The Grief You Feel Is Real

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For the past few years, we’ve been researching grief for a book we’re writing. When we started out, we were aware that you could experience grief for various reasons caused by loss. These can be as diverse as the death of a loved one, a relationship breakup, the loss of a job that was part of your identity, the loss of your home due to natural disasters – and everything in between. But along the way we learned that aside from what we all know as common or “normal” grief, there are many other types of grief. We’ve honed in on nine that you or someone you know may experience at some point in your lives:

Abbreviated grief is a shortened response to a loss. It can occur when the void that was left by the loss is immediately filled by someone or something else; or when one has experienced anticipatory grief (see below).

Absent grief is when a person shows only a few, or no, signs of anguish about the death of a loved one. The cause may be denial or avoidance of the emotional realities of the loss. It may also happen if the deceased was ill, especially for some time, and the person who lost their loved one experienced anticipatory grief. Other reasons this may occur are if the loss hasn’t sunk in yet, or if the relationship wasn’t close.

Anticipatory grief occurs before an impending loss. Usually, the loss is the expected death of someone we’re close to due to illness. It can also be experienced by the dying person. However, life-altering surgeries (i.e., a mastectomy, the loss of a limb, or heart surgery), the likelihood of the end of a relationship, business downsizing, or war can also cause anticipatory grief, which does not generally replace post-loss grief. Since grief is different for each of us, the grief experienced before the loss doesn’t necessarily reduce the grief after death. That said, for some, there may be little post-loss grief due to anticipatory grief. In fact, they may feel relief.

It’s not unusual for anticipatory grief to cause additional stress and a decrease in physical and mental health. For this reason, it’s helpful for those affected in these ways to seek support from each other as well as any professionals involved, i.e., hospice, social workers, and nurses.

Collective grief is experienced by a group of people, such as a community or nation, due to a natural or man-made disaster, terrorist attack, war, the death of a well-known person, or an event resulting in mass casualties such as COVID-19. Collective grief can include feelings of loss of not only control, but also justice, identity, and predictability. In some instances, such as a global pandemic, the losses are ambiguous: We don’t know how or to what extent we’ll be affected, or for how long. In times like these, it’s healthy to grieve about what’s been lost so we can adapt and move forward. Like common grief, collective grief can cause periods of mourning and sadness as well as periods of acceptance and even happiness. Moving in and out of these feelings is more than okay, and it’s actually good to distract yourself, experience joy, and laugh. In effect, doing so helps cope with grief and loss.

Complicated grief. If grief becomes debilitating and symptoms such as painful emotions are so severe that you don’t improve in time and have trouble resuming your life, you may be suffering from complicated, chronic, or prolonged grief (see below). This heightened state of mourning interrupts the healing process. Some signs of complicated grief are:

• Intense sorrow and reflection on the loss, usually of a loved one.
• Inability to focus on little except the loss of the deceased.
• Intense and persistent longing for the loved one.
• Problems accepting the death.
• Numbness or detachment.
• Bitterness about the loss.
• Feeling that life holds no meaning or purpose.
• Lack of trust in others.
• Inability to enjoy life or think back on positive experiences with the loved one.

Although the following are common during grief, if they continue for an extended length of time, they may indicate complicated grief:

• Difficulty carrying out normal routines
• Isolation from others and withdrawal from social activities
• Depression, deep sadness, guilt, or self-blame
• Belief that you did something wrong and/or could have prevented the death
• Feeling that life isn't worth living without your loved one
• Wishing that you had died along with your loved one

While we don’t know why some people suffer from complicated grief, it might entail environment, personality, inherited traits, and the body’s natural chemicals.

Cumulative grief can occur when the grieving process isn’t complete before another loss happens, or when multiple losses occur at one time. It can also happen if a loss years earlier wasn’t adequately dealt with (see delayed grief, below) which may cause the new loss to be overwhelming. Experiencing multiple losses in a short time can cause complicated grief. Avoidance may increase as well as self-medication (alcohol, drugs) to numb the pain, which then also delays grief. When such substance abuse is reduced, or ceases, cumulative grief may become staggering.

To integrate multiple losses into our lives, it’s important to individually grieve each one, taking into consideration the relationship with that person, as well as the circumstances of their death. If one is religious or spiritual, cumulative grief can test one’s faith. It can cause people to question why such a thing would occur or even to strengthen their belief in a higher power. Either way is normal.

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Delayed grief is when common grief is suspended but reappears later. Delayed grief isn’t unusual after the death of a loved one due to the numerous things that need to be accomplished. Many people who’ve lost a loved one feel they must appear strong for others and tamp down their emotions to be a sturdy shoulder for others in their family. Keeping busy with projects and work is another common way for people to delay their grief process.

Trouble is: If we suppress our emotional pain and ignore it, it doesn’t go away. It can work its way into other aspects of our lives. Delayed grief can have a negative impact on our health and cause headaches and stomach problems, as well as a myriad of other concerns. It can also ruin previously healthy social relationships. We’ve been trained in our culture to hide our emotions of grief and sorrow. We’re told to buck up, to smile through the pain and sadness, to be “strong.” It isn’t any wonder that many of us find ourselves suffering from delayed grief.

Disenfranchised grief occurs when a loss is ignored or minimized by others, and is often linked to cultural, societal, or religious beliefs. In these instances, grief is minimized, experienced out of public view, and often disregarded. The societal stigma of suicide and drug overdose, whether intentional or not, may cause a mourner to experience disenfranchised grief. The mourner then feels they are not acknowledged, validated, or supported by society. If the griever’s relationship with the deceased is, for some reason, not recognized, the mourner can also experience disenfranchised grief.

Prolonged grief is a recognized disorder (PGD) with distinct symptoms – intense longing for the deceased, difficulty accepting the loss, flattened affect and emotional numbness, confused identity, bitterness, an inability to trust others, and feeling trapped by grief – which remain intense and are disabling for six months or more after the death. Mental health assistance is a necessity for those suffering from PGD as destructive behaviors and suicidal thoughts can develop.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.