The Grief Process: Stages, Symptoms, and Treatment Options

In this article, I will discuss the grief process, including the definition of grief, symptoms of grief, and treatment for grief. First, let’s consider a definition.

What is Grief?

In our society, grief, mourning, and bereavement are typically used to explain the experience of loss. Grief is defined as the emotional response someone has to the loss they have experienced.

Mourning is the behavioral response to this loss, and bereavement is a term that explains the change of status, such as wife to widow. Bereavement is the period of time that one is going through grief and mourning.

This article will focus on the grief process and mourning. While grief and loss are common experiences that all humans share, each person has their own unique response and experience.

There are common beliefs in research about what is grief and what are the stages and process of grief. A majority of the research that has been done in this field has been done by Elizabeth Kubler-Ross, Robert Kastenbaum, and George Bonanno.

What is the Research on the Grief Process?

Elizabeth Kubler-Ross and her research on the five stages of grief is the most known process of grief. This research was published in the psychologist’s book, On Death and Dying, in 1969.

Kubler-Ross’ research was based on her interviewing over 200 patients in a terminally ill unit in the hospital. She recognized that there was a common experience of grief in most of the patients who were grieving their own impending death.

Five Stages of Grief

Kubler-Ross defined this shared experience as stages that people go through. These stages were: denial, anger, bargaining, depression, and acceptance.

There is a common misconception that all people go through the stages in order, and that all people go through all the stages. Some people might not go through all stages, and some people might be experiencing a couple of stages at once, or not experience one or more of the stages at all. Ross’ research is still relevant, in that most of the stages are still a common experience amongst the grieving.

Denial

Denial is a stage in which the person is unwilling or unable to accept the news of a loss. This was seen in most patients when they were told that they had a terminal illness and that they were going to die. This stage can happen when someone gets the news that a loved one has passed away as well.

Anger

Anger is the stage in which the person who is dying or experiencing the death of a loved one blames others, events, or a higher power for the situation. For example, a person who was diagnosed with a terminal illness can be mad at God for causing their pain. This can also include a loved one being mad at the person who is terminally ill for having unhealthy eating habits.

Bargaining

Bargaining is when a person attempts to make deals with anyone to prolong their life, to not die, or to bring a person back to life. People will bargain with doctors to stop their unhealthy habits. They will bargain with God to give them one more year. They will bargain with their loved ones to try and get out of the hospital.

Depression

Depression is another stage that appears with symptoms such as crying, sadness, difficulty sleeping or over sleeping, not performing personal hygiene, and not engaging in preferred activities.

Acceptance

The last stage in Kubler-Ross’ research is acceptance, in which the person with a terminal illness acknowledges that they are going to die and starts to “make peace” with the people around them before they pass away.

Death Systems

Another psychologist by the name of Robert Kastenbaum conducted research around death, dying, and grief. In 1998, he came out with research about death systems. As defined by Kastenbum, the death system is the interpersonal, sociophysical, and symbolic network, through which an individual’s relationship to mortality is mediated by his or her society.

What this means is that everyone has his or her own grief process based on his or her environment. This includes family culture, the activities that you do, the religion that you associate with, what country you live in, what area of that country you live in, the time period, and even what your friend group looks like.

Your belief about death and dying and your grief process differs depends on the environment around you and your experiences in life. With each individual culture comes cognitive, emotional, and behavioral components that teaches its members how to think and feel and even how to react to death.  Because of this learned response to death and grieving, each person has a different process for grief.  This belief also differs from the research of psychologist George A. Bonanno.

Resilience

George A. Bonanno did most of his work between 2002 and 2004. His research surrounded resilience and how resilience can play a role in how a person responds to loss.

First, what is resilience? Resilience is the ability to successfully maintain relative stability, being able to generate positive emotions and healthy levels of functioning both physically and psychologically when faced with an isolated and highly disruptive event. These events could include the death of someone you are close to or a life-threatening event.

Resilience is the ability to return to baseline after these events relatively quickly. Resilience happens when a person is able to use their mental processes and behaviors to promote personal protection factors to limit the negative effects of stress that comes along with loss. These are the same coping skills or behavioral protective capabilities that allow people to stay calm in everyday stressful or chaotic situations. Without these protective skills for the negative effects of stress, there are long-term negative consequences to physical and mental health.

