Grief is a natural response to loss, whether losing a loved one, a significant relationship, or a meaningful career. It is a complex and deeply personal experience that can often be difficult to understand and navigate. Many people want to know what to expect and how long their grief will last, but the truth is that there are no simple, universal answers. Grief is different for every person and for every loss.
One model that has become widely accepted as a stage theory of grief is the “DABDA” model, which Swiss psychiatrist Elisabeth Kübler-Ross originally proposed in her influential book On Death and Dying. The model outlines five stages that terminally ill patients may experience as they come to terms with their impending death: Denial-dissociation-isolation, Anger, Bargaining, Depression, and Acceptance. These stages are often described as a natural and orderly progression, with the idea being that individuals will experience each stage in turn before ultimately reaching acceptance.
However, it is important to recognize that grief may not necessarily occur in stages and that each individual’s experience of grief is unique. Bowlby and Parkes were the first to propose a stage theory of grief, which included four stages: Shock-Numbness, Yearning-Searching, Disorganization-Despair, and Reorganization. These stages were later incorporated into the DABDA model and are now often used to describe the grief process.
Regardless of the specific stages, an individual may experience, it is important to remember that grief is a normal and natural response to loss. It is a process that takes time and patience, and it is important to allow yourself the space and time to grieve in your own way. Seek support from friends, family, or a mental health professional if needed, and remember that it is okay to seek help if you are struggling to cope with your grief. Grief is a challenging experience, but with time and support, it is possible to move through it and find healing and acceptance.
Forms of Grief
According to Bonanno et al (2004), there are two main types of grief: acute grief and integrated or abiding grief. Acute grief is a more intense and short-term experience, while integrated or abiding grief is a more enduring and long-term process.
Acute Grief
Acute grief ensues in the early aftermath of a loss, such as the loss of a loved one. It is a intense and painful experience that can be characterized by behaviors and emotions that may seem unusual in everyday life. For example, it is common for bereaved individuals to dream of their deceased loved ones, feel their presence, or “speak” to them in their thoughts. During acute grief, people may also experience disrupted eating and sleeping patterns, difficulty concentrating, and a lack of interest in other people or daily activities. It is important to remember that each person’s experience of acute grief is unique and will depend on the individual and the specific loss they have experienced.
Integrated or Abiding Grief
Integrated or abiding grief is a form of grief that occurs after the initial intensity of acute grief has passed. It is characterized by feelings of sadness and longing and often involves the process of healing and returning to a fulfilling life. During the transition from acute to integrated grief, which typically begins within the first few months after a loss, individuals begin to assimilate the reality and meaning of the loss. They are able to engage in pleasurable and satisfying relationships and activities once again. It is important to note that even though the grief has been integrated, the person does not forget or stop missing the person or thing that was lost and may still experience sadness. However, the loss becomes integrated into autobiographical memory and thoughts and memories of the deceased are no longer preoccupying or disabling. Integrated grief does not persistently disrupt other activities or preoccupy the mind like acute grief. While grief is often associated with pain, it is important to recognize that it is a multifaceted experience involving other emotions and experiences.
Uncomplicated Grief
During a typical grief process, it is common to experience a mix of painful and positive emotions, such as relief, joy, peace, and happiness. While these positive feelings may sometimes lead to negative emotions like disloyalty or guilt, they are actually a sign of resilience and are associated with good long-term outcomes (Bonanno et al, 2004). In an uncomplicated grief process, it is normal to experience both positive and negative emotions, even though it can be difficult to reconcile these feelings.
Complicated Grief
Complicated grief, also known as unresolved grief or traumatic grief, is a syndrome that affects about 10% of bereaved people. It occurs when an individual fails to transition from acute to integrated grief, and is characterized by significant impairments in work, health, and social functioning.
Stages of Grief
The DABDA model of grief proposes five stages that individuals may experience as they come to terms with a significant loss:
- Denial-dissociation-isolation: When faced with a significant loss, it is natural to experience a range of emotions. One common initial reaction is denial, which may involve blocking out the reality of the situation or hiding from the facts. This is a defense mechanism that helps to buffer the immediate shock and calm overwhelming emotions, and is often followed by a state of numbness or disorientation. Some people may experience a trance-like state or short-term dissociations from awareness, which may help them come to terms with the loss gradually instead of being overwhelmed by all their feelings at once. For a person who is grieving, denial may be more symbolic than literal, with disbelief being expressed through phrases like “I still can’t believe he’s gone” rather than a literal belief that the event didn’t happen. It is important to recognize that each person’s experience of grief is unique and that it is a normal and natural response to loss.
