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grief
Grief, Loss, and Bereavement
Loss is something that binds us together as human beings,

and grief is a part of life that all of us will experience when
we su er loss, whether it takes the form of someone’s
death, losing a job, a relationship, hopes, dreams, or other
things that you value.
Powerful feelings of grief and loss are so normal and

natural that they are typically not given a ‘diagnosis’ like
other conditions such as anxiety or depression. There is no
right way to grieve and no ‘quick x’, but there are ways
that you can help yourself to come to terms with your loss.
When you have experienced loss, it is natural to feel a wide range of

emotions, and you might feel overwhelmed by grief. Grief is a powerful
emotional and physical reaction to the loss of someone or something. It
is characterized by deep feelings of sadness and sorrow, and often by a
powerful yearning or longing to be with that person again. Other e ects
of grief include feeling numb and empty, as if there is no meaning to
anything, or being annoyed at yourself for how you are feeling
compared to how you ‘should’ be dealing with things. You might feel
angry that your loved one has gone and left you behind. Perhaps others
are expecting you to be moving on and this is making you feel worse.
You may also be worried that you will never feel better, or that you will
not be able to cope.
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Grief is also felt physically: you might be struggling to eat or sleep, or
might feel sick in your stomach. These feelings may come in waves, and
you may be tossed from one to another. All of these feelings are a
normal part of grieving. Despite the pain, the process of grieving is an
important part of how we come to terms with loss.
Powerful feelings of grief and loss are so normal and natural that they
are typically not given a ‘diagnosis’ like other conditions such as anxiety
or depression. There is no right way to grieve, and unfortunately, no
quick x.
Although there are no short-cuts, there are things you can do to help
yourself along the way. Judging and comparing yourself to how you
‘should’ be feeling can add to your su ering and pain. Start by learning
to be patient, kind and understanding with yourself, like you would with
a dear friend. This is a di cult journey, and treating yourself kindly can
support you along the way.
What is it like to grieve?
Gloria and Mario
Gloria was 62 when her husband Mario died from prostate cancer.
Unfortunately, his cancer was only diagnosed once it was in a fairly
advanced stage. Mario had surgery and underwent hormone therapy and
chemotherapy. Gloria was by Mario’s side every day and hoped and
prayed that he would recover, but he got weaker and weaker with each
treatment. He was ill for nearly two years before he was eventually moved
to a hospice three weeks before he died. Gloria knew then that her
husband would never return home.
Gloria and Mario had been married for forty-two years and had three
children and six grandchildren. They had their ups and downs during their
life together, and it hadn’t always been easy. Mario used to like having a
drink and this had been an ongoing tension for them for as long as they
had been together. However, despite these challenges they loved each
other dearly and were looking forward to all the things they would do in
retirement together when Mario became ill.
Gloria then became his carer, which was di cult for them both as Mario
had always been a very independent man. As the cancer spread, he got
weaker and required more and more help each day. There were times
when Gloria found it tiring and demanding caring for Mario, although she
never complained and tried not to show how it was a ecting her. When he
was moved to the hospice, she felt many di erent emotions. She was
scared and knew his death was imminent, and she was worried how she
would cope without him. On the other hand, she also felt relief that she
didn’t have the physical demands of caring for him round the clock. This
made her feel guilty, and she felt ashamed for having such a thought.
While Mario was in the hospice, Gloria was there every day. She would
read to him, play his favourite music, and helped the nurses to care for
him. On the day he died, Gloria had left the hospice to buy cakes for the
nurses. When she returned, she found Mario had died – the nurses told
her that he had slipped away peacefully. Gloria felt awfully guilty for not
being by his side in his last moments, and this was something that she
kept playing over in her mind.
Gloria’s life and home felt empty without Mario. For a while after he died
the house was busy with her family, and she was kept busy with planning
for the funeral. When things became quieter afterwards, she felt helpless
and didn’t quite know what to do with herself. The past years had been so
busy each day caring for Mario that Gloria couldn’t remember what life
was like before. There was also part of her that felt relief that he was no
longer su ering and in pain.
As Mario had been unwell for some time, Gloria thought that she would
be, to some extent, prepared for his loss. However, she was shocked by the
deep despair and yearning she felt for him once he died. She often
replayed regrets in her mind, all the things she wishes she had said and
done. She wished she hadn’t argued with him about his drinking and
hoped he didn’t go with the memories of her nagging him. She thought
about the future they would never have. She couldn’t imagine what her
life would be like without him.
Gloria tried to keep herself busy to distract from her pain. Fortunately, her
children and grandchildren lived nearby, and she was able to throw
herself into their lives and helping with childcare. Her children told her
how strong she was and praised her for the way she was dealing with
things. However, she knew on the inside the e ort it was taking to supress
how she was really feeling. When she heard his favourite song on the
radio she would feel like she had been hit in the stomach. Keeping busy
helped Gloria get through the days, however at night she would lie awake,
unable to sleep. She would feel a deep longing for Mario and the life they
had planned in their retirement. Gloria started to feel very fatigued from
all the business and lack of sleep. Eventually her grief started to catch up
with her and she felt consumed by it. She couldn’t get up in the mornings
and felt like all the joy had been drained from her life.
Aspects of counseling that Gloria found helpful
Gloria saw a bereavement counselor after her daughter suggested that she
might nd it helpful to speak to someone. In counseling Gloria felt
listened-to. She started to talk about how much she was struggling. She
felt like her counselor wasn’t judging her, and let her tell her story. Gloria
found it helpful to tell her counselor about her life with Mario and how he
had died. Gloria shared her regrets about not being with him when he
died, and the guilt she felt for having felt relief when he passed. Her
counselor helped Gloria to see that these were normal reactions. This
helped Gloria to forgive herself and her attitude towards herself became
kinder.
In counseling Gloria also shared her fears about the future. When she
looked ahead everything felt bleak and dark. She felt useless, her children
were all grown and didn’t need her as much as they used to. She couldn’t
imagine what life would be like without Mario. Gloria also felt guilty and
didn’t want to let go of Mario or move on without him. Gloria’s counselor
helped her to realize that grieving wasn’t about letting go or moving on,
but instead learning to live without Mario while also carrying him in her
heart.
She also found it helpful to learn about di erent ways of understanding

