Breaking the Silence: Understanding and Transcending Grief and Painful Loss

What is grief?

Grief is defined as an intense yearning for what is lost and it can be accompanied by emotional, cognitive, physical, and behavioural manifestations (Worden, 2009). According to Worden (2009), some common manifestations/symptoms include:

The reaction, duration, and intensity vary from person to person. Grief is a unique process that needs to be honoured and not viewed as a static event (Bryant & Peck, 2009). It is also important to note that grief is not limited to the death of a loved one. We can experience grief when:

• A relationship has ended
• We lose our community
• We experienced injustice and trauma that is beyond our control (ie. childhood trauma, systemic oppression)
• We lose our sense of belonging
• We lose the certainty we once had (because of a career change, moving, life transitions)

What are the different types of grief?

Please note that the grieving process is different for everyone and it is important that we take the time to honour our experience and emotions. Some of the definitions, particularly “normal” grief, are based on societal expectations. The purpose of this section is to offer insight into the various types of grief and it is not meant to shame anyone that grieves outside of a particular timeframe.

Normal or Uncomplicated grief

The bereavement process of normal or uncomplicated grief is marked by gradual emotional, physical, cognitive, and behavioural symptom reduction, within a 12-18 month timeframe (Bryant & Peck, 2009). In other words, we are able to grieve within the timeframe that society deems “acceptable.” Furthermore, we are able to accept the loss and readjust as we move through the grieving process (Bryant & Peck, 2009). It is important to note, however, that important occasions like death anniversaries, birthdays, important family holidays can cause some of the symptoms to briefly return.

Anticipatory Grief

Anticipatory grief is marked by experiencing the initial phases of the bereavement process (denial, anger, bargaining, depression) before our loved one’s death. In other words, dealing with our loved ones’ terminal illness or debilitating disease forces us to experience the emotional strain in advance. Due to the ambiguous and prolonged nature, the emotions we experienced during this process can be conflicting:

• A part that feels sadness and dread
• A part that wants closure
• A part that feels anger for having to be the caregiver
• A part that feels guilty for being angry for not wanting to be the caregiver

Moreover, it is important to note that the grieving process becomes more complicated when there are unresolved issues within the relationship (between us, our loved one, and other family members). For example, conflicting ideas on how to help our loved ones and allocating caregiving responsibilities are common issues that arise (Bryant & Peck, 2009).

Disenfranchised Grief

Disenfranchised grief is experienced when society refuses to recognise our loss as significant; in turn, we feel we cannot publicly mourn or have limited opportunities to express our feelings. Some examples of these situations are:

• Miscarried pregnancy
• Stillbirth
• The disappearance of a loved one
• Death from a disease that society stigmatise
• Death of someone with whom the relationship is not sanctioned or recognised by society
• Death of a previous partner
• Death of a pet

Complicated or Unresolved Grief

When we continuously experience intense emotions and mourn beyond the acceptable timeframe that society has in place, it is categorised as complicated grief. Complicated grief affects our daily routine and desire to engage with others. When we experience complicated grief we are unable to progress towards resolution (Bryant &Peck, 2009). It is important to note that complicated grief shares similar symptoms with depression, anxiety disorder, and Post Traumatic Stress Disorder. Complicated grief is also broken into subcategories such as chronic grief, absent or delayed grief, and inhibited or distorted grief.

Chronic Grief

Chronic grief occurs when we grieve for an extended period of time without reaching a resolution. We are unable to adjust to our environment without our loved ones. The reactions and feelings that we exhibit prevent us from functioning and engaging in our daily routine.

Absent or Delayed Grief

Absent or delayed grief occurs when we experience grief symptoms at a later time (this can be months or years after our loved one’s death). Initially, through denial and repression, we did not experience any symptoms of grief (Bryant &Peck, 2009), However, with time, we unexpectedly experience a full grief reaction that might have been triggered by a minor loss. Bryant and Peck (2009) reported that absent or delayed grief is common when we experience a traumatic loss because we are usually forced to take on obligations or roles, during that time, which didn’t give us the opportunity to grieve.

Inhibited or Distorted Grief

According to Bryant and Peck (2009) when we restrain or minimise our grief, our emotions become displaced. We become irritable, angry, and hostile, and direct these emotions on others.

Unanticipated Grief

Bryant and Peck (2009) explained that we experience unanticipated grief when our loved one’s death occurred suddenly and/or traumatically. The sudden and unexpected nature of the death causes us to experience extreme feelings such as:

• Depression
• Anxiety
• Denial
• Anger
• Guilt

The grieving process is prolonged because there is a feeling of unfinished business and a lack of closure.

Masked Grief

Masked grief occurs when we experience physical symptoms and/or engage in risk-taking behaviours without knowing that they stem from experiencing loss. In other words, we experience symptoms without realising that they are related to our repressed feelings about our loss.

Honouring our grief

Grief is a universal experience; however, it is a topic that people are uncomfortable with. When we muster the strength to share our experience with someone, it is often minimised, brushed aside, or greeted with insensitive remarks such as:

• “Don’t get upset; it is going to make (insert family member) upset too.”
• “ It happened such a long time ago. I don’t understand why you are making a big deal out of this.”
• “You will get over it.”
• “It is not a big deal.”
• “Time will fix it.”
• “Keep yourself busy. You will be fine.”
• “There are so many people that have it worse than you.“
• “Stop being so sensitive.”

Consequently, we don’t feel like there is a safe place to express and honour our grief. We feel vulnerable, raw, and alone, as we suffer in silence. The world keeps moving and we feel the pressure; the external force that tells us to get up and go, even when we are in despair. We know that if we take time to rest and mourned we will be questioned, viewed as “weak,” and shamed that we cannot “get over it” within the timeframe that society deems acceptable. So, we do what our external world tells us, “ Get up and go.” This method, however, does not work long-term. The more you try to suppress and control it, the stronger it becomes.

Some ideas that might help

• Give yourself the space and opportunity to grieve
• Take it one day at a time
• Gently remind yourself that there is no set timeframe. Grieving is a unique process
• Foster a sense of belonging by joining a social support group
• Finding a therapist that is a good fit for you

References

Bryant, C. and Peck, D., 2009. Encyclopedia of death and the human experience. Los Angeles [Calif.]: SAGE.

Worden, J.W. (2009). Grief counseling and grief therapy: A handbook for the mental health practitioner (4th Ed.). New York: Springer Publishing Co.