The Impact of Unfulfilled Dreams

The Unrecognized Grief

Grief is an often overwhelming emotion commonly associated with losing a loved one or a personal tragedy. But, what if grief arises from a dream that never materializes or when life continually falls short of expectations? Nonfinite grief occurs when one mourns for what was never realized as opposed to grieving something that has been lost.[1] In terms of duration, nonfinite grief is a continuing presence of loss that may be physical, psychological, and/or emotional.[2] In a world where life's disappointments and unfulfilled hopes can be devastating, understanding nonfinite grief can help people process and comprehend the spectrum of human emotional experiences.[3]

Assumptive World

Throughout a person's lifetime, their early experiences shape their beliefs, expectations, and assumptions about how the world operates. These foundations are influenced by various factors such as culture, people's behaviors, upbringing, and other elements, collectively called the "assumptive world".[4] Conversely, the shattered assumptions theory, introduced by Janoff-Bulman in the context of traumatic experiences, explains that individuals rely on these assumptions about the world and themselves to maintain healthy human functioning.[5] Edmondson et al. (2011) explains that without these assumptions, individuals may face a breakdown of their life narrative and a loss of self-identity, as described in the shattered assumptions theory.[6] The predictable worldview's function is to provide individuals with a sense of purpose, self-worth, and the illusion of invulnerability.[7] 

Conversely, when one’s assumptive world undergoes severe disruptions, individuals can experience nonfinite grief. This grief can manifest from different types of life experiences, as demonstrated by the following examples:

Physical: An athlete has been diligently preparing for a life-changing game. Due to a recent injury, they were rendered ineligible to participate in that pivotal game and left devastated.

Psychological: An individual tirelessly worked towards a promotion at their job. They were passed over, leaving them with a deep sense of disappointment.

Emotional: An individual longs for the day they exchange vows with their long term partner. However, as the years pass, they find themselves single and the dream of marriage seemingly slipping away.

Recognizing the Grief

Grief, when it falls outside of societal norms, can be hard to identify. The Dual Process Model for Non-Death Loss and Grief displays some of the everyday experiences of an individual oscillating between loss orientation and restoration orientation.[8] Wang et al. (2021) explains how loss orientation refers to the focus on coping with the loss itself whereas restoration orientation is a coping strategy that focuses on emotional recovery.[9]

In the Dual Process Model (as shown below) people oscillate between two types of orientation during their every day lives.[10]

In order to try to recognize one’s grief, the following three main factors separate nonfinite grief experiences from grief caused by death:[11]

1. The loss causes a persistent feeling of despair and emptiness from the reality shaped by their previous expectations with their envisioned future.

2. The loss is due to an inability to meet developmental expectations.

3. The loss is intangible, such as a loss of one’s hopes or ideals related to what the individual believes should have, could have, or would have been.

Furthermore, individuals grappling with nonfinite loss, such as erosion of long-cherished hopes and aspirations, often contend with persistent uncertainty regarding what the future holds.[12] A pervasive feeling of helplessness and powerlessness accompanies this ongoing loss, which is often met with little recognition or acknowledgment by others.[13]

Finding new meaning to life

Discovering new meaning to life can feel incredibly challenging especially when initial hopes and expectations were high. Amidst the grieving process, acceptance is more about recognizing that the new reality is permanent rather than merely adjusting.[14] Furthermore, acceptance includes taking a non-judgemental attitude towards oneself rather than labeling the grieving as a negative or positive experience.[15] When grappling with the complexities of grief, specialized therapy such as Complicated Grief Therapy (CGT) can help. This therapy is designed to address intense yearning, persistent longing, intrusive thoughts, and the acceptance of the reality of loss.[16] In addition to alleviating these specific symptoms, CGT also emphasizes the importance of personal growth, nurturing relationships as part of the healing process, and is based on attachment theory.[17] CGT with elements of cognitive-behavioral principles has been shown the most promise for individuals.[18]

An individual in CGT would cover seven core themes spanning over 16 sessions, including:[19]

1. Understanding and accepting grief

2. Managing painful emotions

3. Planning for a meaningful future

4. Strengthening ongoing relationships

5. Telling the story of the loss

6. Learning to live with reminders

7. Establishing an enduring connection with memories of the loss

Although 16 sessions is recommended, CGT is a flexible program. 

