Grief is characterized by a contradiction.
On one hand, it is a complex and painful maelstrom of thoughts and emotions triggered by the loss of someone precious to an individual.
On the other hand, it is a natural and positive healing process that plays an essential role in helping us work through and let go of the often unavoidable trauma of loss.
In this article, you’ll learn how to resolve this contradiction and understand that while grief is challenging and complex, it is ultimately straightforward to understand and navigate.
Before you continue reading, we thought you might like to download our three Grief Exercises [PDF] for free. These science-based tools will help you move yourself or others through grief in a compassionate way.
This Article Contains:
- How Does Grief Affect the Brain and Body?
- Grief vs Complicated Grief
- Helpful Resources From PositivePsychology.com
- A Take-Home Message
What Is Grief? 5 Symptoms & Common Emotions
Put in the simplest terms, grief is an intense emotional experience triggered by a loss. Grief is most commonly experienced in the context of death, such as the death of someone close to the grieving individual or the individual themselves in the process of dying.
However, loss comes in many forms, and grief can also be experienced following the loss of a relationship, a job, faith, significant material assets, and so on.
It’s appropriate that the word ‘grief’ has its roots in the Latin ‘gravis,’ which roughly translates to ‘a heavy burden.’ Grief emerges from the heavy burden of emotions triggered by the loss (Dunne, 2004).
Before you read any further, it’s important to bear in mind that grief is not a clinical condition. Assuming that your client is experiencing a clinical issue can be a dangerous approach, as it may alienate them during a time when they are already feeling isolated and make them withdraw or feel shame about disclosing experiences that are completely healthy.
After all, everyone is likely to experience grief during their lifetime. Grief can also present differently between individuals. Your client’s experience will be shaped by their personal expectations and beliefs about the nature of grief, which are themselves shaped by the unique combination of your client’s personality, faith, culture, and life history.
With that in mind, several symptoms that are common among grieving individuals can also characterize grief. We can group these symptoms into five different categories: physical, cognitive, emotional, interpersonal, and lifestyle (Stroebe & Schut, 1998).
These are symptoms that have a physiological effect on the grieving individual. They resemble the physical symptoms of depression and include loss of appetite, difficulty sleeping, fatigue and loss of energy, physical pains (which may be psychosomatic), and a suppressed immune system. More acute physical symptoms may be episodes of weeping, wailing, or intense physical agitation.
Grief can also influence how an individual thinks and perceives their world. For example, the grieving individual might feel a sense of dissociation and distance from reality, linked to feelings of disbelief concerning the loss. They may also experience confusion, poor memory, and lack of focus.
The most typical symptom of grief is negative emotion. The spectrum of possible emotions can be diverse, including depression, guilt, anger, hostility, anxiety, despair, hopelessness, and feelings of isolation. These emotions rarely occur simultaneously and may appear in connected but distinct phases.
The effects of grief can spill over into the grieving individual’s relationships with others. For example, grief is often accompanied by social withdrawal and feelings of distance or resentment toward relationships that may have been healthy before.
Finally, symptoms of grief can also be observed in lifestyle changes, such as failing to perform daily routines and self-care and resigning from activities that the grieving individual previously found stimulating.
The role of anger while grieving
It may surprise you to see anger mentioned as one of the possible symptoms of grief. Anger is essentially our brain protesting against something we are experiencing that is perceived as unjust and frustrating.
A grieving individual is beset by a number of confusing and stressful experiences caused by a loss that is often perceived as unfair and frustratingly uncontrollable. In this sense, anger and grief go hand in hand, as anger provides a way of expressing the powerlessness and despair experienced by the grieving individual (Rueth & Hall, 1999).
The consequence of this is that it may seem as though the individual is hostile or bitter toward surrounding people or themselves. But it is important to look past this and recognize that anger may be a necessary expression of the deeper psychological stress of grief.
How long does grief last?
Fundamentally, the duration of grief depends on the nature of what was lost. It stands to reason that the more intensely your client is affected by this loss, the longer it will take them to heal. For example, grief following the loss of a beloved pet or a valued job is no less legitimate than grief following the loss of a loved one, but it is likely to be less intense and, therefore, shorter.
