The grieving process describes how a mourner copes with and progresses through the emotional and behavioral response to the loss of someone or something meaningful. It is considered to be a healthy, adaptive process that helps a person find healing and resolution so she can return to a sense of wellness and equilibrium.
The Complexity of Grieving a Loss
According to a World Psychiatry review article, grief experts don't all agree on the pathway through the grieving process. Current consensus is that grieving is complex, and the intensity and duration of the grieving process varies between individuals and culture.
Each person experiences grief uniquely. Some people may not experience every known symptom or stage in the process, and some people may take longer to move through one stage or another. Some have only a mild grief reaction to loss while others have an extreme response and progress to complicated or dysfunctional grieving.
Concepts of the Grieving Process
The complex response to a loss causes many symptoms and disturbances. Experts have proposed various concepts and theories to understand the complex response. Psychologists, such as Dr. Elizabeth Kubler-Ross, imagine the process as stages of grief. Other experts describe grief as phases or overlapping symptoms.
In his book Grief Counseling and Grief Therapy (Chapter two, pages 25-50), Dr. J. William Worden views the normal process of grieving as a series of tasks that include:
- Acceptance of the loss of the loved one
- Working through the psychological pain that the loss brings
- Adjusting to an environment and a life without the deceased in it
- Emotionally separating from the loss by forming a different connection with memories of the person who was lost
Groups of Symptoms
Dr. Worden groups common symptoms conveniently into four general types.
- Emotional: Crying, anger, fear, sadness, sorrow, or despair
- Behavioral: Sleeplessness, dreams of the deceased, calling out for the deceased, poor appetite, depression, or anxiety
- Cognitive: Disordered thoughts, visual and auditory hallucinations, and preoccupation with the dead
- Physical: Lack of energy, chest or generalized pain, difficulty breathing, headaches, or gastrointestinal distress
Other negative responses may include feelings of self-blame, guilt and shame, as someone wonders if she could have done more for a loved one during his life or illness. Amidst the negative responses, some people may even experience relief, joy and laughter because their loved one is no longer suffering.
Examples of Grieving
Grieving is not only about the death of a loved one or special person. The process is also triggered by other losses including:
- A national or international traumatic event
- Loss of job, status, or an opportunity, or changes in the workplace
- Loss of youth or physical abilities
- Response of health caregivers to the death of a patient
- Reaction of a child to parent's divorce
Factors That Influence the Grieving Process
According to Dr. Worden, factors that influence the types of symptoms, and the severity and duration of a person's grieving process include:
- Cultural context, cultural and personal beliefs, and mourning rituals
- The type of loss (death versus divorce, job loss, or loss of physical abilities)
- The relationship to the deceased
- How the person died
- Coping skills, resilience and outlook on life
- Existing vulnerabilities such as other stressors, previous losses, multiple losses, or a psychological disorder
The Five Stages of Grieving
Adapting Bowlby's four stages of mourning, psychiatrist, Dr. Elizabeth Kubler-Ross first explored her five stages of grieving or mourning theory in her 1969 book, On Death and Dying as a way to understand and teach the process of grieving during dying. She grouped the various emotions, thoughts and behaviors that a griever can experience into five stages for convenience and simplicity. The five stages include:
- Denial: In the denial stage of grieving, emotions, feelings and even actions are numb or suspended. There can be shock and disbelief or a sense of surrealism.
- Anger: Anger against the deceased, God, loved ones, caregivers and others is considered a natural part of grieving. It can connect a person with reality, provide an outlet for feelings and energize the mourner where denial can produce a phase of inaction.
- Bargaining: When death seems near, people may resort to bargaining to try to turn it back. This may involve making bargains such as promising to do good deeds or change negative ways if God will just let a loved one live. After a death, there may be similar promises in exchange for the loved one's return. Guilt and blame can be powerful players in a bargaining state.
- Depression: This is a natural response to the stress of a deep loss and is a deep level of grieving. Like denial, it is a way of coping by withdrawing from emotions and feelings that become overwhelming. Symptoms include loss of appetite, sleep disturbances, lack of energy, hopelessness and despair.
- Acceptance: Acceptance is a phase of healing that brings a light into the possibility of living without the dead. It is an emergence from the darkness of grief and a look to the future. Your life begins to regain its meaning and equilibrium.
According to Dr. Kubler Ross and her later co-author, David Kessler, the stages theory was not meant to suggest that grieving is a step-by-step process. Instead, a griever might move back and forth through the "stages," or experience several groups of symptoms at once.
An Investigation of the Stage Theory of Grieving
Published in 2007 in the Journal of the American Medical Association, Yale researchers investigated the Kubler-Ross five-stage theory of grieving in a study of grief after a death from natural causes. The authors proposed that in a normal grieving process, their version of the stages grief (which may overlap) peaked within six months in the following sequence:
- Disbelief and shock over the loss
- Anger
- Yearning for the presence of the one who is gone
- Depression
- Acceptance
Groups of symptoms progressively improved after six months in the same general order. This study serves as a guideline for how long it takes to go through the stages of grief. However, every situation is different, and some people may move more slowly or quickly through stages.
Grieving Is Healing
The grieving process helps you cope and heal from the loss of a loved one. Grieving is natural, healthy and expected and helps you learn how to refocus on a life without someone you treasured and valued. Don't compare your grieving with that of another, as everyone grieves differently.
