Expert Contributor
Heather Bass, LCPC

Heather Bass, LCPC has been a licensed psychotherapist for 15 years and has worked specifically with grief for the past 10 years.

Grief is normal and healthy, and grieving people should honor these feelings of loss. They need loved ones to listen to them when they want to talk about their loss and to hold them when they feel overcome by emotions. Most importantly, the bereaved need patience from others. Although grief has stages, it does not have a specific timeline. Learn more about grief, including the different types of grief and how grief counselors can help, with this guide.

Grief Resources for Help Now

Grief counselors work in a variety of settings. You may be able to find a specialized counselor at locations associated with your loss, such as a military affairs office, a nursing home, a funeral home, a hospital or a school. Many of these locations offer grief counseling free of charge.

If you are not associated with an organization that offers grief counseling, there are still many resources available to you. Look for mental health crisis centers in your area for immediate support, and know that many grief counselors have their own private practices that are easily accessible.

If you are suicidal or in immediate crisis, please call one of the following crisis hotlines

National Suicide Prevention Hotlines 1-800-SUICIDE, 1-800-273-TALK
National Youth Crisis Hotline 1-800-442-HOPE

Types of Grief

Grief can manifest in a number of ways. The table below shows some of the more common forms of grief

Type of Grief Description
Normal grief Should not be thought of as easy. Rather, it is the process of moving toward accepting the loss as symptoms steadily dissipate, allowing the person to gradually reengage in daily activities.
Anticipatory grief Begins prior to the actual loss. This is most commonly found when a person is dying from a long-term illness, and the bereaved begin their grief process the moment the impending loss sinks in. Anticipatory grief can be difficult for people because they may feel guilty for feeling such strong emotions of loss prior to their loved one dying.
Chronic grief A strong reaction of grief in which symptoms do not dissipate over time.
Delayed grief Occurs when a person does not begin to feel the symptoms of grief until long after the loss. In many cases, the person consciously or subconsciously avoids the reality of the loss.
Inhibited grief Happens when people keep their grief symptoms to themselves. The feelings are kept inside until they manifest in the body, often with somatic complaints.

Stages of Grief: Modern Elements and Traditional Processes

Traditional, gender-based stereotypes may impact the way people grieve, as males and females process grief differently. A common gender bias is that it is acceptable for grieving women to cry, but taboo for grieving men. It is important to recognize and understand these gender messages.

Religious and spiritual sources can factor in to the grieving process and affect the way people understand and cope with loss. Mourners may find spiritual outlets provide a path to a greater sense of peace.

Traditions, rituals and values may play a part in how, why and when different people express their grief. Cultural elements may provide stability, security and common ground for those in mourning.

A person’s personality may shed light onto the way they choose to grieve. Some find solace internally, while others may be outwardly emotional. Some may mask or condemn themselves from sharing their true feelings, or cope in a way that doesn’t seem to match their personality.

A safe and supportive environment can make all the difference for someone in grieving. A person’s social support system, including family, friends and co-workers can provide comfort through the grieving process.

In 1969, psychiatrist Dr. Elizabeth Kubler-Ross first addressed the way critically ill patients were viewed and treated with her book, “On Death and Dying”. This compilation of observations and reflections came after many conversations with dying patients, and focused on their emotional reactions to death. She outlined five basic emotional stages people facing death experienced—denial and isolation, anger, bargaining, depression and acceptance. Though some stages overlapped or were skipped for many patients, they were groundbreaking for the time, and recognized by the mental health community as five stages of loss.

Today, modern grief research branches out from these generalizations, and recognizes the emotions associated with death and mourning as more complex, unique feelings that vary from person to person. Contemporary thoughts on grieving address individuality, pinpointing personal differences like gender, religious and cultural background, personality, social demographics and environment, among other things, as elements that play a different role in each person’s unique, personal grieving process.

Symptoms of Grief

Physical

Head and body aches

Exhaustion

Loss of appetite or overeating

Insomnia

Oversensitivity to noise

Shakiness

Dizziness

Shortness of breath

Emotional

Guilt

Anger

Anxiety

Panic

Resentment

Helplessness

Shock

Fear

Unable to feel

Behavioral

Crying

Unable to talk to others

Avoidance

Panic

Withdrawal

Substance misuse or abuse

Cognitive

Disbelief

Confusion

Disconnection from self

Preoccupation with deceased

Vivid dreams, both disturbing and not

Topics in Grief

Grief and Children

Loss can be extremely difficult for children to comprehend, let alone process.

