Therapy for people who have unusually serious grief reactions. The goal of grief therapy is to identify and solve problems the mourner may have in separating from the person who died. When separation difficulties occur, they may appear as physical or behavior problems, delayed or extreme mourning, conflicted or extended grief, or unexpected mourning (although this is seldom present with cancer deaths).
Grieving Thoughts and Behaviors
Grief is not limited to feelings of sadness. It can also involve guilt, yearning, anger, and regret. Emotions are often surprising in their strength or mildness. They can also be confusing. One person may find themselves grieving a painful relationship. Another may mourn a loved one who died from cancer and yet feel relief that the person is no longer suffering.
People in grief can bounce between different thoughts as they make sense of their loss. Thoughts can range from soothing (“She had a good life.”) to troubling (“It wasn’t her time.”). People may assign themselves varying levels of responsibility, from “There was nothing I could have done,” to “It’s all my fault.”
Grieving behaviors also have a wide range. Some people find comfort in sharing their feelings among company. Other people may prefer to be alone with their feelings, engaging in silent activities like exercising or writing.
The different feelings, thoughts, and behaviors people express during grief can be categorized into two main styles: instrumental and intuitive. Most people display a blend of these two styles of grieving:
Instrumental grieving has a focus primarily on problem-solving tasks. This style involves controlling or minimizing emotional expression.
Intuitive grieving is based on a heightened emotional experience. This style involves sharing feelings, exploring the lost relationship, and considering mortality.
No one way of grieving is better than any other. Some people are more emotional and dive into their feelings. Others are stoic and may seek distraction from dwelling on an unchangeable fact of living. Every individual has unique needs when coping with loss.
MODELS OF GRIEF
Grief can vary between individuals. However, there are still global trends in how people cope with loss. Psychologists and researchers have outlined various models of grief. Some of the most familiar models include the five stages of grief, the four tasks of mourning, and the dual process model.
Five Stages of Grief
In 1969, Elisabeth Kubler-Ross identified five linear stages of grief:
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
Kubler-Ross originally developed this model to illustrate the process of bereavement. Yet she eventually adapted the model to account for any type of grief. Kubler-Ross noted that everyone experiences at least two of the five stages of grief. She acknowledged that some people may revisit certain stages over many years or throughout life.
COMPLICATED GRIEF
The experience of grief is not something a person ever recovers from completely. However, time typically tempers its intensity. Yet an estimated 15% of people who have lost a loved one will experience “complicated grief.” This term refers to a persistent form of bereavement, lasting for one year or more.
Again, the length of time it takes for a person to grieve is highly variable and dependent on context. But when symptoms persist without improvement for an extended period, they may qualify as complicated grief. In addition, the symptoms of complicated grief to be more severe. Complicated grief often dominates a person’s life, interfering with their daily functioning.
Prolonged symptoms may include:
- Intense sadness and emotional pain
- Feelings of emptiness and hopelessness
- Yearning to be reunited with the deceased
- Preoccupation with the deceased or with the circumstances of the death
- Difficulty engaging in happy memories of the lost person
- Avoidance of reminders of the deceased
- A reduced sense of identity
- Detachment and isolation from surviving friends and family
- Lack of desire to pursue personal interests or plans
The Diagnostic and Statistical Manual (DSM-5) does not classify complicated grief as a clinical condition. Yet it does include diagnostic criteria for “persistent complex bereavement disorder” in the section of conditions requiring further study.