An Introduction to Grief and Loss

Grief is a broad term used to describe reactions to loss. It encompasses thoughts, feelings, behaviours, and physical symptoms that are more or less commonly experienced by people affected by a significant loss. Although there are many common features of grief, it is important to remember that it is a highly individual experience – no two people will experience a loss and grieve in the same way. In other words:

Before we go any further, it is important to define a few key terms. There are many types of losses that people can experience over their lifespan that may result in a grief response (we will be exploring these shortly). The term grief reaction or grief response is often used to refer to grief experiences relating to any type of loss. The term bereavement specifically refers to the experience of having lost a loved one to death, while mourning refers to the different cultural and religious practices through which bereavement is expressed (e.g., in Western culture it is common to have a funeral, wear black clothing, and sadly contemplate the deceased).

Grief is complex and multi-faceted. A person’s individual experience and expression of grief is influenced not only by the nature of the loss but also by personal characteristics such as personality and the social and cultural context in which the person is living. You will learn more about these factors and their influence on the grieving process later in this module.

Types of Loss

Grief and loss are often associated with people who have been affected by the death of a person close to them (i.e., bereavement), and you will meet clients who have experienced such losses. However, clients are more likely to present with many other types of losses. Humphrey and Zimpfer (2008) identify the following categories of loss: relationship loss; loss of some aspect of self; developmental loss; and loss of treasured objects. (Although you may be able to think of other kinds of loss, too!) We will discuss these briefly now and, as you work through this unit, try to identify these and other types of loss in the issues and cases we present.

Relationship Loss

This may occur through the death of a loved one (e.g., through illness, accidental, or violent death) or the breakdown of a relationship (through divorce, illness, abuse, distance, etc.)

Loss of Some Aspects of Self

This may occur as a result of a relationship loss. For example, a woman may lose her role as a wife through the death of her spouse. However, any situation that involves a significant change to one’s sense of self, such as illness, disability, physical changes, sexual assault, physical assault, domestic and family violence, and more may result in grief (Humphrey and Zimpfer, 2008)

A loss of dreams or hopes may also be included in this category. For example, parents of children with special needs may have to adjust to a different future than the one that they had envisioned for their child and themselves. Consider the various types of losses that the carer below has experienced as a result of his son’s accident.

Circumstantial or life-changing events, such as those described above, tend to take place over a relatively short period of time with little or no opportunity for preparation and tend to involve permanent, long-lasting consequences. They also tend to require significant adjustment to a person’s beliefs or assumptions about the world (Parkes, 1993, cited in Machin, 2009). They may be individual or can affect families or even whole communities. For example, at times of war, significant losses including loss of homes, loved ones, and injury and disability are experienced across entire communities. Refugees and migrants, in particular, may face significant losses including their family, home, and identity.

Developmental Losses

Another less visible and obvious source of grief includes those losses that arise from developmental change across the lifespan.

Loss of Treasured Objects

Although objects are considered by most as replaceable and unimportant, the symbolic significance or memories that may be attached to them means that their loss can be deeply upsetting. For example, family heirlooms represent an irreplaceable link to the past for many people and, if lost through theft or fire, can result in powerful feelings of loss that may go unacknowledged.

Understanding Different Types of Loss

^{(Adapted from Humphrey & Zimpfer, 2008, p. 12)}

Understanding different types of loss provides a framework that encourages counsellors to assess and consider various losses, both past and present, and to acknowledge the full significance and meaning of these to the client (Humphrey & Zimpfer, 2008). This can be missed when we focus solely on bereavement.

It is also important to understand that losses do not occur in isolation. People typically experience a number of losses throughout their lives, and, in some cases, these loss experiences can build on each other. For example, consider the history of loss of the following client:

This client has experienced a number of loss events throughout her life. Some events, such as attending a boarding school, may have been expected transitions for this client, but even when expected, situational and developmental changes can involve losses and result in grief responses. The client’s experience might also have been impacted by various circumstantial stressors and changes relating to the losses; for example, her parents may have had to work more after declaring bankruptcy.

