Navigating the Many Types of Grief and Loss
Written by Stephanie Foxman, MS, LPC
Grief shows up in my therapy practice in many shapes and sizes. Sometimes, providing clients with specific terminology for what they are experiencing is a first step toward validation and re-orientation. Below is a list of different types of grief that I assist with. The list is not exhaustive, and the categories are not all mutually exclusive, but the terms can help clarify what might otherwise feel murky and confusing. Do you recognize yourself in one or more of these descriptions?
Anticipatory grief – This type of grief occurs when a loss is expected but not yet complete, such as the anticipated loss of a loved one with a terminal illness. It’s common to experience some of the symptoms of grief while the person is still alive; this can be confusing and must be navigated skillfully, lest it negatively impact your capacity to be present in ways you value during the time that is remaining.
Ambiguous grief – This type of grief occurs when closure is not possible. For instance, when a person we care about is still physically present but is psychologically absent, as with Alzheimer’s disease; or when someone is psychologically present but their physical whereabouts are unknown, such as with a missing person. Lack of closure inhibits rituals for both public and private acknowledgement of loss. Those facing ambiguous loss can benefit from therapy, which helps to explicitly and intentionally validate what is otherwise not acknowledged.
Disenfranchised grief – If you have lost someone under circumstances that are not socially recognized or valued, you may be experiencing disenfranchised grief. When a loss is not socially legitimized or prioritized as significant, the bereaved is deprived of an opportunity to feel validated and supported, which inhibits grief and can cause isolation. Losses stemming from socially stigmatized circumstances – such as death by drug overdose or suicide – are highly susceptible to disenfranchisement. Losses that are less socially recognized, such as the loss of a mentor or the loss of a pet, may feel dismissed or minimized by others. Seeking support is crucial to processing disenfranchised grief, whether through grief groups, individual therapy, or with understanding friends and family. Structured rituals, such as lighting candles during mourning or writing a letter to the deceased, can help provide formal acknowledgement of the loss.
Inhibited grief – Sometimes we are cut off from our emotions surrounding a loss. This can happen for a variety of reasons including a belief that we need to “stay strong,” or a fear that we will be completely overwhelmed and permanently incapacitated by grief. Sometimes, grief becomes inhibited when our true emotions (such as relief or anger) feel unacceptable; we may judge ourselves for what we are genuinely feeling, or we may fear judgment by others. It’s so important to have safe spaces where we can explore our difficult emotions without fear of judgment.
Cumulative grief – The accumulation of significant losses can compound the emotional toll on the bereaved. New losses often trigger associations with prior losses, leading to despair and overwhelm.
Collective grief – A good rule of thumb for managing crises/losses is to provide comfort and support to those who are closer to the center of a loss than you are, and to seek comfort and support from those who are further removed than you are. But what happens during a collective loss, like a pandemic, when we are all at the center? On the one hand, by definition we are not alone with collective grief – many others can deeply empathize with what we are experiencing. At the same time, with everyone experiencing at least some level of distress, we may all be seeking comfort and feel too depleted to provide comfort. In these times, communal rituals are a key to re-regulation of our nervous systems.
Non-death grief – Grief isn’t just for those experiencing loss due to death. We attach deeply to people, places, and concepts – and we feel these losses profoundly. Here are just a few of the many losses we may need to grieve: loss of identity; loss of youth; loss of community; loss of functioning due to illness; loss of a partner due to divorce; loss of a friend or family member due to a cutoff; loss of a job.
Even when we proactively initiate a positive change, such as moving to a new city that we are excited about, we may grieve what we leave behind. Parents may be proud that their children are maturing and ready to leave home, while simultaneously grieving the empty nest that ensues. Taking time to work through loss helps us feel more coherence and continuity between the “before” and “after” of these shifts, paving the way for better adaptation.
Traumatic grief – Trauma can result from losses that are sudden, violent or destructive, untimely, perceived as preventable, or personally witnessed. Symptoms of traumatic loss include shock, horror, intrusive recollections, flashbacks, hyper-vigilance, nightmares, emotional numbness, and avoidance of people/places/things that remind one of the loss. If you have experienced a traumatic loss, seeking multiple sources of support can help restore functioning and improve coping.
No matter the type of grief, we all need to feel safe, supported and resourced in order to process a loss, cope with the new reality, and find meaningful ways to move forward alongside the loss. If you or someone you know is grieving, therapy can help. I encourage you to reach out and schedule a brief complimentary phone consultation with me; together we can explore whether I might be helpful to you.