Grief symptoms can look like

  • Disbelief, disorientation, detachment, or numbness

  • Sense of your life feeling surreal or feeling out of body

  • Waking up in the morning having “forgotten” what’s true

  • Feeling profound sadness and yearning for loved one or former life

  • Noticeable changes in sleep and appetite

  • Overwhelm, difficulty with focus or follow through

  • Physical and emotional exhaustion, low motivation

  • An ambiguous or inconsistent sense of loss or absence

  • Withdrawal from people, especially those who “don’t get it” or worry of “burdening” others with your grief over time

  • Facing reminders and memories

  • Complicated emotions like regret, guilt, anger, relief

  • Existential confusion or anxiety, unanswerable questions like “why” or new focus on mortality or meaning

  • Feeling unable to reconcile between old reality and new reality

  • Uncertainty or anxiety about how the future will be or look

  • Difficulty with specific dates, anniversaries, birthdays, etc

Types of loss

There are many types of losses. They can include what comes to mind for many, such as the loss of a loved one or the end of a significant relationship (divorce or breakup). Sometimes losses can mean a permanent change in role and identity, physical health, and community (as is the case with immigration or displacement). The loss of a cherished pet or a childhood home can be deeply painful. Unexpected losses such as miscarriage or neonatal death can represent the loss of an entire imagined future and family. Some types of losses are hard to describe. The term “ambiguous loss”, coined by Pauline Boss, refers to losses that are not easily defined by explicit absence or presence, such as caring for someone with dementia or chronic mental illness. Some losses occur slowly, over long periods of time while others may be sudden and lack any opportunity for goodbye or closure. Even if you anticipate a loss, the effects may be devastating or even traumatic. The truth is, everyone - at some point - will experience loss individually and collectively; it’s something we all have in common.

Definitions of bereavement, grief, and mourning

The terms bereavement, grief, and mourning are sometimes used interchangeably - it can be helpful to differentiate them. Bereavement is defined specifically as the loss of a loved one, such as the death of a parent or spouse. Grief is the natural response to any type of loss, which often involves reactions on emotional, mental, physical, and spiritual levels. Mourning is often understood as the outward or social expression of grief, such as gathering for a wake or funeral. Mourning may vary depending on a range of reasons, such as situational context, cultural norms, spiritual beliefs, personality differences, and multicultural identities.

park bench facing grass next to tree

Debunking the five stages of grief

You’ve likely heard that there’s no “right way” to grieve; that everyone has their own unique process when they experience a loss. You’ve probably also heard of the five stages of grief from psychiatrist Elisabeth Kubler-Ross. So which is it? First of all, the five stages of grief (denial, anger, bargaining, depression, acceptance) is a theory that was developed in the 1960s after observing terminally ill people facing their own mortality. While the five stages theory has been widely applied to all types of loss, it’s important to remember its original intention and context. While some people experience these feelings while grieving, research has since disputed that all people progress through these emotional stages during a loss. A guess as to why the stages of grief model remains such a popular framework? It appeals to the part of us that wants answers, order, and certainty - especially when we’re in pain. When our lives are upended or changed by loss, we want to know what to expect. It can feel like a life vest in the ocean. While understandable in its appeal, there’s simply no way that one single paradigm for grief makes sense for all types of losses, and that’s okay. Grief is an embodied, psychological, and deeply personal way of us trying to reconcile a loss. There have been multiple theories and evidence-based models of grief since the five stages theory. Each one has something to offer, and may resonate differently for you.

A multicultural note: cultural obstacles to mourning

While grief is a human and universal response to loss, mourning (the outward display of grief) may take on many shapes and is influenced by your social location and multicultural identity. For example, these factors influence whether you cry or not, if you participate in faith-based rituals or social practices (e.g., wearing black), and even your sense of a designated mourning period. Cultural display rules, or the learned cultural norms we each have about how, when, where, and with whom we express emotions, can also shape mourning practices. Unfortunately in Western culture, our overemphasis on overcoming, productivity, happiness, and resolution means that it can be incredibly difficult to mourn in a way that helps process loss, especially if it falls outside of what’s socially “acceptable”. This can mean when grieving, we are pressured to expedite, hide, or conform grief or mourning so as to not draw negative attention. You may even feel self-conscious or self-critical if your own grief experience or needs are different from others or what’s “expected”. Part of grief is deciding how to mourn (and how your mourning may evolve over time). Being open and attuned to what mourning can look like that aligns with who you are and what matters to you can be a very meaningful part of your grief.