Grief and Loss Theories: 4 Models & Cycles
To understand the processing of an immense loss, various theories have been modeled. Below are four main theories.
Grief response model: The 5 stages of grief
A popular theoretical approach is to structure grief as a progression through a series of stages that follow a systematic and often linear order.
Kübler-Ross (1969) proposed a five-stage theory based on the experiences of terminally ill individuals coming to terms with their death. Here, grief begins with denial, in which the grieving individual is not merely unable to process their loss, but actively unwilling, and they will try in vain to avoid acknowledging what has happened.
This leads to the next stage, in which failure to deny the loss forces the individual to face it, causing acute feelings of frustration and bitterness that manifest as anger and hostility.
When anger does not provide comfort, grief then evolves into attempts to bargain, characterized by the grieving individual seeking means to reverse the loss in return for a sacrifice, often involving appeals to religion or spirituality. This often does not succeed, and the grieving individual may increasingly ruminate over the loss and experience feelings of guilt or despair as they consider how it could have been avoided.
This leads to depression, as the individual resigns to their fate while still fundamentally existing in a state of conflict with their loss. The silver lining of this otherwise bleak stage is that the individual no longer attempts to avoid accepting their grief (through denial, bargaining, etc.), which eventually leads to true acceptance and letting go of their loss, or at least reaching a state of amnesty.
An alternative theoretical perspective is referred to as ‘grief work.’ Grief work assumes that an individual will not be able to overcome their grief unless they actively try to let go of what was lost. Once they do this, they can take the energy that was invested into despair and use it constructively to adapt to any changes that have happened because of the loss (Lindemann, 1944).
Worden (1982) provided a formal description of this process of grief work in the form of a series of tasks that the grieving individual needs to work through in sequence in order to accept their loss and move on.
The first task is to accept that the loss has actually occurred and move past any attempt at denial. The second task is to allow the pain of grief to be experienced without attempting to suppress or redirect this pain elsewhere.
The third task is to accept that life no longer features whatever was lost and begin to adapt to this new life. The final task is to take the energy that was invested into the relationship that was lost and reinvest it into a new or existing relationship.
The grief cycle
Not all theoretical approaches to grief are structured as a linear progression through a series of stages. Some prefer to represent grief as a cyclical process, where the grieving individual repeats phases multiple times on a gradual journey to recovery.
The dual process model of grief (Stroebe & Schut, 1999) is an example of a cyclical model, in which the grieving individual oscillates between two processes of grief. The first, loss orientation, involves acknowledging the loss and experiencing associated pain as a necessary process of emotional healing.
The second, restoration orientation, involves stepping away from emotion and dealing with the more practical lifestyle issues caused by what was lost. These two processes cycle repeatedly, gradually healing the grieving individual, until they can move on from their loss.
The grief curve
The theories described above may be unnecessarily complex for your practice or may not be easily communicated to your client. If this is the case, a much simpler way of thinking about grief is the idea of the grief curve. This concept was originally developed to complement the Kübler-Ross (1969) stage theory described above, but it can be used independently of a specific theory.
The grief curve is a simple representation of grief as a U-shaped curve, moving from high morale and energy, to low morale and hopelessness, and then back to high morale and energy. The high point at the beginning of the curve is characterized by the almost manic energy of denial, shock, and anger.
The low point in the middle of the curve is the depth of despair and depression after the initial investment of energy proves futile. Finally, the high point at the end of the curve is the restoration of energy and morale as the loss is accepted and life resumes.
This can be used as a simple map to represent your client’s journey through the grief experience. They can make an easy estimate of where they feel they are on the curve, without grappling with the more complicated theories of stages, cycles, or tasks.
How Does Grief Affect the Brain and Body?
The severe emotional pain experienced in grief can have a profound effect on the brain and body as well. You may have noted this earlier when potential physical symptoms of grief were described.
This is a stark reminder of the connection between our mental and physical health, and it can be useful to have a sense of the latter when working with your client on the former.
Grief is associated with noticeable changes in brain activity detectable via neuroimaging. These changes are seen in a variety of brain regions linked to different aspects of the grief experience.
When exposed to words related to their loss, grieving individuals exhibited increased activity in the amygdala, an ancient region of the brain strongly implicated in negative emotion and fear. Regions associated with rumination also show increased activity, similar to individuals with clinical depression (Freed, Yanagihara, Hirsch, & Mann, 2009; O’Connor, 2019).