Another valuable approach for addressing grief is Acceptance and Commitment therapy (ACT).[20] Similarly to CGT, ACT uses core themes for individuals to work through their loss and life transitions including:[21]

1. Acceptance or willing to experience negative emotions or thoughts

2. Cognitive defusion

3. Contact with the present moment 

4. Self as context

5. Values

6. Committed Action
   

Malmir et al. (2017) explored the effectiveness of ACT for grieving individuals between the ages of 20 and 40 who were experiencing a range of symptoms, including anxiety, shortness of breath, illusion, and sleep disturbances.[22] The before and after outcomes were evaluated using a questionnaire designed to gauge the participant’s level of hope and anxiety.[23] The results of ACT therapy showed a significant reduction in symptoms among the eleven women and six men who received therapy compared to the ten women and seven men who did not.[24] The effectiveness of this modality in terms of healing from grief comes from increased cognitive flexibility, which is the main component of ACT.

If you or someone you know are experiencing nonfinite grief and loss that is impacting daily life and overall well-being, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for additional guidance and support.

Contributed by: Kelly Valentin

Editor: Jennifer (Ghahari) Smith, Ph.D.

REFERENCES

1 Bruce, E. J., & Schultz, C. L. (2001). Nonfinite Loss and Grief: a psychoeducational approach. https://openlibrary.org/books/OL8601025M/Nonfinite_Loss_and_Grief

2 Neimeyer, R. A., Harris, D. L., Winokuer, H. R., & Thornton, G. (2021). Grief and bereavement in contemporary society: Bridging Research and Practice. Routledge.

3 Harris, D. L. (2011). Counting our losses: Reflecting on Change, Loss, and Transition in Everyday Life. Routledge.

4 Parkes, C. M. (1971). Psycho-social transitions: A field for study. Social Science & Medicine. https://doi.org/10.1016/0037-7856(71)90091-6

5 Edmondson, D., Chaudoir, S. R., Mills, M. A., Park, C. L., Holub, J., & Bartkowiak, J. (2011). From shattered assumptions to weakened worldviews: trauma symptoms signal anxiety buffer disruption. Journal of Loss & Trauma. https://doi.org/10.1080/15325024.2011.572030

6 Ibid.

7 Ibid.

8 Harris (2011)

9 Wang, W., Song, S., Chen, X., & Yuan, W. L. (2021). When learning goal orientation leads to learning from failure: the roles of negative emotion coping orientation and positive grieving. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2021.608256

10 Stroebe, W., Schut, H., & Stroebe, M. S. (2005). Grief work, disclosure and counseling: Do they help the bereaved?. https://doi.org/10.1016/j.cpr.2005.01.004

11 Harris (2011)

12 Bruce, E. J., & Schultz, C. L. (2001). Nonfinite Loss and Grief: a psychoeducational approach. https://openlibrary.org/books/OL8601025M/Nonfinite_Loss_and_Grief

13 Ibid.

14 Cianfrini, L. R., Richardson, E. J., & Doleys, D. (2021). Pain psychology for clinicians: A Practical Guide for the Non-Psychologist Managing Patients with Chronic Pain. Oxford University Press.

15 Ibid.

16 Wetherell, J. L. (2012). Complicated grief therapy as a new treatment approach. Dialogues in Clinical Neuroscience. https://doi.org/10.31887/dcns.2012.14.2/jwetherell

17 Ibid.

18 Ibid.

19 Iglewicz, A., Shear, M. K., Reynolds, C. F., Simon, N. M., Lebowitz, B. D., & Zisook, S. (2019). Complicated grief therapy for clinicians: An evidence‐based protocol for mental health practice. https://doi.org/10.1002/da.22965

20 Speedlin, S., Milligan, K., Haberstroh, S., & Duffey, T. (2016). Using acceptance and commitment therapy to negotiate losses and life transitions. Research Gate.

