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'''Grief''' is a multi-[[facet]]ed [[response]] to [[Death|loss]], particularly to the loss of someone or something to which we have formed a bond. Although conventionally [[focused]] on the [[emotional]] [[response]] to loss, it also has [[physical]], [[cognitive]], [[behavioral]], social, and [[philosophical]] [[dimensions]]. Common to human [[experience]] is the death of a loved one, whether it be a [[friend]], [[family]], or other companion. While the terms are often used interchangeably, bereavement often refers to the [[state]] of loss, and grief to the [[reaction]] to loss.

'''Grief''' is a multi-[[facet]]ed [[response]] to [[Death|loss]], particularly to the loss of someone or something to which we have formed a bond. Although conventionally [[focused]] on the [[emotional]] [[response]] to loss, it also has [[physical]], [[cognitive]], [[behavioral]], social, and [[philosophical]] [[dimensions]]. Common to human [[experience]] is the death of a loved one, whether it be a [[friend]], [[family]], or other companion. While the terms are often used interchangeably, bereavement often refers to the [[state]] of loss, and grief to the [[reaction]] to loss.

Losses can range from loss of [[Work|employment]], pets, [[status]], a sense of [[Security|safety]], order, or possessions, to the loss of loved ones. Our [[response]] to loss is varied and [[researchers]] have moved away from [[convention]]al views of grief (that is, that people move through an orderly and [[predictable]] series of responses to loss) to one that considers the wide variety of responses that are influenced by [[personality]], [[family]], [[culture]], and [[spiritual]] and religious [[beliefs]] and [[practices]].

Losses can range from loss of [[Work|employment]], pets, [[status]], a sense of [[Security|safety]], order, or possessions, to the loss of loved ones. Our [[response]] to loss is varied and [[researchers]] have moved away from [[convention]]al views of grief (that is, that people move through an orderly and [[predictable]] series of responses to loss) to one that considers the wide variety of responses that are influenced by [[personality]], [[family]], [[culture]], and [[spiritual]] and religious [[beliefs]] and [[practices]].

 

Bereavement, while a [[normal]] part of life, carries a degree of [[risk]] when limited support is available. Severe reactions to loss may carry over into familial relations and cause trauma for [[children]], spouses and any other [[family]] members: there is an increased risk of marital breakup following the [[death]] of a child, for example. Issues of [[faith]] and [[beliefs]] may also face [[challenge]], as bereaved persons reassess personal definitions in the face of great [[pain]].

Bereavement, while a [[normal]] part of life, carries a degree of [[risk]] when limited support is available. Severe reactions to loss may carry over into familial relations and cause trauma for [[children]], spouses and any other [[family]] members: there is an increased risk of marital breakup following the [[death]] of a child, for example. Issues of [[faith]] and [[beliefs]] may also face [[challenge]], as bereaved persons reassess personal definitions in the face of great [[pain]].

While many who grieve are able to work through their loss independently, accessing additional support from [[professional]] psychiatrists or therapy may promote the [[process]] of [[healing]]. Grief counseling, professional support groups or educational classes, and peer-led support groups are primary resources available to the bereaved. In the United States, local hospice agencies may be an important first contact for those seeking bereavement support.

While many who grieve are able to work through their loss independently, accessing additional support from [[professional]] psychiatrists or therapy may promote the [[process]] of [[healing]]. Grief counseling, professional support groups or educational classes, and peer-led support groups are primary resources available to the bereaved. In the United States, local hospice agencies may be an important first contact for those seeking bereavement support.

==Stage theories and processes==

==Stage theories and processes==

[http://en.wikipedia.org/wiki/Elisabeth_Kübler-Ross Dr. Elisabeth Kübler-Ross] posited sequential stages of grief including denial, [[anger]], bargaining, [[depression]], and [[acceptance]], which are commonly referred to as the "grief cycle."

[https://en.wikipedia.org/wiki/Elisabeth_Kübler-Ross Dr. Elisabeth Kübler-Ross] posited sequential stages of grief including denial, [[anger]], bargaining, [[depression]], and [[acceptance]], which are commonly referred to as the "grief cycle."

The stages model, which came about in the [http://en.wikipedia.org/wiki/60%27s 1960]s, is [[theoretical]], based on [[observation]] of people who are dying, not on [[scientific]] [[research]] into the [[experiences]] of people who have survived the death of a loved one. This [[model]] has largely been debunked because of the rigorous work of bereavement research pioneer, George Bonanno.

The stages model, which came about in the [https://en.wikipedia.org/wiki/60%27s 1960]s, is [[theoretical]], based on [[observation]] of people who are dying, not on [[scientific]] [[research]] into the [[experiences]] of people who have survived the death of a loved one. This [[model]] has largely been debunked because of the rigorous work of bereavement research pioneer, George Bonanno.

In 1991, Bonanno began studying grief for the first time using rigorous, peer-reviewed scientific [[techniques]]. Until then, the field of grief was largely based on theoretical models, such as the stages model, or that of John Bowlby and Parkes, or [[Sigmund Freud]]. Bonanno's [1] many studies followed people over time who have suffered a loss: such as death of a child, a spouse, or a loved one. In none of his many studies did he find [[evidence]] that the stages exist. In large part due to his work, the stages model is now considered invalid scientifically but it remains a popular [[idea]] among the [[public]].[2]

In 1991, Bonanno began studying grief for the first time using rigorous, peer-reviewed scientific [[techniques]]. Until then, the field of grief was largely based on theoretical models, such as the stages model, or that of John Bowlby and Parkes, or [[Sigmund Freud]]. Bonanno's [1] many studies followed people over time who have suffered a loss: such as death of a child, a spouse, or a loved one. In none of his many studies did he find [[evidence]] that the stages exist. In large part due to his work, the stages model is now considered invalid scientifically but it remains a popular [[idea]] among the [[public]].[2]

Adolescents may respond by delinquency, or oppositely become 'over-achievers': repetitive [[actions]] are not uncommon such as washing a car repeatedly or taking up repetitive tasks such as sewing, computer games, etc. It is an effort to stay 'above' the grief. Childhood loss as mentioned before can predispose a child not only to [[physical]] illness but to [[emotional]] problems and an increased risk for suicide, especially in the adolescent period.

