Grieving Non-Death Losses

On breakups, coming out, addiction, and living family

From: https://tinyurl.com/griefpostoninstagram

Grief is a multifaceted emotional response to loss, encompassing a wide range of feelings and behaviours that vary greatly among individuals. It is often associated with bereavement, the period of mourning and adjustment following the death of a loved one. However, grief can also arise from non-death losses such as breakups, identity transitions, addiction recovery, and changes in family dynamics. Loss refers to the emptiness and sadness experienced when someone or something of significance is no longer present, while mourning involves the cultural and social rituals that individuals engage in to express grief and facilitate healing (Worden, 2018).

I invite you to dive into your own understanding of grief related to non-death losses using the widely known Stages of Grief model developed by Elisabeth Kübler-Ross (1969). This article will critically examine the five stages of grief — denial, anger, bargaining, depression, and acceptance — and apply them to non-death losses through brief case scenarios. Although the model has limitations, it provides a useful framework for understanding the complex emotions involved in various types of non-death losses and mitigating disenfranchised grief.

The Five Stages of Grief

Denial

Denial is the first stage of grief, characterized by an inability or refusal to accept reality. It serves as a defense mechanism, allowing individuals to process their emotions gradually. In this stage, a person may feel numb or in shock, unable to comprehend the magnitude of their loss.

Anger

Anger is the second stage, where the individual recognizes the loss but feels frustrated and helpless. Anger can be directed at oneself, others, or the situation itself, and it is often a mask for deeper feelings of pain and insecurity.

Bargaining

Bargaining is the third stage, involving attempts to negotiate or change the situation. Individuals may dwell on “what if” scenarios, hoping to alter the outcome. This stage is often characterized by a search for meaning or attempts to regain control.

Depression

Depression is the fourth stage and involves deep sadness and despair. It reflects the individual’s awareness of the loss and its impact on their life. During this stage, individuals may withdraw from others and experience feelings of hopelessness and isolation.

Acceptance

Acceptance is the final stage, where the individual comes to terms with the loss. It does not mean happiness or total resolution but rather a recognition of the new reality and the ability to move forward. Acceptance allows for emotional adjustment and the beginning of healing.

Critique of the Five-Stage Model

The five-stage model of grief, initially developed by Kübler-Ross (1969) to describe the emotional processes of terminally ill patients, has since been applied to various forms of loss. However, this model has been critiqued for several reasons. One major criticism is its lack of empirical support and oversimplification of the grieving process (Stroebe et al., 2017). The notion that grief unfolds in a linear and predictable sequence does not account for the diverse and fluctuating nature of individual experiences (Neimeyer, 2000).

Furthermore, the model implies that all individuals must go through these stages to heal, which can lead to misunderstandings about the normalcy of grief reactions (Bonanno & Boerner, 2007). It may also foster unrealistic expectations about how one “should” grieve, potentially leading to feelings of inadequacy or failure among those who do not conform to the model (Silver & Wortman, 2007). Instead, more recent grief theories emphasize the variability and individuality of grief, recognizing that it is not a one-size-fits-all process (Worden, 2018).

Despite the critiques of the five-stage model, it can still offer valuable insights when applied flexibly and non-linearly to non-death losses. By understanding the stages as potential experiences rather than a strict sequence, individuals can gain awareness of their emotions and navigate their grief more effectively. This approach can help mitigate disenfranchised grief by validating the complex feelings associated with non-death losses.

Disenfranchised Grief

Disenfranchised grief refers to grief that is not socially recognized or validated. It occurs when the loss is not acknowledged by societal norms, resulting in a lack of support for the grieving individual (Doka, 2002). Disenfranchised grief can occur in situations such as non-death losses, where the emotional pain experienced is often minimized or dismissed. This lack of recognition can exacerbate feelings of isolation and hinder the grieving process, making it difficult for individuals to find closure and healing (Doka, 2002).

Applying the Five Stages of Grief to Non-Death Losses

Let’s consider the following forms of loss that are often relegated to the realm of disenfranchised grief.

