Bereavement ( Due to the death of someone close to us ) Is the most severe stressor imaginable It is a time of overwhelming emotions. Can be profoundly painful and distressing. Brings a high risk of mental and physical health problems for a long time Normal reaction in every culture across the world. If ooccasionally aware in advance about someone's certain end of his/ her life then the experience of grieving partly begins before their death occurs. Despite these feelings it may be possible to plan ahead for this difficult time which Can help reduce the complications in the First hours and days of bereavement, and Later as you struggle to carry on. Can be comforting because you are able just to cope with the circumstances without the added pressure to “get yourself together” and sort things out

1. Compiled by Col Mukteshwar Prasad(Retd),
Mtech(IITD),CE(I),FIE(I),FIETE,FISLE,FInstOD,AMCSI
Contact -9007224278, e-mail –
muktesh_prasad@yahoo.co.in
for book ”Decoding Services Selection Board” and SSB
guidance and training at Shivnandani Edu and Defence
Academy
Five stages of grief

2. Bereavement Symptoms By Steve Bressert, Ph.D.
 Bereavement ( Due to the death of someone close to us )
 Is the most severe stressor imaginable
 It is a time of overwhelming emotions.
 Can be profoundly painful and distressing.
 Brings a high risk of mental and physical health problems for a long
time
 Normal reaction in every culture across the world.
 If ooccasionally aware in advance about someone's certain end of
his/ her life then the experience of grieving partly begins before their
death occurs.
 Despite these feelings it may be possible to plan ahead for this difficult
time which
 Can help reduce the complications in the
 First hours and days of bereavement, and
 Later as you struggle to carry on.
 Can be comforting because you are able just to cope with the
circumstances without the added pressure to “get yourself together”
and sort things out.
 Build a network of caring people. Family friends, neighbors,
colleagues and strangers in a self-help group who have “been there”
can give support.

3. Bereavement Symptoms By Steve Bressert, Ph.D.
 Look after yourself physically. Try to eat well and get plenty of rest in
spite of
 Difficulty getting to sleep,
 Disturbed sleep by vivid dreams and long periods of wakefulness.
 Losing your appetite,
 Feeling tense and short of breath, or
 Feeling drained and lethargic. Don’t try to do too much.
 Take time off work or at least delegating some of your workload to a
colleague.
 Gather information on the financial and legal aspects of bereavement in
advance, so you feel less overwhelmed.
 Prepare children by explaining the situation and how they are likely
to feel at the time of the death and afterward.
 Warn them if any practical arrangements are going to change.
 Think about solace provider /counselor in case something happens
 Emotionally they get used to the idea of the loss gradually, in fits and
starts.
 Helps one to get used to the reality of the death and work through
some of the pain.
 Let them imagine life after the loss, with the person in your thoughts
and memories.

4. Bereavement Symptoms By Steve Bressert, Ph.D.
 Prepare children by explaining the situation ….loss is different.
 Each culture has evolved their own process and system to reduce the
pain of loss of near and dear ones and also to allow some time period
for rituals to distract the individuals from pain.
 This also helps each person to develop own coping mechanism to
forget or reduce the torment feeling
 12 days Shradh ceremony in Hindus followed by Barkhi after 1 year
 Chautha in Sikhs and Punjabis
 Supurde Khak in Muslims
 Cremation and Church meetings in Christianity
 But if it lasts for a very significant period of time and significantly
impacts the person’s life the there is a need to be cautious check for
clinical depression
 Symptoms may be
 Feelings of sadness and associated symptoms such as
 Insomnia,
 Poor appetite
 Anorexia , and
 Weight loss are its indicator.

5. Bereavement Symptoms By Steve Bressert, Ph.D.
 Prepare children by explaining the situation
…Weight loss are its indicator.
 Certain symptoms as under may indicate major
depressive episode.
 Guilt about things other than actions taken or not
taken by the survivor at the time of the death;
 Thoughts of death other than the survivor feeling that
he or she would be better off dead or should have
died with the deceased person;
 Morbid preoccupation with worthlessness;
 Significant psychomotor retardation (e.g., it’s hard to
get moving, and what movements there are slow);
 Prolonged and serious functional impairment; and
 Hallucinatory experiences other than thinking-
Hearing of voice/ transiently image of, the deceased
person

9. Elisabeth Kübler-Ross’s five stages of grief after the loss of a loved one
 Elisabeth Kübler-Ross suggests that we go through five distinct
stages of grief after the loss of a loved one:
 Denial,
 Anger,
 Bargaining,
 Depression, and
 Acceptance.
 The first stage in this theory, denial can help us to minimize the
overwhelming pain of loss.
 As we process the reality of our loss, we are also trying to survive
emotional pain.
 It can take our minds some time to adjust to this new reality.
 Denial is not only an attempt to pretend that the loss does not exist
but also to try to absorb and understand what is happening.
 We are reflecting on experiences we have shared with the person
we lost, and we might find ourselves wondering how to move forward
in life without this person.
 This is a lot of information to explore and a lot of painful imagery to
process.

