Grief is a natural and universal emotional response experienced when a person loses someone they love or a pet. People’s grief reactions vary during this process. These reactions may differ depending on the person experiencing the loss, the relationship with the deceased person/animal, and the nature of the death. In essence, grief is a process of adaptation. During this time, the individual attempts to cope with the loss, accept it, and continue with life. This process affects the individual emotionally, socially, physically, and cognitively.
Due to individual differences in grief reactions and various factors affecting the process, grief is classified into three main forms: normal grief, pathological grief, and traumatic grief. If a person is going through a normal grieving process, professional support is generally not required. However, for individuals showing symptoms of pathological grief, it is important to seek expert help in order to complete the process in a healthy way. These classifications are as follows:
- Normal Grief: Unresolved or acute grief (normal grief) refers to the emotional, cognitive, physical, and behavioral responses that emerge in individuals following a loss, experienced as a natural consequence of that loss. This process is considered part of the individual’s effort to make sense of the loss, adapt to it, and restructure their life accordingly (Worden, 2001; as cited in Çolak & Hocaoğlu, 2021).
- Pathological/Delayed Grief: Pathological or delayed grief is a form of grief that continues to deeply affect a person’s life even after six months have passed since the loss. It often shows up as ongoing difficulties in daily routines, relationships, and work life (Zhang, El-Jawahri & Prigerson, 2006; as cited in Çolak & Hocaoğlu, 2021). People experiencing this type of grief may feel an intense longing for the person they’ve lost, along with emotions like anger, denial, and constant thoughts about the loss. It’s also quite common for them to struggle with persistent feelings of guilt during this time.
- Traumatic Grief: Traumatic grief refers to the emotional reactions that can occur after the sudden, unexpected, and often violent or horrifying loss of a loved one. These reactions can significantly disrupt a person’s ability to function in everyday life (Parkes, 2001; as cited in Çolak & Hocaoğlu, 2021). For those going through traumatic grief, it often takes longer than usual for their grief responses to ease. The intensity of the trauma may also increase the risk of developing post-traumatic stress disorder (Mestçioğlu & Sorgun, 2003; as cited in Çolak & Hocaoğlu, 2021).
The grief process, as described by Elisabeth Kubler-Ross, consists of several stages: Denial, Anger, Bargaining, Depression, and Acceptance.
Denial/Shock Stage: In this stage, which can last from a few hours to a few weeks, the person refuses to accept the death of a loved one or pet. If the deceased was very close, the grieving person may repeat behaviors from when they were alive. For example, setting a plate at the table, texting or calling them, ironing their clothes, etc. Denial may not always manifest as overt behavior; involuntary thoughts, dreams, or speech indicating the person is still alive, as well as memory difficulties, can be part of this stage. The individual may show confusion, numbness, lack of reaction, a sense of emptiness, and feelings of unreality.
Anger Stage: Lasting days or weeks, this stage brings deepening emotional pain, intense sadness and longing, a desire for the deceased to be present, and crying spells. Thoughts of the deceased and the death dominate the mind. Anger can be expressed in various ways. The individual may be angry at the deceased for “leaving,” at themselves for not doing enough, or at healthcare workers for not intervening effectively. Anger may also be directed at others for not grieving enough or even at a higher power for not preventing the loss. These feelings are part of trying to make sense of the loss.
Bargaining Stage: In this phase, the individual experiences guilt and regret, questioning what they could have done differently. There may be a tendency to bargain with a higher power to reverse the loss.
Depression Stage: Realizing they can do nothing to bring the deceased back, the individual begins to feel hopelessness and helplessness more intensely. Although the person has largely accepted the reality of death, their quality of life is significantly diminished. They may feel tired, unmotivated, and drained; show signs of apathy, withdrawal, and reduced social interaction. Even communication with close ones may be avoided, and self-care may be neglected. Prolongation of this period increases the likelihood of clinical depression.
Acceptance Stage: This phase marks a time when the reality of the loss is faced, and the individual begins to relearn life. As the certainty and consequences of death are gradually accepted, the intensity of longing and sadness decreases. Memories of the deceased are preserved, but the individual begins returning to their daily life before the loss, restructures life, and makes future plans with hope.
Depressive feelings in the first few months after a loss are considered normal. The grief process naturally shows symptoms similar to depression. If a person resumes daily life within weeks of the loss, meets basic needs within a few months, accepts the loss, and begins forming new and meaningful bonds between 6 months to a year, this indicates a healthy grieving process. However, if someone cannot find joy in life for a long time, denies the loss, withdraws socially, loses functionality, and cannot carry out daily tasks, they should definitely seek professional help. Otherwise, grief may turn into trauma that negatively affects mental health.
References
Çoban A. (n.d.). Losses and mourning. Adnan Çoban Klinik.
https://www.adnancoban.com.tr/kayiplar-ve-yas
Çolak, G. V., & Hocaoğlu, Ç. (2021). Loss and mourning: A review. Turkish Cypriot Journal of Psychiatry and Psychology, 3(1), 56-62.
https://doi.org/10.35365/ctjpp.21.1.07
Polat, B. N. (n.d.). The grieving process and psychological resilience. Institute of Positive Psychology.
Turkish Psychiatric Association (n.d.). Mourning process.