Grief, loss, and bereavement: How therapy can support healing

Grief is an inevitable part of life and can emerge after any significant loss, not just the death of a loved one. The experience of loss is deeply personal and multifaceted, with each individual experiencing grief differently. 

As therapists, it is crucial to provide a safe, compassionate space for clients to navigate their journey through grief, using evidence-based approaches and a deep understanding of the complex processes that unfold.

Understanding grief: Perspectives from leading experts

Several key models help shape our understanding of grief and bereavement, each offering valuable insights. J. William Worden's Four Tasks of Mourning is one of the foundational frameworks in grief counselling. Worden argues that, contrary to outdated beliefs that grief is solely about “letting go,” the grieving process involves completing a series of tasks. These are:

To accept the reality of the loss

"Denial is not an uncommon initial response," Worden explains. Whether in moments of numbness or persistent disbelief, people may resist fully acknowledging the depth and permanence of their loss.

To work through the pain of grief

Embracing the pain of grief, rather than suppressing it, is a critical step. As painful as it may be, allowing oneself to feel and process the loss is necessary for healing.

To adjust to an environment in which the deceased is missing

This involves practical, emotional, and internal adjustments. The process is highly individualised and can mean discovering new skills, reframing daily routines, or redefining roles within a family or community.

To find an enduring connection with the deceased while embarking on a new life

Worden emphasises that mourning is not about detachment but about finding a way to continue bonds in a way that allows for life’s progression.

Similarly, grief researchers Margaret Stroebe and Henk Schut proposed the Dual Process Model of Coping with Bereavement, which views grieving as a dynamic process involving a balance between two modes:

• Loss-oriented stressors focus on processing and feeling the pain of loss.
• Restoration-oriented stressors involve the activities and changes that help adapt to a new life, such as taking on new responsibilities or reimagining one's future.

Stroebe and Schut explain that grieving is not linear; instead, individuals oscillate between these modes, finding moments of reprieve and active mourning. This flexibility allows individuals to gradually integrate their grief while rebuilding their lives.

Robert Neimeyer’s work, which emphasises“meaning reconstruction” in the face of loss, underscores that loss often disrupts our personal narratives and beliefs about the world. He observes, “The death of a loved one is not only a loss of the person but also a loss of the assumptive world we lived in before their death.” Therapy can help clients reconstruct meaning, rebuild a coherent sense of self, and honour their loved one in ways that foster personal growth and healing.

The prevalence and impact of grief

Grief is a universal experience, but its impact can be severe and far-reaching. According to a study by the Office for National Statistics (ONS), over 600,000 deaths occur annually in the UK, leaving a wide ripple of bereaved individuals in their wake.

Research suggests that between 10% to 20% of the bereaved will experience complicated or prolonged grief, wherein normal healing is disrupted, and grief symptoms persist and intensify over time. This may lead to depression, anxiety, substance abuse, or physical health concerns, highlighting the critical importance of effective support systems and therapeutic intervention.

How therapy helps those suffering from loss

Therapy offers a supportive environment where individuals can process their grief in a structured, meaningful way. Here are several ways that therapy can facilitate healing:

Providing validation and compassion

Grief can often make people feel isolated or misunderstood. Therapy validates the emotions and experiences of grieving individuals, helping them to see that what they are feeling is normal and understandable.

Navigating complex emotions

Emotions such as guilt, anger, regret, or even relief can surface during grieving. An experienced therapist can help clients explore and process these emotions without judgment.

Building coping skills

Grief can overwhelm daily functioning. Therapists can teach practical coping skills and strategies, such as mindfulness and relaxation techniques, that help clients regain a sense of control and stability in their lives.

Addressing complicated grief

For individuals suffering from prolonged or complicated grief, therapy may focus on breaking the cycles of rumination, avoidance, or distressing emotional responses. Techniques such as cognitive behavioural therapy (CBT) or acceptance and commitment therapy (ACT) can help clients confront and reduce symptoms of complicated grief.

Facilitating meaning-making

Drawing from Neimeyer’s emphasis on meaning reconstruction, therapists can guide clients in exploring how their loss has impacted their sense of purpose and worldview. This can involve creating rituals to honour the deceased, exploring the significance of their relationship, and finding ways to continue their legacy.

Creating a safe space for remembrance and connection

Therapy can provide a structured, safe space for clients to remember, reflect, and continue a bond with their loved one in a way that supports ongoing healing. Whether through memory sharing, expressive writing, or symbolic activities, this process helps integrate the loved one’s memory into the client’s life story.

Practical tools and techniques used in therapy

Therapists often employ various tools to assist clients, such as:

• Journaling exercises to explore emotions and memories.
• Psychoeducation about the grieving process to demystify its stages and fluctuations.
• Creative therapy approaches like art therapy or storytelling to express feelings that words may struggle to convey.

Healing and moving forward

Grieving may not have a defined end, but with support, empathy, and therapeutic tools, those suffering from loss can find ways to integrate their experiences into a renewed and purposeful life. As Worden stated, “The goal of grief is not to move on, but to find a new way to live with the loss.”

Therapy does not promise to erase pain but offers guidance, structure, and an ally in the process of building a meaningful life that acknowledges both the loss and the possibilities for growth.

References

• Worden, J. William. Grief Counselling and Grief Therapy: A Handbook for the Mental Health Practitioner.
• Stroebe, M., & Schut, H. (1999). The Dual Process Model of Coping with Bereavement: Rationale and Description.
• Neimeyer, R. A. (2001). Meaning Reconstruction & the Experience of Loss.