For example, we can feel it following the death of a loved one, the ending of relationships (e.g., friendships), when we are unable to get or keep something that is important to our sense of identity (e.g., employment), if given a life-changing diagnosis (e.g., mental illness), when we move from one life stage to another (e.g., the ageing process), following the loss of physical capacity (e.g., through injury), or in response to the destruction of our environment (e.g., climate change).

Any loss that is associated with a significant or meaningful change can be grieved. Grief typically includes a range of difficult and sometimes painful emotions. Sometimes our grief reactions are accompanied by profound changes in self and worldviews. At times grief can become so overwhelming and distressing that it can lead to periods of difficulty in daily functioning. In summary, grief can present us with significant emotional challenges and it is only through processing the experience that we gradually adjust and adapt to the loss over time.

Bereavement and Grief

When we experience the death of someone with whom there has been an enduring relationship, we are left in a state of bereavement. How we typically respond to being bereaved is that we grieve but in what ways and to what extent, can vary considerably. In particular, our grief responses are influenced by the nature of our relationship to the person who has died and by a range of other factors, such as how we were coping with life before they died, the way that they died, if it was expected and whether it might have been prevented. In other words, because of the variability in the conditions that can surround a death, expressions of grief can vary widely from person to person. For some, there may be minimal distress, they may feel satisfied, relieved, or accepting. For others, however, the death of a loved one may leave them shattered, consumed by grief, depressed, or even traumatised.

Despite the unique range of responses to death, the vast majority – even those with substantial grief reactions – experience a natural and uncomplicated process of recovery. This can include experiencing a range of reactions as part of an acute grieving period. Some of the common emotional, cognitive, physical and behavioural changes during this time include:

Emotional responses

• 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 to the above, grief may also be felt in the form of significant shifts in ones self-perceptions, sense of identity, purpose-in-life and worldviews (e.g., spiritual beliefs and life philosophy). This can lead to significant distress as the person attempts to reconstruct themselves and their meaning in life again.

‘Adaptation’ to Bereavement   

In line with the reality that for the majority of people, grief is a normal process that unfolds naturally over time, adaptation, also, typically occurs for most people over time. That is, the grieving person experiences a gradual reduction (albeit in a fluctuating pattern) in the intensity, duration and frequency of distressing and painful reactions to their loss over time and their ability to function normally in life is restored. In addition, the person comes to accept the reality of the death, to find ways to stay meaningfully connected to their loved one and is able to see their future life as having purpose and meaning again.

Importantly, it is signs that this process of change is occurring – not how long it is taking – that is important in determining overall adaptation to bereavement.

Furthermore, whilst this reflects a ‘typical’ trajectory for adapting to the death of a loved one, it is important to understand and accept the grieving person’s own definitions of what adaptation looks like for them.

In addition, for many people, whilst an ending to the significant distress that can accompany their grief is desired, the grief itself (and the associated feelings of connection and memory of a loved one that it brings) becomes an important way of maintaining an ongoing bond with their loved one. In this way, for some people, adapting to their loss includes accepting that their grief will be part of them forever.

For some people, there is no sense that they will ever “recover” from their loss. It is simply too great and too life altering. In such cases, adapting to the death becomes about learning to find some degree of meaning again in their life, whilst constantly living alongside their grief.

When to seek assistance

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