Understanding loss and bereavement:

Loss is a condition or compilation of feelings associated with being without something or someone cherished. Grief is an emotional state of profound sadness and a reaction to the disruption of an attachment and is closely associated with loss. The period after a loss during which grief and mourning are experienced is known as bereavement. Grief encompasses more than just sadness. A well-known model of grief called "The Five Stages of Grief" identifies denial, anger, bargaining, depression and acceptance as the "stages" our mind goes through after someone we love dies, and we attempt to make sense of the loss. Grief can also include feelings of yearning, remorse, longing, sorrow, and regret. Emotions can be unexpected in their intensity and/or perplexity. Complications during the bereavement period has been the focus of many therapeutic interventions.

What are the stages of grief?

There has been an effort to help an individual unpack and understand their emotions after a significant loss. Elisabeth Kübler-Ross devised a model which theorises five stages of grief and loss. The five stages are:

  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance

Through time, different sources have added what they believe to be other stages of grief. There is a more inclusive 7 stages of grief which expanded on 'The Five Stages of Grief', namely:

  1. Shock and denial
  2. Pain and guilt
  3. Anger and bargaining
  4. Depression, reflection, and loneliness
  5. The upward turn
  6. Reconstruction and working through
  7. Acceptance

It is important to note that while these grief models assist individuals who are grieving to understand their process and how to move forward, grieving is an individual, subjective experience and not everyone will experience the same order of grief stages or even experience every stage as outlined above.

How are loss and bereavement treated?

Everyone grieves differently and at their own pace. Some people recover from bereavement within six months and resume normal activities while still experiencing melancholy at times. After a year, some people may feel better. Other illnesses, most notably depression, can exacerbate grief. The degree of a person's reliance on the deceased may also exacerbate the bereavement process. Many challenging and confusing emotions are often present during the bereavement or grieving process. Self-care, recreation, and social support can all help an individual feel better. Whether the loss is due to death, a breakup, or another cause, grieving the loss of a loved one is a painful process.

Grief is a challenging experience from which no one ever fully recovers. Time, however, usually dampens its ferocity. Complicated or prolonged grieving is long-term grieving that lasts a year or longer, and that gets worse. The time it takes a person to grieve is highly variable and dependent on the circumstances. However, if symptoms remain for an extended period without improving, they may be classified as Prolonged Grief Disorder according to the DSM-5. Complicated or prolonged grief can feel like a heightened, ongoing state of mourning that keeps an individual from healing.

Furthermore, the signs and symptoms of Prolonged Grief Disorder are more intense. Complicated or prolonged grief can take over a person's life and make it impossible for them to operate normally. Complicated or prolonged grief is frequently addressed by employing psychodynamic therapy, supportive therapy, person-centred therapy, cognitive behavioural therapy (CBT), brain working and recursive therapy (BWRT), reset therapy and /or acceptance and commitment therapy (ACT). When done individually or in a group setting, these treatment modalities can be beneficial.

1How long does grief last?
For the majority of people, it is a lengthy process that can take months or years. During the first few months after a loss (acute phase), many symptoms of normal grief are the same as complicated or prolonged grief. However, normal grief symptoms start to fade with time gradually, while those of complicated or prolonged grief linger and get worse.
2Is there a difference between grief and mourning?
Grief is a common and normal psychological and physiological response following a death or a loss that can change over time. Grief includes an acute phase which includes symptoms such as sadness, anger, anxiety, thoughts and memories of the person, longing to be with the person who was lost. Thus, grief refers to the internal experience of loss. Mourning , on the other hand, is an external expression of loss. Common examples of mourning can be wearing black, sharing stories or memories about the person being mourned, honouring the loved one's legacy, etc. These aspects of the mourning process can be influenced by specific cultural rituals or practices and can often give structure to the grieving process.