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What Makes Traumatic Grief Different?

Posted on by Joseph Gerard

Grief - human hands holding black silhouette wordWritten by Marko,

The idea of saying goodbye to someone you love forever is heartbreaking. 

But, as hard as it is, it’s a different kind of hurt when you compare it to losing someone out of the blue. It’s sad, but the truth is, being able to say goodbye is a privilege not everyone gets. 

You have time to sit with it, and to hold your loved one’s hand, even if it’s for the last time.

Then there’s the other way, when you’re just living your normal life. And someone knocks on your door and tells you your loved one is just… Gone. Just like that. No last conversations, no warnings. One minute they’re here, the next, they aren’t, and there’s nothing in between that. 

This kind of shock leaves your brain stuck, and that stuck place is called traumatic grief.

In this article, we’ll go over the differences between traumatic grief and what people call normal grief. And if you’re wondering why that difference is important, it’s because you can’t recover unless you know what you’re recovering from.

How Grief Usually Unfolds When Loss Is Expected

Grief always hurts. There’s no way around that. It doesn’t matter if loss is expected; nobody can prepare for it in a way that doesn’t hurt. 

But the hurt usually doesn’t come all at once. Instead, it follows a somewhat steady path. Imagine if a person has a family member who’s terminally ill. They know what’s coming, and the hard moments come little by little. The whole thing feels like this heavy burden they’re carrying around all the time, and when the time comes, and they finally lose their loved one, they already saw it coming.

This all gives the brain some time to prepare.

That doesn’t mean that there’s a way to be actually ready for what’s going to happen, but you can’t help but have a sort of mental rehearsal going on in your head. So, you might cry in your car every few days, or you might imagine what your life is going to look like once that person is no longer here. There’s time, which means there can be closure, and closure is the first step towards healing.

Time also means emotions can adjust. 

By no means does that mean it follows neat little stages that come one after the other. Grief is messy, and some days are better than others. Still, the little things like going to work and making dinner help in keeping you grounded.

And as time heals you, you’ll still have all the memories of the person who’s no longer with you, but it’ll stop hurting (as much, anyway).

If the loss comes without any warning, though, none of this can happen.

What Changes with a Sudden, Traumatic Loss

It’s very frowned upon to say that one kind of grief is harder than another because everyone deals with grief in their own way. 

You can’t know how someone else is feeling, and you can’t be sure that you have it better or worse than they do. With that being said, the grief that accompanies traumatic loss is very different from the grief that happens after an expected loss, and some might say it’s harder. 

And they wouldn’t be wrong.

The hardest part of traumatic grief is that you now have to deal with two things at once. 

Sudden or violent loss measurably increases risk of prolonged grief/trauma (e.g., PTSD-like reactions). – National Institute of Mental Health

You feel the emotional loss, which is heavy enough on its own. But along with that, you’re also in complete and utter shock. And shock and sadness are two different emotions. 

When you’re in shock, it’s basically your brain slamming the brakes even though there was no yield or stop sign in sight.

For the most part, people go numb right after they hear the tragic news. Not in a cold way like they don’t care, but just blank.

Acute stress reactions )e.g., numbness, confusion, dissociation, etc.) are common side-effects of experiencing traumatic events. – Substance Abuse and Mental Health Services Administration

So, they’ll stare at a wall for an hour, or they’ll answer the door and forget they did it a few seconds later. They’ll hire a wrongful death attorney for fatal car crashes in Chicago when they should have hired one in Joliet, where they live. From the outside, this seems absolutely ridiculous, but two things are happening here: one, the brain is trying to protect you. 

And two, that loss made no sense, so it’s pretty much impossible to accept what’s happening. 

The brain keeps searching and searching for a connection between one moment where life was normal, and the next when it fell apart.

On top of all this, there’s also the real-life stuff to handle because there’s no grace period. You have to sign the papers here, make the calls there, decide on funeral arrangements and finances, and yes, hire a lawyer if someone else is to blame for the tragedy. 

It’s not that hard to believe that, because of dealing with all this, a person would forget they opened the door or hired a lawyer in the wrong city, isn’t it?

How Traumatic Grief Feels Different in Daily Life

Normal grief is heavy, but traumatic grief? That’s both heavy and confusing at the same time. 

Here’s what the difference looks like in everyday life.

There’s No Time to Prepare Mentally

If the loss came out of nowhere, the brain didn’t get any of the warning signs. 

No hospital stays, no bad test results, no slow decline, no last conversations… Nothing. As a result of this, the mind will continue acting as if the person is still alive, regardless of the fact that reality is different.

A person who’s grieving could find themselves picking up a phone to call their deceased loved one, or setting an extra plate for dinner. You might say this is pure denial and nothing else, but that’s not the case here. The brain is having a hard time catching up with what’s actually happening because nothing makes sense. 

The worst part is that this can go on for months.

The Body Stays Stressed

Grief consumes both mental and physical health, and with traumatic grief in particular, the body acts as if the danger is still here. You stay in that terrible fight-or-flight mode for a long time. You might notice your heart starts to race at random times, or you’ll jump at small noises.

Your body can stay in a constant state of heightened stress after experiencing trauma; this can negatively affect sleep, heart rate, body regulation, etc. – National Institute of Mental Health

And sleep? Now, that’s a battle every single night. 

You’ll either sleep too much or too little, but either way, you’ll never truly rest.

As crazy as it sounds, all this is normal. This is basically your nervous system doing exactly what it’s designed to do. The problem here is that there’s no ‘real’ threat to handle. Your mind thinks there is a threat, so it reacts accordingly.

Thoughts Keep Going Back to The Dreadful Event

Normal/regular grief revolves around someone’s memories about the person that’s gone (for the most part). These are inside jokes, things you’ll miss (laugh, jokes, routines, etc.) – the good times.

Traumatic grief is different. This type of grief is stuck on death where your mind replays a few moments over and over again. And it’s difficult to get out of that loop.

Core features of trauma-related conditions  are intrusive (negative) memories and repeated mental replay of the trauma. – U.S. Department of Veteran Affairs

The phone call, the news, the moment you found out, rinse and repeat, over and over.

You don’t consciously choose to think this; it simply shows up. The hardest part about this is that the brain is so focused on that tragic event that you can’t hold onto the happy memories.

It’s not that they’ve disappeared, but they’re buried under that replay button that refuses to stop.

It’s Harder to Find Closure

Harder, and even impossible. 

Normal grief gives you an ending. It’s not a happy ending, but it’s an ending nevertheless, where you might even get to hold the person’s hand and tell them you love them. It all makes sense, as painful as it is.

But there’s no ending with traumatic grief, and nothing makes sense anymore. 

Because of the absence of anticipatory coping/closure after experiencing unexpected loss a person can experience prolonged grief. – Harvard Medical School

So, in order to make it all feel sensical, the ‘what ifs’ start to pop up. What if they left 5 minutes earlier? What if someone had been there? 

None of that helps, but it also can’t go away. You know it’s irrational to play those scenarios over and over, but without a proper goodbye, your mind can’t wrap around the fact that this tragedy happened, and it can’t move past it.

Conclusion

None of this has anything to do with how much you loved the person. 

The only thing that matters is how the tragedy happened: was it expected, or was it a shock? And you might say that neither is worse, but truthfully, traumatic grief hits on more levels. Aside from the deep sadness, there’s also shock and pressure, with no soft landing in sight. It’s like your life just attacked you all of a sudden.

Make no mistake; just because you understand the difference doesn’t mean you can fix anything. But it’s useful because it explains why recovery is slower, and why everything feels more unpredictable. 

At the end of the day, if all you can know is that you’re not going insane, that’s still something.

