WHEN TO REACH FOR SUPPORT

• Depressed
• Severely guilt ridden
• Overly anxious about the future
• Socially withdrawn and isolated
• Having difficulty eating/sleeping
• Chronic anger and bitterness
• Unable to regain a sense of meaning

TYPES OF LOSS ADDRESSED

Topics in this section:

Loss through Death

Hidden Losses

Anticipatory Grief

Complicated Grief

Traumatic Grief

Other

Loss through Death

Your grief reaction is unique in part because you have lost a relationship that is irreplaceable. How you experience the loss is based on many factors—the nature and meaning of your relationship with your now absent loved one, the kind of death, the qualities and functions that were provided by your significant other, other stressors in your life, your resilience, your past losses, and your support system.

Additionally, many non-familial losses can stir you deeply because these relationships come to feel like “family”—providing a secure bond of caring, loyalty, and emotional support.

Partner or ex-partner
Parent
Grandparent
Child
Sibling
Other relative
Friend/Neighbor
Coworker
Boss
Classmate
Student
Teacher/Mentor
Other significant person

Hidden Losses

Some primary personal losses are not visible to others, yet these absences take center stage in your psyche. In this shadowland, you may find yourself profoundly anguished, with little social support and explicit empathy from others. Acting “as if” you are all right places even greater emotional demands on you at this highly vulnerable time:

Non-traditional and socially unsanctioned unions
Miscarriage
Infertility
Newborn death and sudden infant death
Adoption (losses sustained by adoptee, adopted parents, and birth parents)
Failed Adoption

Anticipatory Grief

When a person you are close to contracts a progressive or terminal illness, you may begin a gradual mourning process at the time of diagnosis. The illness may alter the personality of your significant other, which you may experience incrementally as a sense of loss of the person as you knew them. With an elderly person, you may begin to prepare yourself for the inevitable separation by mentally and emotionally “rehearsing” their absense before it occurs. This grief before death occurs with:

Protracted illness (Cancer, Alzheimer’s and other medical conditions)
Old age

Complicated Grief

Complicated grief may follow the death of someone very important and emotionally close to you. You may become “stuck” or blocked in the mourning process, and find yourself unable to adjust over time to your life without your significant other.

Recent bereavement research* highlights that complicated grief is a prolonged, acute, intensely painful response to the death of someone to whom you are deeply attached. Some key features are persistent intrusive thoughts about the person who died, troubling ideas about the wrongfulness of the death including guilty remorse, and the continuous avoidance of reminders that your significant person is gone. Additionally, this form of grief is accompanied by an ongoing sense of disbelief in the loss, an inability to gradually accept the death as final, and a decreased interest and engagement in everyday ongoing life.

You may also be experiencing anger and bitterness, distrust of others, and a profound sense of loneliness. Further, you may have a belief that you would lose the sense of connection to your loved one or be betraying the dead person if your mourning process was less intense. (*See Links, section on Complicated Grief, for the innovative research study and findings of Katherine Shear, M.D. and her coauthors.)

Traumatic Grief

While any death that is personally devastating can cause “traumatic grief” (S. Jacobs, 1999, Traumatic Grief: Diagnosis, Treatment and Prevention), a death can be inherently traumatic (gruesome, shocking, sudden, violent). Traumatic grief overwhelms your coping abilities. It combines separation anxiety with traumatic distress and may persist for several months and sometimes years. Some signs are hyper-vigilance, feelings of helplessness, and avoidance of death reminders. It can undermine your beliefs in, and expectations for, a predictable and safe world. It can make it nearly impossible, for some time, to have faith in a meaningful future with secure relationships. Traumatic stress may be caused by (but not limited to):

Accidents
Sudden death
Murder or suicide
Natural disasters
Sudden illness
Terrorist acts

Other

Pet Loss

The loss of your household pet can be especially devastating when your animal provided an unwavering and unconditional love. The pet may become the “child,” the “sibling,” or the “good mother”—a full member of the family—that perhaps was not available in your family of origin or your current family. For some, the pet may have offered a stable, nurturing relationship that the owner was unable to sustain with a human being.