Usually, people eventually adapt to losses – making sense of them, accommodating and adapting to them and the secondary losses that accompany them – without the need for professional support. This is known as the integration of loss. However, multiple losses, particularly those occurring one after the other in a short time period, leave little time for this process of integration and can significantly reduce an individual’s ability to cope. In the case of the client above, the cumulative impact of these losses could result in cumulative loss. 

The initial focus is most commonly on the distinct events that result in these different categories of loss – the death of a loved one, a relationship breakdown, a natural disaster, accident, or the diagnosis of an illness. However, every loss is multi-layered, involving the primary event and the less obvious associated losses.

The primary loss is the initial, core loss that forms the foundation of the grief experience. In bereavement, this is generally the loss of a loved one. The initial grief response (which we will be exploring in more detail shortly) is usually attributed to this primary loss.

Secondary losses follow or are associated with a primary loss. For example, in bereavement, secondary losses may include changes in or loss of financial security, social status, social and family roles, identities, family structures, and the sense of safety or certainty in the world and/or a higher power. These secondary losses may initially be overlooked given the dominance of the primary loss, but counsellors should listen carefully for secondary losses and their impacts. Not doing so means we may not fully recognise, or help our clients adjust to, the nature of the losses they have experienced.

It is easy to fall into the trap of considering some losses more significant than others, but counsellors need to recognise the client’s perception of the loss and the meaning it has for them, rather than making assumptions about the significance of any particular loss. Understanding and acknowledging the scope of potential client losses encourages counsellors to acknowledge and take into account all types of losses, both past and present, and to consider how these may be impacting on the client’s current situation.

The effects of grief resulting from the types of losses described above extend beyond the individual to include family and other relationships, and even the wider community, particularly where there has been a large scale disaster affecting a community or traumatic event such as a suicide, murder, or well-publicised accident. In the following topics, we will focus on the potential impacts of loss across these dimensions on the individual.

People tend to associate particular emotions with the experience of grief, such as sadness, sorrow, loneliness, and yearning. However, grief reactions can encompass a broad range of other emotions, behaviours, and cognitions, and may impact many aspects of a person’s life.

While there are many common and expected grief reactions, it is important to remember that grief manifests in different ways, with a great deal of variation between individuals (Winokuer & Harris, 2012). The emotional, behavioural, cognitive, and physical features we discuss here are quite common in response to loss, but they are not experienced by everyone. Keep in mind that people have highly individualised responses according to their particular personalities and situations. Being able to recognise the various common characteristics of grief is important for several reasons, including that it will:

• Help you identify possible grief reactions when clients present with issues unrelated to loss.
• Assist you in normalising grief and grief responses, helping clients understand and learn ways to respond to their grief reactions.
• Assist you in identifying where clients may be experiencing more complex grief reactions that require specialist support.

The symptoms, emotions, and behaviours associated with expected grief reactions generally “represent a process of healthy adaptation and are not inherently pathological” (Pomeroy & Garcia, 2009, p. 49). There are, however, certain problematic symptoms and reactions that may present risks to that individual. You will learn more about these in the following sections of this Study Guide. For now, let’s explore some common reactions to loss and grief.

Emotional Features and Impacts

Although most people who have sustained a major loss expect to experience some level of emotional distress, many are taken by surprise by the intensity, fluctuation, and range of emotions that they experience (Pomeroy & Garcia, 2009). These upsurges of emotion may lead people to feel they are on an unpleasant roller coaster ride; just as they start feeling better, they may experience another surge of emotional distress leaving them feeling overwhelmed and ‘out of control’. These fluctuations are a common feature of the grief experience and, according to theorists, play an adaptive function in the grieving process.

There is also a wide range of emotions that may be experienced throughout the grieving process.