Another study found that recovery from grief was slower in grieving individuals who had higher activity in the nucleus accumbens, a region of the brain associated with the pursuit of desires, which likely reflects ongoing activity to seek out what was lost (O’Connor et al., 2008).
This is a cross-section of grief in the brain, but grief also has longer term effects. Individuals who experience severe long-term grief exhibit greater cognitive decline, which is an early indicator of serious acquired neurodegenerative conditions, such as Alzheimer’s disease (O’Connor, 2019).
Use this to empower your client, by impressing upon them how important their efforts to overcome their grief are and that their grief is legitimized by clear physical fingerprints in their brain.
Terms like heartbreak are used colloquially in the description of grief, and clients may express the subjective feeling of pain in their heart accompanying their despair and anxiety.
But this feeling may be more than subjective. ‘Broken-heart phenomenon’ has been the topic of serious scientific study. This phenomenon refers to the increased risk of mortality following the loss of a loved one and, in particular, the risk of death from cardiovascular disease.
In a large-scale survey of widowers, the risk of coronary heart disease was twice as high in the six months following their loss. Another study suggested this increased risk of heart disease was even more significant than the risk associated with smoking (O’Connor, 2019).
The physical stress associated with heartbreak should therefore be taken quite literally. Again, use this as an opportunity to affirm your client’s choices and potentially explore stress management therapies that may help reduce this risk.
Grief vs Complicated Grief
For most grieving individuals, with time and persistence, their grief passes, and the experience can be viewed in hindsight as a necessary and healthy process of letting go.
However, for some individuals, this process is not so straightforward. The grieving process can become obstructed or set on a trajectory that resembles a downward gradient (as opposed to the U-shaped curve that represents the normal trajectory of grief). This stretches the duration of the grief experience into years and transforms it from a healthy process into a serious mental health issue.
The term ‘complicated grief’ is used to differentiate this form of grief from normal grieving.
Complicated grief represents an issue that warrants a clinical approach, as the grieving individual needs professional intervention to avoid spiraling into deeper trauma. In other words, if normal grief is a medicine, complicated grief is a serious allergic reaction to that medicine that requires medical assistance.
Can grief cause depression?
The fatigue and hopelessness experienced by an individual struggling with long-term complicated grief may be a risk factor for comorbid depression, which may then further complicate their already complicated grief.
However, while complicated grief and depression have a lot in common, it is nevertheless important to view complicated grief as a distinct condition.
Where depression is characterized by a sense of self-loathing, this is not seen in grief, and where depression is a generalized loss of interest in life, grief is characterized by an obsessive but painful interest in returning what was lost.
As a result, treating complicated grief should be seen as the priority and not confused with treating any accompanying depression (Shear, 2012).
Can grief and loss lead to anxiety?
Anxiety is a common emotional symptom of grief, characterized by feelings of separation anxiety, feeling overwhelmed, and social anxiety. An individual with complicated grief may experience significant trauma from the long-term experience of this anxiety, and this trauma may be sufficient to trigger an anxiety disorder.
Unfortunately, it can be difficult to identify what anxiety is because of grief and what might be due to an acquired disorder. If you are concerned about your client’s anxiety, work with them to see whether they could meet the criteria of panic disorder or generalized anxiety disorder. This may help you avoid losing track of your client’s grief amid other conditions they may be experiencing.
Helpful Resources From PositivePsychology.com
As part of our Positive Psychology Toolkit©, for which you can purchase an annual subscription, we offer over 400 tools and exercises, plus access to our community of professionals.
Some of our tools that can assist with grief are mentioned below.
- Acknowledging loss can be difficult, especially if the loss is the death of a loved one. It can be helpful to approach acknowledging this loss through a structured and positive framework, which is exactly what The Life Certificate exercise provides.
- Experiencing the pain of loss is a necessary part of grieving. Fostering acceptance of these emotions may help your client cope with this challenging aspect of grieving. They may benefit from practicing our Acceptance of Emotions Meditation.
- For a more striking demonstration, they may find the Practicing Acceptance With Ice Cubes exercise useful.
