Common phases of grief

People have been writing about grief for a long time, and the Bible has many examples of the way men and women have grieved. It's already been stressed that people grieve in different ways. In the last fifty or sixty years, Elisabeth Kübler-Ross described what she saw as seven stages of grief — implying, at least initially, a kind of schedule that grieving people moved through. More recent observers suggest people go through phases rather than stages: certain elements are common, but they don't necessarily follow a set order, and phases can be longer or shorter, more or less intense, and can overlap, from person to person.

Some phases of grief are:

1. Initial shock;
2. Expression of emotion;
3. Denial that the loss has occurred;
4. Anger at the loss;
5. Sadness;
6. A feeling of guilt; and
7. Acceptance and hope.

These may not be evident in every grieving person — they're phases or elements that many people go through. It's also worth recognising that stereotypes associated with males and females may affect how a person feels able to grieve, and that culture is another factor — some cultures are more, or less, outwardly emotional in grief than others.

Some forms of grief

There's no such thing as "normal" grief, but some categories of grieving are more pronounced than others, and it's worth being aware of them as a friend's supporter.

Acute sorrow is probably closest to "normal" grief. A person experiences a loss but is able to cope, arriving at resolution and closure. The loss may be remembered throughout life, but the degree of acceptance enables the grieving person to handle it and generally overcome it.

Chronic sorrow, by contrast, has been described by Susan Roos as "a set of pervasive, profound, continuing and recurring grief responses… the loss is a living loss." As carers, we sometimes meet people with such a loss — they might behave "normally" but become very upset when reflecting on a specific loss from years earlier.

Anticipatory grief is quite common — the emotion expressed in anticipation of a loss, whether by a dying person recognising they're going to lose their life, or by those awaiting the death of another. In this last case, we might see despondence and depression, increased concern for the dying person, and efforts to adjust to the consequences of the death. There are positive elements too: it allows a family to adjust to the reality of impending death over time, allows unfinished "business" between family and the dying person, and enables the family to make plans for the future.

Disenfranchised grief is a difficult term for a simple concept: sometimes people find themselves in a situation where they aren't "allowed" to grieve. This can happen when:

• The grieving person was in a relationship with the deceased that wasn't accepted by their family;
• The loss isn't deemed significant by others — a miscarriage, for example, or "your mother was very old and lived a good life";
• The griever isn't recognised — "the little boy hardly knew his grandfather anyway";
• The mode of death is dismissed — an "at fault" teenager killed in a high-speed accident, or a suicide;
• In a religious setting, pressure is put on the griever to recognise the deceased is "now in a better place, and we should be happy!"

Sometimes, as a friend, we need to help the grieving person realise they're allowed to grieve — it isn't "wrong," and it's important that grieving takes place.