The reason why some people heal faster than others is because each and every one of us has different levels of skill in handling stress, and have had differing levels of stress throughout our lives. Thankfully, there is hope for recovery and learning of these behavioral protective factors that will increase the ability to recover more quickly.

Recovery, defined by Bonanno, is when normal functioning goes below a person’s baseline, which results in symptoms of depression or post-traumatic stress disorder (PTSD), which can last for several months, and then gradually returns to baseline functioning.

There is, however, chronic dysfunction, which is defined as a prolonged period of suffering, and the inability to function that can last for several years or longer. Sometimes this grief process can be delayed as well. This is when you seem to be adjusting well to the loss and then distress and symptoms appear later.

Symptoms of Grief

There are different theories that can shed light on the different ways that people move through the grief process. There are many different experiences in life that can trigger someone to grieve. People can grieve the death of a pet, a divorce, or a break-up. People can even grieve their own death while having a terminal illness, or grieve the loss of functioning, such as losing a limb or your parent having a stroke and not being able to walk or use the toilet on their own.

One person can even have different grief responses to different types of grief that they experience. Even though there are different grieving processes, there are some common symptoms of grief that you can be aware of for yourself or others who are experiencing grief.

Some of these symptoms are psychological, some affect us physically, and some affect our behaviors. The common psychological symptoms are feeling detached from friends and family, feeling sad, angry, or guilty, and feeling like things that happen every day are overwhelming for you, such as showering or getting dressed.

Worrying, feeling frustrated, and having anxiety are also normal parts of grief. A lot of people experiencing grief also start to question the purpose of life and their spiritual beliefs. Some people reject their religion altogether in times of extreme grief.

On top of psychological symptoms, there can be physical symptoms of grief. Some of these symptoms could be difficulty sleeping or over sleeping. This can be tied to psychological symptoms like racing thoughts or feeling hopeless.

Some other physical symptoms can include headaches, aches and pains, tightness in the chest, and even shortness of breath. You can experience memory loss, the inability to focus, your appetite increasing or decreasing, and you can even find yourself getting sick more often.

Some of the behavioral reactions to grief include crying more often and isolating from people that you are close to. Isolating to your room or your house and not answering your door or your phone when family and friends try to show up for you is a good indication that you are in the grieving process.

Repetitive behaviors that remind you of the person you lost is also very common, such as listening to a song over and over again or looking through pictures for hours on end. This may seem like a long list of symptoms and can feel a little overwhelming. Thankfully, there is support available for you.

Treatment for Grief

When looking for treatments for grief, it is best to look for support groups, bereavement groups, or individual therapy. Support groups can help you process your grief with other people who have had a similar experience as you, such as a group for widows, or for stroke survivors, or for people who have been diagnosed with terminal illness.

Bereavement groups help with the shared experience of the death of a close one. Bereavement groups can either follow a curriculum to healing or can be more of a process group to share about your lost loved ones.

Individual therapy can also be very helpful in working through your unresolved grief. You can either attend individual therapy in person or online.

Bereavement groups can be run out of churches and are usually led by people who also have experienced a great loss in their lives. One particular curriculum is called New Day Journal. This journal takes you through the four tasks of grief. These tasks are accepting the reality of the loss, experiencing the pain of the grief, adjusting to an environment in which the person is missing, and emotionally relocating the person and moving forward.

Support groups can be found at churches, therapists’ offices, and clinics all over the city. People who are going through very similar types of grief and can talk about their struggles and their strengths attend these groups. This support is empowering and can lead to a healthy journey to healing.

Therapy with an individual therapist can be very helpful because the treatment can be tailored to you and your individual grief process. A therapist can be with you and support you in your journey without pressuring you or judging you. They can help you learn the behavioral protective factors, or coping skills, that allow you to build up your resilience to stress and combat the negative effects of the stress of loss.

What Can I Do if I’m Grieving?

There are many things that you can do if you feel like you need support in your grief process. Talking to your pastor is always a great place to start. There might be a support group at your church or a church nearby. If there is not one at your church, you should be able to make an appointment to see your pastor one-on-one.

There is always the option of talking to your doctor as well for medication and recommendations for a therapist or support group in the area. If you decide to see a therapist, look around for someone who you think will be a good fit.

Here at Seattle Christian Counseling, we offer a risk-free first session so that you have the opportunity to find a therapist that will be a good fit for you. Seattle Christian Counseling also offers online counseling for you if you are in a rural area or if you feel like you do not have the energy to come in for sessions. Reach out today to get the support that you need and deserve.