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The many stages of Grief

“Deep grief sometimes is almost like a specific location, a coordinate on a map of time. When you are standing in that forest of sorrow, you cannot imagine that you could ever find your way to a better place. But if someone can assure you that they themselves have stood in that same place, and now have moved on, sometimes this will bring hope"

Elizabeth Gilbert

Hello Hello beloved,,

Welcome to the first of a two-part newsletter on Grief. This issue will focus on the 5 stages of grief, the four tasks of mourning, and healthy and complicated grieving.

Many people use the words grieving, bereavement, and mourning interchangeably. I want to clarify the distinction before moving forward.

According to the Dictionary of Psychology, grief is the anguish experienced after significant loss, usually the death of a loved one.

Grief often includes physiological distress, separation anxiety, confusion, yearning, obsessive dwelling on the past, and fear and anxiety about the future.

Mourning on the other hand is the process of feeling or expressing grief following the death of a loved one, or the period during which this occurs. Mourning can go on for a few weeks to a few years. Sometimes there are religious and cultural structures that govern the mourning process and time frame.

Bereavement is the condition of having lost a loved one to death. The bereaved person may experience emotional pain and distress and may or may not express this distress to others. Bereavement may also signify a change in social status, e.g. from wife to widow.

In the healthy grieving process, the bereaved thinks about the loss, talks about it, cries about it, even dreams about it, and over time, will process the pain of the loss and achieve some relief from the loss.

Intense grief can become life-threatening, because of the disruption to the immune system, self-neglect, and suicidal thoughts.

Grief may also take the form of regret for something lost, remorse for something done, or sorrow for a mishap to oneself. It can include the loss of a job or business, the loss of a friendship, neo-natal deaths, or a miscarriage.

Elisabeth Kübler-Ross - Five Stages of Grief Model

Elizabeth Kubler-Ross's 5 stages of grief model is the template used by most therapists to support grieving clients.

Although not much evidence has been found to support this model, it has stuck around in popular culture and is used by coaches, the education system, and other forms of therapy.

The five stages are:

Denial - a feeling of shock, or numbness, or nothingness. Perhaps the loss does not feel real or hasn't really hit home yet.

Anger - this is a time of demands, a demand to know why this loss had to occur. While trying to make sense of the loss this anger will turn inward, sometimes outward. This is heightened if the loss is sudden or unexpected.

Bargaining - in the bargaining stage, the person imagines ‘other’ scenarios where they were able to intervene and prevent or undo the loss. This is a yearning for repair, for time travel, and a desperation to find an alternative solution to the loss.

Depression - includes despair and withdrawal. Depression is common and ranges widely in time and severity. For some this experience can last years.

Acceptance - at the stage of acceptance, the bereaved has fully acknowledged the loss that has taken place. In fact, this stage very commonly occurs early on in the process, with the sense of acceptance gradually becoming larger as time goes on. This may be a stage where peace is found in accepting the grief and loss.

Initially, Kübler-Ross claimed that everyone moves through each of the five stages once and only once. She later acknowledged that some people may only experience some of the stages and that others may revisit any one of the stages later in life.

J.W. Worden - Four Tasks of Mourning

Not as well known but another model of grieving comes from J. W. Worden, who proposed that humans must undergo the 'Four Tasks of Mourning' to heal.

The four stages are:

  1. To accept the reality of the loss

  2. To work through the pain of grief

  3. To adjust to life without the deceased

  4. To maintain a connection to the deceased while moving on with life. The idea of 'gone but not forgotten'.

Dr. Alan D. Wolfelt developed the Companioning Model of Bereavement for caregivers. Anyone can act as the companion/caregiver in this model including a therapist.

Companioning is about…

  • Honouring the spirit, not focusing on the intellect

  • Curiosity, not expertise

  • Learning from others, not teaching them

  • Walking alongside, not leading

  • Being still, not frantic movement forward

  • Discovering the gifts of sacred silence, not about filling every painful moment with words

  • Listening with the heart, not analysing with the head

  • Bearing witness to the struggles of others, not directing them

  • Being present to another person’s pain, not taking away the pain

  • Respecting disorder and confusion, not imposing order and logic

  • Going to the wilderness of the soul with another human being, not thinking you are responsible for finding the way out

On a personal level, I can relate to much on the list above. I had my first experience of loss at the age of 28 when my eldest sister died of lung and brain cancer at the age of 41. I was distraught and literally howled for days. What complicated the experience was the fact that I could not get to the UK in time for her funeral.

Losing a business I'd put everything into for 14 years brought on a similar feeling of loss for me. I fell into a deep depression and did not leave my bed for a week. I experienced the stages of anger and depression, and after much work and many months I arrived at acceptance.

Complicated Grief

Grief is not a pathological condition that needs to be treated. Grief is natural and in most cases through the process of thinking, talking, crying, and dreaming about the loss, the bereaved will heal over time.

When there is a disruption to the grieving process or a loss that cannot heal in a conventional way, this is called complicated grief.

Depending on the circumstances surrounding the death and the unique personalities/relationships of the people involved, certain challenges can occur that may contribute to complicated grief.

In Grief and Mourning Gone Awry, therapist Shear MK identifies the following:

Delayed grief involves the postponement of a normal grief response until a later time, whether intentional or unconsciously.

In some cases, an individual might need to 'be strong' outwardly in order to help another loved one cope following a death, whether during the funeral arrangement process, service or interment, or in the weeks/months that follow. In other instances, someone might not begin grieving right after a death occurs because they already have too much stress, need more time to process the reality of the loss, or can't grieve until they encounter a 'grief trigger' etc.

Disenfranchised grief can occur when a grieving person feels they cannot openly acknowledge a loss to death because of real or imagined pressures exerted by family/friends, cultural or religious beliefs, or society in general. For example, if the death is related to HIV/AIDS, miscarriage or stillbirth, or the death of a same-sex partner or spouse. In these cases, the individual might delay their grief response or feel it necessary to mourn alone or privately.

Traumatic grief can occur when a death takes place violently, unexpectedly, or causes the loss of someone who dies 'before their time', such as an infant, a child, murder or accident victim, someone stricken with a terminal illness etc.

Sudden or traumatic grief can lead to exaggerated reactions and even post-traumatic stress disorder.

Through supporting clients with grief and from my own experience, I find that grief has a bittersweet quality to it. While our heart is aching, we tend to marinate in the sweetness of the love we hold for the loved one.

Grief alters the lens through which we view life, and coats it with wisdom, with reverence for life, and with the complexities of what it means to be a human who can connect deeply.

Healing from grief requires us to move forward while keeping those bonds and memories close, which is not only conducive to thriving but helps to mobilise greater joy and a more richly felt experience.

Dealing with grief can feel heavy and overwhelming, please reach out to me if you need more support.

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