Grief – causes, responses & treatment

Grief is a natural response to loss, and it can be a complex and individual experience. It doesn’t have a fixed timeline, and everyone experiences grief differently. There are several models and theories of grief, but one of the most well-known is the Kübler-Ross model, which outlines five stages of grief: denial, anger, bargaining, depression and acceptance. It’s important to note that these stages are not necessarily experienced in a linear or predictable order, and not everyone goes through all of them. Additionally, newer models of grief have been proposed to better capture the diverse ways people grieve.

Here’s an overview of the Kübler-Ross model:

  • Denial: This is often the first reaction to the news of a loss. It can be a defense mechanism that helps you cope with the overwhelming emotions. During this stage, you might have difficulty accepting the reality of the loss.
  • Anger: As denial fades, it may be replaced by anger. You might feel angry at yourself, others, or even the person you’ve lost. It’s a way of expressing frustration and helplessness.
  • Bargaining: This stage involves trying to negotiate or make deals to reverse or prevent the loss. People often make promises or plead for a way out. It’s an attempt to regain control.
  • Depression: Feelings of sadness, regret, and hopelessness are common during this stage. It’s a time of deep reflection and mourning. It’s important to distinguish between clinical depression and the normal sadness experienced during grief.
  • Acceptance: In this stage, you start to come to terms with the reality of the loss. It doesn’t mean you’re necessarily “okay” with it, but you’ve found a way to live with it and move forward.

 

These stages are not fixed or universal. People may cycle through them multiple times, skip some stages, or experience them in a different order. Some people may also experience a sense of shock or numbness initially.

In recent years, several newer grief models and theories have emerged that provide a more nuanced and contemporary understanding of the grieving process. These models acknowledge the individuality of grief and the need for a more flexible and adaptable framework. Here are a few of these newer grief models:

  • Dual Process Model (DPM): Developed by Margaret Stroebe and Henk Schut, the Dual Process Model recognises that grieving individuals move back and forth between two types of stressors: loss-oriented stressors (related to the actual loss) and restoration-oriented stressors (related to the changes and adjustments in life that result from the loss). This model emphasises the importance of taking breaks from grieving to engage in normal daily activities and coping with the practical consequences of the loss.
  • Continuing Bonds Theory: The Continuing Bonds Theory, proposed by Klass, Silverman, and Nickman, challenges the notion that one must ‘let go’ of the deceased. Instead, it suggests that people can maintain an enduring connection with the person who has died through memories, rituals, and ongoing relationships. This model acknowledges that maintaining a bond with the deceased can be a healthy part of the grieving process.
  • Integrated Grief Model: The Integrated Grief Model, developed by Dr. Robert Neimeyer, recognises that grief is an ongoing process of integrating the loss into one’s life rather than moving through stages. It emphasises the importance of finding meaning and making sense of the loss. This model focuses on helping individuals construct a narrative that allows them to incorporate the loss into their life story.
  • Tasks of Mourning: William Worden’s Tasks of Mourning model outlines four tasks that individuals need to complete during the grieving process: accepting the reality of the loss, working through the pain and emotions associated with it, adjusting to life without the person or thing that was lost and finding an enduring connection with the deceased while moving forward. These tasks can be worked on simultaneously rather than sequentially.
  • Rando’s Six ‘R’ Processes: Therapist and author Dr. Therese Rando identified six ‘R’ processes in her model of mourning: Recognising the loss, Reacting to the pain of grief, Recollecting and re-experiencing the relationship with the deceased, Relinquishing old attachments, Readjusting to life without the deceased, and Reinvesting emotional energy into new relationships or goals. This model recognises that grief is a dynamic and evolving process.

 

These newer grief models reflect a more holistic and adaptive approach to understanding grief, emphasising that there is no one-size-fits-all approach to mourning a loss. They encourage individuals to find their unique path toward healing and integration, acknowledging that grief is a complex and individualised experience.

As for when you’ll know you’ve finished grieving, there’s no definitive endpoint. Grief is a highly individual process, and it can last for weeks, months, or even years, depending on the nature of the loss and the person’s coping mechanisms. It’s important to remember that grief doesn’t have a clear endpoint. Instead, it becomes integrated into your life as you learn to live with the loss. Over time, the intensity of grief typically lessens, and you find ways to remember and honor the person or thing you’ve lost while continuing to move forward with your life. Remember that healing from grief is a highly individual process, and there’s no ‘right’ way to grieve or a specific timetable for when it should be completed.