Loss will affect all of us at some stage in our life. We will inevitably have to face up to the death of a close relative who we loved. We may experience similar emotions over the loss of a relationship with someone who has not died but is no longer in our lives. Both scenarios involve dealing with grief; and grief takes a number of different forms and stages dependent on the type of loss.

Over the years I have dealt with many people who have had to face the death of a close relative. Some forms of loss are more straightforward. It is the normal rhythm of life that parents die before their children so it is more difficult when a parent experiences the death of a child. The circumstances of each death also has a bearing on the qualitative experience of the grief; an elderly person who has been suffering from a terminal condition where death seems a merciful release is very different to the apparent sudden and unexplained suicide of a teenage child.

The loss involved in broken relationships is also qualitatively different. The break-up of a marriage where dysfunctional behaviour is involved may be a very different experience to that of a parent who has been prevented from seeing their children through a court order or where an ex-spouse has gone to live with the children in another country.

Whilst each instance of loss may be different there is a broadly similar pattern involving seven stages of grief, which is apparent in most cases of loss, and it can be very helpful to understand this pattern as a normal part of the grieving process.

1. Shock and denial

The initial reaction to learning of the loss is numbed disbelief; even when the loss is expected the reality is still somewhat shocking. Denying the reality of the loss at some level is an attempt to avoid the pain. Shock actually provides emotional protection from being completely overwhelmed and may last for several weeks.

2. Pain and guilt

As the shock diminishes it is replaced with the suffering of emotional pain. Although the pain may feel almost unbearable, it is an important stage in grief. Some people try to avoid it or escape from it by using alcohol or drugs; although these might provide temporary relief, in the long term it won’t help to come to terms with the loss and can ultimately prevent us moving forward. Many people find it is useful to share their grief by talking about it with someone who can empathise; equally it can be helpful to talk to a professional. Not everyone feels comfortable talking about their grief so another option for helping to move through this stage is to write down the feelings.The guilt that is experienced in this stage may be due to the regrets about things we did or didn’t do with our loved one. It can be useful to talk about or write down the opposite of the regrets i.e. noting everything you were glad you did, rather than the things you were sad that you didn’t do.

3. Anger and bargaining

During this stage people often become angry and lash out emotionally by attempting to lay unwarranted blame for the death (or the end of the relationship) on someone else. Whilst this might at the time seem quite justified it is often quite irrational. Unless someone actually wanted to cause the death then the anger is misplaced. Frequently people will try to pin the blame on the medical profession. Whilst a mistake might have been made, health professionals spend their careers dedicated to trying to help people, but they are human and they do make occasional errors.A very common response to the death of a loved one is to question “Why me?” or to attempt to strike a bargain with God (“I will never do x again if you just bring him back”)

4. Depression, reflection and loneliness

As the individual appears to be adjusting to the loss, friends may think it is now time for them to be getting on with their life. At this point a long period of sad reflection often ensues. This is a normal stage of grief, and it helps to take the individual along the journey of coming to terms with the reality of the loss as the last vestige of the denial disappears. Some people isolate themselves on purpose to focus on memories of the past, which may result in feelings of emptiness or despair, however this may not be as unhelpful as it sounds; constantly keeping oneself busy and distracted is useful up to a point but the reflection is a necessary part of the journey.

5. The upward turn

This occurs as individuals begin to adjust to life without their loved one. Life becomes a little calmer and more organised.and the depression begins to lift slightly. It is difficult to put an exact time-frame on this but many people report reaching this stage after approximately six months.

6. Reconstruction and working through problems

‘Reconstruction’ refers to the process of beginning to think about realistic solutions to problems posed by life without your loved one. The focus is on the practical and financial problems as well as a personal reconstruction of the individual’s identity e.g. as a single person or as a widow.

7. Acceptance and hope

During the last of the seven stages people accept the reality of the situation and become able to look forward to the future rather than looking back or simply trying to deal with each day as it comes. Acceptance does not mean instant happiness but at this point individuals are able to experience moments of happiness without guilt. They are able to think about their lost loved one without the wrenching pain although they will still experience sadness.

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The grieving process take a different time frame for each individual to complete. As a general rule of thumb most people I have worked with seem to find the passage of a whole year is required (although there is often a discernible improvement after six months). The timeframe of a year may be due to the number of ‘firsts’ – this first birthday or Christmas without their loved one or the first anniversary. It does become easier for most people during the second year.

I often ask clients who are going through the experience of the loss one question. “If you had a choice what would you choose: to experience the level of pain you have because you had a wonderful relationship with the person who is no longer with you; or to experience relatively little pain because you were ambivalent about the relationship you had.”

Most people choose the former; the degree of pain is almost always related to how much we loved the person we have lost.

This is a post by Dr Rick Norris