Author Bio 

Marko is an adamant and eager content writer with a decade of experience in various niches,  with healthcare being one of them. With his way of implementing storytelling, comparisons, and examples into hard-to-grasp topics, Marko’s able to make complex things sound interesting and relatable – key ingredients to make something understandable. As a hobby, Marko enjoys offroading, board games, and spending time with his family and his dog Cezar.

 

 

Please also review AIHCP’s Grief Counseling Certification, as well as its Child and Adolescent Grief Counseling Program, Pet Loss Grief Counseling Program, Christian Grief Counseling Program, Grief Diversity Counseling Program, Grief Perinatal Program, Grief Practitioner Program and finally its Grief Support Group Leader Program.

The Creative Grief Cycle

Posted on by Joseph Gerard

The Creative Grief Cycle

Creation, Communication, and Rediscovery in Grief Writing 

Written by Daniel Stern

Grief disrupts the narrative of life. When a profound loss occurs, the future we imagined with that person vanishes, and the past becomes newly charged with memory and absence. 

Yet paradoxically, grief is also one of the most powerful generators of creative expression. Poetry, painting, music, and storytelling have historically emerged from loss, giving shape to emotions that are difficult to express. 

For many writers, including myself, poetry becomes the place where grief first learns to speak. 

I’m not a clinician. What I’m describing comes from my own experience writing poetry about grief. I found that creative expression did more than document loss; it initiated a cycle of emotional processing. My experience aligns with research on expressive writing, poetry therapy, and meaning-making in grief—that creative expression can help people process loss and make sense of it. 

From this intersection of lived experience and research, I began to notice a pattern in how grief can move through creative expression. I refer to this pattern as The Creative Grief Cycle. 

  1. Creation — the act of writing transforms grief into language 
  2. Communication — the work becomes a bridge between the grieving individual and others 
  3. Rediscovery — the creative work can be revisited repeatedly, allowing grief to evolve into reflection 

Together these stages form a self-reinforcing cycle that moves grief from raw emotional experience toward shared understanding and lasting meaning. 

Research on expressive writing, meaning reconstruction, and poetry therapy supports key elements of this cycle.

 

Journaling about loss is a creative and expressive way to cope with grief

Stage One: Creation — Writing as Emotional Processing

The first stage of The Creative Grief Cycle is the act of creation itself. 

When grief is written, it changes form. What was once diffuse emotional pain becomes structured language. Words, metaphors, and images impose order on an experience that initially feels chaotic. 

Psychologist James W. Pennebaker, whose research pioneered the study of expressive writing, demonstrated that writing about emotional experiences improves psychological and physical well-being. His studies showed that expressive writing helps individuals organize traumatic memories into coherent narratives, supporting emotional processing that might otherwise remain unresolved (Pennebaker & Chung, 2011). 

Scholars in poetry therapy also describe writing as a structured way of processing emotional experience (Mazza, 2017). Neimeyer (2012) has similarly emphasized that grief often involves reconstructing meaning after loss, frequently through narrative and creative expression. 

Subsequent studies have found similar benefits. A comprehensive review in Advances in Psychiatric Treatment found that expressive writing can reduce stress, improve mood, and enhance coping with traumatic experiences (Baikie & Wilhelm, 2005). 

In grief specifically, expressive writing has been associated with meaning reconstruction, a central process in bereavement. Neimeyer (2001) describes mourning as rebuilding meaning after a loss disrupts one’s life narrative. 

These findings mirror my own experience writing poetry after the loss of my son. In one poem I wrote: 

“A poem begins in blood. 

My son is gone, yet I write— 

each word a slice of myself.” The Price of a Poem 

Writing did not remove grief. Instead, it transformed grief into something that could be examined and understood. 

Researchers studying poetry therapy describe this process as the movement “from silence to speech.” Stepakoff (2009) explains that poetry allows individuals to represent traumatic grief symbolically, making it possible to approach experiences that initially feel unspeakable. 

In The Creative Grief Cycle, creation is therefore the first step in transforming grief into meaning. 

 

Stage Two: Communication — The Social Function of Grief Poetry 

The second stage of The Creative Grief Cycle occurs when the work is shared with others. 

Grief is inherently isolating. Individuals experiencing loss often feel that their emotions cannot be adequately explained to those who have not lived through similar experiences. 

Poetry can bridge this gap. 

Because poetry communicates through metaphor, rhythm, and imagery, it can convey emotional realities that ordinary explanation cannot. Readers encountering grief poetry can recognize aspects of their own experiences within the work, creating a moment of shared understanding. 

Maybe creative expression can help individuals communicate their complex grief experience when traditional conversation is difficult.

Stroebe (2018) highlights that poetic language can complement scientific models by illustrating the lived experience of grief, bringing emotional depth to processes identified in research. Psychological frameworks describe processes of mourning, but poetry can capture the lived texture of grief—its contradictions, memories, and silences. 

This communicative dimension is visible in many grief poems. In one of my own poems, I describe writing as a way to keep a voice present in the world: 

“I write 

because my voice still walks the earth 

even when his footsteps do not.” Don’t Live Inside That Silence 

The poem becomes more than a personal reflection; it becomes a message others can encounter. 

Communication also allows grief to move across generations. In another poem, written about telling stories to my granddaughter after her father’s death, I wrote: 

“I give her my son 

the only way I still can— 

one story at a time.” Tell Me a Daddy Story 

In this moment, poetry functions as inheritance. Memory travels through language into the future. 

In The Creative Grief Cycle, this is when grief moves from private experience into shared understanding. 

 

Stage Three: Rediscovery — Revisiting the Work 

The third stage of The Creative Grief Cycle emerges and can evolve over time. 

Unlike spoken conversation, creative works endure. A poem written during an intense period of grief can be reisited months or years later. This creates a powerful reflective process. When the writer returns to the poem, they revisit the emotional state that existed when it was written. The poem becomes a preserved record of grief at a particular moment in time. 

Poetry can preserve the emotional complexity of grief in ways that allow both writers and readers to return to the experience with evolving perspectives.

In practical terms, a poem becomes an emotional time capsule. The writer who reads it years later is no longer the same person who wrote it. The grief may have softened, deepened, or transformed. 

In one poem, I tried to capture how silence evolves over time: 

“Silence becomes a cathedral, 

vast and unforgiving, 

its arches built of absence.” The Roar of Silence 

This rediscovery stage allows grief to evolve from raw emotion into reflection. 

In The Creative Grief Cycle, rediscovery completes the cycle by enabling the work to continue generating meaning over time. 

 

The Creative Grief Cycle 

Taken together, the three stages form a continuous cycle: 

Creation → Communication → Rediscovery 

  1. Grief is transformed into language through writing. 
  2. The work communicates the experience to others. 
  3. The work can be revisited repeatedly, generating new insight. 

Each stage reinforces the others. Writing enables communication. Communication deepens meaning. Rediscovery inspires further creative expression. 

This cycle offers an explanation as to  why creative work often continues long after the initial loss. Once grief has been expressed through art, the creative impulse frequently expands into other forms of expression. 

In one poem reflecting on transformation through grief, I wrote: 

“Grief softens us, 

wonder reshapes, 

creation strikes sparks 

across even the softest anvil.” The Furnace Never Cools 

Grief melts what once felt rigid. Creativity reshapes it. 

 

Conclusion 

Grief cannot be eliminated. Loss remains one of the defining experiences of human life. But creative expression changes how grief exists in the world. 

Through The Creative Grief Cycle, grief moves through a process of creative transformation:  

  • Writing transforms emotional experience into language  
  • Communication connects that experience with others  
  • Rediscovery allows the work to continue generating meaning over time 

In this way, poetry does not simply document grief. 

It allows grief to become something else: connection, reflection, and enduring voice. Loss may silence a person’s presence in the world. But through poetry, the conversation continues. 