How can therapy for grief help me?

We know that grief is painful, disruptive, and often isolating. Receiving consistent support, encouragement, and care after experiencing a loss makes an extraordinary difference. Perhaps you grew up in a family where sadness was discouraged, yet you’re overwhelmed by grief after a loss. Or maybe you were so busy taking care of everyone else or “being strong” that there wasn’t any space for you to get support. You may be at a point where you don’t want your days to feel so oriented around grief but are unsure (or even feel guilty) about considering what’s next. Or perhaps you’ve never talked about your losses or considered major experiences in your life through the lens of loss - but know they’ve somehow affected you in a big way. Therapy for grief provides a supportive space for you to reflect, feel, talk, and figure out what’s actually helpful to you wherever you are in the process of grieving. Your therapist can normalize some very common aspects of grief that may be completely new or confusing to you. It can be a chance for you to figure out how you’d like to honor the memory of a loved one or how to manage painful reminders of a loss. Your therapist can help you establish new routines as you adjust to a different reality or find your bearings again. Whether or not your loss was recent or years ago, understanding its impact and how your life altered as a result can shed important light for you. It may also give you permission for self-kindness or empower you to make helpful changes.

field of white flowers

Finding a grief therapist in NYC - we’d love to connect

Every experience of loss occurs through the prism of a unique individual and their life history. Which means that while there may be universal aspects of grief, such as a powerful sense of sadness or absence, there may also be highly unique parts of what you go through. Grief can sometimes feel like a bundle of opposites or paradoxes - you feel overwhelmed and raw and somehow detached and numb. You want to stop feeling sad but feel guilty if you’re not sad enough. You have days completely filled with grief and others where you kind of forgot about it. Our team of psychologists at Manhattan Therapy Collective are trained in a number of evidence-based, relational, and multiculturally sensitive approaches to grief. We encourage you to reach out for support - there is no reason that you should struggle alone. Therapy for grief can help you find a way to live through and with loss with greater clarity, compassion, and support.

Common questions about therapy for grief

 

  • This is a great question. While it’s completely normal (and expected) that grief be painful and even disruptive, if you feel extremely stuck or avoidant with your grief, it may become what’s known as complicated or prolonged grief. It’s not that being in emotional pain in response to loss is unhealthy - but sometimes the way we go about grief may have a larger negative effect on us, rather than helping us make sense of things. If you’re unsure about whether your grief is helping you process or getting in the way of your life - reaching out for therapy can help you clarify.

  • There can be a lot of overlap between the symptoms of depression and grief, such as strong feelings of sadness, tearfulness, and changes in energy, appetite or sleep. However, people who are grieving are often still able to access other emotions, connect with others, and experience some self-efficacy. If you’re unsure if what you’re feeling is grief or depression - we encourage you to reach out for professional support to answer your questions.

  • Grief is often a disorienting experience - there are countless thoughts and emotions that can be hard to navigate on your own. Therapy can help you organize your thoughts or gain clarity on your feelings or reactions. We find that proactively engaging with our emotions transforms them and helps us move through them more adaptively - especially with support and guidance. Unfortunately, pressuring ourselves to “move on”, especially prematurely, tends to backfire and make things worse.

  • It’s completely up to you. The experience of grief can bring up spiritual, religious, or existential questions or beliefs, which we are always open to discussing together. If spirituality isn’t something that resonates for you (or isn’t part of the way you want to grieve a loss), that works too. We will always respect your beliefs and encourage you to focus on what matters to you in your sessions.

  • The adage time heals all wounds isn’t completely true. Time can certainly lessen pain and bring perspective, but the passage of time may not be enough for you to grieve. If you feel as though a prior loss continues to significantly affect you today, there’s no such thing as “too late” when it comes to giving yourself space and support to grieve.