Understanding Grief: Types and healthy ways to cope with grief
- Aaradhana Reddy
- May 20
- 14 min read
Updated: 2 days ago
Published by Aaradhana Reddy
Counselling Psychologist (M.Sc).
All of us at some point in our lives lost someone or something close to us. Grief is an intense and complex psychological response to loss. We understand grief as something that follows the loss of close people and/or family members. But grief can be a result of many other things. It could follow after a divorce; grieving the loss of a relationship the person had with someone they were once close with. After the death of a pet and even after the loss of something that was of significance to an individual. Grieving is unique to the individual, meaning everybody grieves differently. The loss of spouse, child, accident/suicide/homicide are considered especially difficult to cope with. Irrespective of situation that triggered grief, it is a time of intense, overwhelming distress, longing, yearning and sometimes even confusion. Grief is heavily shaped by culture. Some losses are culturally deemed to have less significance. Losses that don’t necessarily require grief responses when compared to others.
In my counselling practice, many losses like the death of a pet, miscarriages, stillbirths are others not mourned and grief is heavily suppressed. Mostly because, people think it doesn't require mourning response or due to stigmas. But what I commonly notice is that suppression of grief leads to mental health complications and safe spaces and support to express are important for moving towards the future. Gender is another factor I notice during grief, men and boys are always expected to be silent, not cry/express and move on. I frequently hear "boys don't cry" "men don't really express" in my practice. This can be very unhealthy and affect their their mental health. I believe that everybody has the right to have their responses to loss and grieve in adaptive ways whether society acknowledges them or not. And as we move into the article we will come to understand why this is important.
In the following sections of the article, we will delve deep into the types of grief, cultural impact and lastly on how to cope with grief and supporting others through theirs.
Contents
Types of Grief
There are many types of grief and all of them may not be associated with bereavement (bereavement refers to the loss of a close family member/friend etc.). It can be associated with the loss of anything that was of significance in the person’s life. It is important to understand and be aware of types of grief as each type has its own mental health complications and subsequent treatment. Before we understand various types of grief; for context let us understand how adaptive grieving looks like. There is no right or wrong way to grieve, neither are there right or wrong emotions. Adaptive ways of dealing with and expressing them is what is important.
Normal or typical grief can last anywhere from 3-6 months. Grief involves emotional, physical and behavioural responses.
Emotional responses include:
Anger
Sadness
Shock
Numbness
Loneliness
Feeling empty
Guilt
Hopelessness
Yearning etc.
Physical symptoms may include:
Fatigue
Headaches
Body pains
Gastrointestinal issues
Increased heart beat
Loss of appetite
Sleep disturbances
Behavioral responses include
Confusion
Difficulty in decision making
Difficulty in concentrating
Wanting space (doesn’t always mean isolating oneself).
Another aspect that is expected during the grieving process is the oscillation between dealing with loss and dealing with the future. This is called the dual process model of grief. Proposed by Stroebe and Schut, the model states that, individuals oscillated between loss orientation and restorative orientation. Restorative orientation is looking towards the future, coping and adjusting without the person. It might involve going back to work, moving etc. Then there is loss orientation, which involves dealing with the loss, grieving, expressing emotions etc. Just after the loss an individual only experiences loss orientation and as time passes, they oscillate between restorative orientation and loss orientation which also gradually reduces over time.
Types:
Anticipatory grief: Anticipatory grief is when a loss is expected. It is most commonly done in hospitals to prepare family members for death. It can be helpful as it gives family members a chance to say what they always wanted to say and spend quality time. It also helps them be present during the final times. It could be with a family member with terminal illness or in cases of accidents or with pets. It usually brings about the same emotions that grief would.
Abbreviated or shortened grief: It is when an individual seems to have grief responses but for a shorter time than expected. It involves moving towards adjustment faster when compared to typical grief responses. This could be in cases of loss of a distant relative or someone not close. It can also be seen after anticipatory grief, as family members would have already gone through grief responses. Hence after the expected loss, grief responses maybe shortened.
Cumulative or compound grief: This occurs when an individual deals with multiple losses at a time or one after the other. For example, during covid when people lost multiple family members or after an accident which resulted in multiple losses. Read more about grief during covid and how to cope with it. Dealing with the death of a child, which later led to divorce etc., can also result in compound grief.
Collective Grief: Collective grief is something felt by a whole community/country/city etc. It could be after the death of a beloved humanitarian, from war, from pandemics, natural disasters etc. For example, when Princess Diana passed away or during the COVID-19 pandemic, World war II etc.
