Grief And Bereavement

Grief is the emotional state experienced after a major loss. When the loss involves the death of a loved one, the state of grief is referred to as bereavement. Bereavement and grief can last for months or years after a loss. As grief is a natural process, the goal of mental health treatment is not to “cure” anything but to help the person work through the symptoms and stages of grief.

In some cases, grief and bereavement develop before the loss has occurred. Anticipatory grief includes feelings of loss accompanying a prolonged illness as the patient and family anticipate the inevitable death. ⁽¹⁾

Sudden, unexpected death or loss may come with other trauma. Grief in these circumstances may require mental health treatment for post-traumatic stress disorder (PTSD) or other unresolved issues.

Stages of Grief

While everyone experiences and works through grief differently, there are a few recognized stages that people experience during the grieving process. One model of addressing intense loss separates the post-loss period into five stages.

The identified stages of grief include: ⁽²⁾

• Denial, which can include feelings of disbelief or numbness when thinking about the loss
• Anger, which may include expressions of blame or angry feelings toward the deceased person
• Bargaining, which often involves attempts to negotiate away the event that led to the loss
• Depression or sadness, which typically includes periods of crying and feelings of loneliness
• Acceptance, which is considered the final stage of grief and involves coming to terms with the loss mentally and emotionally

Grieving individuals don’t necessarily go through these stages in this particular order. Some people skip stages, while others may experience multiple stages of grief at once.

There may also be physical and emotional symptoms that include:

• Headaches and body aches
• Nausea
• Fatigue
• Excessive sleepiness
• Memory lapses and preoccupation
• Depression
• Moments of unexplained euphoria
• Extreme anger or feelings of hopelessness
• Irritability

What Is Grief Counseling?

Grief counseling is a treatment type designed to help people address symptoms of grief and loss. It can include individual or group therapy and may focus on the emotional, psychological, or spiritual aspects of grief recovery, depending on the needs of the bereaved. ⁽³⁾

A 2009 study investigating who benefits from grief counseling found that grieving individuals fell into three groups based on the level of grief symptoms and the coping mechanisms currently in place. People with more symptoms and fewer existing coping mechanisms expressed the desire for and benefited more from counseling than those with fewer symptoms or more robust coping mechanisms. Of those who sought grief counseling, 91% said that the process helped them cope with their bereavement. ⁽⁴⁾

How to Cope With Grief

Because individuals experience grief differently, coping with feelings of loss and bereavement may take many forms. Some people find comfort in talking through their grief with a counselor, trusted friend, or spiritual advisor. Others prefer spending time alone or doing activities to distract themselves from the feeling of grief. The goal is not to make the pain go away entirely but instead to move through the grieving process in a healthy way to reach a point of acceptance and peace.

According to the National Institutes of Health (NIH), about 10% of people who experience a severe loss develop a condition called complicated grief. This type of grief often occurs in conjunction with a traumatic event, such as a natural disaster, sudden medical event, or violent conflict. Complicated grief involves prolonged, intense mourning with recurring thoughts about how the death occurred or might have been avoided. ^{(5, 6)}

Specialized therapy designed to deal with extensive, unrelenting grief may be necessary to help the individual move through the stages of grief. If symptoms last longer than one year, the bereaved person may need help adjusting to the loss.

While the effects of a major loss may never be resolved entirely, healthy coping mechanisms lead the individuals to a place where the pain is tolerable. Successful coping includes adjusting to life without the individual who has died and developing the ability to form new relationships, reconnect with others, and reengage in daily activities. ⁽⁶⁾

How to Help Someone with Grief

Support for a loved one experiencing grief and loss can take many forms. Some specific strategies to help a grieving person include: ⁽⁷⁾

Expressions of Empathy

Empathy involves expressing sorrow about the loss and sympathy for what the grieving individual is going through. Listening to the person process their feelings and acknowledging their emotional stress is better than attempting to make the person feel better or dismissing grief symptoms as temporary.

Offering Practical Support

People experiencing grief often feel overwhelmed and may need help with everyday tasks. Offering to provide meals, help with childcare, or run errands for the grieving individual can help ease the burden.

Asking Questions

Sometimes, a person immersed in grief may need different things, depending on their current mental state. Asking if the person prefers to talk about their loved one or participate in a distracting activity lets them guide their own grief process. In some cases, the person may prefer to deal with grief internally.

Talking About the Deceased Individual

In the case of grief associated with death, sharing pleasant memories of the deceased person can help relieve grief. Friends and family members may be uncertain whether to bring up the loss, but talking about a loved one who has died can be an essential part of the grieving process. Another idea is to do something to honor the memory of the person who died, such as creating a virtual memory book or sharing a special meal.

Presenting Multiple Options to the Bereaved Individual

Sometimes, a grieving person is not able to focus on immediate needs and may not know what kind of help to request. Presenting options such as bringing over takeout or taking the person to a restaurant for a meal can help narrow down the possibilities. When in doubt, it’s okay to ask the grieving person how you can best help them out.