21 Bohlmeijer, E. T., Fledderus, M., Rokx, T., & Pieterse, M. E. (2011). Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. https://doi.org/10.1016/j.brat.2010.10.003

22 Malmir, T., Jafari, H., Ramezanalzadeh, Z., & Heydari, J. (2017). Determining the effectiveness of acceptance and commitment therapy (ACT) on life expectancy and anxiety among bereaved patients. https://doi.org/10.5455/msm.2017.29.242-246

23 Ibid.

24 Ibid. 

How Mortality Changes Our Behaviors: Insights from Death Anxiety Research

Reminders of Death

Everyone eventually dies. Despite this commonality, psychologists like Gordillo et al., (2007) have found that being reminded of our own demise (i.e., mortality salience) can change several of our thoughts and behaviors due to the emergence of imminent death anxiety.[1] Whether we are aware of it or not, we typically become more fearful and sad following death reminders, and our behavior is subsequently impacted[2] as we work towards protecting ourselves through self-preservation. Fritsche et al. (2007) found an increase in reproductive behaviors and desire for offspring and Rosenblatt et al. (1989) found an increase in the defensiveness of culturally-upheld values after mortality becomes salient.[3,4] These findings relate to the evidence-based Terror Management Theory (TMT), which states that death anxiety is a primary motivator for all human behaviors.[5] TMT adds that every culture preserves ideas of immortality to reduce the feelings of this “terror” or anxiety such as memorials, symbolic afterlives and statues. Death anxiety and its impacts on people provide insight into several processes of the human condition as well as mental health treatment and practice.

Mortality Salience in Everyday Life

Presentations of mortality salience (MS) may appear as: viewing a cemetery on the way to work, witnessing constant sickness and death as a healthcare worker, viewing violence and danger on television, seeing an ambulance on the freeway, or anything that may remind someone of their own danger. By fMRI (functional magnetic resonance imaging), the parts of the brain that can be activated after MS include the prefrontal cortex (involved in self-regulation), to regulate and motivate defense of concerns of death.[6] The right amygdala (important for emotional processing), and the behavioral inhibition system (BIS) as well as general anxiety systems, are also involved.[7] Xu et al. (2022) found that MS also increases activation in areas of the brain regarding guilt and shame as one experiences death anxiety.[8]

Changed Behaviors

Cultural Values 

A person’s thoughts and behaviors typically change after they are reminded of their mortality. When self-esteem (i.e., a person's sense of their worth) is high, it is found to be a protective buffer against fears surrounding death.[9,10] Furthermore, Basset & Bussard (2021) found that the strength of one’s religious beliefs and actions increases as fears of death conversely decrease, suggesting that religion can help protect oneself from death anxiety and boost self-esteem.[11,12] 

The impact of the perceived mortality reminder also depends on whether it was felt individually or collectively. Utilizing data across 79 countries, Fog (2023) found that mortality salience of individual danger (danger to oneself) reveals increased religious behavior but no effect on religious beliefs, less regard toward authorities and less nationalism.[13] On the contrary, perceived collective danger (danger to a group of people including oneself) tends to result in increased nationalism, traditionalism, security, religiosity and strict sexual morals.[14] Additionally, Rosenblatt et al. (1989) found that after mortality salience, judges fined prostitutes more and declared harsher punishments, upholding negative views toward prostitution while promoting culturally conservative values.[15] Rosenblatt et al. also found that people promote “heroism” following MS. They found that college students that were primed with a death reminder (when compared with a control group) gave three times as large of a reward to a fictional hero as well as a more severe punishment to a fictional non-violent criminal.[16] 

Decreased Altruism

Possibly in an effort to maintain self-preservation, reminders of death tend to lessen a person’s altruism (i.e., behavior that is unselfishly beneficial to others).[17] Kheibari et al. (2023) found that those with low self-esteem, tend to develop increased stigma about suicide once they face MS.[18] In addition, respondents reported a lower likelihood to intervene and try to prevent another’s suicide, and they responded that they would allocate less money to suicide prevention organizations.[19] 

