Grief in a Psychological Framework
It is that time of year again—the holidays are approaching, and many of the people I work with deal with some type of grief. As much as we enjoy taking our time over the next few months being grateful for what we have and who is in our lives, many times, this is not the case for some individuals.
Fall is always an interesting time for me. There seems to be a confluence of both professional and personal situations that make this time of year challenging. Clinically, I am always working with those faced with family or personal dynamics that cause great stress. This confluence of personal and professional situations is an unstoppable pattern. Our own cultural history has shown this. I mean, why else is A Christmas Carol constantly being remade, or why does It’s a Wonderful Life constantly run during this season? In the music industry, it seems something was not approved, a non-renewal of a contract, some denial of tenure (in both academic and orchestral positions) from the previous spring, and finally, the loss of opportunity after years of service within your field.
These narratives have become increasingly familiar to my ears after many years of clinical practice. And I am not free from this pattern either and can think of countless situations in which grief was a center between October and January. It is also fair to state, without any quantitative, evidence-based research, that social media platforms and editorials can either help or worsen the complex cycle that grief creates.
Without judgment, any platform can provide temporary relief and serve as a reminder that individuals experiencing unwanted transitions are not alone. However, once that external validation subsides, a more subjective question often remains: What happens next?
This is a complex question, though, it is frequently met with overly simplistic answers. Grief, loss, and professional displacement are rarely linear experiences, and the process of moving forward requires more than motivational rhetoric. While narratives of resilience are abundant, narrative alone is insufficient. Stories may inspire, but inspiration by itself does not heal. At best, personal narratives and unneeded lecturing can provide temporary emotional relief; they do not, on their own, resolve grief or restore agency.
The purpose of this article is not simply to discuss grief, but to examine the relationship between grief and perseverance as coexisting psychological and emotional processes. Through this article, I hope to share tools to help anyone enduring the profound impact that physically and emotionally affects us with profound experiences of grief. Hopefully, this perspective will empower readers through a deeper understanding and provide tools that can eventually lead to relief.
When discussing grief, we must first acknowledge that the “five stages of grief” model is inaccurate and outdated. According to O’Connor (2019), current research relies more heavily on attachment theory and cognitive stress theory to understand the process of adapting to loss. Within cognitive stress theory, there are two primary processes. The first is primary appraisal, which refers to the brain’s attempt to evaluate an event and decide whether it is harm, positive change, or a non-threatening situation. In simpler terms, the brain is trying to answer, “What just happened to me, and what does this mean?” The second is secondary appraisal, which involves evaluating available resources and options for coping. In other words, the brain begins asking, “What do I have available to help me handle this?” Its primary function is to ask: Am I equipped to handle this?
A second framework is the Cognitive Activation Theory of Stress, in which stress responses are categorized into three areas: (1) coping, which includes the assumption that action will lead to positive results; (2) not coping, in which the person feels that nothing can be done, leading to increased stress, anxiety, and depression; and (3) ambiguity, in which the brain’s instinctive need for answers is obstructed, preventing it from predicting an outcome.
These are oversimplified descriptions, but they can be expanded into what O’Connor (2019) describes as preoccupation with loss and traumatic distress. Rather than a five-stage framework, grief is now understood through three dominant emotional responses: fear, sadness, and anger. Put more simply, these responses describe what can happen when something changes and we do not know what to do next. We may believe that our actions can make a difference, we may feel that nothing we do will matter, or we may become stuck because we simply do not have enough information to understand what is going to happen.
Within the framework of attachment theory, grief is influenced by attachment style. Defined within the DSM-5, the primary manual of mental disorders, these are generally categorized as follows:
(1) secure attachment, characterized by healthy self-esteem and self-worth.
(2) anxious-preoccupied attachment, characterized by a strong desire for deep, meaningful relationships coupled with an intense fear of abandonment.
(3) dismissive-avoidant attachment, often characterized by high achievement alongside pathological discomfort with intimacy or vulnerability, resulting in maladaptive behaviors designed to avoid emotional exposure at all costs.
(4) fearful-avoidant attachment, characterized by codependent tendencies in which the individual desires closeness but remains in constant fear due to prior experiences of harm, trauma, or chronic environmental instability.
