As we experience loss, grief begins to surface. Loss may begin at the time we or a loved one is diagnosed with a terminal illness or at the time of learning about the death of a friend or loved one. Grief is clinically classified as either normal or complicated, with normal grief lasting no longer than approximately one and a half years.

While we all grieve in our own unique way, knowing what to expect during the process of normal grieving helps to navigate the process. Four general categories are associated with the normal grieving process:

  1. Feeling
  2. Physical Sensation
  3. Thinking
  4. Behavior


Sadness is the most common feeling. Don’t underestimate the healing power of crying. In a 1986 grief workshop given by Terrance O’Brien, he said, “Tears are not a luxury, they’re a necessity.”Tears have a language of their own, a healthy communication to allow others to empathize. Crying is an honest release of one’s innermost emotion, which is directly related to healing power. Releasing innermost emotion is extremely essential in order to avoid complicated bereavement.
Anger, Resentment, Guilt are natural emotional reactions to grief. They are by products of feelings related to loss of control, of feeling all alone with no help, or of fear over what your future may hold. Blaming others for not doing enough to either prevent the death or to make it as painless as possible is not uncommon, even if that blame has no basis in fact. If generalized anger and resentment is a problem, expressing it in a healthy manner can unleash pinned up stress and prevent you from doing or saying something that’s regretted later. I tell clients to write the name of the disease, health care professional or event that is causing the anger on the bottom of their shoe and to imagine grinding that disgusting thing away as they walk around. That may sound silly, but it works. Even a good stomp every once in a while, is cathartic! Survivors often feel guilty for irrational reasons. That, too, is normal. One irrational guilt that comes up often with my clients is not being in the room at the time of death. Another is not taking care of the individual sooner or neglecting to do something they now wish they had done. Irrational guilt leads to anger turned inwards, which can lead to depression. Talking through the feelings with a friend or professional usually dissipates irrational and debilitating guilt.

Anxiety is related mostly to the fear of not being able to take care of oneself. This fear can manifest in many ways, with the most common being anxiety over anticipatory emotional and social loneliness, finances, or actual physical challenges that the survivor now must face alone. A good place to start tackling anxiety is to connect with appropriate individuals in each area of concern and, with their help, weave plans of action geared toward relief from the problems that arise if anxiety is left unchecked.

Loneliness This is a feeling that may be very intense and painful at times. It is a feeling of emptiness in our deepest self; the feeling that no one cares about us or our feelings. Immediately upon experiencing grief, one may even feel a sense of loss of control and question self-identity and self-worth.

Physical Sensation can play a significant role in the grieving process and is often overlooked. Hollowness or “ butterflies” in the stomach, chest tightness, breathlessness, dry mouth or increased perspiration, shakiness, headaches, overall lack of energy, muscle weakness, overly sensitive to noise, a sense of depersonalization, and a“nothing seems real” feeling are sensations normal to the grief experience. Do, however, seek medical help if any of them are severe or persistent.

Thinking patterns that are out of the ordinary generally occur in the early phase of grief and are normal; however, if they linger, they often lead to depression and anxiety.

Pay attention to these:

Disbelief: “This is not happening to me”

Confusion: If there is difficulty maintaining order with thoughts, concentration, or if one experiences memory loss, precautions for safety need to be taken, i.e. when driving or making life changing decisions.

Preoccupation: Many individuals will experience obsessive thoughts about the deceased still being alive or images of the deceased suffering or dying.This usually happens when there is an unexpected loss.
Again, these thinking patterns are not out of line for the early stage of normal grieving, but they must not be allowed to persist.

Behavior that bereaved individuals may see as unusual for themselves is, nonetheless, normal during the grieving period. With the exceptions of sleep disturbances and absentminded behavior, behavior can largely be self-regulated.

Sleep Disturbance: Often individuals will find it difficult to fall asleep or will wake up and not be able to get back to sleep. This behavior many times requires the help of one’s doctor for medical intervention. Excessive sleeping as a coping mechanism may require psychological intervention if it goes on for more than a couple of weeks.

Appetite Disturbance: The grieving individual may either have a loss of appetite or will begin to overeat. Change in weight is not unusual because of a change in eating patterns.

Absentmindedness: Some grieving people find themselves acting in an absentminded way or doing things that may cause inconvenience or inadvertent self-harm.

Social Withdrawal: Self isolation is one of the most common behaviors as grieving people often want to withdraw from others for a while. There may be a loss of interest in activity and social events. The good news is that it is usually fairly short-lived, and people reintegrate at their own pace.

Dreams: It is quite common to dream of the deceased. Dreams can manifest as normal everyday experiences or nightmares.They can be used to determine where the individual is in their grieving process

The principles of grief can apply to a variety of losses –job, death, lifestyle, control, cognitive function –to name a few. There is not one model of grieving that will fit every individual as the grief process is unique.

The big take-away is that normal, healthy grieving requires patience to move through the intense pain. It can be very hard work; however, it is made immeasurably easier when one is willing to express one’s feelings and to move through the process with the understanding that it is actually a process –it has a beginning, middle, and yes, an end. The more we understand grief’s process, the more able we are to release anger appropriately, excise irrational guilt, shed healing tears and move beyond the sorrow.

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Kathy Faenzi - Head ShotKathy C. Faenzi MA is a Clinical Gerontologist and Senior Care Consultant based in San Mateo, CA.

JC Spicer, M.Ed. is a Freelance Social Science Writer and Developmental Editor based in the U.K.