Risk-Taking and Safety Behavior

Being reminded of death has risk-taking implications. Weng et al. (2023) found that among publicly traded firms in the United States, MS inflicted on the director or CEO led to decreased long-term investment by firms.[20] Bessarabora & Massey (2023) also found that MS produced adaptive opinions towards texting and driving, resulting in greater attempts at safe driving and self-preservation.[21] Li et al. (2023) note that people were impacted by the death anxiety caused by negative media exposure during the COVID-19 pandemic.[22] As a result, employees were shown to follow increased human resources practices (e.g., workplace safety behaviors) during the pandemic.[23] In an effort of self-preservation, death anxiety also enhances consumer purchasing desires, alluding to practical applications regarding marketing and advertising.[24] Emergency-related death anxiety from the COVID-19 pandemic additionally led to studies involving panic shopping (i.e., “consumer misbehavior”) as people feverishly sought to stock up on perceived essentials necessary for survival.[25] By collecting responses from 400 consumers that shopped during the pandemic, Scarpi et al. (2023) found that death anxiety impacted customers’ awareness of their shopping misbehavior and individual responsibility.[26] 

Relationships and Attachment

Following a death reminder, Plusnin et al. (2018) note that close relationships were found to be a way of reducing death anxiety similar to self-esteem’s buffer function.[27] Mental accessibility of words related to attachment is also increased after MS, in addition to commitment to a partner and the desire for psychological intimacy.[28] 

Death Anxiety’s Purpose and Relevance

Many elements of an individual’s life are impacted by a reminder of death, yet how this actually functions is less known. Many models are proposed based on sociological, anthropological, philosophical, and neurological evidence (including TMT) making this field extremely interdisciplinary. 

Reasons why death anxiety affects so many human behaviors may relate to legacy motivations[29] and the desire for one’s legacy to last through familial and generational knowledge (akin to symbolic immortality). This perceived immortality through remembrance may act as a coping mechanism to overcome death anxiety and[30] many cultures seek symbolic immortality by preserving life as never-ending through modes such as religion, art and rituals. 

Psychopathology and Death Anxiety

Death anxiety creates a sense of powerlessness and meaninglessness in life and coping mechanisms to combat these sensibilities can sometimes be more hurtful than helpful (such as avoidance) and are correlated with many psychiatric disorders.[31] For instance, existential anxiety may help drive, cause, or sustain many anxiety disorders including:[32]

• Panic disorder

• Separation anxiety disorder

• Agoraphobia (i.e., fear of leaving one's home or specific situations)

• Specific phobias

• Social anxiety disorder 

• Obsessive-compulsive disorder (OCD)

• Somatic symptom-related disorders (related to impairing anxiety about health symptoms)

Research with anxiety disorders will typically prime individuals with a death reminder and observe an increased perceived threat and maladaptive behaviors within individuals when presented with anxiety-provoking stimuli, as opposed to when presented with no death reminder.[33] In addition to promoting a range of anxiety disorders, death anxiety can be a factor in:[34]

• Stress-related disorders and post-traumatic stress disorder (PTSD)

• Depressive disorders

• Eating disorders

• Substance use disorders

• Psychotic disorders

The frequency of death-related thoughts is typically increased for individuals with such disorders. Additionally, those with substance abuse disorders may engage in self-medication as a form of maladaptive coping with death anxiety, as Menzies & Menzies (2023) note that among people with substance abuse disorders, increased symptom severity correlates with higher existential anxiety.[35] 

Treating Death Anxiety

While death anxiety seems to be an inevitable and even unconscious element of being human, an exceeding amount of it may factor into impairment in life. Death anxiety was found to predict psychosis[36] among many mental disorders and targeting death anxiety, itself, may be a way to prevent and treat subsequent life impairments. 

Menzies & Menzies (2023) note that Cognitive Behavioral Therapy (CBT) has been useful in reducing death-related anxiety through methods such as Exposure Therapy that allow patients to confront their fears surrounding death.[37] Death “thought-reframing” has also been employed to encourage positive adaptive coping with death anxiety.[38] Acceptance and Commitment Therapy (ACT), a modality used to focus on awareness of mental states and thoughts, may also be a way for clients to reflect on the meaning of their lives and restore this from what was lost in experiences of death anxiety.[39,40] Relating to Buddhist thought and practice, Anālayo et al. (2022) found that mindfulness also reduces death anxiety through facing mortality, which simultaneously increases self-compassion.[41] 

Death anxiety takes implicit and explicit forms that range from completely expected to life-impairing. Its empirical insights may lead to a holistic perspective of human behavior. Being mindful of these findings may include applying them to practical situations such as justice systems and hospital employees. Aldiabat et al. (2023) note that consideration for perceptions of death and death reminders is relevant to nurses and other healthcare workers for how MS may impact their actions in practice.[42] Further research in the field, including death anxiety and psychiatric disorders, may also open doors for clinical treatment to target existential anxiety, particularly for middle-aged adults, seniors and those with chronic or terminal illnesses. 