what she was going through. She learned that suppressing her feelings
and ‘being strong’ was getting in the way of her processing her emotions.
She found it useful to talk to her children about this, as they had
unknowingly encouraged her to ‘act strong’. It also helped them to open
about their grief, and as a family they started to think about ways to
remember Mario and keep him alive in their hearts and memories. She
worried about how she would cope on his birthday, but the family all got
together and celebrated his life.
Gloria’s counselor encouraged her to talk about the life she had with
Mario, and all the good memories they had together. Gloria made a
memory book to put together all the photos and things that reminded her
of Mario. She enjoyed nding ways to remember him and felt relieved to
not be so consumed by guilt. It took time, but Gloria was able to start
thinking about her future. She started trying new hobbies and seeing her
friends more regularly. Whenever she felt guilty, she would imagine what
Mario would say to her, which helped her to feel better. She knew he
would want her to live a full and happy life and would want her to enjoy
her retirement. Gloria still had her ups and downs, but no longer felt
unable to carry on.
What is loss?
When we talk about loss we often mean the death of someone that we
love. It is important to acknowledge that people can also experience
grief when confronted with other losses such as: the breakup of a
relationship, the loss of an important role such as a job, or the diagnosis
of a life-changing illness. For much of this guide we will refer to
bereavement, but most of it is relevant other losses too.
Losses within the loss
When someone dies you might experience many losses. Part of grieving
is about recognizing what you have lost, and loss comes with many
changes that are not always immediately visible. There is the physical
loss of the person and their presence, and other less tangible losses such
as:
The loss of a shared life, consisting of the things you did together
and for each other.
The loss of a shared future together, including all of your shared
hopes, dreams, and plans for the future.
The loss of your shared social life.
The loss of all that your loved one did for you. They might have
been the one who xed problems around the house, or who
managed your nances.
Characteristics of the loss
Not all losses are the same and not all losses a ect us in the same way.
The circumstances of the loss can a ect how you grieve. Some of the
characteristics of the loss that can a ect how you grieve include:
The manner of the death and whether you had time to prepare
Anticipated and expected. For example, you may have known
that your loved one was going to pass after a long illness.
Their death may not have had any less impact, but in these
circumstances some people notice that they started to grieve
before the person died, or when they learnt of the illness.
Sudden and unexpected. You may have lost your loved one
unexpectedly from a health event, or from an accident. It is
normal to be in a state of shock and disbelief, as your mind
and body tries to understand what has happened.
Traumatic or violent. Your loved one may have died violently
or by suicide. In these circumstances there are often
additional layers of shock and grief.
The type of relationship you had
The type and quality of relationship you had with the person
can a ect the kind of grief you experience. The degree of
emotional closeness, the role that this person played in your
life, and your feelings for them while they were alive are all
factors that can in uence how you grieve for them.
Other people’s reactions

The way that other people react can support or hinder your
grieving. People around us often want us to feel better, but
this can sometimes mean that they fail to give us the space to
actually talk about how we are feeling.
What else is going on in your life?