1. Breakups
2. Considering Coming Out
3. Addiction Recovery
4. Relationships with Living Family

1) Breakups

Breakups often involve the loss of a deeply intimate and emotionally invested relationship. Romantic partnerships can form a central part of an individual’s identity and future plans, and their dissolution can trigger profound emotional distress. Breakups can lead to feelings of rejection, loneliness, and uncertainty about the future. The grieving process may be complicated by the loss of shared social connections, routines, and a sense of belonging. The end of a romantic relationship can also challenge one’s self-esteem and personal identity, as individuals may question their worthiness and attractiveness (Parkes, 1996).

Breakups can lead to disenfranchised grief when the emotional pain experienced is not acknowledged or validated by others. Society often views breakups as a common life event that one should quickly move past, leading to a lack of support for individuals experiencing this type of loss. People grieving a breakup may feel isolated in their emotions, as they might not receive the same empathy or understanding as someone mourning a death. This lack of recognition can exacerbate feelings of loneliness and make it challenging for individuals to process their grief, potentially leading to prolonged emotional suffering (Doka, 2002).

Case Scenario:Mei-Lin, a 28-year-old woman, recently ended a long-term relationship. Her partner, Li Wei, was her college sweetheart. Their relationship was deeply intertwined with their families, and the breakup left her feeling as though she lost more than just a romantic partner.

Denial: Mei-Lin struggles to believe that her relationship with Li Wei is over. She continues to check her phone, expecting messages from him, and finds herself talking about him as if they are still together. She avoids removing his belongings from her apartment, holding on to the hope that they will reconcile. This stage provides Mei-Lin with a temporary escape from the painful reality of her breakup, allowing her to process her emotions at a manageable pace.

Automatic Thoughts:

• How could he give up on us so easily?
• I wasted years on someone who doesn’t care.
• I deserve better than this.

Anger: Mei-Lin becomes increasingly angry at Li Wei for abandoning their relationship. She feels betrayed and blames him for not trying harder to make things work. Her anger extends to herself, questioning her worth and what she could have done differently. This anger is an outlet for her frustration and masks her deeper feelings of hurt and vulnerability.

Automatic Thoughts:

• How could he give up on us so easily?
• I wasted years on someone who doesn’t care.
• I deserve better than this.

Bargaining: Mei-Lin begins to bargain with herself, thinking of ways she could win Li Wei back. She contemplates reaching out to him to rekindle their relationship, promising herself that she will change or compromise on issues that once seemed non-negotiable. Her bargaining reflects a desperate attempt to regain control over a situation that feels out of her hands.

Automatic Thoughts:

• If I change, maybe he’ll come back.
• We could have been happy if I had only agreed to move.
• I’ll do anything to fix this.

Depression: As reality sinks in, Mei-Lin becomes engulfed in sadness and hopelessness. She feels a profound sense of loss, mourning not just the relationship but also the future she envisioned with Li Wei. She isolates herself from friends and family, unable to find joy in activities she once loved. This stage represents the depths of her grief as she confronts the full impact of her breakup.

Automatic Thoughts:

• I can’t imagine a future without him.
• I’m going to be alone forever.
• Nothing feels worth doing anymore.

Acceptance: Gradually, Mei-Lin begins to accept that her relationship with Li Wei is over. She starts focusing on herself, rediscovering her interests and aspirations. While the pain of loss lingers, she embraces the possibility of new beginnings and personal growth. Acceptance allows her to acknowledge her emotions without being consumed by them and to open herself to new opportunities.

Automatic Thoughts:

• I can move forward and create a fulfilling life.
• This is a chance to focus on myself and my goals.
• The memories will always be there, but I’m ready to let go.

2) Considering Coming Out

The process of coming out is about revealing one’s true identity and sexual orientation to family, friends, and society. This can be a deeply personal and vulnerable experience, particularly for individuals raised in conservative or unsupportive environments. The fear of rejection, discrimination, or loss of relationships makes coming out a critical life event that impacts one’s self-acceptance and mental well-being. Successfully coming out can potentially lead to a sense of liberation and authenticity.

