Grief has been poetically described as ‘love wearing a heavy coat’, yet the reality of losing a loved one can be excruciating beyond what words alone can describe.
“In more than 22 years of nursing at all levels and across various healthcare facilities, I have learnt that grief wears many faces,” says Natalie Kubeka, general manager of Netcare Akeso Richards Bay. “I have sat with mothers mourning their children, with families adjusting after unexpected loss, and have watched and nursed individuals grieving relationships, health, identity and dreams. Grief is incredibly personal, yet universal, and none of us grieves in the same way,” she says.
Many have sought to define and understand grief. Foundational studies by Swiss-American psychiatrist Elisabeth Kübler-Ross include her theory of the five stages of grief, presented in On Death and Dying. The American Psychological Association notes that grief encompasses physiological distress, separation anxiety, confusion, yearning, obsessive dwelling on the past, and apprehension about the future.
“Some people can feel frozen in that moment of intense loss for the rest of their lives, while others may, after a time, reach a sense of acceptance and learn to live alongside their loss. Kübler-Ross’s grief model suggests that grief, which unfolds differently for everyone, happens in stages: denial, anger, bargaining, depression and acceptance, but does not always progress neatly or in chronological order,” Kubeka says.
Denial
Denial occurs when grief is so overwhelming that the person often feels shocked and in disbelief, experiences emotional numbness, and feels detached from accepting the reality of the situation.
“Time, support from family and friends, and a safe environment where emotions can be felt, expressed and worked through are beneficial at this stage of grieving. Grounding techniques such as deep breathing and maintaining basic routines help to keep the nervous system in a stable state during this raw emotional period,” she says.
Anger
In the stage of anger, the mind asks, ‘Why did this happen?’ Anger masks deeper emotions such as fear, sadness, guilt or powerlessness. These powerful feelings reflect just how much what has been lost mattered to the person.
Kubeka says the anger that accompanies grief should be validated without judgement, and the underlying feelings can then be identified and processed. “When supporting someone through this stage of mourning, it can be helpful to encourage healthy expression through talking, journalling, and creative activities.”
Bargaining
In this stage of grief, the mind attempts to regain control over the uncontrollable situation.
“This can be a time to address the unrealistic feelings of guilt that are often a natural part of the grieving process. Self-compassion is crucial for distinguishing guilt from regret and for exploring what has been learnt from the loss.”
To work through these complex emotions, Kubeka suggests writing two letters: one expressing the guilt and pain associated with your loss, and the second responding compassionately, as if writing to a loved one in your situation.
Depression
Life often feels empty after a significant loss. Feelings of deep sadness, withdrawal, low motivation, loneliness, and changes in sleep and appetite are commonly experienced during this stage of grieving.
“This is when most people fully realise the extent of their loss. It’s the stage that seems to last the longest and may sometimes require professional help, including psychotherapy and medication, to overcome,” Kubeka notes.
“If the person in mourning has persistent feelings of hopelessness, thoughts of self-harm, and an inability to participate in activities of daily living, these are signs of serious concern that the person needs professional mental health support,” she says.
Psychologists, psychiatrists, and allied practitioners practising at your nearest Netcare Akeso facility offer outpatient consultations as well as multidisciplinary treatment programmes. In the event of a psychological crisis, Netcare Akeso’s 24-hour crisis line is always open on 0861 435 787, where experienced counsellors are available to offer support at any time of the day or night.
Acceptance
Eventually, the loss becomes integrated into the person’s life. Memories are less overwhelmingly painful, and acceptance offers a way of living with the loss.
“This does not mean one forgets, or no longer misses the person. It does mean recognising the new reality and finding a new way forward. Healing does not mean leaving someone behind; it means carrying their love differently,” Kubeka explains.
“Grief affects different aspects of all of us, challenging our physical and mental health, relationships, spiritual beliefs and our sense of identity. The biggest lesson I have been blessed to learn is that we are each transformed by grief, but our willingness to face the loss determines whether we can achieve personal growth from this painful process,” she concludes.