• Sadness is a common response to loss and may be expressed or managed in varying ways (often dictated by social expectations).
• Yearning/pining is associated with the early stages after a loss event, generally a bereavement, where intense ‘pangs’ of grief are experienced. Theorists liken this to the feelings of infants when separated from their main caregiver (as described in Bowlby’s attachment theory). There is a feeling of emptiness coupled with a longing for the person lost (Travers, Niloufer, & Kolkiewicz, 2013).
• Anger is commonly experienced in grief, but it can be a distressing and confusing emotion for those who have experienced a loss. It generally results from a sense of frustration and helplessness about not being able to prevent the loss and may be directed at others (Worden, 2009). For instance, in the context of losing a loved one, the grieving person may feel angry at the deceased for dying, or at a doctor or god for letting it happen.

Although many people are understanding and supportive of people who are grieving or who have experienced well-recognised losses (e.g., bereavement, divorce), they may find certain emotional manifestations such as anger, irritability, or over-sensitivity more challenging to deal with. Although these are common reactions, they may have a significant negative impact on a person’s social and occupational life (Pomeroy & Garcia, 2009).

• Anxiety reactions may range from vague feelings of insecurity to full-blown panic attacks. Upon losing a loved one, there is often a sense of not being able to cope alone, as well as a heightened sense of vulnerability and awareness of one’s own mortality (Worden, 2009). Anxiety is also a common reaction associated with other types of loss (e.g., relationship breakdown, loss of job, moving) as people experience a sense of insecurity or lack of control, and may find themselves worrying about their future. Where anxiety is problematic, counsellors may address this using appropriate approaches (e.g., cognitive behavioural techniques); where anxiety is intense or prolonged, a referral to see a clinical mental health professional is warranted.
• Loneliness is often experienced, particularly in the case of a close relationship involving day-to-day contact. Stroebe and colleagues (1996) differentiate between the emotional loneliness that arises from the loss of a major attachment figure and social loneliness which can be alleviated to a certain extent by social support. For example, people who are grieving the loss of a loved one or a relationship may often feel lonely, even if they are surrounded by friends and family.
• Relief can be the dominant emotion if a loved one experienced a lengthy or painful illness before dying. As one widow described, “the knowing that his suffering, both physical and mental, is over helps me cope” (Worden, 2009, p. 23). It can also occur if the circumstances prior to loss had been particularly challenging; for example, ending a difficult relationship or leaving an extremely stressful job.
• Numbness. Some people describe a lack of feeling after a loss, usually early on in the grieving process. This is not necessarily maladaptive. “We have found no evidence that is an unhealthy reaction. Blocking of sensation as a defence against what would otherwise be overwhelming pain would seem to be extremely ‘normal’” (Parkes & Weiss, 1996, as cited in Worden, 2009, p. 23). However, numbness in the context of other factors such as trauma will require specialist assessment, so a referral to a specialist mental health practitioner should be facilitated. 
• Guilt and remorse are commonly expressed – for lost opportunities, things said or done, or actions taken or not taken. For example, there may have been things not done before a loss, which the person grieving thinks could have prevented it. These feelings are often expressed as ‘if onlys’ (Winokuer & Harris, 2012).

Remember not all clients are going to experience every emotion identified above; there are vast differences in the intensity and emotional features that clients experience. Due to social expectations about grief (we will explore these further in the next section), clients may feel worried or guilty that they are not grieving ‘enough’ or ‘properly’ particularly if they are not feeling intense emotions or not feeling the same way as others who are grieving. It is important that counsellors normalise and reassure clients that they don’t have to grief in a certain way. Grief is, after all, an individualised experience. There is no one ‘right’ way to grieve.

Cognitive Features and Impacts

Grief can disrupt cognitive function, particularly in the days or weeks following a loss. Clients may describe feelings of ‘brain fogginess’ or being ‘brain dead’. For example, Pomeroy and Garcia (2009) describe a client who experienced great difficulty finding her counsellor’s office, despite the fact that she was familiar with the location. Another client, whose daily routine included reading the newspaper, stated that it took “great effort for him to finish reading just one article.” (p. 50). It is not unusual for a client to express worries about ‘going crazy’ or ‘losing my mind’. In fact, experiencing periods where they feel highly distracted and struggle to function is quite common among people who have experienced significant losses. Part of the counsellor’s role is to educate clients about the impacts of loss and grief, including those that people may not anticipate (i.e., normalising).

