A blog by Araminta Jonsson

Grief is not an illness. Mental or otherwise. Bereavement and loss are common themes throughout our lives and are very much part of the normal, painful process of being human. However grief, if not dealt with correctly, does have the potential to lead to mental illnesses, addictions and behavioural problems.

The most well known and frequently cited model of bereavement comes from Dr. Elisabeth Kübler-Ross landmark book - “On Death and Dying”. In her book she describes a linear five step process going from denial to anger, bargaining, depression, and finally acceptance[1]. Her work has helped many people deal with the wide variety of emotions that accompany the death or loss of someone close. Today, however, there is a further acknowledgement that the grief process is very rarely linear, and many experts no longer refer solely to the concept of sequential stages of grief. Something that is linear would move from one stage to another in a chronological process. Grief rarely does this. One moment you may feel like you have healed and are comfortable moving on and forwards in your life, and the next, the weight of your loss comes crashing back down on you again.

Grief works in loops. Much like it is impossible to say that healing from grief is a linear process, it is also impossible to say that there is a standard time frame for grief. As Katherine Schafler says in her wonderful essay, “The One Thing No One Ever Says About Grieving”: ‘Some forms of grief take years to work through, other types take a few solid months, some take a single moment of deep acknowledgement. Everyone grieves differently and for different reasons, but one thing remains constant in the process. It's the one thing no one has ever said about grieving: “I did it right on time.”[2]‘

Since Kübler-Ross’s five step process, many researchers have attempted to list the tasks a bereaved one should complete to deal with their loss. In 1994, Jeanne Katz and Moyra Sidell outlined the key stages noted by the majority of scholars:[3]

  1. Shock and Disbelief
  2. Pining (Defined by the Lexico Oxford Dictionary as ‘suffering a mental and physical decline, especially because of a broken heart.[4]’
  3. Reorganisation and Reintegration

In J. William Worden’s book, “Grief Counselling and Grief Therapy”, he summarises the Harvard Bereavement Study and concludes that the resolution of grief involves four key stages as follows:[5]

1. Acceptance of the reality of the loss

The shock can be profound for those who have not been prepared for a death, and they may have significantly exaggerated difficulty believing it has actually happened, compared with others who have anticipated the event. This primary stage of grief can be aided by our rituals of celebrating the life lost. We do this in the form of a funeral when people begin to accept the passing of their loved ones through some form of ritual whereby the body of the loved one moves from one world to another, either through burial, cremation or another form. The loss is made more real, and the process of acceptance is started by the sharing of experiences of the deceased amongst family members and friends.

2. Experiencing the pain and grief

Colin Murray Parkes conducted a longitudinal study looking at London widows in the first year of bereavement. Within this study he commented that ‘the most characteristic feature of grief is not prolonged depression but acute and episodic “pangs”.[6]’ A pang of grief is an episode of severe anxiety and psychological pain. At such a time the grieving person sobs or cries aloud for the deceased, who is strongly missed. Complete anguish may follow numbness and shock after the death of a loved one, and the grieving person may well re-enter the acute stage of painful loss through certain sensual encounters. Eg: Dreaming of the deceased or smelling an associated odour. Anger and guilt may also be experienced at this time, as well as questions asked such as “how could he/she leave me like this?”

3. Adjustment to the environment in which the deceased is missing

Patterns of everyday living change permanently following the death of a loved one. It is essential for those who are grieving to adopt new tasks and roles in order to achieve successful adjustment to the death of a loved one. The bereaved person should not withdraw from life at this stage, instead adapt in a way to make life work. Assistance can be offered during this time if friends and family are willing to support the bereaved as new challenges emerge.

4. Withdrawal of emotional energy and reinvestment into another relationship

Those who have suffered from grief through the loss of a partner, they will likely return to life’s ‘mainstream’ becoming able to take the risky leap of faith to love again. Mourning would not exist if there was no commitment or connection, as the price we pay for love, is loss. The majority of us can, and do, manage to reconnect with life after time. This natural progression from step 3 to 4 happens more comfortably alongside support and encouragement from those close to the bereaved person who can hopefully build on their courage and optimism to do so. To be able to fully reinvest in life, the bereaved person must be in a psychological position to accept their own vulnerability. Memories of their lost loved one, be they happy or sad will remain part of the fabric of their life and the person they are.

In 1988, Colin Murray Parkes then developed a theory of psychosocial transitions to explain the challenges presented during the process of loss[7]. He refers to our reality as the “assumptive world”. For example; we assume that on any given day we will follow a certain ritual whereby we meet with, communicate with and interact with specific people whilst receiving predictable responses and enjoying certain foods, sights and sounds. Basically, we assume that the day will go ahead as expected, accompanied by a certain degree of assurance about the people we will see, and events we are likely to experience. We would react to a major loss, such as that of a loved one, with disbelief and shock, thus shattering our original expectations - given that we had expected our day to unfold as described above. Disorientation would ensue, followed by feelings of missing the loved one, which would then move onto grief. This is likely to be accompanied by feelings such as despair, guilt, loneliness or anger. Most people feel significantly overwhelmed by a sense of loss at this time. However eventually, if we are able to process our grief in the correct way, we would learn to reorganise our assumptive world in ways that meant we could function again to accommodate the loss.

Children and Grief:

Children can be significantly disturbed by grief. If they have lost a parent or other close family member they may respond by expressing emotions such as guilt or anger. If these emotions are left unaddressed, the child is at risk of experiencing withdrawal, depression, restlessness and learning difficulties. They may also act out with behaviours such as vandalism and truancy. Beliefs surrounding children and death suggest that children are often excluded from funerals and not always informed about their own, and other family members’ critical illness. Depending on the context and how it is consequently dealt with, the loss of a parent or significant other as a child may lead to increased vulnerability later in life. Children’s risks can either diminish or enhance depending on contextual factors around bereavement. The emotional environment is critical, alongside financial, social and other meaningful aspects. Support is vital at this time and schools should act as an essential provider for such support. Young people need to be listened to, held and supported after losing someone close to them. If they aren’t, what may have started of as a tragic, but inevitable part of the circle of life, could become a source of trauma which in later life could turn into addictions or other behavioural problems.