Navigating the Grief Process

Understanding the phases of grief and how to support yourself through each one

Grief & LossInfo SheetFree Resource

Navigating the Grief Process

Understanding the phases of grief and how to support yourself through each one

Navigating the Grief Process

Understanding the phases of grief and how to support yourself through each one

Grief is the natural emotional response to significant loss, particularly the death of a loved one. While no two grief journeys are identical, clinicians and researchers have identified common patterns in how grief unfolds over time. Contemporary models (Shear, 2022; Bonanno & Malgaroli, 2020) describe grief not as a fixed sequence of stages but as a dynamic process that oscillates between confronting the pain of loss and adapting to a changed world. Understanding this process can help normalize your experience, reduce fear about what you are going through, and guide decisions about when additional support may be helpful.

Acute Grief

What it looks like: In the weeks and months immediately following a loss, it is common to experience intense waves of sadness, shock, disbelief, difficulty concentrating, disrupted sleep, appetite changes, and physical symptoms such as fatigue or tightness in the chest. You may find yourself preoccupied with thoughts of the deceased, replaying memories, or searching for signs of their presence.Example: You might find yourself reaching for the phone to call your loved one before remembering they are gone, or feeling a wave of tears while doing something as ordinary as grocery shopping.

What helps during this phase: Allow yourself to feel what arises without judgment. Maintain basic self-care routines including regular meals, adequate sleep, and gentle movement. Accept support from trusted people. Avoid making major life decisions while in acute distress. Give yourself explicit permission to grieve at your own pace.Example: Setting an alarm to eat lunch even when you have no appetite, or accepting a friend's offer to sit with you even when you feel like isolating.

The Oscillation Between Loss and Restoration

The Dual Process Model: Stroebe and Schut's Dual Process Model, one of the most widely supported frameworks in grief research, describes healthy grieving as a natural back-and-forth between two orientations. Loss-oriented coping involves confronting the pain, processing memories, and working through the emotional reality of the death. Restoration-oriented coping involves attending to the practical changes the loss creates, forming new routines, developing a new identity, and gradually re-engaging with life.Example: Spending the morning looking through old photos and crying, then shifting focus in the afternoon to learning how to manage the household finances your spouse used to handle.

Why oscillation matters: Neither pure confrontation nor pure avoidance is healthy. People who spend all their time immersed in grief may become overwhelmed, while those who constantly avoid it may never fully process the loss. Healthy adaptation involves naturally moving between both modes. Some days you will grieve intensely; other days you will focus on the tasks of living. Both are necessary.Example: One week you may feel guilty for laughing at a friend's joke; the next, you may need to sit alone with your sadness. Both responses are a healthy part of grieving.

Integrated Grief

What it looks like: Over time, most people reach a state where grief becomes woven into the fabric of daily life rather than dominating it. You have accepted the reality of the loss, re-engaged with activities and relationships, and found ways to maintain a meaningful connection with the deceased through memories, rituals, or values they embodied. Grief may still surface powerfully at times, especially around anniversaries, holidays, and life milestones, but it no longer prevents you from functioning or finding meaning.Example: You cook your mother's recipe for holidays, feel a pang of sadness, and also feel warmth at carrying on her tradition. The grief is present but no longer consuming.

What integrated grief is not: Integrated grief does not mean you have stopped missing the person, stopped feeling sad, or moved on in a way that erases the loss. It means you have learned to carry the loss alongside the rest of your life. Love and grief can coexist indefinitely.Example: Years later, you still tear up hearing your father's favorite song, but you can listen to it, remember him fondly, and continue with your day.

When Grief Becomes Complicated

Prolonged grief disorder: For approximately ten percent of bereaved adults, the symptoms of acute grief persist at high intensity for twelve months or longer without significant improvement. This condition, now formally recognized in both the DSM-5-TR and the ICD-11, is characterized by persistent yearning, identity disruption, emotional numbness, difficulty accepting the death, and a sense that life is meaningless without the deceased.Example: Eighteen months after the loss, you still cannot enter your loved one's room, feel unable to imagine any future without them, and have withdrawn from nearly all social contact.

Risk factors for complicated grief: Factors that increase the risk include sudden or violent death, the loss of a child, a highly dependent or conflicted relationship with the deceased, limited social support, prior history of depression or anxiety, and multiple concurrent losses. Identifying these risk factors early allows for timely intervention.Example: Someone who lost a partner unexpectedly in an accident while also dealing with estrangement from family may have fewer supports and a harder time processing the shock.

Effective treatments: Prolonged grief disorder responds well to specialized psychotherapy. Complicated Grief Treatment, developed by M. Katherine Shear, combines elements of cognitive behavioral therapy, attachment theory, and interpersonal therapy. It typically involves sixteen sessions and has demonstrated strong efficacy in randomized controlled trials. Other evidence-based approaches include internet-based cognitive behavioral therapy for grief and group-based interventions.Example: A therapist might guide you through a structured retelling of the loss to help reduce avoidance, while also helping you set small goals for re-engaging with activities you once enjoyed.

Self-Care Strategies Throughout the Grief Process

Maintain physical routines Regular sleep, balanced nutrition, hydration, and gentle physical activity support emotional regulation and immune function during a time when the body is under significant stress.Example: Even a ten-minute walk around the block or keeping a water bottle nearby throughout the day can make a meaningful difference in how you feel.
Stay connected to others Isolation deepens grief. Even brief, low-effort contact with supportive people, such as a short text, a walk together, or sitting in the same room, can help you feel less alone.Example: Texting a friend 'I'm having a hard day' when you do not have the energy for a full conversation can still provide a meaningful sense of connection.
Allow yourself to feel and to rest Grief is emotionally and physically exhausting. Give yourself permission to take breaks from the pain, and also permission to feel it fully when it arises. Both are part of the process.Example: Watching a lighthearted movie to give yourself a break does not mean you are avoiding your grief; it means you are pacing yourself through it.
Limit major decisions When possible, postpone significant life changes such as moving, changing jobs, or ending relationships during the first year of bereavement. Grief can temporarily distort judgment and priorities.Example: You may feel a strong urge to sell the house right away, but waiting several months can help you make that decision with a clearer mind.
Seek professional help when needed If grief feels unmanageable, if you are experiencing thoughts of self-harm, or if symptoms are not improving over time, reaching out to a grief-trained therapist or counselor is an act of courage and self-care.Example: If you notice that months have passed and you still cannot get through a workday or are relying on alcohol to numb the pain, that is a sign professional support could help.