 

About the Author

Daniel Stern is a retired engineer turned astronomer and astrophotographer whose poetry explores grief, silence, memory, and renewal. His work lives at the intersection of science and emotion, where observation becomes reflection and language reaches for what cannot be measured. He recently published The Roar of Silence, a collection of 15 poems born from personal loss and the search for meaning in its wake. He also authored Aphelion, a book of poetry fused with his deep-sky astrophotography. In his work as an astronomer, his astrophotography has been recognized numerous times by NASA (APOD). He has discovered planetary nebulae and, in collaboration with others, has been published in peer-reviewed astrophysics journals. Stern lives in Delray Beach, Florida, with his wife, Randie. 

 

Website: www.theroarofsilence.com 

Email: dstern@mea-obs.com 

 

References 

 

Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment, 11(5), 338–346. https://doi.org/10.1192/apt.11.5.338 

Mazza, N. (2017). Poetry therapy: Theory and practice (2nd ed.). Routledge. 

Neimeyer, R. A. (2001). Meaning reconstruction and the experience of loss. American Psychological Association. 

Neimeyer, R. A. (2012). Techniques of grief therapy: Creative practices for counseling the bereaved. Routledge. 

Pennebaker, J. W., & Chung, C. K. (2011). Expressive writing: Connections to physical and mental health. In H. S. Friedman (Ed.), The Oxford handbook of health psychology (pp. 417–437). Oxford University Press. 

Stepakoff, S. (2009). From destruction to creation, from silence to speech: Poetry therapy principles and practices for working with suicide grief. The Arts in Psychotherapy, 36(2), 105–113. https://doi.org/10.1016/j.aip.2009.01.007 

Stroebe, M. (2018). The poetry of grief: Beyond scientific portrayals of mourning. Omega: Journal of Death and Dying, 77(1), 3–16.

 

 

Please also review AIHCP’s Grief Counseling Certification, as well as its Child and Adolescent Grief Counseling Program, Pet Loss Grief Counseling Program, Christian Grief Counseling Program, Grief Diversity Counseling Program, Grief Perinatal Program, Grief Practitioner Program and finally its Grief Support Group Leader Program.

Divorce and Heartbreak Grief Video Blog

Posted on by Mark Moran

The pain of a breakup and divorce has many levels of loss and secondary losses.  While each can be horrible for a person, different individuals have different experiences for a variety of reasons.  This video takes a closer look at the multiple factors in relationship loss and grief.

Please also review AIHCP’s Grief Counseling Certification

 

Grief Counseling: Different Grieving for Different Deaths

Posted on by Mark Moran

They say the only two certain things in life are death and taxes.  Death is indeed definite.  Ironically though is part of life.  Every breath and heart beat is determined from then on and into the future the very moment a the infant takes its first breath outside the womb and its first heartbeat within it.  Every day brings one closer to death but when living, the inevitability of death is rarely focused on or discussed.  Death anxiety is a cultural norm.  The myth and fear that one should not speak about such fearful things as to summon it remains fixed in society.  The moment of death is shunned while birth is celebrated.  Even those of faith, still fear its grasps despite the hope of a better world to come.  Due to the unknown and fear, death subjects become taboo or too morbid to discuss in some families as if the grim reaper is outside the door itself.

The types of deaths we experience in life differ objectively but also subjectively based upon multiple accidental qualities

Obviously such fears of death, or to even discuss the critical part of our entire existence is not healthy.  Death and loss occurs everyday and eventually death finds one’s family and friends.  Those who flee death are less prepared, while those who study it and discuss it understand its implications.  This does not guarantee one escapes the pain of loss associated with death of a friend or loved one, but it does recognize the reality which is crucial in understanding and coping with loss.

With every death, there is pain and loss experienced within a family, community, or culture.  It is unavoidable because with death comes change.  The change of no longer sharing a life with someone or being able to speak with someone or experience that person’s friendship.  Death of a loved one brings emptiness and sadness, but these are not adverse or pathological reactions to be dismissed, rejected, or hidden.  They are instead natural responses to losing someone that is loved.  The reactions of death and loss are a result of love.  Without love or attachment to someone, then there is no grief.  There may be the simple statement of regret for that family, or person, or at a communal level or national level, a sense of anger and injustice, but true loss and pain is directly correlated with a more intense connection.  Connection and attachment correlate with the degree of adjustment and pain in loss.

Every loss is unique and one cannot judge a mere relationship or assume connection with every type of death one experiences within a family or community.  Different deaths have different meanings for people and how they react.  One could lose a parent and be devastated over the loss, while someone estranged to a parent one never knew may feel no connection or intense pain.  One may lose a pet that was the center of one’s world, while another may just see a pet as a pet.  In other cases, one may be deeply struck by losing a grandparent, while others may not even know their grandparent.

In this blog, I preface that while we will discuss types of deaths, this is a general guide to reactions and common feelings.  It in no way attempts to say this is the way one will feel if this person or that person dies.  This should be seen as a general map of the more common grief reactions based on healthy connections without extraordinary circumstances.   So, very well, the reader may connect to one point, but completely disagree with his or her own experience in the next.   So, consider these different types of grief to different types of deaths as a general review.

Please also review AIHCP’s Grief Counseling Certification and see if it matches your academic and professional goals.

Accidental Qualities to Consider in Death and the Reaction to It

Accidental qualities are the unique elements that make deaths different for different people experiencing them.  One could classify a particular relational death but the accidental and subjective aspects the story can increase emotional intensity or decrease.  Some can complicate normal trajectory of grieving into complicated and prolonged grief disorders itself.  Here are some things to consider as accidental qualities

Sudden Death or Expected Death

This is a huge factor in complications in grieving for some.  While complicated grief is less common than normal grieving, complications are tied to sudden deaths at a higher level.  Sudden death also brings more shock and awe and denial than other types of death.  It is the sudden call on the phone at night with the horrible news.  It is the call that one wishes was a nightmare and forever changes one’s life.  One can be at work, or dinner, or at an event and the sudden news forever shatters the person.  Sudden death can also create and imprint upon the person a fearful death anxiety.  Unexpected death makes one question one’s own mortality.

Likewise, expected death while not as abrupt can bring about different reactions.  If someone is very elderly, or if someone is terminal, the death is expected.  One in fact is experiencing anticipatory grief and may be grieving already before the death occurs.  The death can be seen as a relief for caregivers, or for family members who see the deceased as free from suffering.  Some may experience guilt for this reprieve but they should not allow it to overtake them.  Others may feel the intense pain of choosing to take a person off life support or a particular drug.  The choices of palliative care can be a painful one for a family. Family should openly discuss their feelings when someone terminal or elderly finally passes.  Again, this loss could be far more intense for a child who dies of cancer, as opposed to an elderly person in palliative care.  Does this mean the loss is painless or not deserving to be experienced based on these things?  Obviously, one is more tragic, but one should not be felt to pretend to be happy merely because one is finally relieved of suffering.  There is an ambiguous as well as bitter sweet feeling when one loses an elderly family member over a stretch period of time.

Tragic Loss

Sudden loss carries with it a litany of accidental qualities added to the relationship of the death. Please also review AIHCP’s Grief Counseling Program

A tragic loss usually coincides with a sudden loss but also includes a horrible death scene, or way the person died.  This could involve war, a murder, or a tragic violent act.  This can lead the survivor into a deep sense of mourning and anger.  In addition, successful suicides can deeply hurt with with additional emotions of anger, guilt, or increased suicidal thoughts oneself.  Tragic loss does not necessarily mean complications for the survivors, but it can lead to it.

Ambiguous Loss

Some family losses remain ambiguous and one never experiences closure.  These deaths involve unrecovered bodies in war, or acts of nature.  In addition, mourning a person who is kidnapped or loss leaves a person with a perpetual what if scenario.  One cannot grieve death for fear of accepting it or even worst a horrible situation existing for a loved one.

