Grief and Loss
What is Grief ? What do you think of when someone mentions grief?
Grief exists in places where we experience a loss. Grief involves the physical sensations, emotions, and thoughts associated with any kind of loss, and is typically characterized by immense distress or sorrow. Grief is most commonly associated with a loss that occurs through death of a loved one, but there are many different forms of grief.
Anticipatory grief (or preparatory grief): involves grief that emerges prior to the actual loss. Examples of anticipatory grief include grief emerging around the death of a loved one prior to the loss (e.g., at the time of diagnosis), grief occurring when learning your unborn child may have a congenital disorder, or the deterioration or impending death of a pet. There is conflicting evidence about whether anticipatory grief reduces the grieving process when the loss occurs; For some the time of grieving can be shortened, while for others the grieving period is not shortened and complicated feelings can emerge around not being fully engaged in the moments prior to the loss.
Abbreviated Grief: involves moving through a grieving process quickly and can occasionally follow anticipatory grief, though this is not always the case. The period of grieving time is not an indication of the amount that someone cared about the loss, it is more of a representation of where the individual is in processing the emotional labour that emerges in grief. Everyone grieves differently and on different timelines, so for some their experience of “common” grief may appear to be abbreviated grief.
Delayed Grief: involves experiencing the intense emotions of grief days, weeks, or months after the loss rather than when the loss occurs. Delayed grief can emerge due to instances of shock that disrupts the body’s ability to process the emotions associated with the loss. Alternatively, delayed grief can also emerge when there are practical matters that require attention and disrupt the experience of grief until those matters have been tended to (e.g., loss of a loved one occurs, but family members disagree about the will and legal action is taken).
Disenfranchised Grief: involves grief that is not recognized as significant or valid by society. This form of grief does not tend to follow societal attitudes around what is socially accepted, which can result in a prolonged experience of grief due to the lack of open acknowledgement and support provided to the grieving individual. Some examples of disenfranchised grief include overwhelm from grief over loss of a pet, grief over the end of an affair, or grief emerging around an elective termination of pregnancy.
Inhibited Grief: involves the conscious or unconscious supressing of emotions associated with grief, impacting an individual’s ability to recognize, process, or move through grief. Those that suppress their emotions, intentionally or unintentionally, can experience grief showing up in more physical ways, including upset stomach, panic attacks, anxiety, or insomnia, to name a few.
Cumulative Grief: involves working through grief associated with multiple losses. Examples of this can include grieving the loss of a child, while also grieving the subsequent loss of a relationship after child loss, and impacts of living arrangements and supports. Experiencing multiple losses can create particularly difficult and complex experiences of grief.
Collective Grief: involves grief that impacts a large group of people or a collective. Events that impact numerous people, such as pandemics, wars, natural disasters, acts of terrorism, or the death of a cultural icon, can elicit experiences of grief across large groups of people. Collective grief can impact social norms, societal views, and what is perceived as “normal” within the collective group. While there can be shared experiences of grief across the collective, each individual within the group may experience grief associated with the event differently.
What is Loss?
Losses are events that can elicit forms of grief. There are primary losses, which is the initial loss, and secondary losses, which describe the subsequent losses that come as a result of the primary loss. For instance, the primary loss of a parent getting dementia, can also produce secondary losses of changes to interpersonal relationships, changes to roles and responsibilities, and changes to future opportunities.
Grief emerges in the finite losses that are irrevocable and irreplaceable, which have life-altering consequences. Examples of finite losses include the loss of a loved one, loss of an idol/icon, or loss of a home through natural disaster. Finite losses are usually what comes to mind when we think about the losses that can elicit grief.
Grief also emerges in non-finite losses. In contrast to finite losses, non-finite losses are losses that have life-altering consequences but do not involve death. Non-finite losses can be tangible or intangible. Tangible losses can be personal (e.g., loss of senses, infertility, chronic pain, etc.), interpersonal (e.g., end of a friendship or relationship, etc.), material (e.g., loss of job, loss of personal valuables, etc.), or symbolic (e.g., losses related to limited social role definitions or racism, etc.). Intangible losses include losses of self-worth due to victimization, or changes in perceptions or world-views as a result of disaster.
Non-finite losses also include ambiguous loss where there is limited or no closure (e.g., experience of losing a loved one to dementia, where there is physical presence but psychological absence; unexplained disappearance; estrangement; etc.). A modern example of non-finite loss occurs in the trend of “ghosting” someone to avoid the difficult conversation of expressing no intention to further the relationship.
Lastly, it is important to be mindful of the experience of multiple losses that occur for the individual and how those might have a compounding impact on the experience of grief (e.g., loss of spouse, then learning about an infidelity, having the experience of less financial stability resulting in loss of house, etc.).
Important considerations in Grief and Loss
Importantly, while not an aspect of the definition of grief, there are several factors that impact an individual’s understanding and experience of grief. These factors include:
· The attachments held in the connection to people and things, as well as individual attachment patterns, which can have an impact on one’s experience of grief.
· The social and cultural norms the individual holds or is immersed in are important, as there is different levels of acceptance and norms for the expression of grief and loss across cultures. Disenfranchised grief demonstrates the impact of social norms on acceptance of and support for the individual’s experience of grief.
· Stage of development and cognitive understanding of loss impact understanding of grief and experience of grief. Adults experiencing grief tend to exhibit more emotional reactions in grief, whereas children tend to exhibit more behavioural reactions in grief. Further, there are differences in the experience of grief and relationship with grief in for elderly individuals.
For supporters of those experiencing grief, it is important to be mindful of and accommodate for the different variables impacting ways people experience grief. Everyone experiences grief differently, and being mindful of the approaches we are taking and the cultural or social messages they convey, can help us to more appropriately support those experiencing grief.
References:
Cleveland Clinic. Grief. (https://my.clevelandclinic.org/health/diseases/24787-grief.). Edited 02/22/2023
Doka, K. J. (2002). Disenfranchised grief: New directions, challenges, and strategies for practice. Research Press.
Harris, D. L. & Winokuer, H. R. (2016). Principles and Practice of Grief Counselling (2nd ed.). Springer Publishing Company.
Neimeyer, R. (2001). Meaning reconstruction and the experience of loss. Washington, DC: American Psychological Association.
Parkes, C. M. (2002). Grief: Lessons from the past, visions for the future. Death Studies, 26, 367-385. doi:10.1080/02682620208657543
Shear, M. K. (2020). Grief white paper series. The Center for Complicated Grief. https://complicatedgrief.columbia.edu/wp-content/uploads/2020/06/HEALING-Milestones_-What- Grievers-Can-Expect-with-Covid-19-Addendum.pdfd Grief.
Silverman, P. R. (2000). Never too young to know: Death in children’s lives. Oxford University Press. NY.
Worden, J. (2018). Grief counselling and grief therapy: A handbook for the mental health practitioner (5th ed.). Springer Publishing Company