  • Children younger than six years old are very literal, so they will require a balance of comfort and simple, direct answers. They may have difficulty understanding that a loved one will never return.

  • Children between the ages of six and 10 will likely understand what has happened, but may have a lot of biological questions about the process or need to process their feelings through play and art.

  • Children over the age of 10 can be plagued by insecurity to begin with, and may feel this more acutely as a result of loss. This is the time that children start to question death and loss in a more abstract way and to consider questions about the afterlife.

5 Tips for Helping Children Cope with Grief

1

While it is common to want to shelter children from bad news, it is important to be honest with them. Using phrases like “she has gone away” or “he has gone to sleep” will often confuse children because they will not understand the finality of the situation.

2

If a person has died of old age, very literally explain that their body eventually stopped working and that everyone’s body one day stops working.

3

If a person has died in a sudden accident, you can describe the accident simply and explain that it caused the person’s body to stop working suddenly.

4

Lean on your faith in choosing whether to share the concept of heaven or simply state that the person is now in the cemetery.

5

Keep in mind that when young children ask where the person has gone, they are often more curious of the whereabouts than of existential concepts.

No one wants to scar children with difficult news, especially if the event was traumatic. Tone is extremely important while sharing the news of a loss with children. Ask children if they have any questions about the situation. Children may also have questions later, and although it may be emotionally difficult for you to continue discussing the topic, it is important to be loving, patient and consistent with your answers.

Resources for Children and Grief

Children’s Grief Education Association

This site provides online courses and downloadable curricula for support groups.

The Coalition to Support Grieving Students

A grief support site that provides student-oriented learning and coping tools.

The Dougy Center: The National Center for Grieving Children and Families

The Portland-based Dougy Center runs support groups for children in the area, but also has many online resources, some of which can be purchased on its online bookstore.

National Alliance for Grieving Children

Families can use this site’s search tool to find support groups around the country.

National Association of School Psychologists

Helping spread awareness on overall school children psychology, the NASP provides many resources including podcasts, awards, scholarships and grants.

National Center for School Crisis and Bereavement

Teachers and administrators can find help here in the immediate aftermath of a tragedy as well as training resources to prepare teachers ahead of time.

Rainbows: Grief Support Resource

Rainbows aims to help parents guide children through potentially traumatic events, including divorce and military deployment.

Grief and Hospice/Terminally Ill Loved One

Watching a loved one die is extremely challenging for a family. Many family members experience two layers of loss: grief surrounding the anticipated loss and grief surrounding the actual loss when it finally occurs. Grief in the hospice setting often involves numerous family members witnessing one event in different ways. Some family members may feel immense depression or fear. Others may feel more concerned for the dying person, while still others may be focused on the details of preparing for the death. All these feelings are normal, but it can be challenging for a family to experience all of them at once.

3 Tips for Dealing with Hospice Grief & Bereavement

1

It is important to take care of yourself while caring for a loved one who is suffering from a terminal illness and/or in hospice. The most important thing to do is to honor your own feelings without judgment. It’s tempting to “put on a brave face,” but be honest about your feelings. Identify your feelings and express them.

2

Try to welcome support from friends and family, understanding that you need support as well. It’s important to also take time for yourself without guilt.

3

Find a place where you can vent your grief in a way that you may not be able to in the company of the terminally ill person. Some constructive activities are journaling, reading and seeking out support groups online or in person.

Resources for Hospice Grief

Hospice Care, National Cancer Institute, NIH

The NIH-run page provides a brief explanation of what hospice care is and who can benefit.

Hospice Foundation of America

HFA allows family and friends to ask experts questions about hospice, supplies a national directory of hospice organizations, and posts videos and other resources covering end-of-life care and grief.

Hospice of the Comforter

This website for a Florida-based organization provides a useful listing of online information on becoming a caregiver.