Considering coming out can result in disenfranchised grief when the emotional complexities and potential losses involved are not recognized. Society may fail to understand the internal struggle and fear associated with coming out, leading to a lack of support or empathy for those navigating this process. Individuals may grieve the potential loss of familial acceptance or social connections, yet feel unable to express these emotions due to societal expectations or stigma. This lack of acknowledgment can make it difficult for individuals to fully process their grief, impacting their ability to embrace their identity and find acceptance (Doka, 2002).

Case Scenario:Raj, a 22-year-old man, is grappling with his sexual orientation. Raised in a conservative family, he fears rejection and disappointment if he reveals his true self. Raj is at a crossroads, struggling with the decision to come out to his family and friends.

Denial: Raj convinces himself that he can continue living a double life, hiding his sexual orientation from his family. He throws himself into work and avoids situations where his identity might be questioned. Denial serves as a temporary shield against the fear of rejection and the potential loss of familial ties.

Automatic Thoughts:

• I can keep this a secret forever.
• Maybe these feelings will go away.
• I don’t have to deal with this now.

Anger: Raj’s denial eventually gives way to anger. He resents the societal norms and family expectations that force him to hide his true self. His anger is also directed inward, feeling frustrated for not having the courage to be honest. This stage reflects his internal struggle and the unfairness of his situation.

Automatic Thoughts:

• Why can’t they accept me for who I am?
• I hate having to pretend all the time.
• I wish I were different.

Bargaining: In the bargaining stage, Raj considers ways to manage his identity without coming out fully. He thinks about starting a relationship in secret or educating his family about LGBTQ+ issues gradually. Bargaining represents his attempt to mitigate the risks of coming out while hoping for eventual acceptance.

Automatic Thoughts:

• If I educate them, maybe they’ll understand.
• I can wait until they’re ready to hear it.
• If I find the right time, it will be easier.

Depression: Raj feels trapped in a cycle of fear and loneliness. The thought of never being able to live authentically weighs heavily on him, leading to feelings of sadness and hopelessness. He withdraws from social interactions, fearing judgment and misunderstanding.

Automatic Thoughts:

• I’ll never be able to live my life freely.
• I’m always going to be alone in this.
• No one will ever understand me.

Acceptance: Over time, Raj begins to accept his identity and the importance of living authentically. He realizes that hiding his true self is unsustainable and that he deserves to be happy and accepted for who he is. Acceptance empowers him to take steps toward coming out, regardless of the outcome, and to prioritize his well-being.

Automatic Thoughts:

• I deserve to be loved for who I truly am.
• Living authentically is worth the risk.
• I can find support and community.

3) Addiction Recovery

Addiction recovery — whether toward abstinence or significantly reduced consumption — is a challenging process of breaking free from substance dependence and re-organizing one’s life. “Recovery” (however defined by the individual) requires them to confront the impact of using on their health, relationships, and self-worth. It often involves significant lifestyle changes and the loss of familiar coping mechanisms. While recovery is a positive and necessary step toward health and well-being, it is also accompanied by grief over the loss of the addictive substance and the identity associated with addiction.

Addiction recovery is ripe with disenfranchised grief when the emotional pain and loss involved are not widely acknowledged. Society often stigmatizes addiction, focusing on the negative aspects rather than the individual’s effort to recover. People in recovery may feel unsupported or misunderstood, as the focus tends to be on the positive outcome rather than the grieving process associated with letting go of addiction. This lack of recognition can hinder emotional healing and make it difficult for individuals to fully embrace their new identity in recovery (Doka, 2002).

Case Scenario:Aisha, a 35-year-old woman, is in recovery from alcohol addiction. She is navigating the complexities of rebuilding her life, mending relationships, and managing the cravings and triggers that threaten her sobriety.

Denial: In the early stages of recovery, Aisha grapples with denial about the severity of her addiction. She tells herself that she can still enjoy alcohol in moderation and underestimates the impact it has had on her life and relationships. This denial serves as a barrier to acknowledging the necessity of change.

Automatic Thoughts:

• I can handle just one drink.
• I’m not as bad as others think.
• I can quit whenever I want.