The other things that are going on in your life can a ect how
much space you have to grieve. You might feel under pressure
to care for others, to carry on as normal, or return to work
sooner than you might like.
What is grief?
Grief is more than just sadness and you might be overwhelmed by a
variety of di erent emotions and feelings in your body as your grief
changes over time. Grief is di erent for everyone: everyone deals with it
in their own unique way.
We can separate the e ects of grief into thoughts, feelings, and

behaviors. You might experience some, all, or none of these.
How you might think and How you might feel How you might act
remember emotionally and in your
body
Thoughts about Strong emotions Dwell, ruminate,

unfairness Fear ponder
Worries about how Anxiety Avoid reminders
you will cope Guilt Avoid being alone
Anger at the person Regret Avoid being with
for leaving you Numb people
Thoughts that you Hopeless Carry on as normal
can’t go on Helpless Keep busy
Thoughts about what Anger Tell other people you
you should have done Sadness feel ok
or said Yearning Stay in bed
Thoughts about how Longing Stop doing things
things are going to be Frustration that you used to do
di erent Forgetfulness Drink alcohol
Thoughts about what Irritable Distract yourself
you are going to miss Tired Behave recklessly,
Remembering Fatigued take risks
conversations (or Pain Remember them
arguments) Heartache Visit their resting
Wishing that you had Emptiness place
done things No feelings at all Want to be near them
di erently Shock Talk to them
Unwanted memories Disbelief Look at photos
Dreams or Feeling sick Speak to people who
nightmares Unable to eat were close to them
Happy memories Unable to sleep Look through their
Thoughts that Tired belongings
they’re at peace Relief
Thoughts that they Peace
are not su ering Content
Seeing or hearing
your loved one
Grief often feels like it comes in waves that can initially feel intense and
overwhelming. These waves of grief can feel like they come out of
nowhere, or can be triggered when you are reminded of the person you
lost. When you rst lose someone, it can feel as though you are
constantly being hit by enormous waves of grief – sometimes so close
together that it feels as though you hardly come up for air between
them. With time, the size of the waves tends to lessen, with larger gaps
in between waves. As the weeks, months, and years pass by you will
experience many ‘ rsts’ as you navigate life without your loved one –
your rst dinner out, your rst supermarket trip, your rst birthday
without them. In each of these moments it will be natural to feel their
absence, and for waves of grief to be triggered again.
Figure: Grief often feels like it comes in ‘waves’. To begin with, the
waves feel intense and frequent, but over time they tend to be spaced
further apart and feel more manageable.
The difference between normal and complicated grief
There’s no ‘right way’ to grieve, and no ‘right amount’ of time to grieve

for. However, some people’s grief seems to last for longer than others,
follows a di erent course, and doesn’t seem to get better with time as
we would expect. Psychiatrists sometimes call this ‘Prolonged Grief’ or
‘Persistent Complex Bereavement Disorder’. The main di erence from
‘normal’ grief is that the strong grief reactions continue at an
unbearable intensity for much longer than would be expected, and
impact the bereaved person’s life in powerful ways.
Figure: An illustration of di erent ‘trajectories’ of grief. The most
common type is ‘resilient grief’. ‘Prolonged grief’ typically follows the
rough trajectory of ‘chronic grief’. [1]
If you are struggling with a prolonged grief reaction you can feel as if
you are in the depths of grief all the time, and can feel overwhelmed by
an intense longing for the person you have lost. It can be a real struggle
to carry on with your daily life and you might nd you can’t get on with
the things you used to do before, such as working, socializing and seeing
friends and family. A prolonged grief reaction is more likely when the
loss was particularly traumatic, for example after losing a child, or
losing a loved one in sudden, violent or traumatic circumstances.
How other people might respond to your loss and your grief
It is natural for your friends and loved ones to want to be supportive.

