lack of knowledge or acceptance, like with issues concerning substance use or STD-related complications.
When you know the outcome of any situation is ultimately a grave loss, you begin to experience feelings of deep sadness before the event has occurred. This most commonly occurs when a loved one is facing a long term, terminal illness.
Elizabeth Kubler Ross, a psychiatrist proposed a model involving five stages of grief in her book, ‘Of Death and Dying’ in 1969. Though it has been over 50 years, the model still holds relevance.
What is often not understood is that Kubler Ross states that everyone experiences these stages differently. Two people suffering from the same loss – like the loss of a parent or a house, could have very different reactions. Broadly, most people go through the five stages before they reach acceptance. There is no set time frame for each stage.
Most people react to devastating news with shock and numbness. It is almost as though our mind is rejecting the information, not wanting to believe that it is true. If you hear that your spouse has only a few months to live, or that your friend ended her life – it is only natural to not want it to be true. A period of denial is also the time to process the heavy information you have been given. However, prolonged periods of denial can be harmful as it doesn't allow the recipient to try to move ahead with their life.
‘Why me?’ is one of the most common responses of a grief-stricken person. Psychologist David Kessler said “Anger is pain’s bodyguard. It’s how we express pain. That stage gives people permission to be angry in healthy ways, and to know it’s not bad.” Often grief-stricken people start by feeling numb and lost and anger acts as an anchor. It gives people the feeling of control to express anger at something. Try to express your anger through exercise, a punching bag, or sometimes, just screaming into the dark.
Bargaining further travels into a person’s journey of trying to gain control over their emotions. Sometimes, the bargaining can be rational, like a promise to stop smoking or to adhere to treatment plans. Sometimes, it can be a bargain with God or a higher power for a different outcome.
During this stage, people experience intense sadness and sometimes anhedonia (a lack of interest in activities or inability to experience pleasure). Everything reminds them of the loss that they are grieving. While the first three stages often shield you from the pain, this stage is when the reality of the situation dawns and is crystal clear. People may even experience insomnia or excessive sleeping, lack of concentration, decreased appetite, and excessive tiredness. This isn’t the same as clinical depression though there is a fair amount of overlap.
The last of the five stages, acceptance involves finally coming to terms with the loss. You are possibly feeling OK with being a widow, or you’re ready to adopt a new pet. This doesn’t mean you won’t feel sad, there will be moments of sadness, which can often come in waves. However, you will know that it is momentary and you will develop methods to cope. All these stages are considered normal responses to grief.
“People often believe they should feel a certain way,” says Dr. Wendy Lichtenthal, a Psychologist at Memorial Sloan-Kettering Cancer Center. Although there are stages and guidebooks, people experience grief on different timelines. Do not feel pressured to feel normal in a stipulated time. Allow yourself to traverse your healing journey, and surround yourself with people who support you.
Lisa Shulman, MD, FAAN, professor of neurology at the University of Maryland who lost her husband to cancer wrote a book titled ‘Before and After Loss: A Neurologist's Perspective on Loss, Grief, and Our Brain’ where she describes journaling as an excellent tool in her healing process. It also helped her understand what was truly distressing and put it into words. It encouraged her to introspect into complicated aspects of loss like, ‘what it means to move on’. Both the process of writing and reading her own words was cathartic for Professor Shulman and can be for others as well.
There are a vast array of resources constructed to help you deal with grief. From books to videos to guided journals and support groups, the opportunity to serve comfort from other people who have felt similar pain can be liberating. Seeking solace in a community can offer comfort during a period of loneliness, and if you feel like that could help you, it is worth considering.
While coping with grief, it is important to prioritize your feelings for some time. Not everyone processes grief by talking about it. Some people may prefer to express themselves by exercising, swimming, or painting. Finding activities that help anchor you to the present even for a few minutes is helpful. And grief can be quite exhausting, so being gentle with yourself is key.
Wendy Lichtenthal, Director of MSK’s Bereavement Clinic says - “we only learn about our capacity to handle things by moving through them."
At Bloom Clinical Care Counseling and Therapy Services, we are Social Workers registered with the OCSWSSW. We have 25+ years of experience in supporting people experiencing grief & bereavement, depression, anxiety, guilt, anger, low self-esteem, stress, relationship issues and other mental health challenges. We do not require any referrals and are always welcoming new clients.
If you are looking for therapists near you in Toronto, Bloom Clinical Care is located at 1200 Markham Road, Suite 306C, M1H 3C3. We also offer virtual therapy options by phone or video call across Ontario. Help is available, and we may be able to help
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