Grief is a complex emotional experience that occurs after a significant loss in a person’s life, often associated with the loss of a loved one. During the grieving process, an individual undergoes various emotional, psychological, and physiological processes that naturally occur as a person processes loss and adjusts to life after loss.
Zisook and Shear (2009) also propose that it is important to see grief as a non-linear, ongoing process rather than a static state of being. The spectrum of emotional, cognitive, social, and behavioral disruptions of grief is broad, and can range from barely noticeable alterations to profound anguish and dysfunction. If you or someone you love is experiencing grief and could use some support, reach out to one of our qualified New York Behavioral Health (NYBH) clinicians, who are skilled in grief and bereavement counseling.
Theories Defining Grief and Bereavement
Attachment Theory, as proposed by Bowlby (1969), outlines humans having an innate need to form attachments with others, and the loss of an attachment figure can yield grief. Here, it is suggested that grief is a natural response to the disruption of an important attachment, and the degree of closeness in attachment can influence the intensity of the grief experienced.
The Dual-Process Model of Coping with Bereavement (loss of a loved one) proposed by Strobe and Schut (1999) suggests that grief takes place in two parts. The first, called loss-oriented coping, is where an individual focuses on the loss and associated emotions. The second, restoration-oriented coping, is where the individual focuses on adapting to a future with this loss present. The model is not linear, and fluctuation between the two processes is seen as healthy in the grief process.
The Tasks of Grief, proposed by Worden (Martin, 2019) suggests that grief includes four tasks of effective grieving: accepting the reality of the loss, processing the pain of grief, adjusting to a world in the absence of the lost loved one, and finding ways to maintain connected to the lost loved one while moving forward with life.
The Grief Cycle
The grief cycle, proposed by Elisabeth Kübler-Ross (1969), is a widely accepted model describing the emotional and psychological process that individuals undergo after experiencing significant loss. Also known as “the five stages of grief,” it is composed of denial, anger, bargaining, depression, and acceptance. Within the model, individuals will experience different frequencies, durations, and intensities of which each of the stages is experienced.
It is also important to note that, like other models, the grief cycle is not a linear or predictable process, and a grieving individual can experience the weight of moving through more than one stage at a time. Though the model provides a clear understanding of what is to be expected when navigating grief, it is also important to recognize that such a roadmap is a skeletal structure, and professional support is recommended to help address individual grieving needs.
Signs and Symptoms of Complicated Grief
Complicated grief, also known as prolonged grief disorder, is a persistent form of grief that can be debilitating for an individual’s mental health and overall quality of life. Complicated grief is characterized as the result of an individual’s inability to transition from acute to integrated grief (Zisook & Shear, 2009). Simply stated, prolonged grief disorder is the result of grief over a particular loss that continues to perpetuate in one’s life, rather than integrate and transition into next stages of life; it is extended in time, intense, and interferes with daily functioning.
Some important factors indicating prolonged grief disorder include a persistent and intense yearning or longing for that which was lost, difficulty accepting the loss, intense emotional pain and distress, difficulty engaging in daily activities, preoccupations with thoughts of that which was lost, as well as social and emotional isolation, among others. Separation distress and traumatic distress can also be associated with complicated grief (Zisook & Shear, 2009).
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Defining and Expanding Ideas Around Loss
Loss, as we often think of it, is paired with grief in the context of bereavement, or loss of a loved one, but the spectrum of loss and what precedes grief expands past loss of life. There is also loss of a relationship or a marriage (divorce), loss of a job, loss of a limb, loss of a pregnancy (or child), loss of a home (eviction or natural disaster), and even loss of self (often through trauma). While we may default to loss of a loved one, it is important to also recognize that grief isn’t an experience exclusive to death.
The Connection Between Grief and Loss
Grief and loss are deeply connected, with grief being the emotional and experiential response to loss. Grief can include a range of feelinging within the experience such as sadness, anger, guilt, confusion, frustration, and despair, depending on the nature of the loss, the supports in the individuals life, and other social and cultural factors (Stroebe, Schut, & Boerner, 2017). These factors will also have an impact on the duration and intensity of the grief for many individuals.
Loss can also have a significant impact on an individual’s sense of identity and meaning. This type of disruption can lead to an individual reconstructing their sense of identity and meaning during their grieving process (Parkes, 1964). Grief additionally helps individuals cope with the challenges that are inevitable with loss, and this coping is intertwined with the grief cycle, and the emotional loops an individual can incur during this process.