Sometimes though, you might nd that the way that other people
respond to you can be unhelpful. For instance, other people might:
Feel uncomfortable and not know what to say.

Find it di cult to talk about your loss with you and change the
subject.
Avoid you.
Expect you to feel better and move on before you are ready.
Not know how to respond in the way you need.
Say things like “aren’t you over it yet?”.
Want to talk about it too much with you.
Shut you down, or try to cheer you up when actually you just want
to talk about it.
Remember that it’s OK to let people know what you need and what you
don’t. Grief can be like a rollercoaster: there will be times when you
want to talk and other times when you don’t. Sometimes you might
want a distraction and to not think about it, at other times all you might
want to do is talk about how you feel. You may not know what you need
from others and this can be confusing for you and them. Remember that
there are no rules – whatever you’re feeling is OK.
Metaphors and models of grief

Psychologists have many di erent ways of thinking about grief. It used
to be commonplace to think of grief as a process that goes through
various stages. Some of these older models of grief were based on the
idea that people ‘move on’ and ‘let go’ of their loved one. However,
some people nd this notion uncomfortable. More recent models of grief
present alternative perspectives that you may nd more helpful.
As you read the theories and models below, there may be some that
resonate with your experience and others that don’t. That’s absolutely
ne! Remember there is no right way to grieve – the theories are just
some ways of understanding the process of grieving.
Loss is like a wound
When someone you love dies, it can feel as though you have been injured
by their loss. Loss is often described as an open painful wound that
needs healing. Just like a physical injury, the pain of loss is very raw to
begin with. The wound is all that you can think about – it is all
consuming – and any movement reminds you that it is there. In this
early stage you may be so consumed by your injury that friends and
family need to take extra care to look after you and be there for you.
Grief is often described as the process of healing from the wound. If the
conditions are right then wounds will heal naturally in time.
Sometimes, though, it is too painful to acknowledge or tend to a wound

– and so time does not always heal in the way we would hope. If a
wound is left unattended then it can become infected, and the pain of
grief worsens. An infected wound needs to be cared for in order it for it
to heal. Talking about what happened, and how you feel is a way of
tending to your grief and helping it to heal. It does not make the injury
go away – a serious injury leaves a scar. However, as time and life goes
on, it becomes a part of you, and no longer hurts in the same way.
Continuing bonds
Some ways of thinking about grief describe ‘stages’ that grieving people
go through, often ending with ‘acceptance’ or ‘investment in a new life’.
Grief researchers Denis Klass, Phyllis Silverman & Steven Nickman
questioned these stage models, and proposed a di erent way of thinking
about grief[2]. They argue that when a loved one dies you go through a
process of adjustment and rede ne your relationship with that person –
your bond with them continues and endures. They say a relationship
never ends – grief is not something that you go ‘through’ to ‘let go’ or
‘move on from’ your loved one. Instead, grieving is the process that
helps you to form a di erent relationship with them.
Although your loved one has gone physically, you can learn to remember
them, and they can continue to live on in your memories and heart. This
will mean di erent things for each person, for example it could mean
you continue to say goodnight to them and tell them about your day, you
might carry on some of the routines and things that you did together, or
you go to their favourite place on their birthday.
“they are remembered, not forgotten”
Life grows around grief
Another helpful metaphor for grief was developed by Dr Lois Tonkin.

The idea is that we don’t ‘get over’ grief – it doesn’t ‘go away’. Instead
as times goes on, you learn to grow around your grief.
Imagine drawing a circle on a piece of paper. The rst one represents

you and your life. Shade a section within that circle to represent your
grief – soon after your loss it might almost be lling the entire circle of
your life. Many people’s intuition is that with time the shaded section of
the circle becomes smaller as the grief passes. Tonkin’s theory proposes
the opposite – rather than the shaded area growing smaller, the outside
circle (you and your life) grows bigger – your life grows around the
grief. You will have many ‘ rsts’, new experiences, and ups and downs
in your life. You might start to reconnect with your family and friends,
you may meet new people, start to socialize again and even start to have
moments when you feel joyful and happy. As these experiences
accumulate, the outer circle grows bigger. As this happens your grief
remains but it no longer dominates and so becomes more bearable. In
this way your life ‘grows around’ your grief, and you continue to carry
your grief with you.
Tasks of grief
William Worden’s model of grief uses an acronym ‘TEAR’ to describe his