Estranged Family Relationship

Estranged family relationships can intensify or lessen the impact of a loss.  In some cases, when a family member who passes is estranged, there can be a feeling of anger, guilt, or a mixture of sadness and anger.  Whether the justification for estrangement was legitimate or not, it can lead to an array of issues at the funeral with other family members who may feel estranged members are not welcome.

Abuse and Trauma

Abuse leaves trauma and when an abusive family member dies there may exist sadness, but also joy and justification.  Some may feel a mixture of these feelings.  Abuse can also make the abused feel guilty for the death of the abuser.

Emotional Connection

How attached to someone is essential to the equated pain, suffering and adjustment.   Some individuals are closer to siblings or cousins than others.  Some have a deeper connection to a friend than a different friend.  So the mere title of the relationship does not always entail the emotional response.  The more attached and connected to a person emotionally, physically, spiritually and financially, the more intense the change.  Loss always equals change which equals grief.

Age of the Griever 

Children grieve differently than adults.  Those with mental issues also express grief differently.   It is important to be aware of the age of the griever and their relationship with the deceased to fully understand their ability to understand death, much less express it in a healthy way.

Family Support

Support or no support plays a large role in reaction to loss.  One who loses a spouse and has no other family or friends can experience deeper loneliness and pain.  Those with support can share their grief and also receive additional care in funeral planning and post funeral life.

One can consider numerous other accidental qualities to even add to this list which make every death for someone unique and different in their grieving journey

Types of Losses to Death

Loss of a Child

From a purely objective status, the loss of the child is the greatest grief loss

This is considered objectively to be the most painful loss despite subjective accidental qualities.   Losing a child has its own accidental qualities that have a strong universal impact on any healthy parental relationship with the child.   Again, the way it occurred suddenly in an accident, or in a cancer ward, shapes different experiences, but the emptiness, pain, and life long mark upon the heart never leaves.   Losing a child in the womb, at birth, in infancy, adolescence, or young adult are all horrible in their own unique ways for the parent.  It is singularly the most destructive change agent in a person’s life.   The universal component captures the essence of unnatural.  Children bury their parents, not the other way around.  So while, some situations may give different perspectives on the loss, the grim reality remains a parent has buried his or her child.  This type of loss that individuals like to avoid to even think about.  The intense anxiety that the  thought itself produces in the mind is painful enough.  The intrusive image, or even conversation usually is immediately dismissed abruptly.  One can then only imagine the nightmare and pain a parent carries in his or her heart when this loss occurs within any accidental possibilities.  The nature of itself is horrible enough to keep one awake at night.

Loss of a Parent

Losing a parent is considered objectively to be the second most painful loss.  Again, without a variety of accidental qualities, this loss ties oneself to one’s very existence.  The caregiving and connection over life itself bonds the child to the parent.  This attachment matures and changes throughout life to different needs.  Obviously a child who loses a parent experiences a far greater blank in life.  The pain of growing up without the parent and experiencing the parent in one’s life into adulthood.  For adults who lose their parents, there is still a pain but it does follow a logical and natural course of burying an elderly parent.  This too can have complications in whether the parent suddenly passed away or was terminal.   Grievers may feel they are no orphans to the world when the final piece of source of physical existence no longer remains.  For many, this emptiness comes sooner while others are blessed to experience this pain far later, but whether sooner or later, the loss of a parent leaves a deep emptiness and existential question of self.  It also shifts one responsibility.  One becomes, in adulthood, the new patriarch or matriarch of the family and with that new responsibilities and worries.

Loss of a Grandparent

For many, the loss of a grandparent is something that occurs in younger adulthood.  Again, it can strike at any age which also creates different responses.  For some, a grandparent may have raised them while others may have rarely seen the grandparent.  Grandparents usually represent the first experience of death at a intimate and closer level of relationship for individuals.  It introduces the person to the reality of death and that everyone will eventually die.  For others, a grandparent represents unconditional love.  In many cases, one represents reprieve from harder discipline that comes from parents.  They are sources of wisdom, family history, and wit them dies a certain era and part of one’s life. Some may even feel guilt for not seeing them enough, which is a natural reaction and not one that should be allowed to fester.

Loss of a Sibling

Losing a sibling, especially, at a younger age, or in a sudden and horrible accident can have great impacts on an individual.  For many, siblings, as well as cousins, are a a loss a long term relationships that are meant to span across one’s entire life. Siblings should be a person’s first friend.  A shared story and identity in culture and family values and traditions binds brothers and sisters, and cousins, together.  The assumed outcome is a long life, but when lives are shortened, this can bring one to horrible life changes and death anxieties.    The closer the bond, even twins, the more intense the pain of loss.

Loss of a Spouse

Losing a spouse should be an intense loss equal to that a parent in some cases.  With divorce and so many bad decisions, the modern world has come to see spouses as replaceable, but for those truly in love, losing a partner can leave one truly alone in life.  A younger couple who experiences this may subjectively suffer differently from a couple with children as opposed to a couple who has spent 50 years of marriage together.  With these losses, unique challenges emerge.  Younger spouses look to rebuild, spouses with children look to raise children alone, and older spouses may very well die of a broken heart.   With these losses, roles of duties, income disparity, and other secondary losses with groups of people can all emerge and create further pain and discomfort in the new adjustment of life.

Loss of a Pet

This is the most disenfranchised of losses because according to some, pets are not people.  The connection and love that human beings share do not need to be confined to merely other humans.  In fact, many pets carry higher family values than some actual family members.  Many pets are considered children to the person and play a deep connective and important emotional role to the person.  While, pathology can exist in some extreme cases, for most pets, they are family and deserve the same love and grief when they are gone and people will grieve their pets as grieving any other family member.  In fact, this is normal in itself and should be respected.

Conclusion

Please also review AIHCP’s Grief Counseling Certification Program

While the death of a person creates loss for other people, the type of death and the accidental qualities surrounding it make one singular event a very different experience for other people.  Grief Counselors need to be aware of the whole story surrounding the grief of someone who has lost a friend or family member.  Grief Counselors can just not assume the loss will be felt in a certain way due to relationship status, but must instead understand the subjective relationship the person had with the deceased.  There will be some common threads with particular losses but there will also be numerous accidental qualities to a particular loss that can play a key role how the person reacts and how the person adjusts to the loss.

Please also review AIHCP’s Grief Counseling Certification, as well as its Child and Adolescent Grief Counseling Program, Pet Loss Grief Counseling Program, Christian Grief Counseling Program, Grief Diversity Counseling Program, Grief Perinatal Program, Grief Practitioner Program and finally its Grief Support Group Leader Program.

All programs are open to qualified clinical and non clinical professionals.

Additional Blogs

Death of a Friend: Click here

Child Grief and Death. Click here

Additional Resources

Fisher, J. (2023). 5 stages of grief: Coping with the loss of a loved one. Harvard Health Publishing. Access here

Solomon, D. (2025). Do’s and Don’ts When a Loved One Is Dying. Psychology Today.  Access here

Ten Reasons Why Losing a Grandparent Still Hurts Deeply as an Adult — Understanding Adult Grief and Ways to Cope. Grief Support Center. Access here

Bahou, C. (2025).  “Coping with the loss of a parent: Handling grief and more”. MedicalNewsToday.  Access here

The Myths That Silence the Most Important Question in Healthcare

Posted on by Joseph Gerard

healthcare power of attorney advance directive papers with on a table with a pen near itWritten by Dr. Erin Jenkins

As healthcare professionals, many of us will never forget 2020. During a global pandemic, millions of people died, and families were forced to grieve losses they never imagined they would face. Loved ones were taken by a virus that moved quickly and unpredictably, leaving little time to prepare emotionally or practically. During this period, I was working in hospital based palliative medicine. In more typical times, our work focused on supporting people living with chronic illness, managing symptoms, and helping patients clarify how they wanted to live while navigating conditions such as COPD, CHF, and cancer.

