Bereavement, Loss, Grief & Mourning

Bereavement is the state of having lost someone important to you through death.

Loss is wider; it can include death, but also divorce, a miscarriage, losing health, work, a home, a friendship or the dream of the future you thought you’d have.

Grief is what happens inside you because of it; the emotional, physical and mental reaction. 

Grief isn’t a straight line. It can come in waves:

• sadness,
• anger,
• relief,
• guilt,
• numbness,
• even moments of laughter,
• sometimes all in the same day. 

Your body may feel it too:

• tiredness,
• tight chest,
• appetite changes,
• brain fog,
• poor sleep,
• or feeling “unreal”.

Mourning is how grief shows on the outside – what you do to express it (funerals, rituals, talking, time off, anniversaries, wearing black, keeping photos, visiting a grave). 

But it's also your mind acclimatising itself to the new circumstances in which you find yourself. It's building a new model of the world in your mind and devising a plan to enable you to survive in it; without the object which had previously been your source of strength and comfort.

Models of the world

We're not born with a ready-made understanding of the world and our place within it. Although we arrive with innate capacities that draw our attention to human faces and help us form attachments with those who nurture and protect us, much of our understanding of ourselves, other people and the world develops through experience.

As we grow, we gradually construct an internal model of ourselves in relation to the world around us. We use this model to help us navigate life: learning what to expect, where dangers may lie, what we can rely upon and, importantly, who we can turn to for comfort, support and protection. The people to whom we become deeply attached therefore become part of the way we understand and navigate our world.

When one of those people dies – or when another significant loss removes something upon which we've come to rely – the world changes suddenly, but our internal model of it cannot change at the same speed. For a varying period of time, our map no longer represents the territory and we can become badly disorientated.

This can explain why grief can intrude into the most ordinary moments. Something happens and our first thought may be to tell the person who has died. We wake and, for a fleeting moment, expect them to be there. We encounter situations in which our model of the future included them, only to be confronted again by their absence. The familiar world can therefore feel disorientating and, particularly where that person was an important source of security, the loss may leave us feeling profoundly unsafe.

In this model of bereavement, mourning involves gradually editing our map of the world so that it once again becomes a reliable guide to the world as it now is. It means adjusting to changed circumstances and finding ways of managing the emotional and physiological stress that can accompany loss while that process takes place.

This doesn't mean erasing the person who's died from our internal world or bringing the attachment to an end. Rather, their place within our model changes. Gradually, we become better able to inhabit the world as it is now, retaining our memories and the significance of the relationship while becoming increasingly able to navigate life without the person's physical presence.

There's no right timeline. You don't simply “get over” a meaningful loss. Gradually, however, the world can begin to feel navigable again. The relationship with what's been lost may change, while its meaning and significance remain part of you. Support, kindness and space to remember can help that process unfold at its own pace.

How I work with bereavement and loss

Drawing on more than 20 years of working with grieving people in Manchester and online, I first try to ensure that they can experience therapy as a safe place to come and talk about how their loss is affecting their lives.  I offer my grieving clients the core conditions of Person-centred therapy – unconditional positive regard, congruence and empathy – which can help them to feel accepted just as they are, and to recognise that difficult, contradictory and sometimes unexpected emotions can all be part of grieving. They're allowed to adjust at their own pace and are never pushed into “moving on”, “getting over it” or “pulling themselves together”.

I help them to understand that mourning is a period of profound change. It's a period during which the brain gradually adapts its understanding of the world to accommodate the reality of what's happened. As this occurs, the grieving person can begin to discover how to live within their changed circumstances and, where the loss has disrupted their sense of security, how they might begin to feel safe in the world again.

For some people, grief is complicated by traumatic memories surrounding the loss, for example, the circumstances of a death, witnessing distressing events or intrusive images that continue to feel as though they're happening in the present. Where appropriate, I may offer EMDR to help process these traumatic aspects of the experience, so that distressing memories can become less intrusive and the work of mourning can continue.