Grief is a process that takes place after a loss, be it of a loved one, a job, a relationship, an object etc. Grieving affects psychologically but also affects the behaviour and the physique of the person who suffers it . It is a necessary, universal and painful process. The important thing is to integrate it into life and re-establish a relationship with it.
Human beings establish relationships by nature. We are constantly interacting with those around us: we build bonds throughout our existence to satisfy our needs for safety and protection as children, to develop our identity as adolescents and to give and receive love as adults . This urge to connect with the outside world arises from the moment a baby is born and begins to relate to its mother.
It is a process, it evolves through time and space , it is normal (everyone can be a victim of a significant loss), it is dynamic, it depends on social recognition, it is intimate (each person carries it in a different way) but it is also social as it involves cultural rituals and, finally, it is active, the person will make his own decisions and give them meaning. Its function is to elaborate the impact of the loss and to adapt to the new situation.
The grieving process is a mechanism to adapt to a loss, it is standardized since its characteristics are present in most duels. In normal grief there are about six behaviours that occur normally: somatic or bodily discomfort, concern for the image of the deceased, guilt related to the deceased or the circumstances of the death, hostile reactions, inability to act normally and, finally, many patients develop some features of the deceased in their own behaviour.
How long does the normal grieving process take?
The duration of the duel is between two and three years (if it is a significant person), it starts from the moment the person begins to show the separation and ends when the person accepts it definitively.
It is also normal that some people affected by a traumatic event may, as a result of their coping, experience positive changes in their life. There are personality factors that can predict this post-traumatic growth which includes changes in oneself, in interpersonal relationships and in the philosophy or meaning of life. Post-traumatic growth can coexist with suffering. In fact, difficult emotions may be necessary for these changes to occur.
Phases of grief
Normal grief is usually structured in stages that occur in succession:
1. Emotional denial
It is a way of distancing oneself emotionally from the fact, it is the absence of reactions that ends when it occurs, it should last between 2 weeks and 3 months.
It is done with the closest people although the real anger is with the lost person, it is very necessary to express this stage.
It is where there is the greatest danger of stagnation, isolation from the world, it is necessary to have 3 to 5 relationships with whom to talk about the loss.
4.Intellectual and global acceptance
It begins to be accepted, it begins to be difficult to talk about and it ends with small comments about the loss.
5.Searching for the Global Meaning
It consists of talking about everything that that relationship has involved in the person’s life.
6.Elaboration and new attachments
To be able to link to other relationships without being a replacement of the lost person.
Abnormal types of duels
Apart from normal grief, there are other more complicated or pathological types of grief:
- Chronic mourning → of excessive duration, the person cannot move on.
- Delayed mourning → the emotional reaction was not sufficient and manifests itself some time later, triggered for example by memories.
- Exaggerated grief or → symptoms of excessive and disabling intensity.
- Masked grief → the person is not aware of the effects of the loss.
- Unauthorized Dueling → the mourner is not socially recognized and his pain cannot be publicly expressed.
In the latter case, the absence of supportive contact at the time of the traumatic event and in later time is itself another cumulative loss or trauma.
Coping with grief
There are two types of coping mechanisms in the grieving process: those oriented to loss and those oriented to restoration .
In order for the mourning to be adjusted, these two mechanisms must occur in an oscillatory manner, although as the process advances over time, restoration-oriented mechanisms predominate.
The emotional needs of people who have suffered a loss
Grieving people have certain needs that must be met to successfully overcome the loss.
- They need to be heard and believed in their whole story of loss.
- They need to be protected and have permission to express emotions.
- They need to be validated in the way they deal with grief (knowing that what happens to them is natural, it is well done and it is not bad to feel this way).
- They need to be in a supportive relationship based on reciprocity (that the other person understands them thanks to a similar experience or that the other person “knows” what the affected person is talking about).
- They need to define themselves in the individual and unique way of living through grief (that other people support their way of coping).
- They need to feel that their grief experience has an impact on others (that their pain or their explanation of what they are suffering marks others).
- They need to be in a relationship where the other takes the initiative as they are not able to, for example, start talking about the topic.
- And finally, they need to be able to express love and vulnerability in front of other people.
Production of special types of losses
There are certain ways of dying and certain circumstances that require special treatments that go beyond the usual processes. We review them below.
Those affected are left with not only a sense of loss, but also a legacy of shame, fear, rejection, anger and guilt . It is possible that a suicide bereavement may be more intense and last longer than a bereavement due to another type of loss.
The most notable feeling is shame, which affects both the individual and the family unit or nucleus and guilt, the relatives take responsibility for the action of the deceased and have the feeling that they could have done something to prevent that death or, conversely, guilt is manifested by blaming others for that death.
They occur without warning. In this type of death, the loss is perceived as if it were not real, the mind does not assimilate such an abrupt change so a specific treatment is necessary to help accept it.
In this case it is necessary to give importance to the mourning of the deceased baby because, if it is disregarded, it can incite the parents to produce another pregnancy that would only serve as a replacement for the previous one and could lead to subsequent problems.
It is usually a masked mourning that manifests itself through other events or facts , without the patient knowing that they are due to a previous induced abortion, as it is a provoked loss, it is not usually spoken about and is intended to be quickly forgotten.
In early grief, death is known in advance so the emotional process or responses are started before the loss takes place . Prolonged grief can produce resentment and, in turn, lead to guilt. Early grief does not have to shorten or reduce the intensity of the post-death grieving process
Due to the stigma of AIDS, it is really complicated to find social support for this grief as there is the fear of rejection or of being judged if the cause of death is discovered. Because of these fears, it is likely that the patient will be isolated. An affective way of coping with this type of grief is support in social groups that are in the same situation.
In short, grief is a process that every person can be affected by or involved in at some point in life . It is a difficult but resolvable process in which the support of others is very necessary in order to overcome it. In grief, the presence of a psychologist is not necessary to help us overcome it, but sometimes the service that the psychologist can offer is of great help.
There are many types of duels and many ways of coping with them but they all have a common basis or principle that will help us to identify them.
Grief is a serious process that can cause many problems if it is not treated properly so it is vitally important to know about it and be prepared to offer help to victims both from a professional perspective and from a closer view such as helping a family member or friend to cope.
- AMELA, Victor-M. “Qui se suïcida no veu cap altra sortida, no té elecció”, La Vanguardia, 25-26 December 2012, p. 56 (back cover)
- CONANGLA, Maria Mercè. Lexicon and affections, Abandonment. CONANGLA, Maria Mercè. Emotional crises. Barcelona: RBA Pocket, 2007, p. 189-190.
- NEIMEYER, Robert A. Learning from loss. Barcelona: bolsillo payós, 2007. ISBN 8449311799.
- NOMEN MARTIN, Leila. Mourning and death. The treatment of loss. Madrid: Pirámide, 2007. ISBN 9788436821420.
- PAYÁS PUIGARNAU, Alba. The tasks of mourning. Grief psychotherapy from an integrative-relational model. Madrid: Paidós, 2010. ISBN 9788449324239.
- WORDEN, William J. The treatment of grief: psychological counseling and therapy. Barcelona: Paidós, 2004.ISBN 9788449316562.