The Nature of Grief

Although human beings, along with other social animals, tend to cry and to search when separated from those they love, the expression of grief following a permanent loss is very variable being influenced by learning from early childhood. Hence there is no blueprint for grief and the concept of “normal grief” needs to be considered in the light of demographic and cultural variables.

Key points:

• Most bereaved people oscillate between episodes of intense pining for the lost person (loss orientation) and relatively calm periods during which they can plan and carry out forward-looking activities (restoration orientation). Problems arise if either of these activities is carried out to the exclusion of the other (Stroebe 2001a).
• Feelings of anxiety, tension, anger and self-reproach commonly occur (Parkes 1996). In the course of the first year of bereavement the intensity of distress usually declines steadily but thereafter any further decline is much more gradual. It is difficult to estimate time range of bereavement symptoms because there are so many aspects to grief, some of which are “permanent” (e.g. “He lives on in my memory” and others less so. Thus, following the death of a spouse, the loss of appetite seldom lasts more than a month and, by the end of the first year, weight gain is more likely to be a problem than weight loss. The first year is usually the worst and there are likely to be several “turning points” in the course of the second, when people realize that new directions are emerging and they can relish life again.
• Most often the experience of bereavement eventually leaves people more mature, confident and sympathetic to the suffering of others.
• Many bereaved people cherish their memories of the dead person who is often felt to be near at hand and may even be perceived as a transient (“hypnagogic”) hallucination or illusion. These phenomena usually provide comfort and should not be seen as “denial” or indicating a need for psychiatric help. The hypnagogic hallucinations may persist indefinitely. They are distinguished from psychotic hallucinations by their transience, they disappear when people “wake up”.