Hospicenet.org

Hospicenet’s website shares a myriad of information for patients and caregivers, covering everything from the Family and Medical Leave Act to a comparison of name brand and generic drugs.

National Hospice and Palliative Care Organization

The organization’s website serves as a clearinghouse for information for both caregivers and professionals.

Grief from a Sudden Event

Sudden losses are impossible to prepare for and can be very traumatic. People may experience sudden loss due to a suicide, an accident or a crime. People may also experience sudden loss when a partner leaves them, they are suddenly evicted, a natural disaster takes place, or any number of unexpected events happen.

People who experience sudden loss may go through depression, distressing thoughts, insomnia, nightmares, anxiety and fear, and social isolation.

3 Tips for Dealing with Sudden-Event Grief

1

After experiencing a sudden loss, it is important to take care of yourself and reach out for help. Everyone who experiences loss from a sudden event needs to prioritize eating, sleeping and seeking out emotional support from friends, a grief counselor or clergy.

2

If the sudden event was an accident or crime, one of the first things you should do is appoint a dear friend to notify others and shield you from the media, including from watching the news.

3

Try to take some time off of work and other time-dependent activities. Understand that you will be entering a grieving process that may bring unexpected symptoms, so try to line up support early on to help you through it.

Sudden-Event Grief Resources

Grief and Bereavement in Accidental and Sudden Death

This is an article about the author’s own dealings with grief and how he moved through bereavement to acceptance.

Grief Speaks

In discussing sudden loss, the author covers everything from abstract feelings about death to practical funeral arrangements.

Job Loss and Unemployment Stress

The goal of this page on mental well-being is to provide tips on staying positive while job hunting.

Sudden: Supporting People After Sudden Death

Sudden’s site provides guides for children and adults about dealing with bereavement, both initially and over the long term.

Grief and Relationships

People often assume that grief comes when a person is lost to death, but a significant breakup can bring the same grieving symptoms, such as denial, anger and, eventually, acceptance. Meanwhile, one must adapt to life without this person even though reminders of him or her seem constant.

5 Tips to Cope with a Lost Relationship

1

Allow yourself to grieve. Don’t rush this process.

2

Allow yourself to experience the pain. Avoid distracting yourself from the pain or quickly entering into a new relationship to mask uncomfortable feelings.

3

Surround yourself with people who you love, and who love you. This will remind you of your value and that the lost relationship was not your only important relationship.

4

Focus on gratitude. Reflect upon what was gained from the relationship, such as lessons learned, incredible children or fun experiences.

5

Look for the silver lining. It might be tough at first, but challenge yourself to look for the benefits in your changed relationship status. No relationship is perfect, and the loss of one might signal an opportunity to find fulfillment elsewhere.

Resources for Help with Relationship Loss

7 Steps to Overcome Your Divorce

A licensed therapist gives practical advice on getting through divorce.

Coping With the End of a Relationship

A quick read, this article gives five key points about finding peace once a relationship is over.

The Dynamics of Grief When a Relationship Ends

Another quick read, this page applies Kubler-Ross’ stages of grief directly to lost relationships.

The Five Phases of Abandonment Grief and Recovery.

This page applies Kubler-Ross’ stages of grief directly to lost relationships and discusses the “SWIRL” process — shattering, withdrawal, internalizing, rage and lifting.

Grief and Loss in Adoption

Adoptive parents and birth parents giving their children up for adoption have special needs, which this site caters to. The latter can grieve their loss, while the former can learn how to talk to their children about the experience.

What to Do if You Are Grieving

Many people can feel rudderless during the grieving process, not only because they are experiencing new and challenging emotions, but also because there is no rulebook for how to act or feel. Although there is no one way to feel, there are resources to help people move forward.

