Grief is a natural and normal response to the loss of a loved one; most people are able to process their grief over a period of time without intervention, but for those who find themselves mired in grief bereavement counselling is an effective form of treatment.
Grief is most commonly understood to be the emotional response to the death of a loved one, but in reality, grief is an emotional reaction to loss.
We can grieve for people and pets who die, of course, but for many people, the loss of a relationship, job, or even perception of self can spark a grieving process.
Each person processes grief in a unique way; not all grieving processes require intervention in the form of counselling. When it comes to the death of a loved one, however, there are three main types of grief which commonly require intervention.
There are three main different categories of grief which we describe below:
1. Anticipatory Grief
Though the common perception of grief is that it is something which happens after death, this is not always the case; for people acting as caregivers to terminally or chronically ill loved ones the process of grieving often begins with diagnosis.
Anticipatory grief is exhausting, especially when combined with the stress of caring for someone who is ill, fighting addiction. In some cases, spouses of active military personnel also struggle with anticipatory grief.
2. Secondary Loss
Secondary losses are the losses which are triggered by that first bereavement, usually a death. Though less well understood, they are nonetheless triggers for grief and be very distressing and destabilising.
The most obvious examples of secondary loss are loss of financial stability, the loss of a home as a result of this, the loss of a family structure, and the loss of an important relationship.
3. Complicated Grief
Complicated grief leaves people feeling unable to recover even a long time after the initial bereavement, and while there is no time limit on healthy grieving studies suggest that complicated grief may be identifiable 6 months after the loss.
A number of factors can complicate grief; the nature of the relationship with the deceased, circumstances surrounding the loss, the age of the person who has died, and existing mental conditions all play their part.
What is Bereavement Counselling?
Bereavement counselling is an umbrella term for a range of therapies, from cognitive behavioural therapy to mindfulness, which is designed to help people who are struggling to cope with grief following the loss of a loved one.
The aim of bereavement or grief counselling is to help those who are overwhelmed by a loss to process their feelings and develop healthy coping mechanisms that will enable them to face their current situation, and any future losses, with confidence.
When is Counselling Necessary?
When we lose a loved one or even a beloved pet, it is expected that a period of mourning and grief will follow. The symptoms of grief can include:
- Problems with sleep
- Uncontrollable crying
- Unstable moods
- Increased irritability or anger
- Self-medication with alcohol or drugs
- Lack of self-care
- Panic attacks
- Nightmares (very common in traumatic loss)
- Lack of motivation
- Feeling suicidal
All of these reactions are natural as there is no single way in which to grieve. Counselling or intervention may be necessary if you feel persistently suicidal, attempt suicide, or if multiple symptoms are persistent over a long period of time.
There is no set period for processing a loss and the circumstances surrounding that loss can affect the way in which grief is processed.
However, if severe symptoms persist for months on end, overall grief persists for more than six months, or persists despite self-care activities such as journaling, meditation, and talking to family and friends: then counselling may be necessary.
Treatments for Bereavement
The incredibly personal nature of bereavement and grief means that the process of treatment and counselling must be flexible. This is why talking therapies, group therapies, and other person-led options are the most common counselling methods.
Treatments for prolonged or intense grief can be taken on an inpatient or outpatient basis, and while most people prefer to retain their day to day schedule, inpatient treatment is the best option for anyone who poses a risk to their own safety.
For most people, talking therapy or cognitive behavioural therapy (CBT) is the most effective options, but programmes of mindfulness and recreational therapy are often successful, too.
Below, we have listed the most common forms of therapy for bereavement:
Depending upon the circumstances surrounding the bereavement, either talking therapy or cognitive behavioural therapy may be required, though a mixture of both is often beneficial.
The ability to talk about the events surrounding the death of a loved one (talking therapy) and an action-focused approach to managing unhealthy thoughts and behaviours (CBT) are often instrumental in recovery for those who find that grief has become complicated.
Grief can feel isolating, even when we are surrounded by friends and family. Group therapies help people struggling with loss to connect with others in the same situation. The unique and intimate understanding of the grieving process which they share is often key to encouraging recovery.
By sharing anecdotes, coping methods, and feelings these support groups have the capacity to help bereaved persons to realise that grief is not a permanent state.
Grief shares many symptoms with anxiety and depression, and so treatments for mild iterations of these disorders are often helpful. Mindfulness, in particular, can be very helpful for people facing complicated grief because it encourages them to listen to their bodies and reduce the prevalence of negative thoughts and actions as a result.
Mindfulness is often instrumental in accepting a loss.
The Stages of Grief
Living with the loss of a loved one is never easy; the symptoms and feelings it can throw up areas often physical as they are mental, and they often differ from person to person. Likewise, the ‘cycle’ and stages of grief differ from person to person.
They do not always appear in the same order, but the accepted 7 stages of grief are:
It is most common for people to freeze or become very still and quiet as the first process the news of a bereavement.
Commonly, denial is the next step. Refusing to believe that they have understood correctly, or that the situation is happening are common reactions. “It can’t be true!” – “They wouldn’t do that.” – “I don’t believe it.”
Anger may come next or be delayed depending on the nature of the situation and manner of bereavement. “Why me?” – “Why would they/anyone do this?” – “It’s not fair!”
Bargaining is the point at which a person might try to ‘fix’ the situation with prayer or self-blame. “Maybe if I-” – “There must be something we can do!” – “Please God…”
Guilt commonly takes place after the initial shock and denial have passed and bargaining clearly won’t work. This could be guilt for things they said, did, or failed to do. “If I had only…” – “It’s all my fault.” – “I should have…”
Symptoms of depression are evident throughout the process of grieving, but there will be times when these feelings overshadow everything else. This stage is characterised by weeping, self-isolation, and lethargy. However, self-harm and suicide are risks that you should watch out for.
While not happy about the loss, acceptance is the stage at which we have processed the events and begin to return to normal life.
For those who lose a loved one to suicide, the process of grieving can be incredibly complex and bereavement counselling may be the best option from outset, especially if they were the person to find the deceased.
If you or someone you love has recently been bereaved and you are worried that the grieving process has become complicated, or you are struggling with feelings of worthlessness and suicidal thoughts, please contact a grief counsellor immediately.
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