Professor William Worden stresses that mourning, which he defines as the emotional process that occurs after loss, is an essential and necessarily painful healing process, which is achieved through a series of tasks (Worden, 1991).
1. Facing Reality
Initially the bereaved person is likely to be in the state of shock and numbness, even when a death has been anticipated. This can be manifest as over-reaction, whereby the bereaved person feels faint, cries uncontrollably, becomes hysterical or collapses. However the antithesis is also seen and the person may display no emotion at all, appearing very controlled, calm and detached. This initial shock may last several days and usually allows the bereaved to deal with all the necessary practicalities and cope with the funeral without losing control - a form of emotional protection.
It is very important that the bereaved person gradually accepts the death of this significant person in their life and that they can never return, in order to allow them to begin the task of adjustment. Some people may not immediately be able to talk about it. Initially being able to see the dead person, being involved as much as possible in the preparations for the funeral, and observing rituals and traditions, all assist people to face the reality of what has happened. Families from ethnic minorities may need permission and support for the mourning rituals appropriate to their culture.
2. Experiencing the pain of grief
Once the numbed feeling gradually subsides and the reality of what has happened is experienced, the bereaved person may have intensely painful feelings, which may last weeks or months. Their grief may overwhelm them so that they are incapable of thinking about anything or anybody else but themselves and how they feel. It gets in the way of everything or anybody else but themselves and how they feel. It gets in the way of everything they think and do. They may over react to other people's comments and appear irritable. Susan Hill, a writer and a bereaved mother, eloquently described her extreme sensitivity as "having one skin less".
As well as feelings of extreme sadness, the bereaved often experience guilt, anger and resentment. Many people struggle with guilt about some aspect of their relationship with the dead person. Perhaps they had left unsaid their true feelings, or said things they didn't really mean. Maybe they had not spent enough time with them or really listened.
Feelings of anger can be extremely powerful. The bereaved person may feel anger towards the dead person; anger for the loss of control that death brings; anger at the medical team for not curing the illness or not keeping the dead person alive; and anger at their God for letting it happen. They may feel resentment towards a family member who they feel contributed in some way to the death.
Grief is not a mental illness, although sleeplessness, anxiety, fear, anger and a preoccupation with self can all add up to a feeling of 'going mad'. These feelings are natural and when experienced and expressed will become less frequent and begin to subside over time. Talking about them and bringing them into the open is helpful. Expressing grief is cathartic, and attempts to short circuit these feelings rarely help in the long term and may cause deep-seated problems in the years ahead. If grief is denied, or anger and guilt persist to the exclusion of other feelings, help may be requested from a trained professional counsellor.
3. Adjusting to the new reality
Facing life without someone you love is a difficult and painful process. No one can fill the aching void the person has left and each day life brings constant reminders of their absence. The future seems uncertain or even frightening and a tremendous effort is required to get through every day. It may take many months before the bereaved person is able to dwell less on the sad events surrounding the death and start to function more as they did before the loss.
4. Emotionally relocating the person who has died and moving on with life
This involves moving on to a new way without the dead person, whilst holding on to memories. It is a way of reinvesting in life again alongside the knowledge that the dead person will never be forgotten. This can often feel like betrayal and is perhaps the most difficult task of all.
There is a sense of resurrection, of putting the sadness aside and looking to the future, whilst recalling happy times spent with the person who has died and finding comfort and pleasure in those memories. It is also a way of making life more meaningful and winning back control, so that the bereaved person is not continually ambushed by memories of the person who has died and trapped by painful feelings, but rather can choose when they want to reflect about their relationship with the dead person. It is normal at anniversaries for feelings of grief to be aroused again and to be as vivid as on the day the death occurred.