10. 1.DENIAL
 Denial is the first of the five stages of grief.
 Physical and mental status/effect of grief at 1st stage(Denial)
 World becomes meaningless and overwhelming.
 Life makes no sense.
 Are in a state of shock and denial.
 Tendency to go numb.
 Wonder how we can go on, if we can go on, why we should go on.
 We try to find a way to simply get through each day.
 How does Denial help us to cope with grief
 There is a grace in denial
 It helps us to survive the loss.
 Denial and shock help us to cope and make survival possible.
 Denial helps us to pace our feelings of grief. .
 It is nature’s way of letting in only as much as we can handle.
 As you accept the reality of the loss and start to ask yourself
questions, you are unknowingly beginning the healing process.
 You are becoming stronger, and the denial is beginning to fade.
 But as you proceed, all the feelings you were denying begin to
surface.

11. 2. ANGER
 Anger is a necessary stage of the healing process.
 At first grief feels like being lost at sea: no connection to anything.
 There are many other emotions under the anger and you will get to them in
time, but anger is the emotion we are most used to managing.
 We know more about suppressing anger than feeling it.
 The anger is just another indication of the intensity of your love.
 Then you get angry at someone,
 Maybe a person who didn’t attend the funeral,
 Maybe a person who isn’t around when you needed them
 Maybe a person who is different now that your loved one has died.
 May even be friends, the doctors, your family, yourself and your loved
one who died and even God.
 Suddenly you have a structure – – your anger toward them.
 The anger becomes a bridge over the open sea
 We must hold onto to anger, feel it and grief will start dissipating
,you will heal and will feel better
 Anger is strength and it can be an anchor, giving temporary structure to
the nothingness of loss.

12. 3.BARGAINING
 It is common to feel desperate when faced with loss of loved that one is
willing to do almost anything to alleviate or minimize the pain.
 Bargaining can come in a variety of promises including:
 "I promise to be better if you will let this person live."
 "God, if you can heal this person I will turn my life around."
 "I'll never get angry again if you can stop him/her from dying or leaving
me."
 When bargaining starts, we are often directing our requests to a higher
power, or something bigger than we are that may be able to influence a
different outcome.
 There is an acute awareness of our humanness when we realize there is
nothing we can do to influence change or a better outcome.
 This feeling of helplessness can cause us to react in protest by
bargaining, which gives us a perceived sense of control over something
that feels so out of control.

13. 3.BARGAINING….
 While bargaining we also tend to focus on our personal faults or regrets.
 We may note all of the times we felt disconnected or may have caused
them pain.
 May recall times when we may have said things we did not mean, and
wish we could go back and behave differently.
 We may also assume that if things had played out differently, we would not
be in such an emotionally painful place in our lives.
 Guilt is often bargaining’s companion. The “if onlys” cause us to find fault
in ourselves and what we “think” we could have done differently.
 We may even bargain with the pain.
 We will do anything not to feel the pain of this loss.
 We remain in the past, trying to negotiate our way out of the hurt.

14. 4.DEPRESSION
 This is inevitable for all people who experience a significant loss.
 This can be the hardest and longest-lasting stage, with the most physical
symptoms.
 In this stage, we have to work through painful memories and start
coping with the changes in our life resulting from the loss.
 During our experience of processing grief, there comes a time
 when our imaginations calm down and
 we slowly start to look at the reality of our present situation.
 Bargaining no longer feels like an option and we are faced with what is
happening.
 We tend to pull inward as the sadness grows.
 We might find ourselves retreating,
 being less sociable, and
 reaching out less to others about what we are going through. Although this
is a very natural stage of grief, dealing with depression after the loss of a
loved one can be extremely isolating.
 If grief is a process of healing, then depression is one of the many necessary
steps along the way.