- Anger: This stage is characterized by feelings of anger and frustration. While not everyone experiences anger after a loss, some find that once the pain-masking effects of denial and numbness wear off and reality emerges, so does anger. This may be due to a feeling of not being emotionally ready to deal with the overwhelming feelings triggered by the loss, and a tendency to deflect intense feelings of sorrow into expressions of anger. Anger may be directed at friends, family, strangers, or inanimate objects, and may be particularly intense when the loss is sudden or unexpected. For example, after a loved one dies, it is common to feel anger at God, a disease, a doctor, or a hospital. It is also common to feel anger at the deceased loved one, even if this is irrational and unfair. It is important to recognize that these emotions are normal and to find healthy ways to cope with them. It is also important to seek support from friends, family, or a mental health professional if needed.
- Bargaining:It is a normal reaction to feelings of helplessness and vulnerability after experiencing a significant loss. It is a way of negotiating the pain of loss and trying to regain control. This may involve making secret deals with God or the universe, having thoughts of “if only,” and ruminating about what could have been done differently to change the outcome. It is common to feel a deep yearning for the person or thing that has been lost and to be triggered by reminders of their presence. Bargaining may also involve feelings of guilt, which may be its own separate stage of grief. These feelings of guilt can be unproductive and can prevent the individual from moving towards acceptance. It is important to recognize that the outcome of the loss cannot be changed, and to find healthy ways to cope with the pain of grief. Seeking support from friends, family, or a mental health professional is also important if needed.
- Depression: The sadness and pain associated with loss can lead to feelings of depression, which is a normal part of the grieving process for many people. However, it can be difficult to distinguish between grief-related depression and clinical depression. Some studies have found that as many as 25% of grieving people diagnosed with depression and prescribed antidepressants may not actually be clinically depressed and may benefit more from supportive therapies that can prevent the development of full-blown depression (Wakefield et al, 2007). Grief and clinical depression share some characteristics, such as low mood, poor concentration, sleep disturbances, appetite and weight changes, rumination, fatigue, and a sense of despair. However, most people grieving a loss are not clinically depressed, although those with a history of clinical depression may be more prone to it. It is important for anyone experiencing substantial impairment in work, health, and social functioning for sustained periods to seek help from a mental health professional, who can determine whether treatment for clinical depression is needed. Grief is a normal reaction to loss, while clinical depression is a disorder that requires treatment.
- Acceptance: Acceptance is often equated to “closure,” and is often seen as the ultimate goal of the grieving process. However, most grief therapists agree that for most people, grief is never fully “completed,” and it is possible to achieve acceptance and go on to live content, meaningful lives after a loss. Acceptance involves adapting to a new normal, rebuilding one’s life to accommodate the loss, and finding meaning in the aftermath. Unfortunately, not everyone is able to achieve acceptance, and for some, intense feelings of anger or other emotions may prevent them from finding peace with the loss. It is important to recognize that each individual’s grieving process is unique and to seek support from friends, family, or a mental health professional if needed.
It is important to note that not everyone will experience these stages in the same order or with the same intensity, and that each person’s experience of grief is unique. The DABDA model is simply a way to understand the different ways in which grief can manifest.
Grief is not a state but a process involving a range of thoughts and emotions. It may occur in stages and follow a specific sequence, as proposed by models such as the DABDA theory, but it is important to recognize that every person’s experience of grief is unique and may not fit neatly into these stages. Grief often proceeds in fits and starts, with moments of intense emotion followed by periods of relative calm. It is important to understand the complicated thoughts and emotions involved in each stage of grief and to learn how to manage them effectively.
Coping with Grief, Coping with Loss
Sahaja Yoga meditation is a practice that aims to help individuals achieve acceptance and resolve grief. It is important to remember that there is no right or wrong way to grieve and that each person’s experience of grief is unique. However, it is possible to manage grief in healthy or unhealthy ways. Sahaja Yoga meditation may be a helpful tool for some individuals as they navigate the grieving process. Grief can be a challenging experience, but with time and support, it is possible to move through it and find healing and acceptance.