In order to understand grief, we must first understand loss in all its formats. Grief can be defined as the neuropsychobiological response to any kind of significant loss, with elements both typical and unique to each individual or situation. The grief response is generally associated with degrees of suffering, at times intense or even unbearable, and of widely variable duration. Grief is a systemic event, whether the system is an individual or a larger group of individuals thrown out of equilibrium through changes brought on by loss. (Bruce, 2007, p. ES33)
Without an understanding of loss, people risk having difficulty identifying and responding effectively to grief-related problems. I is common to seal over grief from previous losses, sometimes masking it with alcohol or drugs. Children and teens may develop other maladaptive behaviors such as aggression to cope with anger from a significant unresolved loss.
According to Therese Rando (1984), losses may be of two kinds:
1. Tangible (Physical): the permanent loss of a life or an object(like a home in a fire) the state of having experienced the death of a significant person.2. Symbolic (Psychosocial): the loss of a role, identity, bodily function or a relationship. (Divorce and job demotion are examples of symbolic losses.)
Symbolic loss is not always identified or recognized as a loss, and therefore those experiencing symbolic, or “psychosocial,” loss may not realize they need to grieve.
Individuals express their grief uniquely! It is important to understand “normal” and “complicated” grief reactions for your own healing.
Most often, the social and emotional support that is provided by friends, families, and communities is sufficient to assist an individual with normal grief (although the pandemic disrupted these usual supports). This is known as "normal" grief and is defined in mental health as the loss of a loved one that begins to fade into adequate coping mechanism within six months. Over the course of time, with average social support and the opportunity to participate in mourning rituals within a cultural or spiritual community, most individuals will gradually experience a diminishment of acute grief reactions. Normal grief includes common reactions from the chart below.
Individuals with complicated grief may have persistent distress long after a loss. A history of depression, anxiety, or difficult adjustment to previous losses may be contributing factors. Grief therapy is typically recommended for those with complicated or prolonged grief.
Elizabeth Kubler-Ross, MD, (1969), a physician who studied individuals diagnosed with terminal illness who were facing death, made major contributions to our understanding of grief. Publications in the 1960’s and 1970’s described her stage model:
1. Denial and Isolation2. Anger3. Sadness/Depression4. Bargaining5. Acceptance
Kubler-Ross later stated that she never intended for her stages to be used as they were. We cycle through them and back throughout our life.
Grief is not regulated by a specific timeline! We learn to walk alongside grief rather than overcome it move forward rather than move on.
