Grief beyond bereavement

Grief is a process which we go through when we steadily adjust to the loss of someone. Grief involves experiencing a range of different emotions, sometimes uncomfortable and tricky ones. There is no right or wrong way to grieve, making it a very individual process. Grief also has no end, so once experienced, it’s something that will walk alongside people’s lives forever. And, despite the uniqueness of grief, researchers have proposed that for most people, grief comes in stages, introducing the concept of ‘The Stages of Grief’ — courtesy of Kübler-Ross (1969).

While much of this is an accepted part of life, there is another type of grief that we typically don’t discuss. Do the stages apply to these experiences, too? Are the stages really even that accurate anymore, when we know that we all process grief differently?

Just like with the death of someone important, do humans still experience the process of grief for other losses that they may encounter in their lives? And are these losses recognised by society? Do people receive the same support emotionally as someone who is bereaved? Every client I’ve worked alongside has demonstrated their grief in a unique way. Therefore, have we gone beyond ‘The Stages of Grief’, and do the stages described in Kübler-Ross’ model, potentially put unnecessary pressure on those grieving?

To help answer these questions, I want to explore different examples of loss, where feelings of grief can occur — hopefully helping to normalise the intense feelings that can come with any type of loss.

To begin with, it’s safe to say that people do still experience the feelings associated with grief if they lose something other than the death of a loved one. In support of this, Kenneth Doka, a member of the American Counselling Association suggests “grief is a reaction to the loss of anyone or anything an individual is attached too deeply”.

So, what are some examples of other types of losses that can conjure up feelings of grief beyond bereavement?

• financial loss
• a relationship breakdown, due to divorce or separation
• the unexpected loss of a job through redundancy
• a change of location, an unexpected relocation
• a sudden decline in the physical and/or mental health of someone
• the loss of plans/hope for the future e.g. birthing a healthy baby who becomes very poorly
• unseen losses, such as miscarriage or stillbirth
• shameful/secret losses – the loss of who someone once was e.g. when adultery has taken place

When grief is experienced, research suggests that there appears to be a ‘general’ process that individuals go through. Despite acknowledging that everyone grieves in their own unique way, the process of grief does tend to unfold in those commonly known stages.

The 5 stages of grief

1. Denial: shock and disbelief that the loss has occurred
2. Anger: that someone we love is no longer here
3. Bargaining: all the what-ifs and regrets
4. Depression: sadness from the loss
5. Acceptance: acknowledging the reality of the loss

When someone is bereaved; society, family, friends and/or communities are often, and hopefully, quick to support an individual through their grief. In some ways, they are expected and ‘given permission’ to have the uncomfortable, tough feelings that come with grief. However, what about individuals in the scenarios listed above — are they ‘given permission’ to grieve and are they offered similar support to someone who is bereaved?

First, let’s unpick and explore an example of loss when there is a sudden decline in the physical and/or mental health of a loved one.

B’s story

B is in his eighties, and he has been married for 45 years to his dear wife, G.

Sadly in 2020, G was diagnosed with early-onset Dementia and due to the isolation of the COVID-19 pandemic, her symptoms progressed far quicker than B could ever have predicted. G began to lose her sparkle, and B found himself experiencing the feelings associated with the stages of grief: denial and bargaining. B often blamed himself for the deterioration in his wife’s health, wishing that he had noticed the signs quicker and that he himself was healthier so that he could take better care of her.

G’s symptoms worsened when she began to be unfamiliar with who B was and other members of her wider family. This deterioration was a devastating loss for B and it was with a very heavy heart that B made the decision, that for G’s safety and welfare, she needed to move into residential care. This decision left B feeling guilty and alone, causing him to enter the fourth stage of grief, depression. He now lives alone, and he has lost his previous comfort. In fact, he feels like he’s already said goodbye to G, even though she is still very much alive.

B’s feelings of grief match perfectly with the feelings described in Kübler-Ross’ model, emphasising yet again, grief beyond bereavement. B and his family have already begun to grieve for the loss of who G once was, and it is crucial that this process of pain is acknowledged and recognised as grief. B and his family, along with any readers who find themselves in a similar situation, must find compassion and support to assist them through this, allowing them to find joy and peace when they do get to spend time with G.

B’s story is also a brilliant example of ‘anticipatory grief’ — a process like ‘normal grief’ but with it occurring before an actual death. In other words, the grief process has begun early for B and his family, which brings with it these difficult feelings and emotions B experiences. Some days may feel harder than others, some days B may not experience grief at all and feel OK, and this is completely normal. Again, a big part of dealing with B’s situation is to help normalise his feelings for him. Just like with ‘normal grief’, ‘anticipatory grief’ is a journey, and B will need to take each day as it comes and be kind to himself to ensure that he is in the best possible mental and physical health to continue to enjoy the time he does have left with G.

Whatever your past, current or future loss may look or feel like, remember that every loss is worthy of time and compassion

Now, let’s examine another example of loss but this time the loss is associated with shame/or a secret.

J’s story

J was going about her everyday routine — the kids had been dropped at school, the errands were run and she was settling down to do some work — just like any other day. However, in an instant, her entire world changed forever because she distressingly discovers that her partner has been having an affair.

Similarly, to an individual’s response to when someone dies, J finds herself thrown into ‘The Stages of Grief’ model, first experiencing feelings of denial. She doesn’t want to believe what she is hearing, it can’t be true, surely? After several incredibly emotionally charged and difficult conversations with her partner, it’s confirmed.