If one is experiencing death anxiety that is impacting daily life and overall well-being, please reach out to a licensed mental health professional (e.g., a psychotherapist, psychologist or psychiatrist) for guidance and support.

Contributed by: Phoebe Elliott

Editor: Jennifer (Ghahari) Smith, Ph.D.

References

1 Gordillo, F., Mestas, L., Arana, J. M., Pérez, M. Á., & Escotto, E. A. (2017). The Effect of Mortality Salience and Type of Life on Personality Evaluation. Europe's journal of psychology, 13(2), 286–299. https://doi.org/10.5964/ejop.v13i2.1149

2 Huang, C., & Hu, C. (2023). The terror management and sorrow management of death consciousness. Acta Psychologica Sinica, 55(2), 318-335. doi:10.3724/SP.J.1041.2023.00318

3 Fritsche I, Jonas E, Fischer P, Koranyi N, Berger N, Fleischmann B. Mortality salience and the desire for offspring. Journal of Experimental Social Psychology. 2007;43:753–62. https://scholar.google.com/scholar_lookup?journal=Journal+of+Experimental+Social+Psychology&title=Mortality+salience+and+the+desire+for+offspring&author=I+Fritsche&author=E+Jonas&author=P+Fischer&author=N+Koranyi&author=N+Berger&volume=43&publication_year=2007&pages=753-62&

4 Rosenblatt, A., Greenberg, J., Solomon, S., Pyszczynski, T., & Lyon, D. (1989). Evidence for terror management theory: I. The effects of mortality salience on reactions to those who violate or uphold cultural values. Journal of personality and social psychology, 57(4), 681–690. https://doi.org/10.1037//0022-3514.57.4.681

5 Greenberg, J., Solomon, S., Pyszczynski, T., Rosenblatt, A., Burling, J., Lyon, D., Simon, L., & Pinel, E. (1992). Why do people need self-esteem? Converging evidence that self-esteem serves an anxiety-buffering function. Journal of personality and social psychology, 63(6), 913–922. https://doi.org/10.1037//0022-3514.63.6.913

6 Silveira, S., Graupmann, V., Agthe, M., Gutyrchik, E., Blautzik, J., Demirçapa, I., Berndt, A., Pöppel, E., Frey, D., Reiser, M., & Hennig-Fast, K. (2014). Existential neuroscience: effects of mortality salience on the neurocognitive processing of attractive opposite-sex faces. Social cognitive and affective neuroscience, 9(10), 1601–1607. https://doi.org/10.1093/scan/nst157

7 Ibid.

8 Xu, Z., Zhu, R., Zhang, S., Zhang, S., Liang, Z., Mai, X., & Liu, C. (2022). Mortality salience enhances neural activities related to guilt and shame when recalling the past. Cerebral Cortex (New York, N.Y.: 1991), 32(22), 5145-5162. doi:10.1093/cercor/bhac004   

9 Greenberg et al. (1992)

10 E.G. Hepper, Self-Esteem, Editor(s): Howard S. Friedman, Encyclopedia of Mental Health (Second Edition), Academic Press, 2016, Pages 80-91, ISBN 9780123977533, https://doi.org/10.1016/B978-0-12-397045-9.00076-8. 