Cognitive features of grief include confusion, difficulties in concentration, and problems with maintaining focus. Decision-making, organisation, and keeping track of things may also be affected. Clients may describe their minds as ‘constantly busy’ but not in a productive way (Winokuer & Harris, 2012). These disruptions in cognitive function can impact the individual’s performance at work or school, particularly if they have only had limited time off work after the loss. Counsellors can discuss these impacts with clients, helping them understand and find strategies for dealing with them.

Disbelief can occur in response to a range of losses, including deaths, and may be particularly common if the death is unexpected. For example, a bereaved person may say, There must be some mistake.” “This can’t be happening. I don’t believe it.” “This must be a dream. I’ll just wake up and everything will be fine.”

Preoccupation with thoughts of loss are also common. For example, a person who has recently experienced a break-up may think of the breakup, the relationship, their former partner, and the events that lead to the separation repeatedly. Similarly, a bereaved person may be preoccupied with the thoughts of the person who has died. At times, this may take the form of intrusive and upsetting thoughts or images (Worden, 2009).

Some bereaved people also describe a sense of the deceased person’s presence, particularly early on, which they may find either comforting or frightening (Worden, 2009). In a study of bereaved children, 81% felt watched by their deceased parent four months after the death, with 66% reporting the experience two years after the death (Worden, 1996). Visual and auditory hallucinations are also a frequent experience during this time and do not necessarily indicate problematic grieving; they may even represent a functional role in the grieving process (Parkes, 2005, as cited in Winokuer & Harris, 2012). Dreams in which the person has communication with the deceased are also common.

Physical Features and Impacts

Grief often results in physical symptoms. Some people who are grieving may talk about, or seek medical attention for, physical symptoms such as those shown below (Winokuer & Harris, 2012; Worden, 2009):

What other physical features and impacts may occur in response to loss?

• Sleep disturbances, including difficulty in getting to sleep and early waking are common, and tend to dissipate as time goes on.

  After Bill lost his wife suddenly, he would wake up at five o’clock each morning filled with intense sadness and review over and over the circumstances surrounding the death and how it might have been prevented, including what he might have done differently. This happened morning after morning and soon caused problems because he could not function well at work. After about 6 weeks the disorder began to correct itself, and eventually it disappeared.”

  ^{(Worden, 2009, p. 27)}

  Grief is also associated with decreased immune functioning, with evidence suggesting that “the strong link between sleep and the immune system suggests that disrupted sleep following bereavement may affect health directly by suppressing the immune system” (Hall & Irwin, 2001, as cited in Pomeroy & Garcia, 2009, p. 51).
• Appetite disturbances are also common, manifesting as either under or over-eating, sometimes resulting in changes in weight (Worden, 2009).
• Fatigue, lack of energy, or ‘restless exhaustion’. For example, people may feel continuously busy or agitated in their minds but exhausted physically (Winokuer & Harris, 2012).
• Some bereaved people will talk about having symptoms that mimic those their loved ones had before they died. Winokuer and Harris (2012) provide the example of one of their clients attending the hospital three times with shortness of breath and chest pain after her husband died of a heart attack. Pomeroy and Garcia (2009) also point out that focusing on physical symptoms may be a way of attempting to manage or avoid emotional distress.

The discomfort of physical issues such as sleep disturbance and fatigue can significantly reduce a person’s ability to cope and can impact their cognitive, emotional, and social functioning (Pomeroy & Garcia, 2009). But while we need to recognise the potential physical effects of loss, counsellors must not assume that any reported physical symptoms are due to grief; we need to refer clients who experience physical symptoms to their doctor for assessment and treatment of potential medical conditions which could be the actual cause.

Behavioural Features and Impacts

Certain behaviours are common and even expected in those who have suffered a loss. It is important to note that these expectations are influenced by cultural and social context, and may or may not be met by any particular individual.

