Grief, Loss, and Bereavement

Overview

When we lose a loved one, the pain we experience can feel unbearable. Understandably, grief is complicated and we sometimes wonder if the pain will ever end. We go through a variety of emotional experiences such as anger, confusion, and sadness.

The 5 Stages of Grief

A theory developed by psychiatrist Elisabeth Kübler-Ross suggests that we go through five distinct stages of grief after the loss of a loved one: Denial, anger, bargaining, depression, and finally acceptance.



Denial

The first stage in this theory, denial helps us minimize the overwhelming pain of loss. As we process the reality of our loss, we are also trying to survive emotional pain. It can be hard to believe we have lost an important person in our lives, especially when we may have just spoken with this person the previous week or even the previous day.

Our reality has shifted completely in this moment of loss. It can take our minds some time to adjust to this new reality. We are reflecting on the experiences we have shared with the person we lost, and we might find ourselves wondering how to move forward in life without this person.

This is a lot of information to explore and a lot of painful imagery to process. Denial attempts to slow this process down and take us through it one step at a time, rather than risk the potential of feeling overwhelmed by our emotions.

Denial is not only an attempt to pretend that the loss does not exist. We are also trying to absorb and understand what is happening.

Anger

It is common to experience anger after the loss of a loved one. We are trying to adjust to a new reality and we are likely experiencing extreme emotional discomfort. There is so much to process that anger may feel like it allows us an emotional outlet.

Keep in mind that anger does not require us to be very vulnerable. However, it tends to be more socially acceptable than admitting we are scared. Anger allows us to express emotion with less fear of judgment or rejection.

Unfortunately, anger tends to be the first thing we feel when we start to release emotions related to loss. This can leave you feeling isolated in your experience and perceived as unapproachable by others in moments when we could benefit from comfort, connection, and reassurance.

Bargaining

When coping with loss, it isn’t unusual to feel so desperate that you are willing to do almost anything to alleviate or minimize the pain. Losing a loved one can cause us to consider any way we can avoid the current pain or the pain we are anticipating from loss. There are many ways we may try to bargain.

Bargaining can come in a variety of promises including:

• “God, if you can heal this person I will turn my life around.”
• “I promise to be better if you will let this person live.”
• “I’ll never get angry again if you can stop him/her from dying or leaving me.”

When bargaining starts to take place, we are often directing our requests to a higher power, or something bigger than we are that may be able to influence a different outcome. There is an acute awareness of our humanness in these moments when we realize there is nothing we can do to influence change or a better end result.

This feeling of helplessness can cause us to react in protest by bargaining, which gives us a perceived sense of control over something that feels so out of control. While bargaining we also tend to focus on our personal faults or regrets. We might look back at our interactions with the person we are losing and note all of the times we felt disconnected or may have caused them pain.

It is common to recall times when we may have said things we did not mean, and wish we could go back and behave differently. We also tend to make the drastic assumption that if things had played out differently, we would not be in such an emotionally painful place in our lives.

Depression

During our experience of processing grief, there comes a time when our imaginations calm down and we slowly start to look at the reality of our present situation. Bargaining no longer feels like an option and we are faced with what is happening.

We start to feel the loss of our loved one more abundantly. As our panic begins to subside, the emotional fog begins to clear and the loss feels more present and unavoidable.

In those moments, we tend to pull inward as the sadness grows. We might find ourselves retreating, being less sociable, and reaching out less to others about what we are going through. Although this is a very natural stage of grief, dealing with depression after the loss of a loved one can be extremely isolating.

Acceptance

When we come to a place of acceptance, it is not that we no longer feel the pain of loss. However, we are no longer resisting the reality of our situation, and we are not struggling to make it something different.

Sadness and regret can still be present in this phase, but the emotional survival tactics of denial, bargaining, and anger are less likely to be present.

Types of Grief

As we consider the five stages of grief, it is important to note that people grieve differently and you may or may not go through each of these stages, or experience each of them in order. The lines of these stages are often blurred—we may move from one stage to the other and possibly back again before fully moving into a new stage.

In addition, there is no specific time period suggested for any of these stages. Someone may experience the stages fairly quickly, such as in a matter of weeks, where another person may take months or even years to move through to a place of acceptance. Whatever time it takes for you to move through these stages is perfectly normal.

Your pain is unique to you, your relationship to the person you lost is unique, and the emotional processing can feel different to each person. It is acceptable for you to take the time you need and remove any expectation of how you should be performing as you process your grief.

Additional Models

Although the five stages of grief developed by Elisabeth Kübler-Ross is considered one of the most easily recognizable models of grief and bereavement, there are other models of grief to be noted as well.

Each model or theory works to explain patterns of how grief can be perceived and processed. Researchers on grief and bereavement hope to use these models to provide understanding to those who are hurting over the loss of a loved one, as well as offer information that can help those in the healing professions provide effective care for those in need of informed guidance.

Attachment Theory and Grief

Legendary psychologist John Bowlby focused his work on researching the emotional attachment between parent and child.³ From his perspective, these early experiences of attachment with important people in our lives, such as caregivers, help to shape our sense of safety, security, and connections.

British psychiatrist Colin Murray Parkes developed a model of grief based on Bowlby’s theory of attachment, suggesting there are four phases of mourning when experiencing the loss of a loved one:

• Shock and numbness: Loss in this phase feels impossible to accept. Most closely related to Kübler-Ross’s stage of denial, we are overwhelmed when trying to cope with our emotions. Parkes suggests that there is physical distress experienced in this phase as well, which can lead to somatic (physical) symptoms.
• Yearning and searching: As we process loss in this phase, we may begin to look for comfort to fill the void our loved one has left. We may try to do so by reliving memories through pictures and by looking for signs from the person to feel connected to them. In this phase, we become very preoccupied with the person we have lost.
• Despair and disorganization: We may find ourselves questioning and feeling angry in this phase. The realization that our loved one is not returning feels real, and we can have a difficult time understanding or finding hope in our future. We may feel a bit aimless in this phase and find that we retreat from others as we process our pain.
• Reorganization and recovery: In this phase, we feel more hopeful that our hearts and minds can be restored. As with Kübler-Ross’s acceptance stage, sadness or longing for our loved one doesn’t disappear. However, we move towards healing and reconnecting with others for support, finding small ways to reestablish some normalcy in our daily lives.

How to Help When Others Are Grieving

It can be so difficult to know what to say or do when someone who has experienced loss. We do our best to offer comfort, but sometimes our best efforts can feel inadequate and unhelpful.

Here are a few tips to keep in mind:

• Avoid rescuing or fixing. Remember, the person who is grieving does not need to be fixed. In an attempt to be helpful, we may offer uplifting, hopeful comments, or even humor, to try to ease their pain. Although the intention is good, this approach can leave people feeling as if their pain is not seen, heard, or valid.
• Don’t force it. We may want so badly to help and for the person to feel better, so we believe that nudging them to talk and process their emotions before they’re truly ready will help them faster. This is not necessarily true, and it can actually be an obstacle to their healing.
• Make yourself accessible. Offer space for people to grieve. This lets the person know we’re available when they’re ready. We can invite them to talk with us but remember to provide understanding and validation if they are not ready just yet. Remind them that you’re there and not to hesitate to come to you.