1
Support
  • Instead of trying to be alone, seek out support from friends and family. If you feel a tendency toward social isolation, identify one or two people you feel comfortable around even when you aren’t feeling well, and try to spend time with them.
  • Seek support from a grief counselor or therapist. Professionals can help you understand what you are experiencing and give advice on coping with your feelings.
  • Look for support groups for people going through similar events. Camaraderie is integral to validating your own experience instead of feeling alone in it.
2
Self Care
  • Prioritize eating and sleeping. Sometimes grief is so consuming that we forget the importance of these most basic acts.
  • Make time for physical exercise. Whatever your fitness level, try to get outdoors and spend time in nature. Exercise releases endorphins and clears the mind. Nature has an incredible way of helping us feel centered and in touch with something larger than ourselves.
  • It may seem silly at this time, but pamper your body. Schedule regular massages, hair treatments or pedicures. Not only is it important to remind yourself of what it feels like to be cared for and to feel good physically, but body treatment helps process emotions so they can be released through the body.
3
Significant Activities
  • Write a list of things you love to do. In periods of grief people often feel scattered and forget what activities bring them joy.
  • Prioritize expressive activities such as art projects, crafts or woodworking. It can be therapeutic to create something new and beautiful at a time of loss, whether it is a painting, an old car you are repairing or something else.
  • Consult friends and therapists before returning to work. Eventually it will be very healthy for you to reengage in your previous behaviors to keep your mind active and your sense of self-worth strong.

Supporting the Grieving

Supporting a grieving person is an important job. You will not know what to do in all situations, so the most important thing is to be patient and communicate with your loved one that you are willing to support them however you can. The following tips will help you provide support to grievers without suffocating them or hindering their own personal progress.

Listen

Provide them with an opportunity to talk about their loss and process it externally. Ask open-ended questions about their loved one, then let them share what comes up. Be careful not to judge or try to fix their problem.

Avoid telling people they should move on

There is no timeline for processing grief, and it can be extremely upsetting and invalidating for a grieving person to feel as though others think their feelings should be resolved within a particular timeframe.

Avoid saying “I know how you feel.”

People often think this will generate a feeling of solidarity, but no one can know exactly how another person feels, and it can feel invalidating to be told otherwise.

Ask how you can help

Offer to bring food or help with transportation or childcare. If you are a family member, in the case of a death, offer to help make funeral arrangements or coordinate communication with other family and friends.

Keep the bereaved updated on what is going on with you, but treat their response with respect

For example, if a friend has experienced a miscarriage, don’t pretend your healthy baby does not exist. Tell them what is going on in your family’s life, but be prepared for them to say it is too hard for them to hear right now.

Avoid telling people the event was God’s will

You may be trying to help them find meaning or a silver lining, but faith is an extremely personal topic and it may feel exceptionally raw during a period of loss. Allow grievers to process their faith without asserting your own beliefs.

Grief Myths

There are numerous myths about grief. The following are a few of the most common:

Myth: It is best not to talk about the loss and bring up sad feelings

Reality:

It is very healthy to allow the bereaved to talk about the loss. Often they will want to talk about very specific details surrounding the loss. The goal of grief is to find a healthy way to accept the loss and reintegrate into a meaningful life — not to pretend the lost person or thing never existed and that the loss never took place.

Myth: We should worry if the bereaved is crying a lot.

Reality:

Crying is a very valuable part of the grieving process. Crying discharges tension and releases toxins produced during trauma.

Myth: Grief support groups are depressing.

Reality:

Support groups are often focused on sharing experiences, and providing others with strength, and hope. People learn different methods that have helped others alleviate pain and find hope in stories that remind them of their own.

Myth: Grief is only an emotional response.

Reality:

Grief can be experienced and felt physically, cognitively, behaviorally, socially and spiritually.

Myth: After grieving, people will return to normal.

Reality:

Grief is not a process with an end date. Life will never be the same, and the goal is not to return to normal, but rather to find a “new normal.”

Myth: Grief and mourning are the same thing.

Reality:

Grief is an inward process, whereas mourning is an outward display of the grief process that we choose to share with others. Because of this, everyone will grieve, but not everyone will mourn.

Grief Counseling Helps
  • Grief counseling, also known as bereavement counseling, is a way of comforting people who have experienced a significant loss and are struggling to move through the stages of grief. The goal of grief counseling is to help the person adjust to life without the person or thing that has been lost. It is important that people adjust to this new life and find a way to cope with their loss — not just to live life as if the loss never occurred, but to accept it and move on while still honoring who or what was lost.

  • Common challenges found in people who seek out grief counseling include difficulty in relationships, intense guilt or depression, difficulty maintaining daily activities and quality of life, and difficulty continuing to live without their loss.

