Grief

Everyone deals with grief differently. Some cry for days, hardly taking a moment to care for themselves. Others laugh, whether nervously or because they manage pain with humor. Others feel numb and wonder why they aren’t crying or laughing like the others.

Each of these reactions is normal—there’s no right way to grieve!

That being said, grief can become a problem. Grief can trigger dormant mental illness, bring back old traumas, or the grief itself might persist far longer than it should.

What is Grief?

Grief refers to the thoughts, feelings, and behaviors connected to the loss of something important. It could be the loss of a relationship, a loved one, a job, an object, or anything else a person values. However, when we talk about grief, it’s usually in the context of bereavement.

Bereavement refers specifically to the period of mourning after the death of a loved one. In this guide we will be focusing on bereavement, but the information can pertain to other forms of grief, as well.

The Process of Grieving

Before describing the “normal” process of grieving, we should note that what’s normal varies wildly between cultures, individuals, and situations. The following information serves as only a small window into what one should expect.

Acute Grief

For several months after the loss of a loved one, a person may experience symptoms of acute grief.

Although these symptoms are common, they are very intense. Typically, those who are grieving will still be able to experience moments of happiness. This differentiates grief from depression, where even brief glimpses of happiness are rare.

The symptoms of acute grief will generally begin to resolve themselves naturally. Over the course of several months, the sadness associated with grief will lose some of its intensity, and other symptoms will become less frequent.

Integrated Grief

As the deep wound of acute grief heals, integrated grief begins. During this stage, a person resumes normal activities as the pain of grief slowly subsides. This does not mean that the bereaved misses their loved one any less, or that the pain fully disappears. Instead, the bereaved has learned to integrate the loss into their life. They have found a way to stay connected with the deceased within the context of a new reality without their loved one.

Occasionally, the bereaved will fall back into acute grief (especially around significant events, such as holidays and anniversaries). This is normal, and does not represent a failure. It’s simply another part of the process.

For many, integrated grief will be a permanent, normal, and healthy stage. The bereaved will continue to feel heartache for the rest of their lives, and they will never stop missing their loved one, but the symptoms of grief are no longer debilitating. They have made sense of the loss, and they accept its reality.

Complicated Grief

When a person fails to transition from acute to integrated grief, they may develop complicated grief. During complicated grief, the bereaved experiences symptoms of acute grief for years after the loss. Memories of the deceased continue to be frequent, deeply painful, and debilitating.

A person with complicated grief may become ashamed of their grief, and wonder why they haven’t managed to recover. Other times, they feel that enjoying their life, or overcoming grief, is a betrayal to the deceased.

Psychotherapy can help those who are experiencing complicated grief. Typically, the goals of therapy for complicated grief revolve around overcoming obstacles to the normal grieving process, and coming to terms with the loss.

A Metaphor for the Grief Process

Other Models of Grief

Because of the many unique ways that grief is experienced, no model of grief can perfectly describe every person’s experience. However, learning about the various models of grief can help clients make sense of their own feelings, and learn that they are not alone in their experience.

The Two Styles of Grief

The ways that people grieve can usually be categorized into two basic styles: instrumental and intuitive grief. In reality, these styles exist on a continuum. A person might lean toward one or the other, but no one experiences exclusively one style.

Instrumental Grief	Intuitive Grief
Focus on the “thinking” part of grief. Often involves problem-solving, such as making funeral arrangements. Recurring thoughts about the circumstances of death: the how and why. Less emotionally expressive about loss.	Focus on the “feeling” part of grief. Strong emotional responses to loss, and more outward display of emotion. More likely to seek emotional support.

Stereotypes tell us that men are instrumental grievers, and women are intuitive grievers. While men and women are more likely to grieve in these ways, there’s significant crossover between genders. Many men grieve with the “emotional” style, and vice versa.

Five Stages of Grief (The Kübler-Ross Model)

Denial, anger, bargaining, depression, and acceptance. These stages make up what is perhaps the most well-known model of grief: the Kübler-Ross model. Each stage represents a common emotional response to significant loss. **Something that is important to remember is you may not go through these stages in order; you can go back and forth between stages.

The stages as a very loose depiction of what a person may experience during grief.

*The above information is thanks to Therapistaid.com

References
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

2. Neimeyer, R.A. (2000). Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies, 24, 541-558.

3. Versalle, A., & McDowell, E. E. (2005). The attitudes of men and women concerning gender differences in grief. OMEGA-Journal of Death and Dying, 50(1), 53-67.

4. Zisook, S., & Shear, K. (2009). Grief and bereavement: what psychiatrists need to know. World Psychiatry, 8(2), 67-74.