The shock, sadness, and confusion that accompanies loss can be extremely intense and painful. Whether the loss was expected or sudden, the process of grief, and the complex feelings surrounding grief, unfolds differently for everyone. There are, however, certain common threads that run through the grief experience.

The grief process

Grief is the pain that we naturally experience due to a loss, which can feel acute and overwhelming. Loss of a family member, friend, co-worker, or another meaningful person can trigger feelings of grief. However, we may also feel grief after a major life change, such as divorce.

One of the most well-known descriptions of the grief process was made popular by Swiss psychiatrist Elisabeth Kübler-Ross in her 1969 book, On Death and Dying. She said that when confronted with a loss, we typically go through a five-stage process. It is important to note that we do not go through these sequentially, rather we can go back and forth between stages and we may even be in more than one at the same time.  Healing involves noticing your own experience and accepting whatever that is-rather than evaluating “how far” you are in the process. Even so, it helps to have this model to put words to one’s experience:

 

  1. Denial. We may become numb to our emotions, isolate ourselves, or attempt to rationalize, and/or deny the reality of what has happened. This is natural and buffers us from the initial shock.
  2. Anger. The intensity of the pain can express itself in the form of anger toward others, the person who died, doctors, or even inanimate objects. It can feel endless and may leave us feeling guilty.
  3. Bargaining. We review the past, often using “what if?” or “if only…” statements. By going over the details and imagining scenarios, we are attempting to regain a sense of control and ultimately escape the hurt.
  4. Depression. We feel intense sadness as the reality of the loss settles in.
  5. Acceptance. While we will never be “okay” with the loss, we attempt to start living with it as a reality.

David Kessler, grief expert and co-author with Kübler-Ross on two of her books, also offers a sixth stage of grief called Finding Meaning. In this stage, he suggests that instead of “closure,” what really helps us move forward after loss is being able to put the loss into a meaningful context for ourselves. In that, Kessler does not ask one to find meaning in the loss itself, but rather find meaning in what comes afterward.  Can we honor what we lost in our present?  Can it bring us new meaning in our present and future?  He suggests that we can.

The many faces of grief

While grief often involves the loss of a loved one, other losses can just as readily trigger feelings of grief. We all expect grief when someone dies, but there are times when grief might be unexpected, and yet it is there. During the COVID-19 crisis, one might find a loss of safety, a loss of a sense of stability in the future, a loss of financial independence, or even a sense that you have lost parts of yourself  - which are all forms of loss that lead us to feel grief rather than types of grief themselves. 

Other examples include breast cancer survivors who may feel a loss of femininity after a double mastectomy, children of divorce who grieve the loss of their previously intact family, older adults who feel a loss of independence as they physically decline, or a couple who must face the reality of their infertility, feeling the loss of a loved one who is sick while they are still alive, or grieving the death of a loved one as they are slowly progressing through a dementia. 

There is also disenfranchised grief- which is not always recognized by others around us – such as the loss of a beloved pet, the loss of an extramarital lover, or the loss we feel when someone famous or someone we admire greatly passes even though we had no in-person relationship with them. 

We can expect to grieve not only when we lose a beloved person, but any time we experience the loss of our identity, hopes and dreams, or expectations.

When someone you know is grieving

It can be hard to know how to act or what to say when someone you know is grieving. Still, make the effort to reach out. You might hesitate, not wanting to remind them of their loss, but they will inevitably be thinking of it often. Shows of support and love are very comforting at this time, and healing invariably includes talking about your experience with others and sharing stories. However, be mindful of how they react as well. Do not push if they make it clear they need to be alone or would rather not talk any further.

Learning how to recognize the signs of grief in different types of people can also be helpful. Differences in age, maturity and coping styles can make grief look radically different. For example:

Children who are grieving may especially express symptoms of anxiety. They may start acting younger than their age (for example, using baby talk, wetting the bed at night, or not wanting to be alone) They may have gastrointestinal impacts or become more irritable or act out behaviorally. Children may also be afraid their loved one died because of something they did or said. Still, remember that children are not too young to grieve. They understand that something has happened and they need adults in their lives to talk about it and mark/recognize the loss in some way.

Teens may downplay their emotions when it comes to grief. They are often hyperaware of how they appear in front of friends and may also be self-conscious about the attention placed on them. For that reason, they may grieve more privately than you’d expect, but this doesn’t mean they “don’t care.”

Adults tend to not allow themselves enough time and space to grieve, or tend to say they are okay before they actually are. Sometimes adults believe that they are talking too much about their loss or that they are a “downer” to others or burdening them. It is important to ask and make space for the person to talk about their loss, and yes, it may feel uncomfortable when we do that. 

Couples who have experienced a miscarriage may express their grief by feeling anger toward others who announce pregnancies or have babies. Some may withdraw from their families and/or try to mask the pain with alcohol or substance abuse.

Healthy coping strategies

The feelings of grief can seem insurmountable, but some strategies can help. First, allow yourself to feel your feelings, rather than trying to mask or avoid them. Emotions need to run their course. Suppressed feelings can create even more depression, anger, or even physical symptoms.

You may want to document how you’re feeling. Writing in a journal, or writing a letter to the person you may have lost can help externalize your emotions and move you through them. 

Talk to others about the loss. They can understand the loss if you share your experience. 

Create a ceremony to mark the loss or have something to memorialize the loss/the change that has happened.

Also, remember that many losses change us.  We are different after a loss, thus we create a new normal that looks similar to our life before the loss, but is changed slightly. 

Grief is ongoing.  While it improves, we will have periods of grief return.  We grieve losses throughout our lives, though the intensity tends to decrease. Returned grief is normal and is part of their continual lifelong process of honoring that there is something significant they have lost.

Finally, don’t hesitate to speak to a therapist.

Therapeutic support

Therapy can help you move forward in grief, especially if you are having trouble functioning or lack a strong support system. Uncontrollable crying, inability to do daily tasks, and feelings of hopelessness can be difficult to manage on your own.

If you have experienced loss, you do not have to grieve alone. The providers of Orange County Health Psychologists are here to support you through this difficult period. Give us a call at 949.528.6300 or email This email address is being protected from spambots. You need JavaScript enabled to view it. to be paired with a qualified professional or to learn more about our providers and services.  

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—Written by Ekua Hagan for Orange County Health Psychologists