- Finally, they may benefit from using our worksheet on Identifying Emotional Avoidance Strategies.
Another resource that is well worth mentioning is our article Coping With Grief for Children.
A Take-Home Message
Grief has a variety of typical symptoms, but these symptoms may appear in a different combination or intensity between individuals.
Grief is a normal and healthy process, but can be associated with negative changes to physical health. Be vigilant for complicated grief, which poses a serious mental health concern.
There are a number of theoretical approaches to understanding grief and complicated grief. Reflect on the theories you’ve read about here, and think about which (if any) you identify with or recognize in your client.
We hope you enjoyed reading this article. Don’t forget to download our three Grief Exercises [PDF] for free.
- Dunne, K. (2004). Grief and its manifestations. Nursing Standard,18(45), 45–51.
- Freed, P. J., Yanagihara, T. K., Hirsch, J., & Mann, J. J. (2009). Neural mechanisms of grief regulation. Biological Psychiatry, 66(1), 33–40.
- Kübler-Ross, E. (1969). On death and dying. Simon and Schuster.
- Lindemann, E. (1944). Symptomatology and management of acute grief. American Journal of Psychiatry, 101(2), 141–148.
- O’Connor, M. F., Wellisch, D. K., Stanton, A. L., Eisenberger, N. I., Irwin, M. R., & Lieberman, M. D. (2008). Craving love? Enduring grief activates brain’s reward center. NeuroImage, 42(2), 969–972.
- O’Connor, M. F. (2019). Grief: A brief history of research on how body, mind, and brain adapt. Psychosomatic Medicine, 81(8), 731–738.
- Rueth, T. W., & Hall, S. E. (1999). Dealing with the anger and hostility of those who grieve. The American Journal of Hospice & Palliative Care, 16(6), 743–746.
- Shear, M. K. (2012). Grief and mourning gone awry: Pathway and course of complicated grief. Dialogues in Clinical Neuroscience, 14(2), 119–128.
- Stroebe, M., & Schut, H. (1998). Culture and grief. Bereavement Care, 17(1), 7–11.
- Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197–224.
- Worden, W. (1982). Grief counseling and grief therapy: A handbook for the mental health practitioner. Springer.
Grief is typically conceptualized as a reaction to death, though it can occur anytime reality is not what we wanted, hoped for, or expected. Persistent, traumatic grief can cause us to cycle (sometimes quickly) through the stages of grief: denial, anger, bargaining, depression, acceptance.What does psychology say about grief? ›
The most typical symptom of grief is negative emotion. The spectrum of possible emotions can be diverse, including depression, guilt, anger, hostility, anxiety, despair, hopelessness, and feelings of isolation. These emotions rarely occur simultaneously and may appear in connected but distinct phases.What are the five stages of grief explain each? ›
The five stages – denial, anger, bargaining, depression and acceptance – are often talked about as if they happen in order, moving from one stage to the other. You might hear people say things like 'Oh I've moved on from denial and now I think I'm entering the angry stage'.What was Kübler-Ross theory? ›
The five stages of grief model (or the Kübler-Ross model) is popularly known as a model that describes a series of emotions experienced by people who are grieving: denial, anger, bargaining, depression and acceptance. In actuality, the Kübler-Ross model was based on people who are dying rather than grieving.What is the hardest stage of grief? ›
Depression is usually the longest and most difficult stage of grief. Ironically, what brings us out of our depression is finally allowing ourselves to experience our very deepest sadness. We come to the place where we accept the loss, make some meaning of it for our lives and are able to move on.How does the brain process grief? ›
Your brain is on overload with thoughts of grief, sadness, loneliness and many other feelings. Grief Brain affects your memory, concentration, and cognition. Your brain is focused on the feelings and symptoms of grief which leaves little room for your everyday tasks. and recognize it as a step towards healing.What is the root of grief? ›
The word grief comes from the Latin word gravare, which means to make heavy. Gravare itself comes from the Latin word gravis, which means weighty. So think of grief as a heavy, oppressive sadness. We associate it most often with mourning a loved one's death, but it can follow any kind of loss.How long does grief last psychology? ›
Some grief experts conclude that grieving may last six to twelve months while others believe the grieving process can last longer. Every person who experiences loss needs time to grieve and heal.How does the death of a loved one affect you psychologically? ›
Profound emotional reactions may occur. These reactions include anxiety attacks, chronic fatigue, depression and thoughts of suicide. An obsession with the deceased is also a common reaction to death.How long does it take to go through the stages of grief? ›
It's common for the grief process to take a year or longer. A grieving person must resolve the emotional and life changes that come with the death of a loved one. The pain may become less intense, but it's normal to feel emotionally involved with the deceased for many years.