four ‘tasks’ of grief [3].There is no order to Worden’s tasks, and grieving
involves cycling between tasks over and over as you learn to come to
terms with your loss.
T = To accept the reality of the loss. Accepting the reality of the

loss means accepting that your loved one has died. It is natural in
the early days to want to deny what has happened, perhaps
wanting to avoid the pain of grief. Sometimes it can be di cult to
accept loss when your loved one died in tragic circumstances such
as an accident or suicide. You may not want to think about how
they died, which can get in the way of accepting the reality of their
death. However, denial hinders grieving and in the long term can
make you feel worse. Rituals and ceremonies when someone dies
can help you to accept that the person you loved has physically
gone.
E = Experience the pain of the loss. This task involves working
through the pain of grief. We live in a world where many of us have
learned to supress or avoid di cult emotions. Others around you
also want you to be OK, and so it can be di cult to nd space to
work through how you are feeling. However, avoiding our feelings
does not make them go away, and can make the grief persist. The
way we feel after a loss is di erent for everyone. There is no
formula about which emotions you need to work through. Worden
acknowledges that for each person grief is di erent. It is natural to
feel any emotion like sadness, longing, anger, relief, despair,
anxiety, numbness, guilt, shame or regret. Whatever you feel, it’s
important to nd ways to process and deal with your pain, however
it a ects you. This could mean talking about it with people you
trust, or seeking counseling.
A = Adjust to a new life without the lost person. Adjusting to life
without your loved one will take time, and you may even feel guilty
for doing so. This process will be di erent for everyone. It will also
depend on the relationship you had and how much of your life you
shared together. For example, losing a good friend who was a big
support and con dant in your life will involve nding new ways of
connecting with others and doing things that perhaps you used to
do together. If you have lost your partner in life you may be
guring out how to do all the things your partner used to do. You
may need to learn new skills and do things that you had never done
before.
R = Reinvest in the new reality. By ‘reinvesting in the new reality’
Worden means nding ways to continue an emotional connection
with your loved one. This involves living your new life whilst also
holding dear the memories of your loved one and allowing them to
live on in your heart and memories. This will mean di erent things
for each person. For many people it involves engaging with new
connections and things in your life, that bring pleasure and
meaning to your life again.
Kubler-Ross’s ve stages of grief
Many people have heard of Elizabeth Kubler-Ross’s stage model of grief.

This theory was popular in the 1960s and – for good or bad – has
become a part of Western popular culture. What many people don’t
realize is that Kubler-Ross originally developed her model while
conducting therapy groups with terminally ill people: it was developed
as a way to understand the stages of her patient’s own grief as they were
dying. The model proposes that people go through ve stages of grief
which include denial, anger, bargaining, depression and acceptance.
Not wanting to face the reality of your loss. This may involve
carrying on as if nothing has happened.
Being angry about your loss, feeling that it is unfair and unjust. You
may feel angry at others, or at your loved one for leaving you, or
angry at yourself.
Trying to gure out if there is anything you can do or change to
make your loved one come back.
Believing that there is no purpose and no meaning in life without
your loved one. Feeling hopeless and depressed. Withdrawing from
life and the people who care about you.
Starting to come to terms with your loss. Beginning to feel that you
will be able to live your life without your loved one.
An unfortunate aspect of the stage model is that it can set up an

expectation that there is a ‘right’ way to grieve: a correct way to move
through the stages. Actually, what we know is that grief a ects people
di erently. A better way of thinking about the Kubler-Ross model is to
understand that the stages are not linear: people don’t necessarily go
through all the stages or in any particular order, and it is natural to
move back and forth between stages over and over.
Treatments for grief
Psychological treatments for grief
If you feel that you are struggling to come to terms with your loss you
may nd it helpful to speak to someone about how you are feeling. Many
people nd bereavement counseling helpful, and you may be able to nd
a specialist bereavement counselor near you.
If you are struggling with symptoms of prolonged grief or traumatic

bereavement, speci c psychological interventions are recommended for
these conditions.
Medical treatments for grief
Grief is a normal human experience for which there are no
recommended medical treatments. Some medical professionals argue
that symptoms of depression (which may perhaps predate or ‘sit
alongside’ experiences of grief) can be distinguished from symptoms of
grief and propose that medical treatments such as antidepressant
medication can be helpful in these cases. This view is not without
controversy.[4]
How can I help myself to grieve?

