Grief is the natural reaction to loss, and can influence the physical, emotional, cognitive, behavioural and spiritual aspects of our lives.
Grief can be experienced in response to a variety of loss-related events, such as the death of a loved one, separation or divorce, the loss of a sense of safety or predictability, physical incapacity through disability, or the loss of one’s home or community due to disaster. Feelings of grief can also emerge before an impending loss, such as when a loved one is experiencing a terminal illness, and this is known as ‘anticipatory grief’.
People cope with grief and loss in a variety of ways. While some might find it helpful to talk openly about the experience, others might prefer time alone. The intensity and duration of the grieving process can also differ between individuals. For most people, the experience of grief will dominate their emotions, thoughts, and behaviours for a number of weeks or months.
As time passes, most people learn to cope with their grief and go about their daily lives with support from others, although for many the loss will remain a part of them. Many people who experience loss will not need professional help, however others may seek and require professional support.
Symptoms
Grief is an individual experience and people can respond to loss in a variety of ways. Responses include emotional, cognitive, physical, relational/social and behavioural changes.
Emotional responses can include:
- sadness
- anger
- guilt and remorse
- anxiety
- loneliness
- helplessness
- shock and disbelief
- a sense of yearning
- relief.
Cognitive changes can include:
- confusion
- difficulty concentrating
- preoccupation with the loss
- a loss of interest in enjoyable activities
- vivid dreams or nightmares.
Physical and behavioural responses can include:
- muscle tightness
- tiredness/reduced energy
- sleep disturbances
- social withdrawal
- changes in appetite
- crying
- restlessness
- avoiding places or people who remind the individual of the loss
- treasuring objects that are associated with the loss.
In addition, there can be significant changes to a person’s spiritual or philosophical views and beliefs. For example, people may question their faith or the meaning of life.
Treatment
Grieving is a difficult and challenging process. Its nature depends on a number of factors, such as the person’s coping style and personality, as well as the type of loss. However, regardless of the circumstances, losing a loved one can cause great pain and suffering.
Most people learn to manage their grief and adjust to their loss in their own time. Maintaining self-care activities and routines, and having adequate social support available, can be helpful during this time of adjustment. However, for people who experience prolonged or complicated grief reactions, a number of more targeted psychological treatments and strategies can be of great benefit, including:
Navigating difficult thoughts and behaviours
Cognitive-behavioural therapy for complicated grief helps support people with any difficult thoughts and behaviours that may be emerging alongside their experience of grief. Meanwhile, acceptance and commitment therapy can provide people with ways to “be with” their difficult feelings and experiences in a more manageable and less overwhelming way. Therapies such as these can help improve a person’s mood and increase their quality of life as they move through their grief process.
Complicated grief treatment
Complicated grief treatment addresses the symptoms of loss by helping people re-establish relationships and focus on personal life goals.
Improving family relationships
Some psychological treatments focus on strengthening family bonds and developing good communication patterns as this can help prevent people from experiencing significant psychological distress as a result of the loss. Psychologists sometimes refer to this as focused family grief therapy.
Finding meaning
Finding meaning and significance in the loss that a person has experienced can also be helpful. Psychologists may use a range of meaning reconstruction approaches to help achieve this.
Seeking help
Seeing a Psychologist
Grief is a normal response to loss, and while many people will learn to adjust to the loss with the support of family, friends, and other important people, some individuals may require assistance by a psychologist to help them adjust to their loss and cope with their grief. Psychologists are highly trained and qualified professionals skilled in helping people with a range of wellbeing concerns and life experiences, including grief and loss.
There are a few ways you can access a psychologist. You can:
- Use the Australia-wide Find a Psychologist service or call 1800 333 497
- Ask your GP or another health professional to refer you.
If you are referred to a psychologist by your GP, you might be able to get a Medicare rebate that may assist you in meeting the costs of treatment. You may also be able to receive psychology services via telehealth so you don’t need to travel to see a psychologist. Ask your psychologist or GP for details.
Tips to help with grief and loss
Helping yourself
- Where possible, participate in bereavement activities such as planning and attending a funeral/memorial service, or engaging in cultural customs or social rituals which are associated with the loss.
