Sometimes we need people for validation of emotion. We need one or another person who could be like a partner—an emotional buddy. Sometimes we have parents and sometimes we have kids—sometimes we have insight and lack of insight.
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What is Grief?
Bereavement and Loss
Bereavement refers to the loss of loved ones and includes the experiences of family and friends after their death, along with the changes and adjustments they face.
Grief comes from distress, and we all experience it when we lose a relationship. This sadness can become overwhelming, leading to negative emotions that block our ability to see the present. Emotional disconnection from loved ones contributes to this feeling. Both the loss of a person and the loss of a relationship can cause grief, such as when a breakup happens.
Understanding Grief as a Natural Response
Grief is a normal reaction to loss and refers to the distress resulting from bereavement. Grief is multidimensional with physical, behavioral, and meaning/spiritual components and is characterized by a complex set of cognitive, emotional, and social adjustments that follow the death of a loved one.
We have a particular period of bereavement—it is a kind of exposure therapy where we get a graded exposure to a certain stimulus. Always on certain days it feels light. In Asian culture, there is a period of bereavement. Bereavement should not turn into grief; here psychological intervention is needed. Grief is short-seated and it could remain for months. Anything prolonging from weeks to several weeks is grief.
Acute Grief: The Initial Impact
Acute grief manifests as numbness, shock, and denial. Sadness, longing and emptiness, anguish, loss, anger, regret, and guilt. Anxiety, fear, loneliness, and depression.
Trauma is any event that leads to emotional havoc. Grief is something where there is loss of relationship. Bereavement is a normal reaction. If the bereavement is continuing for months, and we are not able to function well, the family is distorted. There are people who change their personality from introvert to extrovert—there is grief that needs to be sorted.
Acute grief could lead to numbness, shock and denial, sadness, longing and emptiness, anxiety, fear, loneliness, and depression. It leads to depersonalization, and one feels overwhelmed. Sometimes it feels fine and sometimes it leads to aggravated grief and reduces in intensity and frequency.
Real Stories of Grief
A Tragic Loss
There was a boy who was 25 years old who met with a car accident—the only son, and the only boy in the family. He had gone abroad for higher studies. He told his mother and father that he was going abroad and couldn’t meet friends, so he was going out to meet friends. They were having something in a restaurant, and he felt like somebody was calling from across the road. He didn’t see the road and crossed; a car ran over him.
What we got to know: when the mother heard the news, she fainted. The mother and father became so weak within a month that people were not able to recognize them. Within 6 months, the father also passed—the father was in grief, the mother fainted. The mother was in acute grief but she recovered. Females are emotionally strong, so she managed the family well.
The 25-year-old had a girlfriend, and they thought that they would get married. When the girl heard the news, she fainted and something happened—she went into a coma. She was in a coma for 1 week. When she recovered, in 2 years, her personality completely changed. She was under psychological interventions. The girlfriend was in chronic grief.
Anyone who has not seen situations where grief is not there—we have all seen grief, and that needs to be understood.
Integrated Grief: When Life Must Go On
Integrated grief occurs when there is recognition that they have grief, but they have not processed it. A lady, 70 years old, lost her husband. They were running an organization—the husband was 73 and healthy. On that day the temperature was 42 degrees, and they were in a hilly area. He suffered a cardiac arrest and lost his life. There were 2 sons—one in the US and the other an army officer. Everything was handled by the mother; she was the pillar of the family. She handled everything and never got time to be bereaved.
After 3 months, she said she was not able to sleep. She said she had accepted the situation but still could not come out of it. She seemed to be working fine and kept busy throughout. There are so many unresolved things that we resolve with death—death is not just sudden loss of a person. The wife said that the day before his death, he said, “We will talk about it tomorrow,” and tomorrow never came. There was something unresolved, and it was not clear what he wanted to talk about.
Normal Grief: The Natural Process
Normal grief—grief in and of itself is normal. Any time you suffer a loss, it’s the most normal thing in the world to have feelings of grief. There is a huge range of emotions that you may experience during the process of grief. Some of the grief could be physical, but some are behavioral.