Adolescents may respond by delinquency, or oppositely become 'over-achievers': repetitive [[actions]] are not uncommon such as washing a car repeatedly or taking up repetitive tasks such as sewing, computer games, etc. It is an effort to stay 'above' the grief. Childhood loss as mentioned before can predispose a child not only to [[physical]] illness but to [[emotional]] problems and an increased risk for suicide, especially in the adolescent period.

==Death of a child==

==Death of a child==

Death of a child can take the form of a loss in infancy such as miscarriage, stillbirth or neonatal death, SIDS, or the death of an older child.[8] In all cases, parents find the grief almost unbearably devastating, and while [[persons]] may rate the death of a [[spouse]] as first in traumatic life events, the death of a child is still perhaps one of the most intense forms of grief, holding greater risk factors.

Death of a child can take the form of a loss in infancy such as miscarriage, stillbirth or neonatal death, SIDS, or the death of an older child.[8] In all cases, parents find the grief almost unbearably devastating, and while [[persons]] may rate the death of a spouse as first in traumatic life events, the death of a child is still perhaps one of the most intense forms of grief, holding greater risk factors.

This loss also bears a lifelong [[process]]: one does not get 'over' the loss but instead must assimilate and live with the [[death]].[9] Intervention and comforting support can make all the difference to the survival of a parent in this type of grief but the risk factors are great and may include [[family]] breakup or suicide.

This loss also bears a lifelong [[process]]: one does not get 'over' the loss but instead must assimilate and live with the [[death]].[9] Intervention and comforting support can make all the difference to the survival of a parent in this type of grief but the risk factors are great and may include [[family]] breakup or suicide.

Feelings of [[guilt]], whether legitimate or not, are pervasive, and the dependent [[nature]] of the [[relationship]] disposes [[parents]] to a variety of problems as they seek to cope with this great loss. Parents who suffer miscarriage or abortion may experience resentment towards others who experience successful pregnancies.

Feelings of [[guilt]], whether legitimate or not, are pervasive, and the dependent [[nature]] of the [[relationship]] disposes [[parents]] to a variety of problems as they seek to cope with this great loss. Parents who suffer miscarriage or abortion may experience resentment towards others who experience successful pregnancies.

==Death of a spouse==

==Death of a spouse==

Although the death of a spouse may be an expected [[change]], it is a particularly [[power]]ful loss of a loved-one. A spouse often becomes part of the other in a [[unique]] way: many widows and widowers describe losing 'half' of themselves. After a long [[marriage]], at older ages, the elderly may find it a very difficult assimilation to begin anew.

Although the death of a spouse may be an expected [[change]], it is a particularly [[power]]ful loss of a loved-one. A spouse often becomes part of the other in a [[unique]] way: many widows and widowers describe losing 'half' of themselves. After a long [[marriage]], at older ages, the elderly may find it a very difficult assimilation to begin anew.

Different cultures grieve in [[different]] ways, but all have ways that are vital in healthy coping with the [[death]] of a loved one.[10]

Different cultures grieve in [[different]] ways, but all have ways that are vital in healthy coping with the [[death]] of a loved one.[10]

==Notes==

==Notes==

# http://www.tc.columbia.edu/faculty/index.htm?facid=gab38 George A. Bonanno's Columbia University Faculty Website

# https://www.tc.columbia.edu/faculty/index.htm?facid=gab38 George A. Bonanno's Columbia University Faculty Website

# http://www.perseusbooksgroup.com/basic/book_detail.jsp?isbn=0465013600 "The Other Side of Sadness: What the New Science of Bereavement Tells us About Life After the Loss"

# https://www.perseusbooksgroup.com/basic/book_detail.jsp?isbn=0465013600 "The Other Side of Sadness: What the New Science of Bereavement Tells us About Life After the Loss"

# http://www.grief.net/Articles/Myth%20of%20Stages.pdf

# https://www.grief.net/Articles/Myth%20of%20Stages.pdf

# O'Connor MF, Irwin MR, Wellisch DK. (2009). "When grief heats up: Pro-inflammatory cytokines predict regional brain activation", Neuroimage, 47: 891–896PMID 19481155 doi:10.1016/j.neuroimage.2009.05.049

# O'Connor MF, Irwin MR, Wellisch DK. (2009). "When grief heats up: Pro-inflammatory cytokines predict regional brain activation", Neuroimage, 47: 891–896PMID 19481155 doi:10.1016/j.neuroimage.2009.05.049

# Freed PJ, Yanagihara TK, Hirsch J, Mann JJ. (2009). Neural mechanisms of grief regulation. Biol Psychiatry. 66(1):33-40. PMID 19249748

# Freed PJ, Yanagihara TK, Hirsch J, Mann JJ. (2009). Neural mechanisms of grief regulation. Biol Psychiatry. 66(1):33-40. PMID 19249748