Additionally, not everyone will experience all stages of grief, and you may not go through them in order. For example, you may begin coping with loss in the bargaining stage and find yourself in anger or denial next.Do the stages of grief go in order? ›
The “five stages” model is the best known, with the stages being denial, anger, bargaining, depression and acceptance. While there is some evidence for these stages, the experience of grief is highly individualised and not well captured by their fixed sequence.What happens in the last minutes before death? ›
Facial muscles may relax and the jaw can drop. Skin can become very pale. Breathing can alternate between loud rasping breaths and quiet breathing. Towards the end, dying people will often only breathe periodically, with an intake of breath followed by no breath for several seconds.Which grief pattern is universal? ›
The only thing that is universal about grief is grief itself. Every person experiences grief at some point in life. Whether facing a major change in life or navigating the loss of a loved one or a job, grief is a common experience.Is anger a stage of dying? ›
This landmark book identified 5 stages in the dying process. Kubler-Ross identified anger as one of those normal stages. This conclusion was based on her clinical work with dying patients. Anger is a predictable part of the dying process.How long is too long grieving? ›
There is no timeline for how long grief lasts, or how you should feel after a particular time. After 12 months it may still feel as if everything happened yesterday, or it may feel like it all happened a lifetime ago. These are some of the feelings you might have when you are coping with grief longer-term.Is there a difference between grief and mourning? ›
➢ Grief is what we think and feel on the inside when someone we love dies. Examples include fear, loneliness, panic, pain, yearning, anxiety, emptiness etc. ➢ It is the internal meaning given to the experience of loss. ➢ Mourning is the outward expression of our grief; it is the expression of one's grief.What's the difference between grieving and mourning? ›
In other words, grief is the internal meaning given to the experience of loss. Mourning is when you take the grief you have on the inside and express it outside yourself. Another way of defining mourning is “grief gone public” or “the outward expression of grief.” There is no one right or only way to mourn.Do you ever get over losing your mother? ›
When loss is fresh, it feels like you will feel that way forever—but you won't. “If you allow yourself to grieve, and if others allow you to grieve,” says Schmitz-Binnall, “you will probably notice that the really intense feelings will lessen during the first few months after the death of your mother.”How does grief affect memory? ›
Grief, especially early grief, is not a normal time. It makes perfect sense that you're disoriented: everything has changed. Memory loss, confusion, an inability to concentrate or focus – these things are all normal inside grief. They do tend to be temporary, but they last a lot longer than you would think.
Intense grief can alter the heart muscle so much that it causes "broken heart syndrome," a form of heart disease with the same symptoms as a heart attack.What does the Bible say about grief? ›
“Therefore you too have grief now; but I will see you again, and your heart will rejoice, and no one will take your joy away from you. God is our refuge and strength, A very present help in trouble. The righteous man perishes, and no one lays it to heart; devout men are taken away, while no one understands.What is Luctus? ›
mourned, grieved, lamented.What help can you give to someone who is experiencing grief? ›
- Be a good listener. ...
- Respect the person's way of grieving. ...
- Accept mood swings. ...
- Avoid giving advice. ...
- Refrain from trying to explain the loss. ...
- Help out with practical tasks. ...
- Stay connected and available. ...
- Offer words that touch the heart.
While the stress of grief may bring on general health impacts, there is a legitimate and specific medical condition called "taktsubo cardiomyopathy" — or heartbreak syndrome — that doctors say is dying of a broken heart. But it's incredibly rare.How do you accept death? ›
One of the most helpful strategies for accepting death and resolving grief is to design a new life without the deceased. This doesn't mean pretending they were never a part of your life, but it does mean moving forward with your own as a way of honoring them and caring for yourself.How does the death of a spouse affect a person? ›
The grief of losing a spouse or partner affects not just emotional and mental health, but physical health as well. Numerous studies show that the surviving spouse or partner is likely to develop health problems in the weeks and months that follow.What are the 7 stages of grief after a death? ›
- Shock. Feelings of shock are unavoidable in nearly every situation, even if we feel we have had time to prepare for the loss of a loved one. ...