• Crying is a common behavioural feature of grief, but is strongly influenced by personality, social, and cultural variables. For example, in some cultures individuals may be encouraged to adopt a ‘stiff upper lip’ (that is, to not express emotion), while in other cultures overt behaviours such as sobbing are considered very much a part of the grieving process. Similarly, men and women may be subjected to different expectations.
• Searching behaviours, particularly after death, may involve literally looking for the person, visiting places that the person frequented, or searching within to try to find a sense of connection with the lost person (Worden, 2009).
• Social withdrawal. It is not unusual for people who have sustained a loss to want to withdraw from other people. Social withdrawal can also include a loss of interest in the outside world, such as not reading newspapers or watching television (Worden, 2009).

  Many bereaved individuals isolate themselves because they have a great deal of difficulty handling social situations where they may be triggered by their grief or where the effort to engage in small talk seems like a great deal of work because their lives have been filled with such deep grief and profound questioning of life and themselves. Many of these individuals have a difficult time fitting neatly in a social context – they may no longer be able to identify with the role that was associated with the deceased person – for example, a widow is no longer a wife, a parent to a deceased child is still a parent, but the child is missing. In addition, many bereaved individuals sense the discomfort of others around them, as people struggle to find the ‘right’ words to speak or avoid them to prevent the discomfort of an awkward social exchange.”

  ^{(Winokuer & Harris, 2012, p. 85)}

It is important for counsellors to be able to recognise risk factors and potentially destructive behaviours and address these with the client, applying risk management strategies where appropriate. One useful distinction is proposed by Pomeroy and Garcia (2009, p. 52) who differentiate between ‘life-enhancing’ and ‘life-depleting’ behaviours:

It is important to note that the behaviours listed here may not apply to all individuals. For example, not all people express their grief through crying or wanting to talk about the loss. Additionally, in some cases ‘life-depleting behaviours’ may be adaptive. For example, temporarily withdrawing from others may be an adaptive response to a loss, allowing the processing and conservation of energy. However, the above categorisations can be useful in helping a counsellor identify potentially destructive behaviours, as shown in the case study below.

Spiritual Features and Impacts

A person’s sense of meaning and understanding of the world is often very much influenced by their spiritual beliefs. (Spirituality may or may not be manifested in religious or theological beliefs.) Bereavement or other significant loss can represent a challenge to a person’s spirituality and may have different impacts depending on the person and the context. For some, spiritual beliefs and religion offer a sense of structure, belonging, and ritual (e.g., funeral liturgy, mourning rituals, etc.) that can be reassuring in the aftermath of a loss (Winokuer & Harris, 2012). Clients will often share how their faith communities are sources of support while belief in an afterlife provides hope of reunion with a loved one for many bereaved people (Humphrey & Zimpfer, 2008).

For others, a loss can present a significant challenge to their beliefs. For example, experiencing the death of a loved one, particularly an untimely death, can be difficult to reconcile and make sense of. Losses and challenges can lead to questions, sometimes very painful ones, about one’s beliefs. Bereaved people may query the existence of a God who could let this happen or wonder if they are being punished. Worden (2009) describes how one of his clients told him, “I must be a bad person for this to happen.” This disconnection from one’s faith is often experienced by the mourner as a secondary loss (Pomeroy & Garcia, 2009). Naturally, other types of losses and challenges can also lead to questions, sometimes very painful, about one’s faith.

A lack of spirituality can present different problems. Some people without a belief in something or someone that transcends their personal situation may experience particular challenges when confronted with life-changing events. For example, they may report wishing they had something “to ‘hang on to’ or to ‘fall back on’ during this time of loss… that they envy the strength and comfort that faith and hope provide”. (Humphrey & Zimpfer, 2008, p. 13).

Spiritual beliefs can offer opportunities for meaning and support in times of grief, but counsellors should not assume that this may be the case for all clients. Bereavement and loss can challenge the faith and belief of people resulting in additional issues that may need to be addressed. In addition, changes in belief or the diminution of faith can also be experienced as losses. These may also lead to secondary losses, such as the loss of a faith community, sense of identity, or relationships with others in which a shared faith was central.

