Understanding bereavement: grief, loss, and healing.

Grief is a deeply personal and complex journey that touches everyone in different ways. While most of us associate bereavement with the death of a loved one, there are many types of loss that can trigger the grieving process. Loss can come in many forms, not just through death but also through significant life changes that impact our sense of self, security, and connection.

In this blog, we’ll explore the different types of bereavement and loss, how grief can affect both mental and physical health, and the ways in which therapy can help individuals navigate these emotional challenges. Through their grief journey, helping them understand and cope with the complex emotions associated with loss.

Types of bereavement and loss

Death and traditional bereavement

The most common type of grief is the loss of a loved one through death. This could be the death of a spouse, parent, child, or friend. The emotional and physical toll from such a loss can be overwhelming. It’s normal to experience a wide range of feelings, from shock to intense sadness, anger, and sometimes even guilt. This type of grief often comes with an acute sense of emotional pain and can significantly disrupt day-to-day life.

Vicarious bereavement

Vicarious grief refers to the grief experienced through the suffering or loss of another person. It’s common in people who care for individuals experiencing terminal illness, trauma, or serious health problems. You may grieve alongside someone you care about, particularly when you witness their pain or when the outcome is inevitable. The emotional toll of this type of grief can be just as profound as direct loss.

Ambiguous loss

Ambiguous loss is a complicated form of grief where the loss is unclear or unresolved. This may occur when a loved one is physically present but mentally or emotionally absent, as in cases of dementia, Alzheimer’s, or severe addiction. It can also happen when a person goes missing, or when there’s a significant life change, such as divorce, where the end of the relationship isn’t clear-cut. The lack of closure in these situations can make the grieving process feel prolonged and uncertain.

Grief through life changes

Grief isn't always related to death. Life changes, while sometimes positive, can trigger grief as we mourn the loss of familiar roles, routines, or stages in our lives.

The transition to menopause can bring physical and emotional changes, and some women experience grief as they come to terms with the loss of fertility, changes in their body, and the shift in how they view themselves.

The end of a marriage or long-term relationship often brings grief due to the loss of the life you imagined, the future you planned, and the daily companionship. It’s not only the emotional loss of the relationship but often the loss of shared connections with friends, family, and even financial stability.

Though retirement is often seen as a positive life milestone, it can bring a sense of loss related to work identity, daily structure, and social connections. Many retirees experience a mourning process as they navigate the loss of the work environment and purpose.

When children leave home, parents often experience an "empty nest" grief. The loss of day-to-day parenting and the shift in the family dynamic can lead to feelings of emptiness, sadness, and a need to redefine personal identity.

Chronic illness or a severe health condition can lead to a grieving process as individuals come to terms with the loss of physical abilities, independence, or a change in how they see themselves. The emotional weight of facing limitations can be just as impactful as physical suffering. The loss of a limb, whether through amputation or a traumatic injury, can be a significant grief experience. The physical loss is accompanied by an emotional adjustment, as individuals navigate how their body and sense of self have changed.

Moving home can feel like a bereavement because it often involves the loss of familiar spaces, routines, and a sense of stability, which can trigger deep emotional reactions. Much like experiencing the death of a loved one, moving home can evoke feelings of grief for several reasons:

Loss of Attachment.  Just as people can develop strong emotional connections to loved ones, they can also become attached to their homes. These attachments may involve memories of milestones, relationships, or comfort. Saying goodbye to a place where someone has lived for years can feel like losing a part of their identity or history. Disruption of Routine. Moving forces people to leave behind daily routines, interactions with neighbours, or established surroundings. This disruption can bring about a sense of uncertainty and loss of control, similar to the feelings one might experience when faced with a sudden change or bereavement.

Sense of Finality. Moving away from a home can feel like a finality, much like the end of a chapter in life. The act of leaving often marks a transition, and the emotional response can be similar to the grieving process as people come to terms with this "end" and adapt to new circumstances. Emotional Attachment to the Environment. A home can symbolise security, comfort, and belonging. When we leave that behind, we might feel vulnerable or displaced, which can stir emotions akin to mourning the loss of something precious. Nostalgia and regret. Like any loss, moving can bring about feelings of nostalgia for the good times spent in the old home, alongside possible regrets or "what-ifs" about leaving. People may also struggle with "unfinished business," such as saying goodbye properly or feeling that they didn’t get enough closure with the place. Moving home can trigger emotional responses that are very similar to those experienced during grief or bereavement because it involves a form of loss, change, and adjustment. The process often requires individuals to mourn what they’ve left behind before they can fully embrace their new surroundings.

