Understanding Grief and Loss

Approved by the Cancer.Net Editorial Board, 06/2013

Listen to the Cancer.Net Podcast: Understanding Grief and Loss, adapted from this content

Key Messages:

  • Grief is a natural response to loss that occurs over time and involves a wide range of emotions, thoughts, and behaviors, as well as physical feelings.
  • Grief is often felt in waves that vary in intensity, and it may be described in stages or as tasks that a grieving person needs to work through.
  • How a person grieves depends on many factors that are specific to the individual and their relationship to the person who has died.

When a person loses someone close to them, it is natural to grieve. This process takes time and usually includes many different emotions and behaviors. Although grief often refers to an emotional response to the death of a loved one, people with cancer and their families may grieve other cancer-related losses, such as the loss of a breast, the loss of fertility, or the loss of independence.

The terms grief, mourning, and bereavement are often used interchangeably; however, they have slightly different meanings. Grief is a person’s emotional response to the experience of loss. Mourning is the outward expression of that grief, which may include cultural and religious customs surrounding death. Mourning is also defined as the process of adapting to life after a loss. Meanwhile, bereavement refers to the period of grief and mourning after a loss, such as the death of a loved one.

Common grief reactions

Reactions to loss, called grief reactions, vary widely from person to person and vary in the same person over time. Not every person has the same set of grief reactions, but common ones include difficult feelings, thoughts, physical sensations, and behaviors.

Feelings. People who have experienced loss may experience a range of feelings, including shock, numbness, sadness, denial, despair, anxiety, anger, guilt, loneliness, depression, helplessness, relief, and yearning. A grieving person may start crying after hearing a song or comment that makes them think of the person who has died. Or that person may cry for no apparent reason.

Thoughts. Common thought patterns include disbelief, confusion, disorientation, difficulty concentrating, preoccupation, and hallucinations (briefly thinking that you see or hear the deceased person).

Physical sensations. It is common for grief to cause physical sensations, such as tightness or heaviness in the chest or throat, nausea or an upset stomach, dizziness, headaches, physical numbness, muscle weakness or tension, and fatigue. It may also cause vulnerability to illness.

Behaviors. When a person is grieving, it may be difficult to fall asleep or stay asleep, and he or she may lose energy for enjoyable activities or lose interest in eating or interacting socially. A grieving person may also become more irritable or aggressive. Other common behaviors include restlessness, hyperactivity (excessive activity), and listlessness (lack of interest, energy, or spirit).

Religion and spirituality

Grief may also affect a person’s religious and spiritual beliefs. For instance, loss may cause a person to question his or her faith or view of the world, or it may strengthen the person’s faith by providing a new understanding of the meaning of life.

Experiencing grief

Each person experiences grief differently. Often, a person feels grief in waves or cycles, with periods of intense and painful feelings that come and go. People who are grieving may feel they are making progress but suddenly face overwhelming grief again. These renewed periods of grief may occur at significant dates, such as holidays or birthdays, or they may occur without reason. Over time, these periods of intense grieving typically become less frequent and less intense as the person adjusts to his or her loss.

 Tasks of mourning

Researchers have often described the grief process as a series of tasks that the grieving person may work through to resolve the grief. One model describes four tasks of mourning:

Task one. Accept the reality of the loss.

Task two. Experience the pain of grief.

Task three. Adjust to life without the person who died.

Task four. Withdraw emotional energy (from the person who has died) and focus on other people and activities.

Factors affecting grief

Throughout the stages of grief, the nature and intensity of grief reactions and the length of time a person grieves are affected by a variety of factors:

  • The nature of the person’s relationship with the deceased (For example, the intensity of grief over the death of a spouse or parent may be different than the intensity of grief over the death of a neighbor or coworker.)
  • The cause of death (For example, the grieving process may differ depending on whether the person died suddenly or was ill for an extended time.)
  • The age and gender of the person who is grieving
  • The life history of the person who is grieving, including previous experiences with loss
  • The personality and coping style of the person who is grieving
  • The support available from friends and family
  • The customs of the person who is grieving
  • The religious or spiritual beliefs of the person who is grieving

In addition, the grieving process is often more difficult and complicated when the person who is grieving has unresolved feelings toward or conflicts with the person who has died. People who are struggling with complicated grief may find it helpful to talk with a counselor, such as a clinical social worker, psychologist, or spiritual counselor.

Grief in different cultures

Although each person's grief is unique, the experience is shaped by his or her society and culture. Each culture has its own set of beliefs and rituals surrounding death and bereavement that affect how people experience and express grief. Funerals and memorial services help people who are grieving connect with their community and share their grief. However, the way a person expresses or experiences grief may be at odds with cultural expectations for bereavement. For example, someone who feels numbness or disbelief may not cry as might be expected at a funeral. Another person may experience a level of despair that feels out of step with cultural values or beliefs. It is important to allow people to grieve in ways that feel right to them. Learn more about grief within a cultural context.

More Information

Grief and Bereavement

Coping With Grief

Coping With Change After a Loss

Additional Resources

National Cancer Institute: Grief, Bereavement, and Coping With Loss

LIVESTRONG: Grief and Loss

CancerCare: Grief and Loss