Grief is a natural response to the loss of a loved one, but it may also occur following a trauma, serious health complication or serious employment loss. Generally, the more significant the loss, the more profound and longer lasting the grief. While everyone grieves differently, most people work through five specific stages. Grief counselors can assist grieving persons through these stages more quickly and safely.
Denial
Denial is generally the first stage of grief. It is often accompanied by social isolation, possibly in an attempt to avoid contact with others who may remind the grieving person of his loss. The grieving person may refuse to acknowledge the death of his loved one or other loss, and make every attempt to continue on with his daily routine as though nothing has changed, expecting the deceased to just "show up" or refusing to look for another job "just in case" he is asked back to his old one. According to Memorial Hospital in Towanda, Pennsylvania, the denial stage may last several months or longer. People rarely seek counseling during this stage of grief.
Anger
The second stage of grief is marked by intense anger. This anger may be directed at the deceased, at other loved ones, at the world or at a higher power. Often, the anger is directed inward, resulting in self-loathing and guilt. Relationships may become strained during this stage, as the grieving person lashes out at friends and family or becomes obsessed with seeking revenge for any real or imagined hurt inflicted on him or on his deceased loved one. Counseling during this stage may focus on helping the grieving person to cope with his feelings, and on offering constructive ways of venting anger, frustration and guilt.
Bargaining
Bargaining, the third stage, is most pronounced in highly religious people. During this stage, the grieving person makes repeated attempts to bargain with a higher power to turn back time. He may promise to change his own life or do some specific task if only his loved one will be returned to him. Bargaining also is seen in non-religious survivors, although the pleas and prayers are typically less specific. Both religious and non-religious grieving persons can benefit from spiritual counseling and support.
Depression
The depression that occurs following a significant loss is generally one of numbness and a loss of interest in activities. Sadness, hopelessness, loss of appetite, changes in sleeping patterns and underlying anger also may be present. The depression of the fourth stage of grief may be mild or may become severe and require medical intervention and supervision. Crisis counselors should monitor the grieving person during this stage in order to intervene if suicidal thoughts develop or if the person becomes unable to function in daily life.
Acceptance
Acceptance is the final stage of grief. Once the depression and anger ease, and the reality of the loss comes into focus, the grieving person can accept the loss and begin rebuilding his life. Initially, transient periods of depression or anger may arise during the acceptance stage, but these become less frequent and less severe over time. Counselors can assist the grieving person by offering coping skills and general support.