Grief’s impact on mental and physical health

Grief doesn’t just affect your emotions—it has a profound impact on your mental and physical health. Mentally, grief can lead to feelings of depression, anxiety, and confusion. The mind may constantly replay memories, struggle with regret, or experience an overwhelming sense of hopelessness. This can affect focus, decision-making, and day-to-day functioning.

Physically, grief can manifest as fatigue, loss of appetite, sleep disturbances, or even physical pain. Chronic stress due to grief can weaken the immune system, increase inflammation, and lead to conditions like high blood pressure or heart problems. The grief process is often felt in the body as much as in the heart, and it’s important to recognise how the emotional and physical aspects of grief are intertwined.

What are grief models and how do they support the grieving process?

Grief models are frameworks that aim to explain and help people understand the complex emotional, psychological, and physical responses we experience after a loss. These models are not one-size-fits-all solutions but offer insights into how grief can unfold and evolve, helping individuals process their feelings in a structured way. While grief is highly personal and can manifest differently for everyone, grief models provide valuable guidance for both individuals navigating their own grief and therapists offering support.

In this blog post, we’ll explore some of the most well-known grief models, explain how they work, and show how they can help support individuals through the grieving process.

The Kubler-Ross five stages of grief

One of the most widely recognised grief models is Elisabeth Kübler-Ross's five stages of grief, introduced in her 1969 book, On Death and Dying. Initially, this model was based on observations of terminally ill patients, but over time it has been applied to various forms of loss, including the death of a loved one, the end of a relationship, or even a life-changing illness. The five stages are:

Denial. This is the initial shock or disbelief after a loss. The person may feel numb or have difficulty accepting what has happened.

Anger. Feelings of frustration and helplessness can manifest as anger, sometimes directed at others, the person who passed, or even themselves.

Bargaining. This stage involves attempting to reverse or avoid the loss, often by making deals with a higher power, such as "If I do this, will I be spared from this loss?"

Depression. At this point, the reality of the loss settles in, and sadness, despair, and deep sorrow are common.

Acceptance. The final stage involves coming to terms with the reality of the loss. Acceptance does not mean forgetting or moving on, but rather learning to live with the loss and finding a way to move forward.

How it supports? The Kubler-Ross model is helpful for understanding that grief is not linear. People may experience these stages in different orders or revisit certain stages throughout their grieving process. This model validates that feelings of loss and pain are normal and part of a healing journey.

The Worden four tasks of mourning

In 1991, J. William Worden introduced the Four Tasks of Mourning, which focus more on the actions individuals can take to process their grief rather than a set of emotional stages. Worden’s model presents mourning as an active, ongoing process.

Task 1: Accept the reality of the loss. The first task involves recognising that the loss has occurred and accepting it emotionally. This might be the most difficult step, especially in the case of sudden or unexpected losses.

Task 2: Experience the pain of grief. Grieving individuals must allow themselves to feel the pain and sorrow that comes with loss, rather than avoiding or suppressing these emotions.

Task 3: Adjust to an environment in which the deceased is missing. This task is about making practical and emotional adjustments to life without the person. It might involve reorganising daily routines, redefining roles, or finding new ways to fill the emotional gap left by the loss.

Task 4: Find an enduring connection with the deceased while embarking on a new life. While acknowledging the loss, this task focuses on finding a way to maintain an emotional connection to the deceased without letting the grief dominate life. It encourages individuals to continue living fully while honoring their memories.

How it supports. Worden’s model provides a more flexible, task-based approach, acknowledging that grief may not follow a predictable path and can be unique for each person. It emphasises the importance of moving through grief in manageable steps and encourages individuals to keep progressing, even after an initial overwhelming sense of loss.

The dual process model of grief

Margaret Stroebe and Henk Schut's Dual Process Model of Grief, introduced in 1999, takes a different approach by recognising that grieving individuals must balance two critical needs: the need to grieve and the need to live. 

Loss-oriented stressors. These are the emotions and activities related to the loss itself, such as feeling sad, remembering the deceased, or focusing on the pain of the loss.

Restoration-oriented stressors. These are the daily life demands that require attention and may include returning to work, managing practical matters, or focusing on new roles or relationships that arise after the loss.