11 Bassett, J. F., & Bussard, M. L. (2021). Examining the Complex Relation Among Religion, Morality, and Death Anxiety: Religion Can Be a Source of Comfort and Concern Regarding Fears of Death. OMEGA - Journal of Death and Dying, 82(3), 467–487. https://doi.org/10.1177/0030222818819343 

12 Szcześniak, M., & Timoszyk-Tomczak, C. (2020). Religious Struggle and Life Satisfaction Among Adult Christians: Self-esteem as a Mediator. Journal of religion and health, 59(6), 2833–2856. https://doi.org/10.1007/s10943-020-01082-9

13 Fog, A. (2023). Psychological and cultural effects of different kinds of danger. An exploration based on survey data from 79 countries, Culture and Evolution (published online ahead of print 2023). doi: https://doi.org/10.1556/2055.2023.00029

14 Ibid.

15 Rosenblatt et al. (1989)

16 Ibid.

17 Kheibari, A., & Cerel, J. (2023). The Role of Death Anxiety and Self-Esteem in Suicide Attitudes. OMEGA - Journal of Death and Dying, 86(3), 1069–1088. https://doi-org.colby.idm.oclc.org/10.1177/00302228211000935 

18 Ibid.

19 Ibid. 

20 Weng, D. H., & Kim, K. H. (2023). Letting go or pushing forward: Director death and firm risk-taking. Long Range Planning, 56(3), 102322. ISSN 0024-6301. https://doi.org/10.1016/j.lrp.2023.102322.

21 Bessarabova, E., & Massey, Z. B. (2023). The effects of death awareness and reactance on texting-and-driving prevention. Risk Analysis, 00, 1– 13. https://doi-org.colby.idm.oclc.org/10.1111/risa.14107 

22 Li, S., Young, H.R., Ghorbani, M. et al. Keeping Employees Safe During Health Crises: The Effects of Media Exposure, HR Practices, and Age. J Bus Psychol 38, 457–472 (2023). https://doi.org/10.1007/s10869-022-09837-9

23 Ibid.

24 Menzies, R. E., & Menzies, R. G. (2023). Death anxiety and mental health: Requiem for a dreamer. Journal of Behavior Therapy and Experimental Psychiatry, 78, 101807. ISSN 0005-7916. https://doi.org/10.1016/j.jbtep.2022.101807. 

25 Scarpi, D., Pantano, E. and Marikyan, D. (2023), "Consumers' (ir)responsible shopping during emergencies: drivers and concerns", International Journal of Retail & Distribution Management, Vol. 51 No. 6, pp. 791-806. https://doi.org/10.1108/IJRDM-08-2022-0300 

26 Ibid. 

27 Plusnin, N., Pepping, C. A., & Kashima, E. S. (2018). The Role of Close Relationships in Terror Management: A Systematic Review and Research Agenda. Personality and Social Psychology Review, 22(4), 307–346. https://doi.org/10.1177/1088868317753505

28 Ibid.

29 Waggoner, B., Bering, J. M., & Halberstadt, J. (2023). The desire to be remembered: A review and analysis of legacy motivations and behaviors. New Ideas in Psychology, 69, 101005. ISSN 0732-118X. https://doi.org/10.1016/j.newideapsych.2022.101005. 

30 Ibid.

31 Menzies, R. E., & Menzies, R. G. (2023). Death anxiety and mental health: Requiem for a dreamer. Journal of Behavior Therapy and Experimental Psychiatry, 78, 101807. ISSN 0005-7916. https://doi.org/10.1016/j.jbtep.2022.101807. 

32 Ibid.

33 Ibid.

34 Ibid.

35 Ibid.

36 Easden, D., Gurvich, C., Kaplan, R. A., & Rossell, S. L. (2023). Exploring fear of death and psychosis proneness: Positive schizotypy as a function of death anxiety and maladaptive coping. Clinical Psychologist, 27(1), 35-44. DOI:10.1080/13284207.2022.2070426. 