During the pandemic, that work shifted dramatically. Patients who had long been managing chronic disease were suddenly confronted with a virus that disproportionately affected those same conditions. Regardless of diagnosis, one reality remained constant: COVID significantly increased the risk of death for patients with chronic illness.

End of life conversations became part of our daily work. We spoke with patients struggling to breathe, many dependent on oxygen or ventilatory support, including individuals with no prior respiratory disease. Yet, when asked about their wishes, most patients did not have clear answers. Families often struggled to accept that their loved one might die. Hope persisted, as it always does in medicine, but it became increasingly apparent that many patients and families were completely unprepared to make these decisions. Some waited until it was too late.

It was during this time that I began to fully grasp how many Americans lack end of life plans, even those who regularly interact with the healthcare system. Research suggests that fewer than one third of U.S. adults have completed an advance directive to guide care during times of crisis (Auriemma, Halpern, Asch, Van Der Tuyn, & Asch, 2020). These rates vary based on age, education, and other social determinants. Together, these findings highlight the gap between clinical recommendation and real-world readiness. It suggests a broader disconnect between patients and providers, as well as between patients and their families, leaving many unprepared to make critical decisions under duress. The question is, why?

One persistent myth in healthcare is that end of life planning is only for the elderly or those with terminal illness. This belief delays conversations that are both necessary and appropriate for all. End of life planning is for everyone and involves more than signing a document. It is a process designed to align care with what matters most to patients and their families. While these discussions can feel uncomfortable, proactive conversations lead to better alignment of care, reduced moral distress, and support clearer decision-making during times of crisis. These discussions include preferences regarding CPR versus DNR status, surrogate decision makers, mechanical ventilation, artificial nutrition, and post death wishes. While formal documentation is important, the most critical step is initiating the conversation. Without clarity, families are left to make life altering decisions under intense emotional strain, and clinicians are placed in ethically challenging positions.

Another common myth is that discussing end of life planning takes away hope. During the pandemic, many clinical teams hesitated to initiate these conversations out of concern that they might cause anxiety or signal that death was imminent. But our experience in palliative care showed the opposite. Even when the focus of conversation is a difficult topic, patients often felt less anxious and more supported. Additionally, research shows that advance care planning improves proximal outcomes, including communication quality, decisional confidence, and patient-surrogate congruence (Malhotra et al., 2022).Trust between patients and their care teams also increases. These discussions are not about removing hope. They are about preserving dignity, honoring autonomy, and reducing unnecessary suffering.

There is also a common misconception that patients will bring up these conversations “when they are ready”. In reality, no one ever feels ready for these discussions. Patients cannot ask for guidance around decisions they do not yet understand or know need to happen. That is where we come in. As healthcare professionals, part of our role is to guide patients through complex medical decisions, including those related to end-of-life care. Many clinicians who consulted our palliative care team in 2020 did so because they were unsure how to begin these conversations. Some were waiting for patients to say they were ready, while others felt that they were not equipped to lead the discussions themselves. While palliative and hospice teams are often seen as the experts in end-of-life discussions, the responsibility for these discussions is shared. At their core, these are conversations about goals and values. When framed that way, they become more approachable for both patients and clinicians.

Another misconception is that there simply is not enough time during a visit to address end of life planning. Anyone who has worked in primary care understands the challenge of limited time within the appointment. But these conversations do not need to be lengthy. They also do not need to occur in a single visit. Clinicians can begin with a simple question: “I was hoping we could talk a little about your goals in case there came a time when you could not make decisions for yourself.” From there, some foundational questions can be explored: who would serve as a surrogate decision-maker, what types of interventions the patient would or would not want, and how they wish their body to be cared for after death, including organ donation. These discussions frequently can unfold over two or three brief visits. What matters most is our willingness to normalize and prioritize them.

Despite the documented benefits of advance care planning and strengthened communication between patient and clinician, barriers remain. Many clinicians report lack of training or confidence in initiating end-of-life discussions, time constraints that reduce opportunities for discussion, and concerns about disrupting the clinician-patient relationship. Yet, when these conversations occur, they contribute to greater alignment of care with patient values and help prevent crisis-driven decision-making that may not reflect what patients would choose.

So, the question becomes this: have you had these conversations with your patients? And if not, what are you waiting for?

Author Biography:

Dr. Erin Jenkins is a certified Family and Psychiatric Nurse Practitioner with 23 years of experience in critical care, family medicine, neurosurgery, and palliative medicine. She owns Your Full Potential Psychiatry & Wellness in Southern Nevada, where she helps people improve their overall wellbeing using integrative medicine. Dr. Jenkins also serves as an Advanced Practice Registered Nurse in the U.S. Air Force Reserve, working in base operational medicine and focusing on military psychiatry. Learn more at https://www.yfpwellness.com and connect with her on LinkedIn at https://www.linkedin.com/in/erinjenkinshealth .

References:

Auriemma, C. L., Halpern, S. D., Asch, D. A., Van Der Tuyn, M., & Asch, J. M. (2020). Completion of advance directives and documented care preferences during the Coronavirus Disease 2019 (COVID-19) pandemic. JAMA Network Open, 3(7).  Access link here

Malhotra, C., et al. (2022). What is the evidence for efficacy of advance care planning … BMJ Open, 12(7). Access link here

 

 

 

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Please also review AIHCP’s Grief Counseling Certification program and Grief Counseling CE courses see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Types of Perinatal Loss Video Blog

Posted on by Mark Moran

This video reviews the types of perinatal loss that a woman or a couple can experience.  These range from early miscarriage to later trimester losses, as well as stillbirth.  This type of loss is very difficult and has multiple layers and secondary losses associated with it.  Please also review AIHCP’s Grief Counseling Program as well as its Perinatal Grief and Loss specialty certification and see if it meets your academic and professional goals.

Perinatal Grief and Loss

Posted on by Mark Moran

 

I. Introduction

Perinatal grief and loss are deeply complex experiences, emotionally and psychologically speaking. It’s especially challenging for parents who are dealing with the trauma of losing a child either before or shortly after birth. This kind of loss really challenges what society expects around parenthood, bringing to light a grief that is often not recognized as it should be. As we talk more about perinatal loss, we’re also starting to realize just how much social situations impact how people grieve. Exploring these situations carefully shows us that healthcare workers need to get that perinatal loss can lead to what some call “social death.” In these cases, parents find themselves emotionally unseen in their grief (Borgstrom et al., 2016). In the pages that follow, this essay will explore how personal stories of loss interact with broader societal effects. Furthermore, it will examine the critical role and importance of helpful bereavement support systems, using insights from qualitative research methods to shed light on the real, lived experiences of individuals as they confront perinatal grief (Davidson D).

Perinatal losses include stillborn, neonatal death and miscarriages. Please review AIHCP’s Grief Counseling Certification
Please also review AIHCP’s Grief Counseling Certification and see if it meets your academic and professional goals.

 

A. Definition of perinatal grief and loss

The distress felt by parents after losing a baby around birth—we’re talking from pregnancy to a month after—is what’s known as perinatal grief and loss. It’s intense, both emotionally and psychologically. It’s not just about the baby, either; it’s also the crushing loss of all those hopes and dreams parents had started building (Campbell-Jackson et al., 2014). And it’s tricky because society doesn’t always get how truly difficult this is. Research, such as studies on stillbirths, has shown that how healthcare folks act really shapes what parents go through. Compassionate support that respects what parents want, like whether they want to hold their child, is key (A Lathrop et al., 2015). So, getting perinatal grief means looking at both the personal, emotional side and how bigger things, like the healthcare system, play a role in the experience. Generally speaking, a nuanced approach is needed to fully understand it.

