Grief, Loss, and Bereavement
Grief and loss are a natural part of being human. Grief is the emotional reaction that comes after the loss of someone or something important in our lives. We grieve over the loss of loved ones, sudden deaths, and expected deaths like loved ones in hospice care. The loss of a family pet can cause grief. The loss of your role as an employee if you lose your job will cause grief. There are various types of losses that we must grieve such as the loss of your former life as a caregiver or loss of your role as wife/husband after divorce.
Parents often experience feelings of loss when their children leave the house. The process of grief also accompanies these events. Although your loved ones may still be living or your old job is still there, you have had a loss. This process can also be known as grief or loss.
When you are grieving the loss of a loved one in your life or the loss of an event or circumstance, grief is experienced differently by each person and is as unique as you are.
There are still general ways people cope with loss. Let’s review the three models of grief Psychologists have outlined below.
Elisabeth Kubler-Ross, 5 stages of grief:
- Denial and Isolation: You may use defense mechanisms and deny the loss of your loved one. But denial in grief is around the disbelief that the death has occurred or will occur.
- Anger: Anger when grieving can be because of the circumstances of the death. You may become angry with the doctor because she could not save your loved one. You may be angry with God if you believe in a higher power. You may be angry that you are left behind and that you did not have more time together.
- Bargaining: You may say things like; “I would have and should have”- “If only I would have called sooner, the accident could have been avoided”, etc. The survivor often has feelings of guilt associated with the loss and wishes they could have done something different.
- Depression: Feeling depressed after a loss is a natural reaction to the loss of a loved one. It does not mean you have a mental health condition. You may feel the sadness will never end. You may feel hopeless or exhausted. These are normal responses to loss and will diminish with time.
- Acceptance: This is when you acknowledge that you are not happy with the loss, but you begin to accept the loss and start to move forward at your own pace. Acceptance comes when you are ready.
Four Tasks of Mourning:
Psychologist J. W. Worden also created a stage-based model for coping with the death of a loved one. He divided the bereavement process into four tasks:
- To accept the reality of the loss. You know intellectually that your loved one is gone but you still feel a sense of disbelief. But the reality sets in when you may have to make funeral arrangements or attend an event without your loved one.
- To work through the pain of grief. Grief is experienced physically, emotionally, cognitively, and spiritually.
- To adjust to life without the deceased. You will have external adjustments to make like learning a new skill or taking on new responsibilities.
- To maintain a connection to the deceased while moving on with life. Gradually you maintain a balance of remembering your loved one and having a full and meaningful life.
Dual Process Model:
As an alternative to the stage-based model, Margaret Stroebe and Hank Schut developed a dual-process model of bereavement. They identified two processes associated with bereavement:
Loss-oriented activities and stressors are those related to death. These include:
- Experiencing sadness, denial, or anger
- Dwelling on the circumstances of the death
- Avoiding restoration activities
Grief work starts when you have strong feelings of sadness and longing for the deceased. It is when you are thinking of your loved one, looking at pictures, and holding their things.
Restoration activities and stressors are associated with secondary losses.
They may involve lifestyle, routine, and relationships. Restoration-oriented processes include:
- Adapting to a new role
- Managing changes in routine
- Developing new ways of connecting with family and friends
- Cultivating a new way of life.
Most people will go between loss-oriented and restoration-oriented activities.
Depression and Grief
Bereavement is not considered a mental health disorder. Yet typical signs of grief, such as social withdrawal, can resemble depression.
How can you tell the difference between grief and depression?
- Grief is typically preceded by loss. Depression can develop for many reasons at any time.
- The sadness present in grief is typically related to the loss or death. Depression is described as a general sense of worthlessness, hopelessness, and lack of joy.
- Symptoms of grief may improve on their own with time. Someone with depression often needs treatment to recover.
Depression and grief are not the same experiences. If someone is vulnerable to depression, grief has the potential to trigger a depressive episode. If someone already has depression, their condition may last longer or make your symptoms of depression worse. A counselor can help you recognize and manage any depressive symptoms you may be experiencing.
You may go through these stages, you may skip the stages and move around some, or you may be stuck in a stage. Counseling can help with the grief process. It is important to express your grief by talking about the death or writing in a journal can help. This allows you to process your feelings and reactions, so you don’t stay fixed in a stage. Research supports talk therapy (counseling) as a way to reduce these signs and symptoms. It’s important to remember, feeling the emotions will help you heal from your loss.
If you have had a loss and are in need of information and support, we are here for you. You can contact our grief counselor, Catherine Vlasto, LCSW to learn more about how grief counseling can help you.