Different Types of Grief in Detail
Anticipatory Grief
Anticipatory grief or anticipatory mourning could be common if you are expecting the loss of someone close to you in the near future. To prepare for the impending loss, you might try to envision life without them. It can be especially common in cases when someone you care for is facing a terminal illness. During anticipatory grief, you might try to anticipate how you will be reacting and mourning once your friend and loved ones pass away. You might feel loss or even incredible fear or emotion for the dying person. When you know your boyfriend is going to cheat, that is anticipatory grief.
Complicated Grief
Complicated grief occurs when your grieving process does not move through all the phases of grief. Take the wife of a CCD owner who committed suicide—the wife immediately took over. Whenever there is suicide, there is the medical side, there is the finance side. The wife had nothing, but she had CCD which was in debt. There was no inflow, so the person feels difficult to earn for friends and family and also has to make profit. That is the situation where a lot of areas are hampered—when the grieving process doesn’t move well. The lady was fighting for life, for finance, for everything.
We are always in the future in anticipatory grief. Complicated grief could be prolonged—the ability to function well is prolonged. At the end of the day, there is grief. One might feel disturbed, and the reaction and behavior run for a very long period. It’s complicated because it is the mix of 2-3 types of grief. Complicated grief is most difficult.
A Story of Unimaginable Loss
There was a bodybuilder in 2021 in Dehradun. This boy later won Mr. North, Mr. Universe. There were five members in the family—parents, elder sister, and younger sister. They had one child. This was in 2001, and they decided to go to Vaishno Mata for pilgrimage, and they met with an accident. In the accident, only one person survived, and that was him. All the members—10 members—mother, father, younger sister, husband of elder sister, sister, baby died. Now he had to perform rituals for everybody.
The amount of grief the person experienced loss of parents and now there is no support, loss of parents, loss of siblings, loss of baby, the loss of the whole family. It is difficult for people to just recover from simple grief. What kind of grief was this? Complicated grief.
Financial problems, social constraints, expectations—the way he has come out is because of defense mechanisms. He said that he doesn’t feel like going home. Now he is happily married. This complicated grief is most difficult.
The CCD lady and this person have recovered, and they chose the path of resilience. Obviously, a person who is spending 8-10 hours in physical training inflicts abuse to the body—the body gets tired and there is fatigue. If one is not feeling that, then the mind is. We inflict physical pain to reduce the mental pain.
Chronic Grief
There was an example of a 25-year-old boy who was abused by his mother. He was in trauma—he worried about the love relationship between mother and son. He was taking drugs and going to rehabilitation. He saw rehabilitation was much better. Chronic grief occurs when extreme trauma resides. Chronic grief results when extremely intense reactions to loss do not subside. It can go on for years. These emotions will last for a very long time and cause you incredible distress that continues intensely.
Delayed Grief
Delayed grief occurs if you are experiencing incredibly stark feelings of sorrow and longing, even if the loved one’s death occurred a very long time ago. It can be felt for years after a loss and essentially means that your emotional reaction didn’t happen when it should have.
This might be due to dissociation, which is common when things are too painful for you to feel. To cope, your mind blocks many of the thoughts, emotions, and feelings associated with the loss until you’re ready to process and deal with them. When one is not grieving when one had to, that is called delayed grief. Sometimes dissociation doesn’t happen, but it is delayed grief. You have not experienced grief during that time.
Distorted Grief
Distorted grief involves very intense and extreme reactions to loss. There is typically a noticeable change in behavior overall, and self-destructive behavior is common. Anger and lashing out, both towards yourself and others, is one of the most common emotional symptoms of distorted grief. It involves extreme loss at physical and emotional levels.
Understanding the Timeline
Chronic grief is focused on symptoms, and prolonged grief is focused on duration. Anything which is completed after 12 months is prolonged grief. Multiple types of grief can exist together, and that is why we have complicated grief. If we have not understood our emotions, then we will be lashing out. So this grief has to be resolved.
PS: This is a lecture notes from Trauma and Grief Management Course taught by Dr Deepika Chamoli, Cognitive Psychologist.
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