Grief is a normal emotional response that encompasses a broad range of feelings, thoughts, and behaviours that are common following the loss of someone or something in a person’s life. Grief is not an illness with a prescribed cure and is a highly individualised and variable process (Morris 2008). Events that may be associated with a grief reaction include the death of a spouse, loved one, unborn child, or family pet or companion animal, or hearing of a similar loss or traumatic event (Worden, 2010). Grief can also arise following other losses that do not involve death: job loss through injury, being laid off, retrenchment or retirement, having to move house or relocate unexpectedly or because of ill-health, changes in health condition, marriage breakdown or divorce, custody issues, loss of friendship or significant trust, or any other circumstance involving a loss of something important, either short-term or long-term (James & Friedman, 2009).
It is well known that the death of a loved one is considered to be one of the most powerful stressors in everyday life, often causing significant distress to all those closely connected to the deceased (Holmes & Rahe, 1967). While grief, bereavement, and loss are considered to be normal experiences throughout life, and the majority of people impacted are able to adjust over time to their loss, these can also impact people severely, where adjustments can take months or even years. These severe grief reactions (complicated grief) can affect around 10% to 15% of people and are more likely to impact people who have had depression or anxiety present before the loss (Bonanno, 2004). Moreover, bereaved individuals may be more at risk of serious mental health problems such as depression and substance abuse, as well as an increased risk of suicide (Prigerson & Jacobs, 2001; Stroebe, Schut, & Stroebe, 2007).
While our knowledge and understanding of grief and bereavement continue to evolve through research, we know that grief affects everyone in different ways (Worden, 2010). The process of grief impacts various areas of functioning across emotional, physiological, cognitive, and behavioural domains. It is often experienced in waves, and recovery can take time. Intense feelings of sadness, disbelief, shock, panic, loneliness, helplessness, anger, anxiety, guilt, and numbness may be experienced. Physical experiences may include uncomfortable sensations in the stomach, heart palpitations, chest tightness, sweating, feeling faint, tightness in the throat, noise sensitivity, breathlessness and difficulty breathing, difficulty concentrating, depersonalisation, muscle weakness, dry mouth, and a lack of energy. Cognitive difficulties may include denial, disbelief, confusion, preoccupations, obsessive thoughts, a sense of presence, and hallucinations. Behavioural difficulties may include problems sleeping, a reduced appetite and weight loss, absentminded behaviour, withdrawing socially, distressing dreams or nightmares, loss of interest in things previously enjoyed, avoidance of things associated with the loss, sighing, restless hyperactivity, and crying. These are normal in the context of a grief experience.
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