Navigating Grief: A Comprehensive Guide to Healing

February 5, 2024 PCI Centers

Why do we grieve?

Grief is a natural, universal, and adaptive response to loss. It is understood to be a universal social emotion that elicits physiological arousal, subjective feelings, expression through face or voice, and cognitive appraisals after significant loss (e.g. death).

The American Psychological Association defines grief as “the anguish experienced after significant loss, usually the death of a beloved person” (American Psychological Association, 2019). Grief can elicit “physiological distress, separation anxiety, confusion, yearning, obsessive dwelling on the past, and apprehension about the future” (American Psychological Association, 2019). At the extreme, grief can impair healthy functioning of the immune system, bring about self-neglect, and even produce suicidal ideation.

What are the types of grief?

People can grieve various losses and transitions in life. A primary loss refers to who is lost. In other words, it centers the physical and relational loss (e.g. loss of a parent) (Gross, 2018). A secondary loss refers to what is lost in association to a primary loss (Gross, 2018). In other words, it centers the qualitative and psychological loss (e.g. loss of faith). Sometimes the physical and psychological boundaries of loss are unclear, so it continues to feel unresolved. These kinds of losses are typically not due to a death or definite ending, but blurred lines between what was, what is, and what could have been. This loss is called ambiguous loss (Boss, 1999).

Grief can be chronic, which deviates from the cultural norm in duration or intensity of symptoms. Grief can be delayed due to lack of social support, a lack of social sanction, the need to be strong for someone else, or feeling overwhelmed by the number of losses. Grief can be exaggerated, where it develops into moderate-severe psychological/psychiatric disorders. Grief can be masked, manifesting through some somatic or behavioral symptoms.

What to expect during the grieving process:

• Feelings: sadness, anger, blame, guilt, anxiety, loneliness, fatigue, helplessness, shock, yearning, emancipation, relief, numbness,
• Physical sensations: dry mouth, lack of energy, weakness in the muscles, breathlessness, depersonalization, hypersensitivity to noise, tightness in the throat, tightness in the chest, hollowness in the stomach
• Cognitions: disbelief, confusion, preoccupation, sense of the presence, hallucinations
• Behaviors: sleep issues, appetite/eating issues, distracted/absentminded, social withdrawal, dreams, avoidance, searching/calling out, sighing, restless hyperactivity, crying, visiting places or carrying objects, treasuring objects

What affects the mourning and grieving process?

The mourning process is often contingent on a number of factors related to a person’s death. One’s relationship or proximity to the person who passed will make a huge difference, and whether the death was unexpected or preventable can make it significantly harder to cope with. Grief often includes a strong sense of denial of reality and an inability to face it. Coping with grief therefore requires a level of acceptance of your loved one’s death, though this will take time. Individual personalities and their history are also important factors. Someone’s age, gender, attachment style, beliefs and values will all mediate the grieving process.
(Worden, 1996)

How do you treat grief?

Treating grief is an ongoing and complex process that can best be done with a psychotherapist. The goal of therapy is to help the survivor adapt to the loss and be able to adjust to a new reality, as well as resolve the conflicts of separation.

Therapy can help increase the reality of the loss, teach coping skills for emotional and behavioral pain, help overcome impediments to readjustment (external, internal, spiritual) after the loss, and support the survivor to find a way to remember and maintain a bond with the deceased person while moving forward in life. Grief therapy can be tailored to cultural norms. Healing from grief is a process, as grief symptoms come in waves.

Some therapeutic exercises for treating grief include:

• Role playing with a therapist to build skills for feared or awkward situations such as when somebody suddenly asks you about your loss or circumstances surrounding the loss
• Cognitive restructuring can be an exercise done with a therapist to identify irrational/distorted thoughts. In other words, “reality test” your thoughts. (i.e. ”no one will ever love me again”)

How to accept and deal with the loss of a loved one:

• Notice the language you use when describing your current experience. Use past-tense language (e.g. “he was”) and notice any shifts happening when you use direct language (e.g. died vs lost)
• Use symbols to remember and honors what/who was lost – photos, letters, videos, clothing, jewelry
• Write letters expressing thoughts and feelings to the deceased. Tell a story about your relationship with them and anything else you would like them to know
• Draw your feelings and experiences using various colors, mediums, and styles
• Make a memory book or album to include all your stories, events, photos, poems, etc associated with the deceased person. This way, you can have access to memories within arm’s reach and you won’t forget
• Imagine what or who was lost; Or visual them in an empty chair. Then talk to them to amplify the reality of the loss and to establish some relationship. This is different from simply talking about who or what was lost.
• Use metaphors when feelings are too hard to acknowledge (e.g. “grief is like a roller coaster”
• Rituals can be established to meet emotional needs, particularly during significant days, anniversaries, or holidays.

(Worden, 1996)