A Note on Circumstances Existing Prior To Loss

When considering the impacts that a loss may have, it is also important to take into account the circumstances that are present before it. These factors can impact the person’s experience of grief and the effects it has on them. Let’s look at a few examples:

• Previous experience of loss. The losses a person has experienced before may have an impact on the effects of a more recent loss. For example, multiple losses, and the stressors associated with them, may lead to more challenging grief responses or increased risk of mental health issues. On the other hand, people who have experienced prior significant losses may have developed an understanding of loss and grief responses, as well as skills and resources for dealing with them.
• Health situation. Being physically or mentally unwell, particularly for a long period, can be extremely stressful. Hence, people with serious health problems may be more vulnerable and have fewer resources available to cope with loss. For instance, imagine an individual suffering from a long-term illness and being looked after by a family member. Losing that family member or a relationship with them is likely to have a huge impact on the individual’s life and exacerbate the difficulties they experience.
• Financial hardship. Financial difficulty is a common secondary loss, but it may also precede and exacerbate the effects of a loss. A person with limited financial resources or who experiences significant stress as a result of financial hardship may have more difficulty coping with a loss, as compared to someone who is in a better place financially.
• Social stressors. Social support is important in the aftermath of a loss, so having little social support already in place can cause added difficulties when a person experiences loss and grief. In addition, relationship difficulties that existed prior to a loss can exacerbate a person’s grief responses. This is particularly the case when there have been unresolved feelings towards or conflicts with a deceased person.
• Other stressors. There are many other circumstances in a person’s life that can influence their reaction to loss. Normal developmental stressors create additional challenges in adapting to losses in life; for instance, an adolescent who is undergoing physical changes and struggling with peer pressure may have less capacity to cope with parental separation. People from disadvantaged communities might also have fewer resources to cope with a major loss. Imagine the additional difficulties faced by a person who has emigrated to Australia and who has limited English language skills, when they lose their job; they will likely have fewer resources and reduced job opportunities, as well as facing cultural barriers and potential discrimination, for example. It is not possible to mention all the possible stressors that can impact the experience of loss here, but try to think of other examples. Remember, it is important to keep in mind that all people have some existing stressors in their lives prior to loss and, and as a counsellor, you will need to carefully assess the nature, severity, and the impact of these stressors on the client’s grief experience and the needs they have after a loss.

In the case study above, Avanthi’s reactions to her father’s death will need to be considered within the context of relationship difficulties with her father, moving away from her hometown and family (e.g., loss of home and identity, having limited family and social support), and relationship breakdown, as well as the financial pressure that restricted her from mourning the way she deemed appropriate. All these circumstantial factors play a part in exacerbating the effects of her father’s death.

It is important to remember that the existence of such circumstances does not necessarily lead to problematic or complex grief reactions. However, taking into account the impacts of prior circumstances will help you better understand your clients’ grief experiences and respond to their needs.

Bereavement and other loss experiences do not occur in isolation, but have ‘knock on’ effects on relationships and other social structures. Social networks provide both challenges and support for those who are bereaved. People often feel awkward and uncomfortable around a person who has experienced a loss and may not know what to say or how to help. They may offer clichés such as “he’s in a better place now” which can be perceived as dismissive and insensitive, or may avoid the person while rationalising that the person “doesn’t need company right now” (Pomeroy & Garcia, 2009, p. 53). Some family members may act in the role of gatekeeper in an attempt to protect the bereaved person, thus inadvertently isolating them from visitors (Lawton & Lawton, 2012). The lack of perceived understanding and support can result in the person feeling increasingly isolated and is often experienced as a secondary loss (Lawton & Lawton).

A strong social support system can help people in the aftermath of a loss, by providing emotional and practical help in dealing with the stresses and pressure associated with the loss and the grief responses that follow. 

Counsellors can help clients to ask for and accept help when needed from friends and family or connect the client with community support where necessary. 