Anger: As denial fades, Aisha becomes angry at herself for her past actions and the consequences of her addiction. She also feels resentment toward the addiction itself, blaming it for her lost opportunities and strained relationships. This anger fuels her determination to stay sober but also reveals underlying feelings of guilt and regret.

Automatic Thoughts:

• Why did I let it get this far?
• It’s unfair that I have to deal with this.
• I hate what addiction has done to my life.

Bargaining: During bargaining, Aisha considers ways to regain control without fully committing to recovery. She tells herself that occasional drinking won’t hurt or that she can quit once she reaches certain milestones. This stage reflects her struggle to let go of old habits and embrace the changes necessary for long-term sobriety.

Automatic Thoughts:

• I’ll quit for good after this one last time.
• I can reward myself with a drink if I meet my goals.
• Maybe I don’t have to give it up completely.

Depression: Aisha experiences profound sadness as she confronts the reality of her addiction and its impact. She mourns the time lost and opportunities missed, feeling overwhelmed by the challenges ahead. Depression in this stage is marked by self-reflection and a deep awareness of the need for change.

Automatic Thoughts:

• I’ve wasted so much of my life.
• I’ll never make things right.
• This is too hard; I don’t know if I can do it.

Acceptance: Acceptance comes as Aisha begins to embrace her recovery journey. She acknowledges the importance of sobriety and focuses on building a healthier, more fulfilling life. Acceptance allows her to let go of past mistakes and to approach recovery with renewed commitment and hope.

Automatic Thoughts:

• I am capable of living a sober life.
• Recovery is a lifelong journey, and that’s okay.
• I have the strength to overcome this.

4) Relationships with Living Family

Relationships with living family often form a foundational aspect of an individual’s support system and identity. These relationships are often expected to be a source of love, understanding, and acceptance. However, when family dynamics are strained or dysfunctional, individuals may experience grief over the lack of emotional connection, unmet expectations, or unresolved conflicts. This can lead to disappointment, sadness, and longing for the ideal family relationship.

Grief related to living family relationships can be disenfranchised when the emotional pain and loss are not acknowledged or validated. Society often expects individuals to prioritize and maintain family ties, regardless of the quality of those relationships. This can lead to a lack of understanding and support for those grieving the absence of a healthy family dynamic. People may feel isolated in their emotions, as their grief is not seen as legitimate or worthy of attention. This lack of recognition can prevent individuals from fully processing their grief and hinder their ability to establish healthy boundaries and seek fulfillment outside of family relationships (Doka, 2002).

Case Scenario:Fatima, a 40-year-old woman, is dealing with complicated relationships within her family. Her interactions with her parents and siblings are often strained, marked by misunderstandings and unmet expectations. Fatima is trying to find peace and acceptance within these dynamics.

Denial: Fatima initially denies the depth of her family’s dysfunction, convincing herself that things will improve with time. She makes excuses for hurtful behaviour and avoids confronting the issues that strain their relationships. Denial provides temporary comfort by shielding her from the pain of acknowledging reality.

Automatic Thoughts:

• We’re just going through a rough patch.
• They don’t mean what they say.
• It will get better if I just give it time.

Anger: Fatima becomes frustrated with her family’s constant criticism and lack of support. She feels angry at their inability to see her perspective and at herself for allowing their opinions to affect her self-esteem. This anger reflects her struggle for autonomy and recognition within her family.

Automatic Thoughts:

• Why can’t they accept me for who I am?
• I’m tired of feeling like a disappointment.
• They have no right to judge me.

Bargaining: In the bargaining stage, Fatima tries to improve family dynamics by altering her behaviour to gain their approval. She hopes that if she meets their expectations, their relationships will improve. This stage reveals her desire for connection and acceptance despite past conflicts.

Automatic Thoughts:

• If I make them proud, maybe they’ll accept me.
• I’ll try harder to be what they want.
• Spending less time with them might ease the tension.

Depression: Fatima experiences sadness as she acknowledges that her family relationships may never meet her expectations. She grieves the lack of understanding and support, feeling isolated and disconnected. This stage represents her acceptance of the limitations within her family and the emotional toll it takes on her.