There are many things that you can do for yourself that will help you to
work through your grief. We describe a selection of tasks and activities
below that you might like to try. Some of the suggestions might make
more sense at particular points of your grief journey, so don’t feel that
you have to try all (or any!) of them right away. Some might be
appropriate when your grief is raw, and others might be more helpful
when you have had a little time to come to terms with what has
happened.
Rituals & customs
Rituals help us to come to terms with loss and are a way to honor and
respect our lost loved ones. They are so important that all cultures have
their own rituals that are part of the grieving process, for example:
Funerals are a ritual where we say goodbye, acknowledge the loss,

or celebrate the life of the deceased.
In cultures where the deceased are cremated, there is often a
ceremony where the ashes are scattered at a place of rest.
In some Indian cultures it is a tradition for the deceased’s family to
be visited by family and friends to o er condolences and talk about
how the person died.
In many cultures there are rituals around preparing the deceased’s
body, for example by washing the body.
In western cultures a wake is usually held after the funeral.
In Mexico there is an annual Day of the Dead to celebrate and honor
the lives of the deceased.
From a psychological point of view, these rituals are imbued with

meaning and ful l two essential functions – they help us to make sense
of what has happened, and confront the reality of the loss. You can make
your own rituals to remember and celebrate the life of your loved one.
For example, some people choose to plant a tree or hold a memorial
service at their favourite place. You could think about what would be
meaningful for you: how do you want to honor the life of your loved
one? What would you like to do on anniversaries to remember your
loved one?
“I don’t really go in for formal rituals, but I gave my son a name that
would have been meaningful to my Dad. It makes me laugh to sometimes
order his favourite pizza and think about how he used to be. These things
are meaningful to me.”
Express your grief
Talking about your feelings of grief can help you to begin to come to
terms with your loss. Could you nd some close friends or family with
whom you would feel comfortable talking about how you feel?
Another helpful way of expressing your grief is to keep a journal and

write about how you are feeling. Some people nd it helpful to speak to a
professional grief counselor to express how they feel.
Remember that sometimes other people (understandably) want to make

you feel better. Although this is well-intended, it could also mean that
they try to cheer you up when actually you need to talk. If you want to
talk, don’t be afraid to let others know that you don’t need them to make
it better, you just need the space to be heard.
Make a memory box
After a loved one dies, some people nd it important to keep their
memories alive. One suggestion is to put together a ‘memory box’ of
items and photos that remind you of your loved one. For example, you
might include photos, some of their favourite belongings, their
favourite music, a treasured item of clothing, letters, their favourite
book, or sentimental items they gave you. You could place the box in a
special place, and perhaps set a regular time when you visit your
memory box like on their anniversary.
Telling your grief story
Talking about your loss and telling the story of your loss and grief can
help to process what has happened. Whether you lost your loved one
suddenly or after a long illness, there is often much to process and come
to terms with.
As your mind tries to make sense of your loss, you may feel a need and
even an urgency to tell your story and make sense of what has happened.
This can be an important way of processing all the emotions that you are
feeling.
If you don’t feel that you’ve had a proper chance to speak about what
happened then you might nd it helpful to write your story from your
perspective, as if you are telling someone about what happened. If you
decide that this is something you would like to try, here are some tips to
get you started:
What was happening in your life just before you found out about
the death of your loved one? If they had an illness you might write
about what was happening just before you received the news that
they were going to die.
If your loved one went through an illness, it might help to write
about what that was like for you. You might write about the time
you received the diagnosis, the medical interventions they went
through, and your interactions with the medical sta . Try and
notice how you were a ected, re ect on your thoughts and
feelings, and what it was like for you.
Write about the moment you found out your loved one had died.
How did they die? What happened? This moment is often very
vivid, people often say they felt shock. What were you doing at the
time? How did you feel? What did you do or think?
How has your loss a ected you? Re ect on your feelings, thoughts
and how your grief is a ecting your life.
Tackling avoidance
In the early days, the loss may be raw and it can be too painful to do
things that remind you of your loved one. As time goes on, it is
important to begin to face the places and situations that you have been
avoiding. Here are some tips:
Make a list of all the places, situations, people and tasks that you
have been avoiding. For example, the swimming pool you used to
go together, the takeaway you used to eat together, or certain
people that remind you of them.
Organize your list into a hierarchy, with the most di cult
situations at the top.
Make a plan for how and when you will start facing the situations
you have been avoiding. Be kind to yourself, see if you can get a
friend or close family member to come along with you to begin
with.
Pace yourself, you don’t have to jump in the deep end. It can be
di cult to start facing reminders again, so be gentle with yourself
and take your time.
If you notice di cult emotions coming up, perhaps try the “Get in
touch with the parts of your grief” exercise to help you work
through your emotions.
Telling the story of your loved one’s life and your life together
Your loved one’s life wasn’t just about their death. It can help to
remember your loved one’s life and the life you shared together. Writing
from your perspective, imagine telling someone else about your loved
one. Use the prompts below to get you started:
What was your loved one like? What interests they did they have?
What did they enjoy and dislike? What was their life like?
What was your life together like? What did you enjoy together?
Re ect on your memories. When you rst met, how did your
relationship developed and did you share any special moments?
What were your hopes for the future with this person? How did you
imagine that relationship being in times to come?
Write a letter to your loved one
Sometimes the feelings we have about our loved ones are not
straightforward – while they were alive either of you may have said or
done things that were hurtful, or which you regret. Writing to your loved
one can be a helpful way of working through your feelings. Try to
express how you feel, and say all the things you wish you had said. Here
are some tips to get started:
Firstly, there is nothing you cannot say: this is a personal letter and
no-one else needs to see it. Let yourself write freely from your
heart.
You can tell your loved one the things you didn’t get a chance to say
to them.
You might tell them how you are getting on since they died; you
can include the good and the bad.
You can tell them how you remember and honor their memory.
You can share the memories you cherish the most.
You can share your regrets, or your feelings about any issues that
were left unresolved.
You can tell them about how you feel, you might want to include
the di erent parts of yourself.
Once you’re done, think about what you want to do with your letter. You
could keep it somewhere safe, or get rid of it if you prefer. There is no
right or wrong answer, just be kind to yourself and do whatever feels
right for you.
Get in touch with the parts of your grief