The Scope of Grief Effects

Although losses are personal, they also occur in social contexts, including family, peer groups, local communities, society, and cultural contexts. We will explore the influence of culture and other social forces on grief in the next section. For now, we will focus on the impact of grief, bereavement, and trauma on families and local communities. From the effects of personal losses on families to the effects of suicides, murders, publicised accidents, and large-scale disasters on whole communities, the impacts of grief can create a ‘ripple’ effect throughout the social structures shown in this diagram (adapted from Lawton & Lawton, 2012, p. 112):

Families

Families often form the primary source of social support for a person who has experienced significant loss. Some losses bring family members closer together, but the changes that a loss event brings about can challenge family structures, highlight dysfunctional family dynamics, and strain or even break relationships. Individual differences among family members in terms of the effects of the loss and grief on them or in their preferred ways of dealing with loss can also lead to misunderstanding, conflict, and further hurt.

Grief is a highly individual experience, and each family member will have their own way of coming to terms with a loss, influenced by the circumstances, their role in the family, their relationship to the deceased family member, and previous experiences. Differences in the experiences of grief between individuals within the same family may be a challenge, especially in terms of emotional expression and coping strategies. Problems can arise when family members have different grieving styles and there is a perceived lack of understanding, support, and communication within the family. Some family members, including children and adolescents, may feel overlooked, excluded, and unheard, which can lead to feelings of isolation and resentment (Breen, 2011). Depending on the circumstances of the death, family members may also blame other members, or be blamed, for the loss (Breen, 2011).

A significant loss can have a devastating effect on a family unit, as shown in the example below:

As you can see from the above example, various family members will all have their own way of expressing grief and coping with the loss of a close family member. Problems may emerge for both individuals and the family as a whole when communication and relationships within the family become dysfunctional due to these differences.

The economic consequences of loss on individuals and families are easily overlooked but can be of critical importance. Loss of income or financial security is often a secondary loss experienced as a result of illness, retirement or redundancy, relationship breakdown, loss of home, or the death of a partner or family member. In fact, a significant predictor of poverty for women and children is loss. As Carson and Kerr (2014) have pointed out, mothers whose primary relationships have ended are often at particular risk of financial hardship. In fact, single mothers and their children are the family type facing the highest rates of poverty in Australia. In addition, domestic and family violence, which involves a whole range of losses, is a major cause of homelessness for women and children (Mission Australia, 2019).

Being in financial hardship has flow-on effects in many other areas of life. Let’s consider a child who is affected by parental bereavement (i.e. death of a parent). The family may well suffer from financial difficulties – from mild financial strains to poverty and even homelessness (with all the additional losses that entails). The surviving parent may now face financially supporting the family alone. They may be less able to support the child due to their own grief and the responsibilities they face in adjusting to the new circumstances. The family may need to relocate to access affordable housing, job opportunities, or additional support. The child may suffer from a lack of emotional support, reduced opportunities, interference with schooling, health issues, and a wide range of other secondary losses. As such, when supporting a client who has experienced loss, you need to be aware of the impact of loss on the client and their family, including financial considerations, and be prepared to respond to needs arising in different areas.

Communities

Communities can be made up of close friends and neighbours, residents of a particular area, schools, occupational groups, or members of particular ethnicity, culture or religion. In close communities, a loss experienced by an individual is shared and grieved by the whole community, as depicted in the following example.

The involvement of the community in response to loss differs widely according to culture and the types of losses experienced. This is most commonly discussed in relation to bereavement, so we will focus on that here.

In some cultures, the death of a community member is a community experience. For example:

In Aboriginal culture, death or loss of a community member may be referred to as ‘sorry business’ and is understood as impacting the whole community.

In many Western cultural groups, there is an increasing trend towards the ‘privatisation’ of grief, with people restricting their mourning to themselves, immediate friends and family, or professionals. There are exceptions to this, including individual and community differences, and some exceptions that relate to particular types of losses. Losses such as war and natural disasters (e.g., fires, earthquakes and floods), for example, impact directly on entire communities. Natural disasters are usually unexpected, leaving people with little time to prepare. They can have widespread effects, not only on the person experiencing the loss, but also on support networks of friends, family, and community. For example, dealing with the emotional consequences of a natural disaster can be challenging. Those involved may suffer from trauma symptoms such as sleeping and eating problems; headaches and stomach aches; feelings of guilt, anxiety and rage; and a preoccupation with the event (Hughes, 1995). Recovery may be further complicated by the loss of friends or loved ones, as well as secondary losses such as the loss of income, jobs, homes, or possessions (Hughes, 1995). In these situations, grief and grieving tend to be a shared rather than a private event.

