How to understand and deal with the natural stages of the bereavement process

by Sarah Graham
Monday 20 October 2014
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The death of a loved one is a difficult time and people deal with their experiences of bereavement in their own, deeply personal ways. Grieving typically consists of five common stages, described by Doctor Elisabeth Kübler-Ross as Denial, Anger, Bargaining, Depression and Acceptance. We asked some RSCPP therapists with expertise in bereavement to explain these five stages and how therapy can help you work through the complex grieving process.

 

Denial

Denial is a common reaction to a death, even when it was expected. You may 'hear' the deceased, mistake a passer-by for them, keep their possessions 'ready for use', or deny your own feelings (as in, "I don't miss them"). Denial is a normal way to protect yourself while you gradually accept that they will not return. This process takes time, however people sometimes get 'stuck'. Therapy may help by providing a safe space in which to explore the meaning of your loss, work through the painful and complex feelings surrounding it, and gradually move on with your life.

 

Anger

Anger is a natural part of grief, and it is normal to want to blame someone for your loss. You may blame others (healthcare professionals, family members, or even the deceased), or turn the blame on yourself in the form of guilty feelings. Whilst this is normal and understandable, you need to be careful not to alienate others by taking your anger out on them. Therapeutic support may provide a huge benefit by creating a space that's accepting. An important part of the process is being given permission to express that anger without feeling embarrassed or ashamed.

 

Bargaining

Bargaining takes many forms, for example: "If only I hadn't stopped cooking on a Friday night, they wouldn't have gone out for a pizza and been hit by that car." What you may not realise is it's just as likely that someone else grieving might say: "If only I hadn't stopped doing their washing, they wouldn't have got cancer", because this kind of bargaining is about far more than what happens on the surface. Therapy can help you unearth the deep unconscious belief - "if only I had been a better person" - and its irrational conclusion - "they wouldn't have died". The function of this belief is to keep the horror [of death] at bay. I aim to meet your beliefs with respect and compassion, and help shed light on how or why you're thinking that way. 

 

Depression

Depression is a normal response to loss, however if it becomes overwhelming you may begin to feel detached. You may begin isolating yourself, and withdrawing from other people and favourite activities. Exploring your emotions in therapy, talking about your relationship with the deceased, and what the loss means in your life, without feeling guilty or judged, can help immensely.

 

Acceptance

Acceptance is beginning to withdraw your emotional investment from the feelings of loss. It does not mean you're 'over it', but you may feel more able and ready to engage with the world again. Therapy can help you identify ways to create a life of meaning without your loved one. You might feel guilty that you're not keeping your loved one in the front of your mind all the time; this is a normal part of the healing process. Therapy can help you understand that your loss will always be part of you, but it won't always consume the whole of you.

 

Grief is individual

Grief is individual; it is not a one size fits all experience. You may be in touch with your feelings and wish to express these. For others, grief may take the form of anxiety, physical bodily symptoms, a need to be alone or with others. At the same time, you need to go to work and cope with the demands of life. Do not be critical about what you are going through; grieving is a natural response to losing someone. Be kind and gentle to yourself.


Finding support


You can find out more about Bereavement, including how to find a therapist. If this route is not appropriate for you, your GP can assess you and direct you towards support.

Find a Therapist working with Bereavement

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Updated 21 October 2014