For someone who has never encountered attachment theory, this can sound much more complicated than it actually is. At its most basic level, attachment style helps describe how we relate to other people, particularly when we feel vulnerable, threatened, or afraid of losing someone. When grief occurs, those patterns can become more noticeable because loss often brings our deepest fears about relationships, abandonment, trust, and safety to the surface.
To find the correlation between the combined interpersonal, communal, cultural, and early childhood narratives, Silverman et al. (2021) shows that the individual themselves finds this process and that the quantification of any process limits the person from finding resolution from several emotions. However, the idea is to help “pack” someone’s bag so that, as the waves of grief or emotion surface, they will have a multiple set of ideas to help process what they are feeling in the present.
These concepts can sound very clinical, but they are relevant to everyday experiences of grief. When a contract ends, a relationship changes, an opportunity disappears, or something happens that we never expected, the brain immediately begins trying to make sense of what happened. It asks what the event means, whether we have the resources to handle it, whether anything can be done, and what might happen next. We cannot always control what happened to us, but we can begin to understand how we are responding to it. That understanding gives us a starting point for deciding what we can do next.
Moving to Radical Acceptance
I can say from both professional and subjective experiences that we all must work towards radical acceptance. Another idea is my own personal philosophy: “I must let go that the past could have been different.” The more we hold onto the idea that the past could have been different, the more we involve ourselves in what evolves into fear, guilt, shame, embarrassment, and finally, causation. Radical acceptance does not mean that we approve of what happened or that we believe it was fair. It means acknowledging that the event happened and recognizing that we cannot go backward and change the past. Below are some tools to help alleviate this and find an interpersonal, communal, and cultural way to help soothe and hopefully integrate more mindfulness-based practices into your daily routine.
The first is your daily interpersonal self-care routine. This should be non-negotiable. There is absolutely no reason 45 minutes to an hour cannot be devoted to these processes. I hear countless hours weekly of why someone cannot, but after processing with them their circumstances, it turns out that they can but choose not to. This choice is not a criticism, but it usually holds the first emotion and is many times subconscious: fear. This fear of being present, change, acceptance, and coming to terms with our own part to play in any situation can cause much distress. As discussed in earlier articles, they directly correlate with the set of “limited beliefs” that we hold since childhood. These can include the following, for example: “I am not good enough”; “I did not do enough”; “I am always failing because…”; etc. These beliefs are endless due to the subjective nature of everyone’s existence.
As I discussed the importance of journaling in earlier entries, I have added some prompts below as examples to help not only identify what is bothering you, but also some ideas to help alleviate symptomatic behavior. An example of this is below:
What is my professional limited belief?
Example: “I will never be given tenure.”
What is my personal limited belief?
Example: “My portfolio is less than my peers at this institution.”
What limited beliefs did my background teach me?
Example: “You are lazy, unorganized, and need better structure.”
Now, here is the rub. Unfortunately, we have all worked with someone or know someone who has personally felt this way. This identification, however, is particularly important because then, when you are with trusted friends, therapists, advisors, etc., they can help navigate the situation to find out what is affecting what and how.
The purpose of identifying these beliefs is not to tell ourselves that everything is positive or that the loss does not matter. Instead, it gives us an opportunity to examine what we are actually telling ourselves and determine whether those beliefs accurately describe the present situation.
Moving Towards Inspired Action
Now, I encourage you not only to find your “Inspired Truth,” but combine the statement with an “Inspired Action.” An example of this is below:
Inspired Truth #1: I may not be given tenure; however, this does not affect my worth, and this has been a toxic and unhealthy situation because (list 3–5 reasons). I choose to do the following inspired actions to release what is not mine to own, which include:
Inspired Truth #2: My portfolio is meeting the professional requirements; I have no reason to believe I won’t be given tenure. I choose to do the following inspired actions to take accountability and responsibility for my actions, so I do not self-sabotage myself:
Inspired Truth #3: My workplace has said this to me; however, due to institutionalized error, administrative sabotage, and toxic co-workers and students, I did the best I could. If this becomes a reality, I will take the inspired actions to help me cope by, etc.
This is just an example of what to do. As a health care provider, I can tell you already that you cannot stop the feelings from surging or stop the pain. However, I can assure you through 10 years of clinical experience that those who put themselves through this process come to the acknowledgment of what they can do differently instead of hyper-focusing on what they did not know in the beginning.