The Dual Process Model suggests that healthy grieving involves oscillating between these two stressors: facing the sadness and pain of the loss, and gradually shifting focus to rebuilding life and moving forward. This model recognises that constant grieving is not sustainable and that it’s important to give yourself permission to experience joy, rest, and new connections during the mourning process.

How it supports. This model is particularly helpful because it acknowledges that grief is not an all-consuming process. It encourages individuals to take breaks from the intense emotions of grief and focus on rebuilding their lives, which helps reduce the sense of being overwhelmed.

The Continuing Bonds Model

The Continuing Bonds Model challenges the traditional idea of “letting go” of the deceased in order to move on. Instead, it suggests that the bond with the deceased can continue in healthy ways. Grieving individuals may find new ways to maintain a connection with the person who has died, whether through memories, rituals, or living out the values and lessons they learned from them.

How it supports. This model supports the idea that grief can involve a continuation of the relationship, rather than the end of it. It allows for a more ongoing, integrative process where the loss is incorporated into the individual’s life, helping them move forward without feeling the need to “forget” or “replace” the loved one.

Tonkin's Model of Grief, developed by Dr. Sandra Tonkin, is a conceptual framework that focuses on how people process grief and loss. The model highlights the multifaceted nature of grief and its varying emotional and psychological components. Tonkin proposed that grief is not a linear process but rather an ongoing and complex experience that can be influenced by many factors, such as the nature of the loss, the individual's personal coping mechanisms, and social support systems.

In Tonkin's model, grief is described as a combination of different emotional states and responses that may fluctuate over time. These stages are not fixed or sequential, and people may experience them in different ways. The model emphasises the need for personalised grief support, acknowledging that grief does not follow a predictable path and that every person's experience is unique.

While Tonkin's Model is less well-known than other models of grief (such as Kubler-Ross's stages of grief), it provides an important perspective on the emotional complexity of mourning and the ongoing adjustments people need to make when coping with loss.

How grief models help

Grief models help to recognise that their emotional responses to loss are valid and that others may be experiencing similar feelings. Understanding that there is no "wrong" way to grieve can be reassuring. These models offer structure during a time when everything may feel chaotic. They provide people with a clearer understanding of their grief and how it might evolve, helping them feel less lost in their emotions. By following specific models, people can take actionable steps in the healing process. Whether it’s acknowledging the pain, rebuilding their lives, or maintaining connections to lost loved ones, these models provide clear paths to recovery. Therapists can use grief models to tailor treatment to an individual's unique needs. They may help clients process complex emotions, work through unresolved grief, and guide them toward finding peace with their loss.

Grief models provide a framework to understand the emotional, mental, and physical responses that follow loss. While these models aren’t prescriptive and don’t fit everyone in the same way, they offer essential guidance for those navigating the painful journey of grief. Whether through Kübler-Ross’s stages, Worden’s tasks, the dual process of balancing grief and life, or the continuing bond with the deceased, each model offers a different perspective to help individuals cope and heal.

The role of therapy in the grieving process

Navigating grief can feel like an insurmountable challenge, but you don’t have to do it alone. Therapy provides a safe, supportive space to process your feelings, understand your grief, and find healthy ways to cope with the pain. A trained therapist can help you:

- Understand the different stages and models of grief

- Explore and validate your emotions

- Develop coping strategies for managing grief-related stress

- Rebuild your sense of self and purpose

- Work through complex or unresolved feelings tied to ambiguous loss or major life transitions

Therapy can offer a sense of clarity during a confusing time, helping individuals feel seen, heard, and supported through every stage of their grief journey.

Reach out for support

If you or a loved one are struggling with grief, don't hesitate to reach out for support. Phiona is here to walk with you through the process, offering therapy that fits your needs—whether in-person or online in Havant. Together, we can help you find healing, hope, and peace. Phiona understands that grief is unique to each individual, and supports people through these difficult times by offering therapy in Havant (both in-person and online). If you’re struggling with grief, Phiona is here to walk alongside you, providing support and tools to help you heal.

Whether you're dealing with stress, anxiety, trauma, bereavement or looking to break habits, reframe fears, or phobias. Phiona can help you develop approaches to overcome these barriers that prevent you from living life to the fullest. Helping you navigate life’s challenges and take the next step towards a brighter, calmer future.

If you feel you would like support, and you feel therapy may be the answer. I offer 15 minute complimentary  consultations, for you to have the chance to discover how therapy might support you. Visit my website for more information. 

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