15. 5.ACCEPTANCE
 This stage is about accepting the reality that our loved one is physically gone
and recognizing that this new reality is the permanent reality.
 It is not that we no longer feel the pain of loss and learn to live with it.
 But we are no longer resisting the reality of our situation, and we are not
struggling to make it something different.
 Sadness and regret can still be present in this phase,
 But the emotional survival tactics of denial, bargaining, and anger are less
likely to be present.
 We must learn to reorganize roles, re-assign them to others or take them on
ourselves.
 Finding acceptance may be just having more good days than bad ones.
 We can never replace what has been lost, but we can make new
connections, new meaningful relationships, new inter-dependencies.
 Instead of denying our feelings, we listen to our needs; we move, we change,
we grow, we evolve.
 We invest in our friendships and in our relationship with ourselves.
 We begin to live again, but we cannot do so until we have given grief its time.

16. Types of Grief
 People grieve differently and may or may not go through each of
these stages, or experience each of them in order.
 The lines of these stages are often blurred—we may move from
one stage to the other and possibly back again before fully
moving into a new stage.
 There is no specific time period suggested for any of these stages.
 Someone may experience the stages fairly quickly like weeks, where
another person may take months or even years to move through to a
place of acceptance.
 Whatever time it takes for you to move through these stages is
perfectly normal.
 Your pain is unique to you, your relationship to the person you lost is
unique, and the emotional processing can feel different to each person.

17. Additional Models
 Attachment Theory and Grief
 Legendary psychologist John Bowlby focused his work on researching
the emotional attachment between parent and child.
 Early experiences of attachment with important people in our lives,
such as caregivers, help to shape our sense of safety, security,
and connections.
 Colin Murray Parkes developed a model of grief based on Bowlby's
theory of attachment, suggesting there are four phases of mourning
when experiencing the loss of a loved one:
 Shock and Numbness. Loss in this phase feels impossible to accept.
 Most closely related to Kübler-Ross's stage of denial.
 We are overwhelmed when trying to cope with our emotions.
 He suggested that there is physical distress experienced in this
phase , which can lead to somatic (physical) symptoms.

18. Additional Models
 Yearning and Searching. We may begin to look for comfort to fill the void
our loved one has left.
 We may do so by reliving memories through pictures and by looking for
signs from the person to feel connected to them.
 We become very preoccupied with the person we have lost.
 Despair and Disorganization. We may find ourselves questioning and feeling
angry in this phase.
 The realization that our loved one is not returning feels real, and we can
have a difficult time understanding or finding hope in our future.
 We may feel a bit aimless in this phase and find that we retreat from others
as we process our pain.
 Reorganization and Recovery. As we move into this phase, our life feels more
hopeful.
 We may begin to feel like our hearts and minds can be restored.
 As with Kübler-Ross's acceptance stage, this phase of reorganization and
recovery does not mean that we will not still feel sadness or longing for our
loved one.
 This phase offers us a place of healing and reconnecting with important
people in our lives for support.

19. How to Help
 Avoid Rescuing or Fixing
 It can be so difficult to know what to say to someone who has
experienced loss.
 We do our best to offer comfort, but sometimes our best efforts can
feel inadequate and unhelpful.
 Remember is that the person who is grieving does not need to be
fixed.
 Avoid rescuing people from their pain .
 Avoid uplifting, hopeful comments or even try to offer them humor to
help ease their pain.
 Although the intention is positive, this approach can leave people
feeling as if their pain is not seen, heard, or valid.
 Don't Force It
 Don’t force people to talk about their pain when they are not ready.
 Don’t nudge them to talk and process their emotions
 It can actually be an obstacle to their healing.

20. How to Help
 Make Yourself Accessible
 One of the most helpful things we can do is to offer space for people to
grieve.
 In doing this, we are letting the person know that we are available
and accessible when they are ready to talk.
 We can invite them to talk with us, but remember to provide
understanding and validation if they are not ready to talk just yet.
 At that point, you can remind them that you are available when they
feel ready and not to hesitate to come to you.
 A Word From Verywell
 It is important to remember that everyone copes with loss differently.
 While you may find that you experience all five stages of grief, you may also
find that it is difficult to classify your feelings into any one of the stages.
 Have patience with yourself and your feelings in dealing with loss.
 Allow yourself time to process all of your emotions, and when you are ready to
speak about your experiences with loved ones or a healthcare professional, do
so.