It is normal to struggle with di erent emotions when you are grieving:
one minute you might feel angry and outraged, and the next minute
ridden with guilt and regret. Psychologists encourage people to nd
ways to feel and ‘process’ their emotions: to acknowledge and work
through your thoughts and feelings. Many of us are used to avoiding or
suppressing how we feel, so it might feel quite strange and unfamiliar to
face your emotions at rst.
One way of working with your emotions is to imagine each emotion as

one part of yourself. For example, there is one part of you that feels
angry that your loved one has gone, another part that is sad, and
perhaps another part of you that is scared.
Sometimes our emotions con ict with each other. For example, your
angry part might be angry with the part of you that feels scared. Or the
part of you that feels guilty might get in the way of the part of you that
accepts what has happened. Here is an exercise to help you to work with
these con icts. In your own time, work through the steps below:
First, name the di erent emotional parts of you. These might

include the ‘angry part’, ‘scared part’, ‘depressed or sad part’,
‘guilty part’, ‘accepting part’, ‘relief part’, ‘in denial part’ … or any
other parts you are aware of. Remember that no emotion is wrong,
and that it’s OK to acknowledge how you feel.
One at a time, bring each emotional part to mind one at a time and
ask yourself some questions:
What does this part of you think about your loss?
How does this part feel?
Where in your body is that feeling strongest?
What does this part want to do?
Now bring to mind a wise and compassionate part of you. This is

the part of you that always has your best interests at heart, and
which cares for you deeply. Imagine this part listening to all the
other parts of you:
What does this part of you want to say to the other parts?
How can this part of you help the other parts to heal?
What does this part of you want for you?
Dealing with regret and guilt
When someone whom we love dies it is common to feel some regret and
guilt. You may recall things you did or said, or that you failed to do or
say. Events that might ordinarily have seemed trivial may take on a new
meaning in the light what has happened. Over time most people nd
ways of resolving these emotions. However sometimes guilt and regret
can get stuck: as though it keeps looping on a circuit. This can be very
distressing, and can get in the way of grieving in a healthy way. If you
are feeling guilt or regret, here are some things that you might try:
Write down your regrets.