Now, what does J feel? Commonly with feelings of grief, the next stage is anger. J is angry about losing the partner that she thought she had. J no longer recognises the partner that stands before her. It’s like her old partner has ‘died’ and now she has a stranger standing there who she doesn’t know anymore. J may not have lost her partner to death, but she has lost who she thought they were, forever.

Who should J talk to and share this heartbreak with? Will her work understand and give her compassionate leave, just like they would if someone dies? Is what J feeling even normal?

These may be just some of the many thoughts and questions that J could have whirring around her mind — even though she hasn’t done anything wrong, the shame attached to her partner’s behaviour could force her to keep her loss a secret.

As with any type of loss, it’s important to grieve to prevent ‘complicated grief’ from occurring (how J deals with this situation may steer her response for the next time she experiences a loss). However, in this example, there’s a high chance that J won’t want to share, it’s her personal life after all, so she may not want to air her ‘dirty laundry’ and talk so intimately about her relationship.

Before this devastating realisation, J would have shared her worries and fears with her partner, but now that they’ve betrayed her and trust has vanished from their relationship, J may experience feelings of isolation and struggle independently.

Similarly, to B’s feelings of loneliness, it’s possible that J too may experience loneliness, feelings of overwhelm and be consumed by her emotions. These feelings may stall her grief process, creating an unhealthy, damaging grief response e.g. ‘complicated grief’.

Therefore, for anyone in a similar situation to J, where perhaps a loss is being hidden due to shame and fear, please confide in someone (this advice goes out to those in similar situations to J’s partner too, please don’t struggle in silence). Your grief deserves to be heard and understood, just as much as the painful feelings that someone experiences when bereaved. I encourage you to test your story out on someone you trust, perhaps with a friend, or perhaps with a healthcare professional or counsellor — where in both capacities, they are ethically bound to keep everything you share in confidence (unless there is an imminent risk to yourself or others).

Furthermore, just like clients attending bereavement counselling, it’s crucial for J’s feelings of grief to be brought into the room and normalised. In fact, both parties involved in this example deserve the same opportunities as those struggling with bereavement.

What is important is acknowledging that several types of loss exist and we need to understand them for society, family, friends, and professionals to better support those experiencing grief beyond bereavement.

We understand from research that if grief is acknowledged, shared, and worked through, individuals have the chance to experience what the last stage of grief feels like — acceptance. Acceptance doesn’t mean that someone is OK with what they have lost, it simply suggests that they’ve reached a point where they can begin to acknowledge the reality of their loss. Now, in the instance of J, reaching this stage of her grief may provide her with the energy and strength to work on their relationship, or it may give her the courage and resources to go it alone. Regardless of what the future holds for J and her partner, both will require continued support and a listening ear to decipher their ‘new normal’ and allow their grief to walk alongside their lives calmly.

It’s also important to highlight here that reaching acceptance doesn’t mean that grieving is complete. As explained above, the journey of grief has no end, but there will come a point when the intensity of grief will lessen and allow for joy to be experienced again. When someone reaches acceptance, grief becomes a process that runs quietly alongside their life, when it can and will be revisited, but only when needed.

So, let’s return to the questions posed at the beginning of this article and see if we can answer them. 

‘Just like the death of someone important, do humans still experience the process of grief for other losses that they may encounter in their lives?’ — Yes. From the examples listed and the case studies described, we have ascertained that people can experience the feelings and the process associated with grief for losses other than death. An individual may not realise that what they’re experiencing is associated with the process of grief, so it’s important to acknowledge how you’re feeling and consider sharing your experiences with a trained professional, such as a counsellor or GP, or a trusted friend and/or support network. 

‘Are these losses recognised by society, and do people receive the same support emotionally as someone who is bereaved?’ — Yes, they should do, but perhaps there is more work to be done. Healthcare professionals such as GPs and counsellors recognise that whatever an individual’s loss, feelings of grief can be experienced, which requires support and compassion to work through. However, perhaps society, including workplaces, needs to be made aware of the list of alternative losses to ensure there is awareness and resources available to help society demonstrate understanding and acknowledgement of the difficult feelings and emotions experienced with any type of loss. As we know, to prevent future ‘complicated grief’ or ‘complex grief’, talking about the situation is crucial. 

Lastly, ‘have we gone beyond ‘The Stages of Grief’ model and do the stages described, put unnecessary pressure on those grieving?’ — Perhaps, but I don’t think these questions can be answered definitively. David Kessler explained that “the five stages were never intended to be prescriptive” which brings me seamlessly to Kessler’s sixth stage — Meaning. 

Kessler describes this sixth stage of grief as a chance to transform grief into something else, something rich and fulfilling. Therefore, it’s encouraging to discover that grief is acknowledged by experts as a unique continuum that constantly evolves over time — there is ‘no one size fits all’. However, perhaps knowing whether we’ve gone beyond this concept or not isn’t what’s important. What is important is acknowledging that several types of loss exist and we need to understand them for society, family, friends, and professionals to better support those experiencing grief beyond bereavement. 

Whatever your past, current or future loss may look or feel like, remember that every loss is worthy of time and compassion. This will ensure that the natural and necessary process of grief can occur.

At the Counselling Directory, we have over 18,000 professionals offering support in grief and bereavement. If you feel ready to connect with a therapist or to learn more about what you’re experiencing and how therapy may help, simply browse profiles until you find someone you resonate with and send them an email.