 

B. Importance of addressing perinatal grief

Dealing with perinatal grief is really important because it hits parents hard, emotionally and psychologically. Research suggests that when parents face the stillbirth of a baby, they often feel an intense loss, so they really need healthcare providers to give them a lot of support in navigating their grief. For example, some qualitative studies show that allowing parents to connect with their stillborn infants—when handled carefully—can actually help them process their grief and create lasting memories, which can be a big part of healing ((A Lathrop et al., 2015)). Additionally, the effects of perinatal loss aren’t just about the immediate emotional pain; it can even lead to more serious problems like post-traumatic stress disorder (PTSD) after giving birth ((Sawyer A et al., 2015)). So, when we recognize and address perinatal grief, we’re not just easing the immediate pain but also helping to prevent longer-term psychological issues. Ultimately, we’re pushing for a more compassionate and informed healthcare response to these kinds of sad situations.

 

C. Overview of the essay structure

When you’re crafting an essay about the tough subject of perinatal grief and loss, a solid structure is really important. It’s got to help guide the reader through some pretty complicated emotional and psychological territory. The intro needs to set the stage, you know, explain why this topic matters. It should also lay out your main point – that perinatal loss hits parents and families hard. Then, in the paragraphs that follow, you dive into the specifics. We’re talking about the psychological effects, how culture shapes how people grieve, and why it’s so crucial for grieving parents to have good support. Each part of your essay shouldn’t just include hard data and the theories, but also real stories, to make it even richer. And finally, the conclusion should tie everything together, bringing home the point that we need to be understanding and kind when dealing with perinatal grief. It’s also a call for more research and better policies in this delicate area (Smolowitz J et al., 2010-05-20). You can’t just gloss over the importance of this, generally speaking.

 

II. Understanding Perinatal Loss

Perinatal loss – it’s more than just sadness; it can have deep emotional and psychological effects on everyone involved. When a baby is stillborn, for example, the impacts are often not fully appreciated. Studies actually show that stillbirths can cost families more money than live births because of extra medical care and support that’s needed ((Bhutta et al., 2016)). The emotional pain can also leave parents feeling alone, especially moms who might find it hard to get real support from their friends and family. Some women have shared in interviews that their loved ones just don’t get what they’re going through, which can make them feel even more isolated and helpless ((Collins et al., 2014)). It’s really important for doctors, nurses, and all of us to understand all of this so we can build better ways to help families heal after such a loss. Creating proactive support systems is essential for addressing the unique needs and challenges that grieving families face, and can assist in their recovery process.

Perinatal loss and grief

 

A. Types of perinatal loss (miscarriage, stillbirth, neonatal death)

Losing a baby around birth—we call it perinatal loss—includes some really tough situations like miscarriages, stillbirths, and when a newborn passes away. Each one brings its own kind of pain for the parents. A miscarriage, that’s when a pregnancy ends before 20 weeks, can really hit women hard, and it’s often a shock. They might feel super guilty or anxious, you know? Now, stillbirth is when a baby dies after 20 weeks. It’s not just grief; parents sometimes have to deal with people not really understanding what they’re going through. Then there’s neonatal death, when a baby dies in the first month. This adds another layer because parents have already started connecting with their child. Studies generally show that women react differently and cope in their own ways to these losses. This means support needs to be personalized to what each woman is experiencing (Tuba Uçar et al., 2025), (P de-Juan-Iglesias et al., 2025).

 

B. Statistics and prevalence of perinatal loss

Perinatal loss isn’t just a sad thing; it’s a real public health issue, hitting families hard emotionally and psychologically. When you look at the numbers, you see that in richer countries, somewhere between 1 and 5 out of every 1,000 births end in stillbirth. And then, about 2 or 3 out of every 1,000 babies born alive don’t make it very long. This shows you how often these awful events happen. But it’s not just about the immediate loss; it messes with a mother’s mental health and changes how families work. Qualitative research really brings that point home. A big review even pointed out that more than half – over 56% – of these deaths happen in hospitals, so healthcare workers see this kind of thing a lot (Kirshbaum et al., 2011). What’s more, people’s stories show how tricky it can be to deal with the grief, and often, the whole bereavement thing gets even harder because society can be weird about perinatal loss, which means that family and friends might not know how to help (Davidson D).

 

C. Psychological impact of perinatal loss on parents

The profound psychological effects of perinatal loss on parents can resonate for a long time, and really shape their mental health and overall wellness. Studies have shown that the grief following a stillbirth can often lead to problems. Think anxiety, depression, and a really isolating feeling. Parents will often talk about feeling inadequate or even guilty, and this is made worse because sometimes society just doesn’t get how real their loss is, which makes grieving even harder. How healthcare providers handle things is super important for these parents. If they show empathy, it can lessen the mental health impact and actually help parents deal with their grief in a better way (Bhutta et al., 2016). Plus, a lot of parents will say that holding and seeing their baby who was stillborn is important because it helps them make memories; healthcare professionals should really try to make that happen for parents in a compassionate way (A Lathrop et al., 2015). Actions like that can have a big impact on how these individuals heal from their perinatal loss.

 

III. Grieving Process in Perinatal Loss

Following perinatal loss, the grieving process presents intricate challenges, marked by distinct emotions and societal hurdles. In contrast to other bereavements, stillbirth confronts parents with a unique void: a child without lived experiences to remember in the traditional sense. Because there are no shared stories in the same way as family members that have lived longer lives, this inherent lack necessitates a form of what researchers label “identity work.” This refers to active efforts in establishing a lasting identity for the deceased child. Indeed, parental interviews reveal active integration of stillborn children into family stories, cementing connections between the living and departed, as highlighted in (INFANCY CEISADI et al., 2013). These kinds of endeavors illustrate the critical need for society to recognize the particular grief experienced in these scenarios, thereby stressing the role of robust support systems in enabling healthy grief processing amid deep loss.

Finding new meaning and understanding the loss and how it fits in one’s life is key in perinatal loss.

 

A. Stages of grief specific to perinatal loss

Navigating the grief following perinatal loss involves a winding emotional path for parents, deeply shaped by the particulars of each unique situation. At first, there’s often shock and disbelief. It’s hard to accept that the hopes built around becoming parents are gone. As this difficult time unfolds, intense sadness and even anger commonly surface, forcing parents to face the deep emotional hurt tied to the death of their child. It’s also incredibly important to have good communication and support. Research shows that mothers are often unhappy with the care they receive while grieving (Ahmadi et al., 2016). What’s more, mental health approaches, like Interpersonal Psychotherapy, can encourage healthier ways of coping, building resilience in families dealing with perinatal loss (Gray et al., 2014). Given these nuances, the need for understanding care and customized support is really highlighted.

 

B. Individual differences in grieving experiences

Dealing with perinatal grief and loss means we really need to get that everyone grieves differently. What works for one parent after losing a newborn might not work for another; things like where they come from, what losses they’ve been through before, and how they deal with tough stuff all play a part. Some parents, for example, might really want to see and hold their baby, finding it comforting, while others might be scared or unsure—and that can change how they grieve. Qualitative studies, as pointed out by (A Lathrop et al., 2015), show us that not all parents can easily say what they want when it comes to being with their stillborn child. It really drives home how important it is for healthcare providers to be there with good, sensitive guidance. Given this variability, it’s super important for those in healthcare to have talks with parents about what choices they want to make right after the loss. These moments? They can really stick with you. When we acknowledge these differences in how people grieve, we’re not just supporting each parent’s journey, we’re also building more compassionate practices around perinatal care.

 

C. Cultural influences on grief and mourning practices

Cultural factors play a major role in how we, as individuals and communities, deal with the tough issues surrounding grief and mourning. This is especially true when talking about the loss of a baby around birth. The best ways to mourn aren’t the same everywhere; some cultures are okay with showing a lot of emotion, while others prefer to keep things more subdued. Take Vietnam, for example. There, having an abortion starts a specific mourning journey, often influenced by both feeling ashamed and honoring ancestors. Lots of Vietnamese women struggle with what society expects from them when grieving and with the moral questions their loss brings up. As pointed out in the research, some women use the Nghia Trang Online memorial to worship ancestors. This helps them stay connected to the fetus they lost and also express their grief. It really shows how much culture can affect how we grieve, revealing the complicated mix of love, loss, and remembering (Earle et al., 2007), (Heathcote et al., 2014).

