Grief Counseling

What is Grief Counseling?

At Portal Point Counseling we are very sensitive to the experience of loss. We are aware that grief and bereavement are unique to each person and vary by the loss. We also know that religion and culture influence a loss. When working with individuals in grief we are conscience of how these other factors influence you as individual.

Grief and bereavement are buckets that hold a variety of feelings. These feelings can range from deep sadness, to anger, to guilt. There is no set road map when navigating through loss. It is different for every person for a variety of reasons. It depends on history, relationship, a persons background, experiences, culture and beliefs.

There is no one size fits all for grief. It is not simply sadness.

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Bereavement

Everyone experiences loss in their life. What is unique is HOW we experience it. Some typical feelings associated with loss are grief and bereavement but those also look different to each person.

Support is often vital to recovery when you have experienced loss.Therapy can help with any sort of loss, whether society validates the grief or not. Therapy is an opportunity to explore your feelings and memories without judgment. No loss is too big or too small to warrant support. You do not have to endure your grief alone.If a person is forced to grieve alone, they may have a delayed recovery.

It can also involve guilt, anger, resentment, and regret. Emotions wax and wane. They can feel strong or mild and often evolve. This can be very confusing and exhausting.

You may find yourself grieving a relationship that was difficult. You may be mourning a loss of someone you loved but relief because they had been suffering. You may feel left behind. As humans we tend to take a level of responsibility. This is also true during loss.

“I should have spend more time with them.”

“It’s all my fault.”

“The last conversation we had ended in a fight.”

“I know there was nothing that I could do.”

Grieving behaviors also have a wide range. Some people find comfort in sharing their feelings among company. Other people may prefer to be alone with their feelings and reflecting to themselves.

Grief is unique for individuals but there has been research done to organize the typical elements.

Psychologists and researchers have outlined various models of grief. Some of the most familiar models include the five stages of grief, the four tasks of mourning, and the dual process model.

How long will it take for me to recover from grief?

Again there is no road map or time frame for grief. We all grieve in our way and on our own time. Some people recover from grief and resume normal activities within a few weeks or months, though they continue to feel moments of sadness. Others may feel better after about a year. The difficult part is when you have experience a memory or an anniversary that triggers your sadness.

There are some people that grieve for years without finding any relief. This version of grief is likely complicated by other factors and possibly depression.

The grieving process often involves many difficult and complicated emotions. Yet joy, contentment, and humor do not have to be absent during this difficult time. Self-care, recreation, and social support can be vital to the recovery. Feeling occasional happiness does not mean a person is done mourning.

Grieving the loss of a loved one be a difficult process, whether the loss is due to death, a breakup, or other circumstance. One of the hardest challenges is adjusting to the new reality of living in the absence of the loved one. Adjusting may require a person to develop a new daily routine or to rethink their plans for the future. While creating a new life, a person may adopt a new sense of identity.

What is complicated grief?

The experience of grief is not something a person ever recovers from completely. However, time typically tempers its intensity. Yet an estimated 15% of people who have lost a loved one will experience “complicated grief.” This term refers to a persistent form of bereavement, lasting for one year or more.

Again, the length of time it takes for a person to grieve is highly variable and dependent on context. But when symptoms persist without improvement for an extended period, they may qualify as complicated grief. In addition, the symptoms of complicated grief to be more severe. Complicated grief often dominates a person’s life, interfering with their daily functioning.

Prolonged symptoms may include:

Intense sadness and emotional pain

Feelings of emptiness and hopelessness

Yearning to be reunited with the deceased

Preoccupation with the deceased or with the circumstances of the death

Difficulty engaging in happy memories of the lost person

Avoidance of reminders of the deceased

A reduced sense of identity

Detachment and isolation from surviving friends and family

Lack of desire to pursue personal interests or plans

The Diagnostic and Statistical Manual (DSM-5) does not classify complicated grief as a clinical condition. Yet it does include diagnostic criteria for “persistent complex bereavement disorder” in the section of conditions requiring further study.