See if you can bring to mind a compassionate and warm outlook.
We all have regrets and make mistakes, but that’s not the whole
story of you and your loved one. See if you can take a wider
perspective and o er yourself some kindness, like you would to a
dear friend. Ask yourself:
If your loved one could hear and see you regretting and feeling
guilty, what would they say to you? How would they reassure
and comfort you?
What would a dear and wise friend say to you?
If this was another person that was feeling regret and guilt,
what would you say to them?
Talk to your friends and family about how you are feeling, see if
you can listen to their perspective, often they won’t be as harsh on
you as you are to yourself.
Confronting dif cult decisions
The death of a loved one may mean that you are faced with some
challenging decisions. If you lived together you may have to confront
nancial decisions, or even have to move home. Even the smallest of
decisions can feel overwhelming in the early days. If your circumstances
allow, it is often advisable to postpone any big decisions until six to
twelve months have passed.
If big decisions are unavoidable, you may need help to try to think
through your options clearly. Consider enlisting the help of a trusted
friend or family member to help you work out a plan. A classic problem-
solving strategy is to:
Write down what the problem is.

Brainstorm the options that are available to you: what possible
solutions are there?
Consider the advantages and disadvantages of each solution, and
weigh up which is the most helpful and wise decision for all
concerned.
Once you have a made a decision, plan what you need to carry out
your chosen solution.
References
[1] Bonanno, G.A., Malgaroli, M. (2020). Trajectories of grief: Comparing
symptoms from the DSM-5 and ICD-11 diagnoses. Depression and
anxiety, 37(1), 17–25. https://doi.org/10.1002/da.22902
[2] Klass, D., Nickman, L.N., Silverman, P.R. (1996). Continuing Bonds:
New Understandings of Grief (Death Education, Aging and Health Care).
New York: Routledge.
[3] Worden, J. W. (1991). Grief counselling and grief therapy: A handbook for
the mental health practitioner (2nd edition). London: Springer.
[4] Friedman, R. A. (2012). Grief, depression, and the DSM-5. The New
England Journal of Medicine.
About this article

This article was written by Dr Matthew Whalley and Dr Hardeep Kaur,
both clinical psychologists. It was reviewed by Dr Hardeep Kaur and Dr
Matthew Whalley on 2020-08-04.

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grief

Grief, Loss, and Bereavement

Loss is something that binds us together as human beings,

Powerful feelings of grief and loss are so normal and

When you have experienced loss, it is natural to feel a wide range of

What is it like to grieve?

Gloria and Mario

Aspects of counseling that Gloria found helpful

She also found it helpful to learn about di erent ways of understanding

Losses within the loss

Characteristics of the loss

The type of relationship you had

Other people’s reactions

What else is going on in your life?

We can separate the e ects of grief into thoughts, feelings, and

Thoughts about Strong emotions Dwell, ruminate,

The difference between normal and complicated grief

There’s no ‘right way’ to grieve, and no ‘right amount’ of time to grieve

It is natural for your friends and loved ones to want to be supportive.

Feel uncomfortable and not know what to say.

Metaphors and models of grief

Loss is like a wound

Sometimes, though, it is too painful to acknowledge or tend to a wound

Life grows around grief

Another helpful metaphor for grief was developed by Dr Lois Tonkin.

Imagine drawing a circle on a piece of paper. The rst one represents

William Worden’s model of grief uses an acronym ‘TEAR’ to describe his

T = To accept the reality of the loss. Accepting the reality of the

Kubler-Ross’s ve stages of grief

Many people have heard of Elizabeth Kubler-Ross’s stage model of grief.

An unfortunate aspect of the stage model is that it can set up an

Treatments for grief

Psychological treatments for grief

If you are struggling with symptoms of prolonged grief or traumatic

Medical treatments for grief

How can I help myself to grieve?

Rituals & customs

Funerals are a ritual where we say goodbye, acknowledge the loss,

From a psychological point of view, these rituals are imbued with

Express your grief

Another helpful way of expressing your grief is to keep a journal and

Remember that sometimes other people (understandably) want to make

Make a memory box

Telling your grief story

Write a letter to your loved one

Get in touch with the parts of your grief

One way of working with your emotions is to imagine each emotion as

First, name the di erent emotional parts of you. These might

Now bring to mind a wise and compassionate part of you. This is

Dealing with regret and guilt

Write down your regrets.

Confronting dif cult decisions

Write down what the problem is.

About this article

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