Breath and Meditation Tools
Another tool is the use of breath and meditation. Utilizing breath and rhythm within your inhale and exhale, as I have discussed in earlier articles, helps regulate the sympathetic nervous system. For example, you can say the following:
“I am accepting…”
“I am confronting the fear of…”
“I am letting go of…”
Each inhale is one of these affirmations, and each exhale is the negative. For example,
“I am accepting…”
“I was not given…”
“I am accepting that someone treated me badly because…”
“I am letting go of this person because they make me feel…”
“I am confronting my fear that people do not feel…”
There is an inherent, beautiful truth behind each limited belief that grief can cause, and finding this truth is what helps release the pain. The pain usually stems from the last idea, which is causation. Utilizing these forms of self-communication, combined with written mind-body experiences, incorporates the final form of grief that is so hard to let go of: “This was my fault.” However, by incorporating the truth that “I must let go that the past could have been any different,” we can help our sympathetic nervous system control the functions of fight, flight, or freeze, with the result, after much time, usually resulting in a learned lesson or decreased symptomatic behavior.
Healing Through Community
Finally, regarding community, which is what I have found personally and professionally to be the most difficult step, there is the challenge of sitting with oneself when the heart is beating too fast, the mind is running with thoughts of destruction, and all-too-well-documented symptoms of panic and anxiety take over. Accept that there is absolutely no cure for this, but that you need to sit quietly with this physical distress. However, as mentioned above, you can use the following tools: (1) mantras to help your physical distress; (2) a great deal of mind-body connection exercises; and (3) radically accepting that your past has happened and there’s nothing you can do to change it, but by taking inspired actions that “fill” your cup, you can independently move through any situation.
I would like to add some comments to the idea of community. The first is that if anyone tells you what you are physically feeling or emotionally experiencing is “letting others have control,” do not speak to them about your grief. You are setting yourself up for a perceived observation that “you are choosing to give away your power.” Feeling your feelings should be a priority, not a criticism.
Second, do not take unsolicited advice from others during this process. You are highly vulnerable, and to take any ideas from people who take advantage of your processing to give this advice is deflecting and telling you, “I do not want to hear about your pain.”
Finally, the “tough it up and suck it up” attitude is not from those who deserve your space and time. There is a toxic-positive affirmation for this: “We want to see you succeed out of this.” The reality is, they do not care if you succeed or not, and if you do, it is to make them look good in some way. Professionally, an example of this is: “You were fired for a good karmic reason.” Personally, it is the person saying, “I was hard on you because I knew you could handle it, and see, I was right.” And if some life-altering devastation has occurred, within a community, you are the problem for several other people’s problems, which leads into the idea of “flying monkeys,” which I will discuss in another writing.
When finding community, my professional advice is the following: Yes, we all have trauma, and we all live life. Therefore, having your own organized form of selective empathy and sympathy are going to be your tools for success. You will be able to clearly signal out who you can and cannot trust within a given situation.
We all need community during times of grief, and I am astounded by how others find community. It is one of the most important tools one can have for overcoming any type of grief. However, most of those I work with and am personally connected with have long journeys in creating, sustaining, trusting, and keeping community for extended periods of time.
So, I believe what my beloved grandmother, who was a Holocaust survivor, taught me: “To have three digits of your hand be family is to be blessed by God, to have five is to be anointed, and to have ten is to believe in the power of a miracle. I would rather have three and a good BLT.”
With all she had been through in her life, for her to make this statement, which included eating bacon as a Jewish Holocaust survivor, is truly profound. I feel this is the divine truth. She gave me a sign that regardless of her life, she still grieved many times, repeatedly. However, she never gave up on community. She had it until she died, knowing she was loved, at the age of 93.
So, I urge you to embrace grief as an old friend, a relationship you will evolve with that contains every human emotion and leave much with your seen and unseen divine teams. Once you start this balance, you will find a decrease in the shame and guilt. You will begin to understand that the odious and cryptic messages you receive during this process are a duality. Both truths exist at the same time, and it will help with the principle of radical acceptance throughout this journey.
A client I’ve worked with for two years, with TBI and spina bifida, remembered a most important lyric in their favorite musical by Stephen Sondheim: “Witches can be right, giants can be good, you decide what’s right, and you decide what’s good, just remember…no one is alone.”