 

IV. Support Systems for Grieving Parents

Navigating the landscape of grief after perinatal loss is, generally speaking, a difficult journey for parents, presenting challenges that require significant support structures. Research suggests, and rightly so, that mothers and fathers alike often face deep grief and anxiety, particularly in later pregnancies; this highlights a need for interventions designed to meet both parents’ emotional needs (A Yamazaki et al., 2014). Traditional healthcare environments, however, may sometimes fail to fully recognize the specific pain tied to stillbirth, thus it’s important that health providers are trained to provide empathetic and comprehensive support during these times (Totten et al., 2013). Furthermore, effective support, in most cases, ought to facilitate healthy bonding with future children, and not just focus on grief itself. These systems should include community resources, counseling, and peer networks that offer grieving parents a safe space for sharing experiences and feelings. Acknowledging the complexities inherent in perinatal grief allows support systems to better guide parents through their loss and help them foster resilience despite profound sorrow.

Support is essential when overcoming a miscarriage or loss of an infant. Please also review AIHCP’s Grief Counseling Certification

 

A. Role of healthcare providers in providing support

Healthcare providers, in dealing with perinatal grief and loss, are essential not just for clinical reasons; they also provide vital emotional and psychological support to grieving families. It is important to communicate well, since families find comfort in empathetic conversations that acknowledge their emotions and requirements when facing such hardships. For example, one study showed that mothers were often not satisfied with the care they got after a loss. This underscores how important it is for providers to build an understanding atmosphere. Such an environment should respect patients’ dignity and be responsive to their needs (Ahmadi et al., 2016). Furthermore, healthcare providers need to help with the complicated medical and financial issues that can come with perinatal loss, which can add to the stress faced by grieving families (Ahmadi et al., 2016). When providers emphasize both clinical skill and emotional support, they can greatly ease the pain and suffering linked to this profound experience, improving the quality of care bereaved families receive overall.

 

B. Importance of family and community support

The ripple effects of perinatal grief and loss touch more than just the immediate family. A supportive community is really important. Family connections often act like a key support during such tough times, aiding resilience and helping with emotional healing. Empathetic relatives can ease the pain of grief, providing comfort and shared understanding. Furthermore, community involvement matters a lot when it comes to dealing with the wider implications of stillbirths, shown by studies about the impact on mental health and the resources needed for bereaved families (Bhutta et al., 2016). Qualitative research shows us how much structured community support systems and integrated bereavement protocols are needed, which can help with the grieving process (Davidson D). In the end, building strong family ties and community networks is crucial for navigating the complexities of perinatal loss, helping individuals recover and find hope.

 

C. Resources available for grieving parents (support groups, counseling)

Dealing with the difficult emotions of perinatal grief often requires help from others, which shows how important resources like support groups and counseling can be. These resources give grieving parents an essential place to share their stories, feel understood, and get caring support from others who have gone through similar pain. Studies suggest that support programs for bereaved parents can greatly improve their emotional health, especially when care is tailored to individual needs (Boring et al., 2019). In addition, personalized counseling methods, such as Interpersonal Psychotherapy and Cognitive Behavioral Therapy, are key to effective bereavement counseling, as seen in local mental health programs (Gray et al., 2014). Through these resources, parents not only find comfort in shared experiences but also learn coping skills that can help them heal and build resilience after experiencing profound loss.

 

V. Conclusion

To sum up, navigating perinatal grief and loss demands a sensitive awareness of the deep emotional effects on both mothers and fathers. Studies emphasize the intricate, often unspoken, aspects of this grief. Consider, for example, Pakistani men, who face the social disapproval associated with infant loss in their communities (Harrison R et al., 2025). The emotional path typically moves between initial shock and a search for understanding, all closely tied to cultural and religious views. Moreover, it’s important to acknowledge how perinatal loss influences later pregnancies, where guilt from the previous loss is a key factor connecting the intensity of grief to higher anxiety during pregnancy (Keser E et al., 2024). So, a well-rounded strategy for perinatal grief must include supportive actions. These actions should recognize these emotional details and tackle the differing experiences across various demographic groups, to encourage a broader, more inclusive awareness of this delicate subject in healthcare and in wider social settings.

Please also review AIHCP’s Perinatal Grief Counseling Program

Please also review AIHCP’s Grief Counseling Program and see if it matches your academic and professional goals.

 

A. Summary of key points discussed

Delving into perinatal grief and loss reveals some key takeaways that highlight just how complex this experience truly is. To begin, there’s a real need for tailored, well-vetted interventions for grieving parents. We see this emphasized in the systematic literature review, which looks closely at how well different support systems work, from expressive arts therapy to multimodal interventions that combine peer support with healthcare resources (Boring et al., 2019). The emotional and psychological effects of perinatal loss, furthermore, ripple outward, affecting not only parents but also their broader support networks. Because of this, it becomes even more important to have comprehensive and easily accessible support systems for family and friends who are affected indirectly (Feder et al., 2016). This interconnectedness really shows us that bereavement isn’t an isolated thing, it’s a communal one. It demands an inclusive healing approach that tries to address both the immediate and the long-term emotional needs within families touched by such a loss.

 

B. The need for increased awareness and sensitivity

Perinatal loss carries deep emotional consequences, often underestimated and requiring increased attention from healthcare providers and society in general. The bereavement of losing an infant is coupled with a feeling of social exclusion, which can deepen the grief experience and impede recovery. Support groups like HOPE highlight the importance of social justice in perinatal care, as the insights from women who participate expose systemic failures in addressing the various needs of people grieving such a loss (Fermor et al., 2016). Moreover, the physiological elements, for example milk leakage and breast engorgement, add more complexity to the emotional aspects of perinatal grief, therefore healthcare providers must provide comprehensive information and coping strategies (Bakhtiari et al., 2016). Support and understanding can greatly help the care and healing processes for people experiencing perinatal grief.

 

C. Call to action for better support systems and resources

It’s clear that better systems of support and resources are vital for parents experiencing bereavement, particularly when dealing with perinatal grief and loss. Studies suggest that bereavement interventions, as they exist right now, often aren’t as effective or well-designed as they could be. In fact, just a handful of studies show good results for parents working through their grief (Boring et al., 2019). Because of this, many are advocating for the creation of support programs that are evidence-based, address the many needs of these parents, and are specifically tailored to them. For example, models that prioritize the active involvement of those affected, along with therapies such as Interpersonal Psychotherapy, could make support both more accessible and more effective (Gray et al., 2014). We can help bereaved parents not only get emotional support, but also provide the resources they need to heal and build resilience as they cope with their deep loss by using thorough and personalized care strategies.

Additional AIHCP Blogs

Miscarriage and Loss: Click here

Additional Resources

Lebow, T. (2022). “Miscarriage Grief: How to Cope with the Emotional Pain”. PsychCentral.  Click here

Nathan, E. (2024). “Grief After Miscarriage” Psychology Today. Access here

Guarnotta, E. (2022). “Dealing With Perinatal Loss: What You Can Do & Who Can Help”. Choosing Therapy.  Access here

“Coping with Grief in Perinatal Loss” Forever Families.  BYU. Access here

 

 

 

Autism and Grief in Children Video Blog

Posted on by Mark Moran

Autism manifests grief in different ways.  With so much diversity within the spectrum, it is important for Grief Counselors and other caregivers to understand how Autistic children grieve and respond to loss.  This video presents a detailed response to helping autistic children with loss and grief

Please also review AIHCP’s Grief Counseling Program as well as its Grief Diversity Counseling program

 

4 Interventions for Grief Support Groups With Songs

Posted on by Joseph Gerard

Support group patients comforting depressed woman at therapy session, panoramaWritten by Emily Stokes,

No two people process grief in the same way, which makes it essential for healthcare professionals to ensure that support for dealing with it is varied and flexible.

