Understanding bereavement: A psychotherapist's perspective

Bereavement is the period of mourning and adjustment following the loss of a loved one. It's an inevitable part of life, yet its impact can be profound and deeply personal. The experience of bereavement includes a range of emotions and reactions, all of which are normal responses to loss.

The nature of bereavement

Bereavement involves a variety of emotional responses, including sadness, anger, guilt, and a sense of profound loss. These feelings can fluctuate in intensity and may persist for varying durations. Elisabeth Kübler-Ross (1969), in her seminal work ‘On Death and Dying,’ identified five stages of grief—denial, anger, bargaining, depression, and acceptance. While not everyone will experience all these stages, nor in a linear fashion, they provide a framework for understanding the grieving process.

William Worden (2008) introduced the ‘Four Tasks of Mourning’ framework, which involves accepting the reality of the loss, working through the pain of grief, adapting to life without the deceased, and maintaining a lasting connection with the deceased while moving forward in life. These tasks highlight the active process of coping with loss and adapting to significant change.

Responses to bereavement

Individuals respond to bereavement in varied ways, influenced by factors such as the nature of the relationship with the deceased, the circumstances of the death, previous experiences with loss, emotional resilience, concurrent stresses, support system and personal circumstances. The initial response is often one of shock and disbelief, especially in cases of sudden or traumatic death (Stroebe, Schut, & Boerner, 2017). As the reality of the loss sets in, feelings of sadness, yearning, and even anger may surface.

Clients frequently ask, ‘Is it normal to feel this way?’ or ‘When will I feel better?’ These questions highlight the uncertainty and distress that accompany bereavement. It is essential to recognise that there is no ‘normal’ timeline for grief; it is a highly individual process.

The role of therapy in bereavement

Bereavement therapy can be a crucial support for those struggling with the intensity of their grief. Initially, the support of family and friends is often most beneficial. However, as the immediate tasks following the death are completed and the initial shock wears off, the deeper work of grieving begins. This is often when therapy can be most helpful (Shear, 2012).

Bereavement therapy provides a safe space for individuals to express their feelings, make sense of their loss, and begin to rebuild their lives. It can help clients to:

• Process and express emotions: Therapy encourages the expression of complex emotions that might be difficult to share with family or friends.
• Develop coping strategies: Therapists can help clients develop healthy ways to cope with their grief and manage day-to-day challenges.
• Find meaning and purpose: Therapy can assist clients in finding meaning in their loss and integrating the experience into their lives.
• Facilitate adjustment: Therapists support clients as they adjust to life without their loved one, helping them to navigate changes and rebuild their sense of self.

Books on bereavement

Several books and articles offer insights into the grieving process. Joan Didion's The Year of Magical Thinking (2005) provides a poignant narrative of her own experience with loss, capturing the raw emotions and disorientation that accompany bereavement. Paul Kalanithi's When Breath Becomes Air (2016) reflects on his own journey with terminal illness and the impact on his family, offering a personal perspective on facing mortality.

Final thoughts

Understanding bereavement and the varied responses to it is essential in providing effective support to those grieving. Therapy can play a vital role in helping individuals navigate their grief, process their emotions, and find a way to move forward. 

References

Didion, J. (2005). The Year of Magical Thinking. Alfred A. Knopf.

Kalanithi, P. (2016). When Breath Becomes Air. Random House.

Kübler-Ross, E. (1969). On Death and Dying. Macmillan.

Shear, M. K. (2012). Grief and Bereavement in Adults: Clinical Features. Psychiatric Times.

Stroebe, M., Schut, H., & Boerner, K. (2017). Cautioning Health-Care Professionals. Omega Journal of Death and Dying, 74(4), 455-473.

Worden, J. W. (2008). Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner. Springer Publishing Company