Disenfranchised grief: First introduced by Doka in 1989, it is when loss is not acknowledged, publicly mourned or validated. For example, miscarriage, stillbirth, death by suicide, drug overdose, death of ex-spouse or romantic partner etc. Since it is invisible, support is difficult to find, often resulting in prolonged or complicated grief. if you are facing disenfranchised grief, please take help from close friends or professional help where you can safely express.
Masked Grief: Masked grief is when an individual masks their grief, pain and emotions hidden from others. It could also mean that they create rituals that are done alone or that are not overtly visible to others. Masked grief could be due to disenfranchised grief or feeling that others don’t understand how they feel.
Delayed Grief: Delayed grief as the name suggests is when grief responses are delayed or take time to appear. It could be because they were in a spot where they had to be responsible to take care of all death related activities or were responsible for taking care of grieving family members/children etc.
Exaggerated Grief: Exaggerated grief is when there is prolonged, intense grief that exceeds the normative grief process and responses. It may include persistent nightmares, suicidal or self-harm behaviors etc. It is usually considered a risk factor for the development of mental health disorders such as depression, PTSD etc.
Traumatic Grief: Traumatic grief is the loss of a loved one by any traumatic event. It could be an accident, homicide, suicide etc. It could be a sudden, unexpected loss followed by intense grief that can impair daily functioning. It is often recommended to take from a trauma informed mental health professional for traumatic grief.
Absent Grief: Absent grief initially due to shock, can mean an absence of any grief responses. This could be normal, but absent grief even after several weeks or months may be a reason for concern.
Prolonged Grief: Prolonged grief is when grief responses that still persist beyond 12 months. They may affect the daily functioning of the individual with an impact on their social, occupational life and mental health.
Inhibited Grief: Inhibited grief is when an individual withholds grief without showing overt grief responses. Most of the grief is just held internally. In the long term, this is associated with physical symptoms such as headaches, pains, insomnia etc.
Distorted Grief: Distorted grief is an atypical response to loss. It includes persistent denial of loss, self-destructive behaviors, hostility towards others, anger etc. It can cause severe impairments in daily functioning and causes strain on relationships (Laan, 2022).
Prolonged Grief Disorder
Prolonged grief disorder is characterized by intense yearning and longing for the deceased, preoccupation with their memories even after 12 months of the loss. For children and adolescents, it is 6 months. Other symptoms include:
identity disruption
avoidance of aspects that remind them of loss or death
inability to reintegrate with other relationships after loss like meeting friends, relatives, work etc.)
loneliness
meaninglessness
inability to experience and express emotions
anger and sorrow about the loss.
It has marked functional deficit, meaning it impairs daily, social, occupational/educational functioning of the individual. The above diagnostic criteria (some if not all of them) have been present for most days at a clinically significant level since the death.
Note: This is for information only. Please do not self-diagnose. If you associated with the above criteria, please do seek help. Help is available.
Grief and Culture
Just like it’s impossible to understand an individual out of his social context, it is impossible to understand biological and psychological aspects of grief out of the socio-cultural context. Just like an individual, grief is heavily shaped by its socio-cultural context. Every culture has its own rituals, taboos, folkways (these are unwritten rules on behavioural standards shared by a society). There are dos and dont's of grieving process, emotional expression which differ from each type of death, have different customs for different age groups, religions etc. It is also important to understand that these customs around grief have drastic and lasting mental health impact.
From a mental health perspective some practices are adaptive and some may not be. Certain taboos with regard to grief can have significant mental health consequences on the bereaved. For example, certain deaths such as suicide, stillbirths, miscarriages, loss of a pet, death of a live in partner or boyfriend etc., are not really acknowledged, validated and are disenfranchised. People affected show their grief differently or may not show at all due to their socio-cultural perceptions around these types of death.
“…..grief is frequently policed by family members and cultural institutions, which enforce norms of expression and containment, or even silence, in response to death…. when an individual’s grief does not meet culturally sanctioned models of grief, then it may be seen as problematic” (Silvermana, Baroillerb, & Hemer, 2021, p. 3).
Unresolved, unacknowledged and disenfranchised grief has direct correlation with certain mental disorders and physical health. Anxiety, depression, PTSD, brain fog, prolonged grief disorder, strain on relationships, isolation, sleep disturbances, substance abuse etc. are direct consequences of unresolved grief. An immigrant, a minority, an indigenous person all experience grief differently. An immigrant may not be able to do their cultural rituals or express grief when its in contrast to how grief is expressed in the dominant culture of the place. In the Alto region of Brazil, parents who lost their children are expected to be silent during the grieving period and are expected to silently do their rituals as parents (Silvermana, Baroillerb, & Hemer, 2021). In other parts of the world the same scenario will look very different.