37 Menzies & Menzies (2023)

38 Ibid. 

39 Wersebe, H., Lieb, R., Meyer, A. H., Hofer, P., & Gloster, A. T. (2018). The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention. International journal of clinical and health psychology : IJCHP, 18(1), 60–68. https://doi.org/10.1016/j.ijchp.2017.09.002 

40 Ibid.

41 Anālayo, B., Medvedev, O.N., Singh, N.N. et al. Effects of Mindful Practices on Terror of Mortality: A Randomized Controlled Trial. Mindfulness 13, 3043–3057 (2022). https://doi.org/10.1007/s12671-022-01967-8 

42 Aldiabat, K., Alsrayheen, E. A., & Le Navenec, C. -. (2023). Death anxiety among older adults during the COVID-19 pandemic: Implications for nursing practice. Universal Journal of Public Health, 11(1), 89-96. doi:10.13189/ujph.2023.110110  

The Radical Acceptance of an Ocean of Grief

Understanding Waves of Grief

Grief has been described as “the conflicting feeling caused by the end of or change in a familiar pattern of behavior.”[1] Emotions brought on by the experience of a significant loss can be turbulent; and in some cases, can feel like a wave from the ocean as they build and release into one’s reality. Briana MacWilliam (2017) notes, “Some things you never get over, you just learn to carry them.” It is difficult to say whether grief is an experience that one can be rid of, or if it is better understood as something that can be learned to cope with overtime. It is possible for one to feel they have gotten over a loss, and for grief to then show up again causing more unexpected emotional turbulence. Grief can sometimes create the illusion that one cannot move forward, or that one’s life is irreparably damaged. While it is true that one may never be the same, there are ways to grow after experiencing a traumatic loss.[2] 

A loss can take on various forms: the death of a loved one, a romantic heartbreak, loss of a job, loss of a friend, death of a pet, and so on. One cannot control the rain that ruined the picnic, the missed flight that cost a promotion, the fall-out of a romantic relationship, or the cancer that took a loved one’s life. However, one is able to control how to move forward from such experiences. A decision must be made on how to shape one’s future experiences in a positive manner instead of succumbing to horrible events and allowing them to control future events. “Easier said than done,” one might say - and they would be right. However, the initial choice of moving forward is one of the most imperative moments in shaping one’s reality. Dwelling on feelings of heartache is not always a healthy way of honoring the dead or the lost; it can also be a form of self-punishment. MacWilliam notes, “The work of grief is the work of growth.”[3] Tolle (2004) adds that, “It is a choice between falling into a victimized identity or ‘discovering grace’ on the opposite side of helplessness and surrender.”[4] 

After experiencing a loss, there are many ways that one can be reminded of their grief (e.g., hearing a song, the anniversary of a loss, and even seeing something small that reminds you of the person or the loss). Such triggers can make it difficult to maneuver through the five common phases of grief: denial, anger, bargaining, depression, and acceptance.[5] Being reminded about one’s grief can create a feeling of one’s heart being enclosed in a vacuum seal, provoking anxiety about the onset of difficult memories. Various approaches can be used to cope with such emotions and triggers. However, one must first understand common myths of the nature of grief and how societal factors play into one’s experience with grief.  

Common Myths of Grief

In an attempt to cope with grief, society has developed myths about the appropriate approaches to facing our difficult emotions. Popular phrases in the Western world can have a negative impact on the process of growth after experiencing loss. MacWilliam notes a few common phrases associated with myths surrounding how one should experience grief:[6]

• Don’t Feel Bad

• Replace the Loss

• Grieve Alone

• Just Give it Time

• Be Strong for Others

• Keep Busy

The issue with these common myths is that they involve repressing and disregarding feelings of pain, which in turn, can become “stuck” in one’s body, leading to significant diagnoses such as anxiety and depression.[7] Grief is a normal and natural reaction to any kind of loss. Therefore, one should embrace the waves of emotion that are associated with traumatic loss.[8] To embrace grief, one may try:

• Feeling as Bad as You Do

• Not Replacing the Loss

• Finding Others That Share Your Pain

• Taking One’s Time to Acknowledge the Loss

• Letting Others Take Care of Themselves

• Not Burning Out on Distractions

Grieving is Not Selfish

It is common for feelings of grief to become internalized, creating a sense of shame and selfishness in an individual. However, the experience of grief is not selfish, nor is it selfish to move on and experience feelings of joy again. The way in which one reacts to grief is generally in-line with one’s personality traits. For example, if one is quiet by nature, grief might be expressed more quietly and internally. Introverts, as such, are likely to hear encouragement from others to express their grief more outwardly when it happens. Conversely, individuals that are more naturally outgoing might express grief more openly; prompting responses from some people to keep emotions inside.[9] Social acceptance, or the lack thereof, can help or hinder one’s experience of grief. It is important for each individual to figure out what level of expression works best for them on their journey of self-growth. To find what works best for you, there are resources available such as self-help groups. These groups can help one to acknowledge the myths surrounding grief while providing a safe place to express oneself.[10]