  • The above symptoms are extremely common in people dealing with a significant loss, although the degree to which they are experienced varies. In fact, there are some people who experience a significant loss and do not feel any of the above symptoms, or only feel them to a small degree. Grief counseling is recommended for anyone experiencing a difficult loss because the process of grieving is normal and healthy. Grief counseling can help the loss be truly felt and processed, and it also allows the bereaved to feel supported while processing these intense emotions.

  • Grief counseling is not the same as grief therapy. Grief counseling helps people move through an uncomplicated process of bereavement, whereas grief therapy is the use of more intense clinical methods to deal with grief if it deeply shapes a person’s quality of life and ways of thinking over an extended period of time.

How Do Grief Counselors Help People?
  • Grief counselors help people moving through normal experiences of grief as well as people who are greatly struggling through this process. Grief counselors work in a number of settings. Many work in locations associated with loss, such as funeral homes and hospitals. Military offices offer grief counseling for soldiers who have lost comrades as well as for family members of fallen or injured soldiers. Schools often offer grief counseling for students and staff after the death of a student or after a traumatic event.

  • Grief counselors can also be accessed via crisis centers, which are often associated with a local hospital or mental health agency. Many grief counselors and therapists operate private practices.

  • Grief counselors use a variety of methods to support people through their grieving process. Often, counselors will educate grievers about the stages of grief, which can help people feel validated. For some, especially when dealing with difficult feelings such as anger and denial, it is helpful to know they are experiencing something that is part of an actual process.

  • Grief counselors or therapists help a client connect with their loss through memory exercises, reflection or rituals. Talking about this significant loss can trigger any number of responses, most often crying, and sometimes yelling. This is perfectly fine, and grief counselors are prepared to deal with this emotional release.

  • Grief counselors work to reduce additional stress by helping people to organize and approach their day-to-day life and their recovery process.

  • Qualified grief counselors know how to carefully structure conversations in a safe way to allow the bereaved to deal with parts of their process that they feel stuck on.

  • Grief counselors can identify when symptoms of grief, such as sadness, have progressed into more complicated states, such as depression or suicidal thoughts. Grief counselors can address these issues with the client or refer them to a more qualified therapist to work on the particular symptom.

Some grief counselors facilitate grief groups in which people who are grieving similar losses unite to share their experiences, challenges and stories of resiliency and hope. It is the grief counselor’s responsibly to monitor the group to ensure that it is a safe, inviting and therapeutic environment for all participants. In this setting the grief counselor is typically more involved in leading the conversation in the first few sessions before allowing group members to take more ownership of their own conversations and united healing as time goes on and the group bonds.

What Education Is Required to Become a Grief Counselor?

The American Academy of Grief Counseling offers credentials at multiple levels.

To become a certified grief counselor, a person must have at least a bachelor’s degree in a relevant field, such as psychology, and significant career experience.

To become a grief recovery practitioner, it is compulsory to hold a master’s degree. Most states require approximately 3,000 hours of supervised fieldwork to become a certified grief counselor.

With or without certification from the American Academy of Grief Counseling, any licensed therapist with a master’s degree can work on grief. Some grief counselors go on to pursue a doctoral degree, often to do advanced research.

Interview With a Grief Counselor

To gain a professional’s perspective on grief counseling, we interviewed Heather Bass, LCPC, who has worked with grief for the past decade.

What is the intent of grief counseling?

Grief counselors provide a comfortable, safe emotional space to assist people in processing their feelings and experience around grief. The grief may be due to death of a loved one, the loss of a long-term job or an illness that has created changes in lifestyle. So, people grieve losses in many different ways, and a grief counselor is especially attuned to providing a place for people to process this.

What differentiates grief counseling from typical psychotherapy?

The main differentiation from other counseling methods is that a grief counselor supports the experience of feelings and validates the experience of loss, and isn’t as focused on helping people think of things in a different way. In more traditional or more cognitive therapy, we work more on getting people to become more aware of their thoughts and change their thoughts to alleviate suffering. In grief, people may have regret or have a traumatic experience around the loss, so it could be helpful to provide a different perspective on how to look at the experience, but mostly we are honoring the very individual experience of grief and loss, so there is no formula.

Grief Resources