- Denial. ...
- Anger. ...
- Bargaining. ...
- Depression. ...
- Acceptance and hope. ...
- Processing grief.
Additionally, not everyone will experience all stages of grief, and you may not go through them in order. For example, you may begin coping with loss in the bargaining stage and find yourself in anger or denial next.Are there 5 or 7 stages of grief? ›
Dr. Kubler-Ross later regretted the misunderstanding of her original work and revised her 5-stage model to a 7-stage grieving process. The stages of shock and testing were added so that the complete process consisted of shock, denial, anger, bargaining, depression, testing, and acceptance.
- Loss of Appetite. This is perhaps the most culturally aware sign of impending passing. ...
- Discolored Skin. Mottled skin is a late sign of death, especially when present in the upper half of the body. ...
- Mental Confusion. ...
- Labored Breath. ...
- Kidney Failure. ...
- Cool Extremities.
Depression and sadness sets in once you accept reality. This is the longest stage because people can linger in it for months, if not years. Depression can cause feelings of helplessness, sadness, and lack of enthusiasm.
It's common for the grief process to take a year or longer. A grieving person must resolve the emotional and life changes that come with the death of a loved one. The pain may become less intense, but it's normal to feel emotionally involved with the deceased for many years.What is the difference between grief and mourning? ›
➢ Grief is what we think and feel on the inside when someone we love dies. Examples include fear, loneliness, panic, pain, yearning, anxiety, emptiness etc. ➢ It is the internal meaning given to the experience of loss. ➢ Mourning is the outward expression of our grief; it is the expression of one's grief.What can trigger grief? ›
- Death of a loved one, including pets.
- Divorce or changes in a relationship, including friendships.
- Changes in your health or the health of a loved one.
- Losing a job or changes in financial security.
Here are common indicators that you are experiencing unresolved grief: Do you refuse to talk about your loss? Do you avoid thinking about your loved one who died because good memories painful? Do you avoid places or events that remind you of someone who died?How do you accept death? ›
One of the most helpful strategies for accepting death and resolving grief is to design a new life without the deceased. This doesn't mean pretending they were never a part of your life, but it does mean moving forward with your own as a way of honoring them and caring for yourself.What are the 12 stages of grief? ›
- RECOVER FROM A LOVED ONE'S DEATH REQUIRES MORE THAN TIME. ...
- GRIEF IS UNIVERSAL - GRIEVERS ARE DISTINCTIVE. ...
- SHOCK INITIATES US INTO MOURNING. ...
- GRIEF CAUSES DEPRESSION. ...
- GRIEF IS HAZARDOUS TO OUR HEALTH. ...
- GRIEVERS NEED TO KNOW THEY'RE NORMAL. ...
- GRIEVERS SUFFER GUILT FEELINGS. ...
- GRIEF MAKES PEOPLE ANGRY.
The shock or disbelief stage is understood as the numbness often associated with initially receiving the news of the death of a loved one. The guilt stage of grief refers to feelings of regret about difficult aspects of the relationship with the deceased.Is anger a part of grief? ›
Remember, anger is a natural part of grief. Suppressing or swallowing feelings delays coping and moving forward. Voicing your feelings, expressing anger and any other emotions, is empowering, strengthening, and helps us cope.
Agonal breathing or agonal gasps are the last reflexes of the dying brain. They are generally viewed as a sign of death, and can happen after the heart has stopped beating.When someone is dying do they know? ›
They Know They're Dying
Dying is a natural process that the body has to work at. Just as a woman in labor knows a baby is coming, a dying person may instinctively know death is near. Even if your loved one doesn't discuss their death, they most likely know it is coming.
Weeks Before Death Symptoms
They may begin to sleep more often and for longer periods. They will start to refuse foods that are difficult to eat or digest, but eventually they will refuse all solid foods. Do not try to force them to eat, as it will only bring discomfort to them.