Music can be compelling in this context, and there are various ways to use songs as a means of encouraging individuals and groups to work through their complex emotions. Its effects can be subtle or seismic, but in either case, the outcome is positive progress.

It’s vital to implement songs in a grief support setting in a manner that’s structured and clinically sound. So with that in mind, here’s a look at a few different intervention options that work well, and how to make the most of them in your own groups.

Reflecting on Lyrics

Lyrics are the emotional core of many songs, and yet it’s easy to overlook their meaning when listening casually. In a support group dealing with the emotion of grief, the facilitator can encourage members to reflect on what the songwriter has to say on a much deeper level, in turn allowing them to explore their own emotional responses to the message conveyed.

The choice of song matters here, of course, so you need to pick tracks that cover themes or stories related to the kinds of experiences that group members are facing themselves. Loss is a common talking point in popular music, although not all of the songs you use need to be steered by this theme. There’s just as much to be gained from including those whose lyrics deal with resilience and perseverance, for example.

Printing out the lyrics so that members can read along as you play the song in full is a must, as it makes the meaning more transparent and the experience more engaging. Once a full playthrough is complete, ask some specific questions regarding the lyrics.

For instance:

  • What line stood out most, and why?
  • What aspect of the lyrics connected with your own story, and how?
  • What emotion did the lyrics evoke most strongly, and what do you feel about the journey the songwriter takes you on?

The overarching idea is to provide grief support group attendees with a way to express their own emotions and responses to emotive content, while ensuring that this process is less intimidating than a more direct approach.

Collaborative Songwriting

There’s space for creativity in grief support groups, and collaborative songwriting provides an avenue for introducing music as a therapeutic method while also making it less focused on the individual.

It’s useful to begin the songwriting process by deciding on a top-level theme together; ideally, one that’s relevant to the experiences and emotions of everyone. Popular options include hopefulness, resilience, and remembrance of loved ones, but feel free to explore other suggestions from the group.

Again, facilitators must prompt the creative process with questions that spark input from group participants, as it’s likely that many people will be reticent to experiment with songwriting, given that this is a pastime few will have attempted for themselves until this point.

You might ask:

  • What emotions are you feeling most frequently at the moment?
  • What message do you want to get across over the course of the song?
  • What other songwriters inspire you, and what features define their lyrics?

Get input from everyone and note down what they say on a whiteboard or large paper flip chart so that everyone can see the ideas building and recognize that their contributions are relevant. Simplicity and brevity of expression are recommended here, although again, if there are more complex themes and thoughts in play, it’s better to explore and unpack them than suppress them.

Keeping things simple also applies when developing the melody. If there are gifted musicians already within the group, they might take the lead here. If not, it is sensible to take existing tunes and repurpose them as the backdrop for your new lyrics. This takes the pressure off everyone.

Most importantly, don’t force anyone to go outside of their comfort zone. Some will be happy to be more actively involved in the songwriting and any subsequent performance than others. This has to be an inclusive experience.

Sharing what you’ve created is another beneficial outcome, and digital tools make this a breeze. For instance, if you record your finished song, you can then use a service like DistroKid to add it to streaming platforms, including Spotify and Apple Music. From here, the broader network of friends and family who are also within the sphere of grief will be able to hear the songs and take their own comfort from them.

Creating Playlists

Putting together a playlist is a soothing and satisfying process regardless of the aim or intention, so its application in a grief support scenario has obvious upsides.

Here, the motivation for the playlist is to create a combination of songs that reflect the life and legacy of the loved one who has been lost. Every track can spur a memory and hold special meaning for the individual who’s grieving. This is inevitably going to create moments of pain. Still, there is also the opportunity to start looking back and finding moments of positivity and light, rather than every aspect of grieving feeling like a struggle.

Facilitators must stimulate the playlist creation process with guiding questions to inspire participants, because not everyone will find it simple to come up with suitable song choices.

You might ask open-ended queries like:

  • What was their favorite song, and what time in their life is it connected to?
  • What music did you listen to together?
  • What genre or artist do you most associate with them, and why?

As playlists are put together, this also serves as a conduit for sharing stories and having conversations about loved ones within the group. People feel more connected with one another when it’s clear that grieving is a universal experience.

In terms of the technical side of playlist creation, turning to streaming services like Spotify and YouTube is the obvious option. You can, of course, allow those without the technical skills or inclination to use digital tools to write down songs by hand, which you can then add to playlists later.

Once finished, playlists can be shared and enjoyed by group members and their families, allowing for moments outside of the group in which memories and emotions can be discussed freely. It gives structure to this without being overly conspicuous as a clinical tool, so it is especially useful in the case that participants are resistant to more traditional forms of support.

Guided Imagery with Music (GIM)

GIM is a specific therapeutic technique that integrates music with visualization. In a grief support setting, it can be deployed to enable a more personal approach to processing emotions and confronting memories about a loved one who has been lost, without the need for verbal expression.

Facilitators typically choose music which is calming, soothing, and lyric-free, while giving participants instructions on how to visualize a scene which sets out to deal with the emotions they are feeling around the death of someone close to them. Classical music is a popular choice, although ambient music from modern artists can also be appropriate.

The guidance provided by the facilitator does not need to be overly specific. Invite group participants to picture themselves somewhere safe, secure, and ideally connected with a cherished memory they have of the loved one in question. Combine this with talking points about the future and the thoughts of hope and strength that will enable them to move forward positively.

Additionally, ensure that your own input is broken up to allow for moments of quiet reflection on what’s been said, during which only the music is heard. This gives participants space to think and absorb.

The final stage of GIM can revolve around a discussion of the experience, including the opportunity for participants to speak openly about what they felt. Non-verbal options for reflection, such as journaling, are also worth offering, as not everyone will want to share what they’ve encountered with an audience.

The results of GIM vary, and some will find that it taps into memories, thoughts and emotions that were previously obscured from them. In contrast, others will simply appreciate the calmness and tranquility it encourages.

The Last Word

The introduction of song lyrics, songwriting, playlists, and GIM in grief support groups gives facilitators more options for empowering participants and assisting them as they face the toughest period of their lives.

All of the interventions discussed can be effective, but only if they are adopted in a way that’s structured and non-confrontational. Making people participate in activities that they’re not comfortable with is not wise, even if the intentions are good. Be inclusive, sensitive and communicative as you roll out songs for therapeutic purposes, or risk backlash.

Also, keep in mind that you will need some level of tech know-how to enable participants to make playlists and record songs if you decide to adopt this approach. It might add a modicum of complexity to the running of grief support groups, but the payoff more than justifies this.

 

Author bio:

Emily Stokes is a freelance writer with experience in the higher education and non-profit industries. She creates content for blogs and other online resources, and enjoys distilling down complex concepts through her writing.

 

Please also review AIHCP’s Grief Counseling Certification programs and see if it meets your academic and professional goals.  These programs are online and independent study and open to qualified professionals seeking a four year certification

Grief Counseling and Toxic Positivity Video Blog

Posted on by Mark Moran

Behavioral Health views toxic positivity as a way to bypass grief and loss.  It downplays the needed expression of emotion and ignores the true bad of a situation.  It is fine to be sad and to acknowledge something as not good.  Toxic positivity presents blinders to the situation, stunts emotional expression and bullies the griever into remaining quiet. This video takes a closer look at the negative effects of toxic positivity

Please also review AIHCP’s Grief Counseling Certification.  Please click here