There are gendered rules for grieving as well in many societies across the globe. How men and women grieve depends on their socio-cultural and religious contexts. For example, in the Meru tribe in Tanzania, women can express their grief publicly and loudly. Women scream, wail, cry and even faint during the burial ceremonies, while men are expected to be composed and not show or express their grief. We can draw parallels in India as well, where we tell boys “Boys don’t cry”. Men hardly express emotions especially vulnerable emotions, while anger is ok to express. Women can express their vulnerable emotions but not anger. In the Meru tribe as well, men express their opinions publicly in matters of family, politics and economics, while women don’t and are expected to be composed. But, this is juxtaposed when it comes to grieving (Haram, 2020).
We understood the psychological and cultural aspects of grief, with advancements in neuroscience and brain imaging, we now have an understanding of the neurological underpinnings as well. There are major changes in our brain during grief and it affects how we process and regulate our emotions. Read more about the internal working of brain during grief.
Coping with Grief
Grief is hard on all of us, but it is important to process and express grief in adaptive ways. Initially, especially after a sudden loss or of a close family members, it can feel like the world has stopped. Its ok to feel this way. Many cannot do their normal/everyday activities like usual. During these times it can be especially helpful to rely on somebody or have a social support system. It could be a close friend, family members, neighbours who can support you emotionally and also help with handling other everyday things. Following are ways in which you can cope:
Social support: Like mentioned above, social support systems can act as a buffer against complicated grief. Having support one can rely on, can help individuals process and express their grief safely. There is nothing wrong in needing or asking for help.
Take help: If you are experiencing disenfranchised or other forms of complicated grief, take external, professional help. Especially if you are experiencing anxiety, depressed mood, loss of pleasure in hobbies (anhedonia) etc., please consider going to a therapist. Therapy can help you express your grief and all the overwhelming emotions/thoughts that come along with it.
Express your emotions: It is important to express your grief in adaptive ways, initially we all need social support and a safe space to express our pain and loss. One can slowly move on to processing alone as well.
Grief letters and Journalling: Grief letters can be especially helpful during expression. During overwhelming emotions, verbal expression may be difficult. You can write letters to your lost loved ones, express things that were unexpressed when they were alive, their importance and their impact on your life and current emotions about loss. This has been really effective in my counselling practice. If one finds it difficult to write, drawing is another option.
Rituals and memorabilia: Each culture has its own rituals surrounding mourning and grief. These rituals bring the family together and often hold spiritual significance for the deceased souls and afterlife. These rituals can often bring comfort for the bereaved and family acts as social support systems for emotional and everyday support (cooking meals, handling funeral logistics etc.). This also gives the individual time to express their grief. Apart from these, it can be helpful to have your own meaningful rituals to feel close to or honor your loved ones. It could be anything from lighting a candle to talking to memorabilia/photo etc. Especially for children, it can he helpful to involve them in rituals that can help them express grief. Children can choose as to how they wish to be involved.
Self-Care: With time it’s important to start with self-care. Doing things one loves or doing something for themselves. It could mean going out on walks, yoga, reading a book, watching a movie etc. Something that you love doing that relaxes you.
Socializing: It is also important to get back into socializing slowly, with small steps at a time. Grieving can feel very lonely and isolating. Hence, its important to slowly get back with family, friends etc. One can start with slow, relaxed, informal meetings. Going out to a restaurant, movies or walks with your close friends or family. It could also be potluck. Getting a pet is also recommended for unconditional support and companionship.
Supporting others through grief
Many finds themselves in a position of supporting others through grief. People are often overwhelmed themselves or may not really know what to do in these situations. I often hear family members of clients telling me, that they tried to console them or they don't know what to say to them. Below are somethings that might be helpful and what one should do:
Be present: This may sound counterintuitive to some, but just showing up and being present with them in silence is often enough. It’s just important for the person grieving to understand that, you are there to support them. We often hear people say “they are in a better place”, “everything is going to be alright”, but it may not be the right time to color grief positively nor will there ever be. Loss is something you hold on to but hope to move on anyways. Although you mean well, please refrain from saying them.
Support in ways they need: Everybody grieves differently, hence its is important to support them in ways they need or want to be supported. Some would prefer being left alone, while they grieve (although it’s important to notice if they are isolating themselves) and might need support afterwards to deal with the daily activities.