Other exceptions include well-publicised accidents, murders, or unexpected death of a child or well-known figure. In these cases, the loss often results in large-scale communal funeral rituals such as the placing of flowers, and communities may rally around those who were most directly impacted by the loss, providing emotional, practical, or financial support.

Loss and grief affect many dimensions of a person’s life and often create a ‘ripple effect’ across families and communities. This section of the Study Guide was designed to introduce you to these dimensions. It is important to recognise the common manifestations of grief so as to appropriately identify loss-related needs and help people meet them, and so that we do not “pathologise behaviour that should be recognised as normal” (Worden, 2009, p. 31). Of course, there is a lot more to the grief and loss experience...

• Breen, L. (2011). Behind closed doors: Bereavement and the family. InPsych, 33(6). Retrieved from https://www.psychology.org.au/for-members/publications/inpsych/2011/dec/Behind-closed-doors-Bereavement-and-the-family
• Calvary Health Care. (n.d.) Bereavement across cultures: A resource for health professionals. Retrieved from https://www.caresearch.com.au/caresearch/Portals/0/Documents/PROFESSIONAL-GROUPS/Calvary_A5_real.pdf
• Carers Victoria. (2005). An unrecognised grief: Loss and grief issues for carers: A carers’ guide. Footscray, Australia: Carers Victoria.
• Carson, E., & Kerr, L. (2014). Australian social policy and the human services. Port Melbourne, Australia: Cambridge University Press.
• Harlow, I. (2005). Shaping sorrow: Creative aspects of public and private mourning. In S. C. Heilman (ed.), Death, bereavement and mourning. New Brunswick, NJ: Transaction Publishers. pp. 33-52
• Hughes, M. (1995). Bereavement and support: Healing in a group environment. Philadelphia, PA: Taylor & Francis.
• Humphrey, G. M., & Zimpfer, D. G. (2008). Counselling for grief and bereavement. (2nd ed.). London, UK: Sage
• Korff, J. (2019). Mourning an Aboriginal death. Retrieved from https://www.creativespirits.info/aboriginalculture/people/mourning-an-aboriginal-death
• Lawton, S., & Lawton, K. (2012). Bereavement and primary care. In P. Wimpenny (Ed.), Grief, loss and bereavement (pp111-120). Oxon, UK: Routledge.
• Machin, L. (2009). Working with loss and grief: A new model for practitioners. London, UK: Sage
• Mission Australia. (2019). Out of the shadows: Domestic and family violence: A leading cause of homelessness in Australia. Available from https://www.missionaustralia.com.au/domestic-and-family-violence
• Murray, J. (2016). Understanding loss: A guide for caring for those facing adversity. New York NY: Routledge.
• Parkes, C. M., & Prigerson, H. G. (2010). Bereavement: Studies of grief in adult life. (4th ed.). New York NY: Routledge.
• Pomeroy, E., & Garcia, R. (2009). The grief assessment and intervention workbook: A strengths perspective. Belmont, CA: Brooks/Cole Cengage Learning.
• Stroebe, W., Stroebe, M. S., Abakoumkin, G., & Schut, H. (1996). The role of loneliness and social support in adjustment to loss: A test of attachment versus stress theory. Journal of Personality and Social Psychology, 70 (6), 1241-1249.
• Travers, B., Niloufer, A., & Koliewicz, L. (2013). Bereavement in primary care mental health. Mental Health in Family Medicine, 10, 223-229.
• Walter, T. (2001). On bereavement: The culture of grief. Maidenhead, UK: Open University Press.
• Winokuer, H. R., & Harris, D. L. (2012). Principles and practice of grief counseling. New York, NY: Springer.
• Worden, J. W. (2009). Grief counseling and grief therapy: A handbook for the mental health practitioner. New York, NY: Springer Publication Company.