Therapeutic Treatment for Grief
Treating grief can be a complex process that requires a personalized and multifaceted approach. For therapeutic treatment, grief counseling is designed to help individuals who are experiencing grief and loss. The purpose of grief counseling is to provide emotional support, help the individual navigate the complex emotions and thoughts associated with grief, and offer practical strategies for coping with their loss.
Grief counseling may be conducted in individual or group settings, and may involve a range of therapeutic techniques such as cognitive-behavioral therapy (CBT), mindfulness-based approaches, and expressive therapies. The ultimate goal of grief counseling is to help the individual move through their grief in a healthy way and find a way to adapt to life without their loved one. It is important to note that grief counseling is not a one-size-fits-all approach and that the specific techniques and strategies used may vary depending on the individual’s needs and circumstances.
Managing Grief Over Time
Managing the symptoms and challenges that pair with grief is necessary to help regulate the experience and effectively cope with the difficulties that are associated with life after loss. One of the most important factors in managing grief is seeking and building a support network and leaning into help from others. Having a community of family, friends, professionals, peers in a support group, and communal support personnel is important to cultivate to help manage grief over time (Bonanno, 2004).
Taking care of your basic and essential needs also becomes top priority when managing grief; eating well, getting enough sleep, and moving your body regularly are all imperative to staying as healthy as possible during a time of grieving. Incorporating activities inclusive of relaxation, stress-reduction, and restoration, are also very important components in managing grief (Stroebe, Schut, & Boerner, 2017).
Engaging in meaningful activities, such as hobbies or special interests, are additional powerful management tools in the grief process because they provide structure and can bring a sense of purpose (Parkes, 1964). Finally, leaning into coping skills like journaling and mindfulness techniques are go-to management strategies for making room for our grief over time.
Supporting Someone Who is Experiencing Grief and Loss
Supporting someone who is experiencing grief and loss can be challenging, but we are all seemingly bound to help a loved one through their grieving experience in our lifetime. Active listening without judgment is a primary feature of healthy and meaningful support. Individuals who are grieving are looking to be able to express their emotions in the presence of someone with whom they feel safe and comfortable; having open ears, an open mind, and an open heart are key here.
Patience is also an essential feature of support, as grieving can take longer than most would like, and it is possible to see cycles of hope and despair. Finally, respecting the individual’s grieving process is of particular importance, allowing the individual to experience their grief as it happens, without the pressures of conforming to societal expectations or timelines (Stroebe, Schut, & Boerner, 2017).
Multicultural Considerations for Grief and Loss
Grief and loss are universal experiences that affect individuals from all cultural backgrounds. Despite the universality of the experience, the way in which individuals and communities express and respond to grief is largely dependent on the person’s cultural and identity factors. Such factors include cultural beliefs and practices that can influence how an individual mourns and honors the loss, as well as what beliefs are held about post-life experiences.
Language and communication are also important to consider as the way in which grief is expressed can be contingent upon native language without salient translations to other languages (Pentaris, 2011). There are also social stigmas associated with grief in certain cultural contexts that play a large role in how a person expresses their grievances publicly. It is important here to remember that no grief process is created equal, no matter how universal the cumulative experience may be. Rosenblatt (2008) posits that culture creates, influences, shapes, limits, and defines grieving, which are exceedingly important to consider when supporting the grieving person.
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Helpful Resources for Grief
With the universal impact of grief spanning across all identity spectrums, there are an abundance of resources that can be helpful for grief and loss. Online resources such as the National Alliance for Grieving Children, and other national associations such as the American Psychological Association (APA), and the National Institute of Mental Health (NIMH) are all great resources for support.
There are also religious and spiritual outlets, local and national grief support groups and networks, grief and crisis support hotlines, as well as books, podcasts, and literature all dedicated to grief information, care, and support. Among these, professional help is considered a top resource for assistance through grief and loss. If you would like to know more about how a NYBH therapist can help support you or a loved one in their grief, you can contact our care team to book a free phone consultation and discuss your treatment options.
Grief and loss compose a complex human experience that is universal in reach, but individual in emotional and physiological processes. There are several theories that help to bring forth a definition and characteristics of grief, but it is ultimately an individual, non-linear, unique-to-a-person’s-cultural-and-identity, ongoing experience that can vary in both its duration and intensity.
Grief that does not naturally transition through all the stages of the grief cycle often turns into complicated grief, and can have a significant impact on a person’s well-being and overall quality of life. What’s most important to remember is that grief is treatable, and there are supports in place to help individuals cope, process, transition, and find space for grief in their lives.
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