An Individual's Reactions to Bereavement

Losing someone you love or care for is a painful experience. The feelings can be so intense that some people wonder if what they're feeling is normal. Sometimes people worry that their family members aren't coping well with their loss. The following information may help answer some of your questions and increase your understanding of the grieving process.

Bereavement, Grief, and Mourning

Bereavement is the period after a loved one dies when grief is experienced and mourning occurs. There is no rule or formula for how long one spends in bereavement. For most, healing occurs slowly but surely. Some begin to feel better within weeks or months, others not for years. The length of bereavement can depend on several factors, including the person's personality, relationship to the deceased, coping skills, level of support from others, and cultural and religious background.

Grief is a universal reaction to loss. People can experience grief after any loss, including loss of a marriage, job, or health. The loss of a loved one often causes the most intense type of grief reaction.

Mourning is the way people show grief in public. The way people mourn is affected by beliefs, religious practices, and cultural customs. People mourn in many different ways. Some examples are Buddhists praying weekly during a funeral period of 49 days; Catholics participating in the funeral practices of a wake, funeral mass, and final graveside farewell; and Jewish mourners undergoing a seven-day period, called shiva, that includes following certain practices such as covering mirrors.

The Process of Grief

There are several theories about how the normal grief process works. The one developed by Elisabeth Kübler-Ross gained much awareness by the public. Based on her work with patients facing terminal illness, Dr. Kübler-Ross introduced a model to describe the stages that dying people experience. Her identified stages were denial, anger, bargaining, depression, and acceptance. Although Dr. Kübler-Ross never intended her model to be used as a rigid formula for how a person should grieve a loss, that's what happened. People began to generalize and apply her five stages to the grieving process an individual experiences after losing a loved one. At this time, there is insufficient evidence to prove that this theory is correct.

The Hospice Foundation of America, along with many other professional organizations, instead suggests imagining the grieving process

as a roller coaster, full of ups and down, highs and lows. Like many roller coasters, the ride tends to be rougher in the beginning, the lows may be deeper and longer. The difficult periods should become less intense and shorter as time goes by, but it takes time to work through a loss. Even years after a loss, especially at special events such as a family wedding or the birth of a child, we may still experience a strong sense of grief.

The grief process is as personal as one's fingerprints. People in bereavement shouldn't judge or compare themselves to others. Instead, they need to experience their own natural process, whatever that looks like.

Common Responses

There are no right or wrong reactions to a death, but grief seems to affect us on several levels: emotional, physical, cognitive, behavioral, and spiritual. Grieving people often experience some of the following reactions:

• Emotional
  • Emotional numbness, shock, disbelief, or denial
  • Anxiety over being separated from the loved one
  • Guilt and regret
  • Anger
  • Profound sadness
  • Relief (e.g. if the person died after a long illness)
• Physical
  • Sleep disruption
  • Dreams, illusions, hallucinations of the deceased
  • Loss of appetite or weight loss
  • Exhaustion
  • Lowered immunity
  • Tearfulness
  • Sighing
  • Other physical symptoms such as nausea, palpitations, tightness in the throat, or digestive problems
• Cognitive
  • Disorganization in daily routine
  • Preoccupation
  • Distraction
• Behavioral
  • Searching for places or possessions shared with the deceased
  • Withdrawal
  • Loss of interest in hobbies, groups, previous activities, self-care
• Spiritual
  • Anger at one's God or higher power
  • Questioning one's religion or beliefs

Coping with Grief

Research has verified that people with strong social support tend to cope better after a significant loss, like the death of a loved one. Although they might not be used to or comfortable with talking about their inner thoughts and feelings, these individuals don't grieve alone. They get support from family, friends, neighbors, fellow members of your religious organization, coworkers, or a support group.

Another important and necessary component of coping with grief is self-care. Not paying attention to their physical and emotional needs can worsen how grieving individuals feel physically and emotionally. Looking after their health by walking or getting some other form of exercise is critical. So is being able to express their feelings by writing or talking them out to someone with good, nonjudgmental listening skills.

Complicated Grief

For some people, the intense pain of grief doesn't diminish over time and continues to interfere with daily living activities. About 1 in 10 people in bereavement experience what is called complicated grief. Signs include intense longing for and intrusive thoughts of the deceased, denial of the death, difficulty moving on with life, and inability to carry out normal daily functions.

People experiencing complicated grief should seek professional medical or mental health consultation. If not addressed, this intensity of grieving can lead to significant emotional problems and life-threatening health problems, including suicide.