- Remember to ask for help if you need it; don’t be afraid to speak up and admit that you are struggling to cope with your loss.
- Be honest with family and friends about how you are feeling and be open to accepting their help.
- Allow yourself time to grieve your loss.
- Talk with others who share a similar experience; joining a bereavement support group (in person or online) can be helpful.
- Take care of your physical health; participate in regular exercise, eat healthy meals, limit alcohol use, and continue to attend medical check-ups.
- Participate in enjoyable activities, hobbies, and interests as much as you can.
- Try to maintain normal sleep patterns.
- Practice relaxation or mindfulness activities to help calm the mind and body.
- Reflect on your religious or spiritual beliefs.
Helping someone else
- Provide practical support, such as helping with funeral arrangements, assisting with housework and meal preparation, and buying groceries.
- Support the person emotionally; providing comfort and reassurance, talking about the person’s loss, listening with compassion, or sharing memories are important to the healing process.
- Be a source of information support, such as financial advice, or helping the person understand how and/or why the loss occurred.
- Do not just focus on the person’s loss; talk about everyday life and current affairs.
- Check in with the person weeks, and even months, after the loss to show you still care.
- Suggest that they speak to a professional if their grief does not seem to be lessening over time or they are struggling to function.
Additional resources
Head to Health
The Federal Government’s website linking the public to reputable and evidence-based digital mental health services.
www.headtohealth.gov.au
headspace
Australia’s National Youth Mental Health Foundation, providing assistance for individuals aged 12-25
www.headspace.org.au
Lifeline
A 24-hour counselling, suicide prevention and mental health support service
Telephone: 13 11 14
www.lifeline.org.au
References
- Djelantik, A. M. J., Smid, G. E., Mroz, A., Kleber, R. J., & Boelen, P. A. (2020). The prevalence of prolonged grief disorder in bereaved individuals following unnatural losses: Systematic review and meta regression analysis. Journal of Affective Disorders, 265, 146-156. https://doi.org/10.1016/j.jad.2020.01.034
- Johannsen, M., Damholdt, M. F., Zachariae, R., Lundorff, M., Farver-Vestergaard, I., & O'Connor, M. (2019). Psychological interventions for grief in adults: a systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders, 253, 69-86. https://doi.org/10.1016/j.jad.2019.04.065
- Gegieckaite, G., & Kazlauskas, E. (2022). Do emotion regulation difficulties mediate the association between neuroticism, insecure attachment, and prolonged grief?. Death Studies, 46(4), 911-919. https://doi.org/10.1080/07481187.2020.1788667
- Kosminsky, P. (2017). CBT for grief: Clearing cognitive obstacles to healing from loss. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 35(1), 26-37. https://doi.org/10.1007/s10942-016-0241-3
- Lancel, M., Stroebe, M., & Eisma, M. C. (2020). Sleep disturbances in bereavement: a systematic review. Sleep Medicine Reviews, 53, 101331. https://doi.org/10.1016/j.smrv.2020.101331
- Mason, T. M., Tofthagen, C. S., & Buck, H. G. (2020). Complicated grief: risk factors, protective factors, and interventions. Journal of Social Work in End-of-Life & Palliative Care, 16(2), 151-174. https://doi.org/10.1080/15524256.2020.1745726
- Neimeyer, R. A. (2020). What's new in meaning reconstruction?: Advancing grief theory and practice. Grief Matters: The Australian Journal of Grief and Bereavement, 23(1), 4-9. https://search.informit.org/doi/10.3316/informit.439384113866066
- Rosner, R., Comtesse, H., Vogel, A., & Doering, B. K. (2021). Prevalence of prolonged grief disorder. Journal of Affective Disorders, 287, 301-307. https://doi.org/10.1016/j.jad.2021.03.058
- Wetherell, J. L. (2022). Complicated grief therapy as a new treatment approach. Dialogues in Clinical Neuroscience, 14(2), 159-166. https://doi.org/10.31887/DCNS.2012.14.2/jwetherell
- Zaider, T. I., Kissane, D. W., Schofield, E., Li, Y., & Masterson, M. (2020). Cancer‐related communication during sessions of family therapy at the end of life. Psycho‐Oncology, 29(2), 373-380. https://doi.org/10.1002/pon.5268