Automatic Thoughts:

• We’ll never truly understand each other.
• I’m always going to feel alone in this family.
• I wish things could be different.

Acceptance: Acceptance allows Fatima to find peace within herself, recognizing that she may need to set boundaries to protect her well-being. She embraces the relationships that bring her joy and focuses on building a supportive network outside her family. Acceptance empowers her to seek fulfillment beyond familial expectations.

Automatic Thoughts:

• I have the right to create my own path.
• I can choose to surround myself with positive influences.
• It’s okay to prioritize my happiness.

Value of Applying the Stage Model in Non-Linear Ways

The value of applying the stage model to non-death losses lies in its ability to provide a structured framework for individuals to explore and understand their emotions. When used non-linearly, the model can offer insight into the complexities of grief without imposing rigid expectations (Stroebe et al., 2017). By recognizing that individuals may experience the stages in different orders or revisit certain stages, the model can help validate the diverse experiences of grief and mitigate disenfranchised grief (Worden, 2018).

Using the stages as a tool for reflection rather than a prescriptive path allows individuals to identify and articulate their feelings, leading to greater self-awareness and emotional processing. This approach fosters empathy and understanding, encouraging individuals to embrace their unique grieving process while seeking support and connection (Neimeyer, 2000).

The Role of Cognitive Behavioral Therapy (CBT) in Addressing Automatic Thoughts

Cognitive Behavioral Therapy (CBT) is a valuable approach for addressing the automatic thoughts that arise during grief. Automatic thoughts are spontaneous and often irrational beliefs that can negatively impact emotions and behavior (Beck, 2011). By identifying and challenging these thoughts, individuals can develop more balanced and constructive ways of thinking (Beck, 2011).

In the context of grief, using CBT to address automatic thoughts can help individuals reframe their perspectives and find alternative interpretations of their experiences. For example, CBT techniques can guide individuals to recognize distortions in their thinking, such as catastrophizing or personalization, and replace them with more realistic and adaptive thoughts (Beck, 2011).

By promoting cognitive flexibility and emotional resilience, CBT can support individuals in navigating the complexities of grief, facilitating healing and growth (Beck, 2011). This approach empowers individuals to take an active role in their emotional well-being, fostering a sense of agency and hope in the face of loss.

Conclusion

The Five Stages of Grief model provides a framework for understanding the complex emotions associated with non-death losses. By exploring case scenarios involving breakups, considering coming out, addiction recovery, and family dynamics, we gain insight into the nuanced experiences of grief beyond death. While the stages offer a way to navigate these challenging transitions, it is essential to approach each individual’s journey with empathy and flexibility, recognizing the diversity of grief experiences.

References

Beck, J. S. (2011). Cognitive behavior therapy: Basics and beyond (2nd ed.). Guilford Press.

Bonanno, G. A., & Boerner, K. (2007). The stages of grief and bereavement: A critical evaluation. Omega: Journal of Death and Dying, 74(4), 455–473. https://doi.org/10.1177/0030222817691870

Doka, K. J. (2002). Disenfranchised grief: New directions, challenges, and strategies for practice. Research Press.

Kübler-Ross, E. (1969). On death and dying. Macmillan.

Neimeyer, R. A. (2000). Searching for the meaning of meaning: Grief therapy and the process of reconstruction. Death Studies, 24(6), 541–558. https://doi.org/10.1080/07481180050121480

Parkes, C. M. (1996). Bereavement: Studies of grief in adult life (3rd ed.). Routledge.

Silver, R. L., & Wortman, C. B. (2007). The myths of coping with loss. Journal of Social Issues, 44(2), 97–109. https://doi.org/10.1111/j.1540-4560.1988.tb02083.x

Stroebe, M., Schut, H., & Boerner, K. (2017). Cautioning health-care professionals: Bereaved persons are misguided through the stages of grief. OMEGA — Journal of Death and Dying, 74(4), 455–473. https://doi.org/10.1177/0030222817691870

Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner (5th ed.). Springer Publishing Company.

This essay was first published on Medium on August 1, 2024.