Offer help: Some find it difficult to ask for help and it makes it easier for them if we offer it first. For example, you can say “I am here to support you in whatever way you need, just let me know”. Or “I am here to listen, whenever you feel like talking/expressing”. Or notice in what areas they need help. It could be cooking, household chores, packing lunch for kids or picking them up from school/classes etc.
Do not minimize their grief: Please refrain from minimizing grief. It is important to take care not to say things along the lines of it happens to everybody or its time to move on already etc. In some cases, in an effort to help them move on, we tend to tell stories of similar experiences of others and how common it is. These can sound dismissive to the person grieving like their emotions are not normal or necessary. It can sometimes stop them from expressing their grief; which is maladaptive. Grief responses and emotions are normal part of grieving process which have to be expressed adaptively.
Note: Please refrain from pushing people to move on. Grief takes time and can be an emotional rollercoaster. It’s important to support and be there for them through this process.
If you or anyone you know needs help with their grief, please take help and encourage others to do so.
When should you seek professional help for Grief?
If your grief is interfering with your work/education, personal relationships and social life; you must seek help. If you feel like you are unable to express your grief or your grief is not being acknowledged or validated and this is causing you significant distress and you feel stuck with no support; it is important to seek professional help to process your grief in a healthy way.
At Safe Space Counselling, we provide safe spaces for expression of grief and provide counselling and emotional support for people dealing with bereavement, traumatic losses and other situations causing grief.
To understand more about our approach to grief, you can visit our grief services page.
Alternatively, you can also reach to us or chat with us.
Author
Aaradhana Reddy is a Counselling Psychologist with over 8 years of experience with both adolescents and adults. She specializes in adolescent mental health concerns and in dealing with various mental health disorders and other psychological concerns. She is a trained and experienced Cognitive Behavior Therapist and a passionate writer about mental health. She aims to raise awareness on mental health through her practice and blog.
Frequently asked questions about grief
How long does grief usually last?
Greif can last anywhere between 3-6 months. After 3-6 months, you maybe focusing on moving on with your daily activities and towards the future.
Is there ever closure to grief?
There may not be closure to grief, but with time and healthy processing of grief, you may still hold on to it without breaking down over the loss, cherish and remember them and move ahead with your life.
Is it normal to feel grief years after the loss?
Yes, but it depends on the type of grief response. If you have not grieved and are feeling the full weight of grief, then you might be experiencing delayed grief. Grief comes in waves, certain triggers like a birthday or anniversary or something reminding you of them can lead to a grieving response.
What are the common symptoms of grief?
Grief in itself is not a disorder, but common grieving responses maybe crying, sadness, yearning, longing, shock, initial numbness (not long term), unable to concentrate, make decisions etc. Complicated and prolonged severe grief reactions is a disorder- Prolonged Grief Disorder.
What are the common symptoms of Prolonged Grief Disorder?
Common symptoms of Prolonged Grief Disorder are, intense grief responses even after beyond the 6 month period, grief reactions exceed cultural and healthy expectations, pre-occupation with loss that it is affecting their personal, work and social life, isolation etc.
Can grief affect physical health?
Grief can affect physical health. in the initial stages of grief, a person might experience fatigue, headaches, body pains, sleep disturbances and loss of appetite. Complicated and prolonged grief can also affect physical health such as body pains, gastrointestinal issues, immune systems deficiencies, blood pressure etc.
How can I console someone when they are grieving?
When someone is grieving, more than consoling, support, listening and silently holding them while they grief is most important. Consoling usually tends to go along the lines of "it will be ok" "they are in a better place", which might make people feel that they should move on faster or that their grief is not being understood. Its ok to just be present with them and support them with certain daily tasks or preparations around the funeral etc.
How can I cope with grief in a healthy way?
Healthy processing of grief involved healthy ways of expressing grief. It could be talking about how you've been feeling to a trusted friend or family member. It could be through grief letters or journaling expressing what you didn't or couldn't tell your lost loved one. Taking part in rituals or creating your own to show your love and honor them. Creating memorabilia are other ways to express your grief.
When should I seek professional help for grief?
When grief is interfering with your daily life, your work/education, social life and its causing you distress even after considerable time has passed, you should seek professional help and go for grief counselling.
References
Haram, L. (2020). Bodily grief work meets Christian interiority: The Meru case. Death Studies, 1-19.
Laan, C. (2022). The Art of Grieving . Rockpool Publishing.
Silvermana, G. S., Baroillerb, A., & Hemer, S. R. (2021). Culture and grief: Ethnographic Perspectives on Ritual, Relationships and Remembering. DEATH STUDIES, 1-8.
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