subject spotlight
Therapy for grief and loss
Grief and loss is something we all encounter at some point in life, but how we experience and express it is incredibly personal. While many of us have heard about the “5 stages of grief,” it’s important to recognize that these stages—denial, anger, bargaining, depression, and acceptance—aren’t a set formula or a strict pathway. Rather, they offer a helpful framework to understand some of the emotional responses we might go through when facing loss. But it’s never as neat or predictable as we might like it to be.
Grief doesn't come with a set of instructions. No two people will grieve in exactly the same way, and there’s no right or wrong way to do it. Some people may move through the stages fluidly, while others may skip stages, revisit old feelings, or feel stuck in one place for a while. It’s a very individual process, and what’s crucial is to allow yourself the space to feel whatever comes up.
Initially, Dr. Elisabeth Kübler-Ross outlined the five stages of grief in relation to people facing terminal illness. Over time, these stages have been widely applied to other forms of loss—not just death, but also breakups, job loss, and health challenges. Although these stages offer insight, grief often doesn’t follow a predictable order. Instead, we might find ourselves looping through stages, experiencing more than one at a time, or even not identifying with certain stages at all. And that’s okay.
Denial is often the first reaction to a significant loss. It’s as if our mind temporarily numbs us from the full weight of the emotions we’re facing. You may feel disbelief, like what’s happening can’t possibly be true. It’s a way of protecting ourselves from the immediate pain, allowing us to pace ourselves as we begin to process the reality.
Anger comes in many forms. It’s not unusual to feel angry with yourself, others, or even at the situation itself. Sometimes, the anger is directed at the person you’ve lost, or at the universe for allowing this to happen. It’s a natural response that helps us release some of the bottled-up emotional energy. People often feel isolated in this stage because they don’t want to burden others with their anger, but expressing these feelings in a safe environment is key to moving through grief.
Bargaining is where we start searching for ways to change the outcome, even if it’s impossible. You might find yourself replaying events in your mind, thinking about what could have been done differently, or wishing you had acted in another way. In this stage, people often try to make sense of the loss and may feel guilt or regret.
Depression is a stage where the reality of the loss begins to truly sink in. It’s when we feel the heavy weight of sadness, and it’s not uncommon to withdraw or feel disconnected from others. Depression doesn’t just mean feeling sad; it can feel like a wave of hopelessness or a lack of interest in things that once brought joy. This stage can feel like a deep loneliness, even when surrounded by support.
Acceptance doesn’t mean we’re “over it.” Acceptance is about acknowledging the loss and understanding that life will be different moving forward. It’s a stage where we begin to find ways to live alongside the grief rather than being consumed by it. Acceptance is often a slow process and doesn’t erase the feelings of sadness, but it allows us to start healing and finding peace.
Breaking Down the Stages
Loss of a loved one: When someone close to us dies, it’s common to feel a whirlwind of emotions. You might find yourself denying that the person is really gone, or feeling angry at them for leaving. Grief can also bring feelings of guilt—wondering if you could have done something to prevent the loss—or deep sadness as you imagine life without them. Eventually, you may find a way to accept the loss and cherish the memories, though the pain never fully disappears.
Divorce or breakup: Grieving a relationship can be just as intense as mourning a death. The loss of a partner, especially if it was unexpected, can lead to denial—hoping that maybe it’s just a temporary rough patch. Anger might follow, directed at your ex or even at yourself. You may try bargaining, thinking that if you had just done something differently, the relationship might have survived. Depression can set in as you contemplate life without this person, and acceptance comes when you finally understand that the relationship has ended, and it’s time to move forward.
Job loss: Losing a job can stir up grief, especially if it was a big part of your identity. You may deny that it’s happening, believing your employer will change their mind. Anger can build up toward your former boss or colleagues. In the bargaining stage, you might reflect on what you could have done better. Depression can hit as the uncertainty of the future looms, and acceptance comes when you realize that you’re ready to find a new path forward.
Bad news or diagnosis: Receiving a serious health diagnosis can trigger grief over the life you once knew. Denial may lead you to question if the diagnosis is real, and anger could emerge toward the doctors, your body, or even loved ones. You might bargain for more time or search for alternative solutions. Depression often accompanies the realization of how life may change, and acceptance is about adjusting to a new normal and finding meaning in the time you have.
Grief in Different Situations
Complicated grief can even affect your physical health, leading to symptoms like headaches, high blood pressure, and fatigue. If grief is making it hard to function or you feel stuck in sadness, it’s a good idea to seek help. There’s no need to wait until grief feels overwhelming—therapy can provide a safe space to talk, process your feelings, and find relief.
In rare cases, grief can lead to severe conditions like Takotsubo cardiomyopathy, also known as “broken heart syndrome.” It mimics the symptoms of a heart attack, and while it’s not a heart attack, it can be serious. If you experience chest pain or shortness of breath during a period of intense grief, it’s important to seek medical attention right away.
Prolonged Grief and When to Seek Help
The key objectives of grief counseling include:
- Accepting the loss: Denial is a natural part of grief, but therapy helps individuals face the reality of the loss and begin to process the pain that comes with it.
- Working through the pain: Grief hurts, and it’s tempting to avoid or suppress those feelings. However, avoiding the pain only makes it last longer. Therapy helps people confront their emotions in a safe and supported way, allowing them to move through the pain rather than around it.
- Adjusting to life: Loss changes everything. Therapy helps people navigate how to rebuild their life, especially when it feels like everything is different or that moving on means letting go. In reality, it’s about finding a way to live with the loss without letting it define your life.
- Maintaining a connection: Therapy doesn’t encourage people to “forget” their loss. Instead, it helps them maintain a healthy connection to what was lost, whether that’s cherishing memories or honoring the significance of a past relationship. It’s about integrating the loss into life in a way that feels meaningful.
