Mental Health

Grief and Bereavement: Symptoms and Treatment

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Nothing in this world lasts forever, and it is human nature that we attach ourselves to objects or matters that are unfortunately temporary. Grief is the process of suffering that ensues when we are confronted with loss, while bereavement is the state of experiencing that loss. People in grief often experience overwhelming levels of emotional pain which can affect normal functioning, and often take some time to recover from. Some losses, especially the loss of a deeply loved one, permanently alter one’s life, in which the grieving process takes longer.

The Experience of Grief

Sadness. Hopelessness. Anger. Numbness. All of these feelings can permeate the grieving process, all with a purpose. Sadness indicates something is wrong and missing. Hopelessness indicates that there is no meaning in pursuing the current trajectory of life. Anger indicates that something needs to be done and changed. Numbness shields the griever from the potent pain.

There is a popular model of grief known as the Kubler-Ross Five Stages of Grief, which describes grief into different stages. It originally says that grief starts with denial, mentally rejecting the reality of said loss (e.g. “no, it cannot be true that the person is gone!”). Which then becomes anger out of feeling helpless (e.g. “damn you, God, for taking away that person!”). Following that, it will then develop into bargaining, clinging onto possibilities of reversal (e.g. “oh please, just take me instead of him!”). The fourth stage is onset with feelings of depression, constant sadness, and hopelessness (e.g. “what is the point of living any more, he is gone.”). And lastly, fully accepting (acceptance) what has happened and moving on (e.g. “he is gone, and I’m alive, and I have to go on living.”).

However, grieving processes are unique to everyone. As Kubler-Ross later states, some people do not experience all five stages, and some people do not experience grief in the exact order of the aforementioned stages. Some stay in certain stages longer than others. Some may go back and forth (and there are some that just can’t leave the cycle, staying for a long time in the grieving process, which is termed in some clinical circles as “prolonged grief”). Most importantly, rushing and aiming for acceptance is counter-intuitive, if not harmful.

Not all grieving is treated equally: Disenfranchised grief. 

While many forms of grief are widely acknowledged, some people grieve privately as their loss is unseen. Imagine the passing of a pet which is often taken much less seriously than the passing of family members (consider that the pet might have been a greater source of comfort than the family). Imagine the end of a private but intimate affair, in which the person might receive no support for this. Imagine having to accept a loved one losing most parts of their former personality and memories to dementia. The shutdown of a restaurant or cafe that holds important memories, moving out from a meaningful residence, having to leave an important phase of life such as youth or childhood. All of these are losses, but not given affirmation.

How Can Psychotherapy Help?

Not everyone needs psychotherapy to recover from grief. However, psychotherapy is beneficial in processing grief, or doing ‘grief work’. A good therapist can not only help the client accept the loss with dignity, but can turn the loss into an opportunity to grow. Psychotherapy provides the space for the client to express and reflect on the loss, cope with it better, and ideally learn from the loss. Therapy is not about forgetting the loss and pain but seeking hope after the storm.

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Jia Yue Tan
JY is a counselling trainee at Monash University Malaysia under the Master of Professional Counselling program and writes psychology articles to procrastinate from his counselling paperwork and assignments. His interests are in individual differences, psychotherapy, and helping the public understand psychology(s) as a profession. Occasionally reviews books and promote person-centered psychotherapy.

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