What is Disenfranchised Grief?

Disenfranchised grief is when a persons grief is restricted in some way. There are several circumstances in which someone’s grief may be disenfranchised-

Society does see the loss as valuable. An example of this could be the loss of a pet. Losing a loved pet often does not get as much sympathy as loosing another human. Yet a pet is often part of our day to day lives and the relationship is very close. We are often the caregivers to our pets and they are often a source of comfort and company.

The loss is ambiguous. An example of this could be when an adopted child may grieve the loss of their birth parents even if they are still alive. But they are grieving the relationship that could have been.

Pregnancy-related loss is complicated yet not always understood or valued. Women who undergo a miscarriage may feel guilt and shame. They may avoid telling others about the loss to avoid being blamed. This type of loss can also be viewed as ambiguous. People may not understand how you could be mourning the loss of someone that you have never met. See our page on pregnancy and infant loss to read more about this topic.

As a society we don’t often fully understand what a person could be experiencing during a loss. If a person is mourning a co worker who died we might not think it is as “important” as the loss of a family member. We can never truly know the impact that a loss may have on one person to the next. Society doesn’t recognize the person’s relationship to the deceased. We don’t know what other factors are involved or other past experiences of a person who is grieving.

Others do not consider the person capable of grief.

When young children experience loss, adults may recognize the signs of bereavement. They may believe the child is not capable of understanding the loss or have feelings about it. People who have cognitive impairments or intellecutal disabilities may also have disenfranchised grief.

Disenfranchised grief can interfere with the bereavement process. If society does not recognize a loss, the person may have trouble accepting it themselves. They may try to repress or deny their emotions. Shame and secrecy can make the symptoms of grief more severe.

Five Stages of Grief

Elisabeth Kubler-Ross identified five linear stages of grief:

• Denial

• Anger

• Bargaining

• Depression

• Acceptance

In her research Kubler-Ross identified that everyone experiences at least two of the five stages of grief. She also noted that some people may revisit certain stages over many years or throughout life. Let us help you.

Four tasks of Mourning

Psychologist J. W. Worden also created a stage-based model for coping with the death of a loved one. He divided the bereavement process into four tasks:

1. To accept the reality of the loss

2. To work through the pain of grief

3. To adjust to life without the deceased

4. To maintain a connection to the deceased while moving on with life
   

Dual Process Model

As an alternative to the linear stage-based model, Margaret Stroebe and Hank Schut developed a dual process model of bereavement. They identified two processes associated with bereavement:

Loss-oriented activities and stressors are those directly related to the death. These include:

• Crying

• Yearning

• Experiencing sadness, denial, or anger

• Dwelling on the circumstances of the death

• Avoiding restoration activities

Restoration-oriented activities and stressors are associated with secondary losses. They may involve lifestyle, routine, and relationships. Restoration-oriented processes include:

• Adapting to a new role

• Managing changes in routine

• Developing new ways of connecting with family and friends

• Cultivating a new way of life

Stroebe and Schut suggest most people will move back and forth between loss-oriented and restoration-oriented activities.

Am I grieving or am I Depressed?

The DSM-5 does not define bereavement as a disorder. Yet typical signs of grief, such as social withdrawal, can mimic those of depression.

So how can one tell the difference between grief and depression?

Grief is typically preceded by loss. Depression can develop at any time.

The sadness present in grief is typically related to the loss or death. Depression is characterized by a general sense of worthlessness, despair, and lack of joy.

Symptoms of grief may improve on their own with time. Someone with depression often needs treatment to recover.

Despite their differences, depression and grief are not mutually exclusive. If someone is vulnerable to depression, grief has the potential to trigger a depressive episode. If someone already has depression, their condition may prolong or worsen the grieving process. A therapist can help a person in mourning recognize and manage any depressive symptoms.