Radical Acceptance 

Radical acceptance is a technique derived from Dialectical Behavior Therapy (DBT), that encourages one to look at the reality of a situation without judgment or distortion.[11] Instead of idealizing a scenario to be what you want it to be, radical acceptance means understanding that we are all doing the best we can. The practice of radical acceptance validates one’s emotions, thoughts, and actions.[12] Validating emotions such as loneliness and fear can help to change one’s perspective on a situation and in turn the experience of a challenging situation such as grief. Brian Therialut, a writer who lost his wife to cancer, notes that “Grief loses its power when it is radically accepted in the moment.”[13] By normalizing experiences such as grief, one can find coping mechanisms to deal with the stress and heavy emotions. Simple radical acceptance inquiry has been known to significantly improve coping and reduce suffering.[14] Even one’s inquiry into simple radical acceptance has been found to significantly improve coping and reduce suffering.

A study by Görg et al. (2017) measured the success of radical acceptance when treating trauma-related memories and associated emotions. Shame, guilt, disgust, distress, and fear were all found to significantly decrease from the start to the end of radical acceptance therapy. Radical acceptance has been found to be successful in treating emotions associated with trauma because it focuses on how to reduce the avoidance of memories.[15] Specifically, DBT encourages individuals to accept past traumatic events, painful memories of those events, and emotions about having experienced the events. In the study by Görg et al. (2017) the DBT treatment approaches utilized training for self-esteem, mindfulness, psychoeducation, and music or art therapy. In the end, radical acceptance functioned as a way to cope with traumatic or painful memories.

Practice & Implementation

There are various approaches to implementing radical acceptance into one’s reality. For instance, when acceptance of a situation feels almost impossible, Cuncic (2022) offers some coping statements to help one practice radical acceptance:[16]

Image Source: Tori Steffen

Searching for beauty in a difficult situation can replace suffering with feelings of gratitude. Focusing on the sound of rain hitting the roof, the smell of burning firewood, or the taste of your favorite beverage can foster love and compassion. The more beauty one seeks out, the more likely one is to disengage in self-criticism.[17] Another approach is to outsmart your inner critic by discrediting self-doubt. Self-criticism can help one to grow, but it can also be self-destructive in that your perspective is clouded by a negative filter. One way to bring positivity into the picture when you are feeling self-critical is to think of a loved one and write a letter to yourself from their perspective. People often judge themselves too harshly, and rarely look at themselves from others’ perspectives. Taking the viewpoint of a loved one towards oneself can remind one of what they should admire about themselves.[18]

Additional approaches to implementing radical acceptance include embracing vulnerability and giving yourself the love you are searching for.[19] After expressing oneself in a vulnerable manner, it is likely that one can feel they have shared too much of themself. The reality of the situation is that the expresser is the one who reflects and cringes the most after being “too vulnerable”. Those that witnessed someone else being vulnerable are likely to feel closer to said person, and this connection is what fosters a sense of love for others.[20] To give yourself the love that you are searching for in others is to empower your independence and self-esteem. 

Radical acceptance is often not an easy practice to implement in reality due to the nature of heavy emotions associated with grief. Radically accepting a situation does not mean that you agree with what is happening or what has occurred. Rather, it creates a chance to feel hopeful for the future because one can stop fighting the reality of a situation.[21] Lack of acceptance in a tough situation is normal and many have experienced the trials and tribulations of grief. 

Another way to practice radical acceptance includes paying attention to triggers and noticing when acceptance is difficult. Imagining what reality would look like if you accepted the situation can be a great first step in practicing radical acceptance.[22] Ultimately, accepting the fact that life can still be worthwhile even when experiencing pain will help one to navigate the ocean of grief. Moreover, committing to the practice of radical acceptance when feeling resistance will help it to become more second-natured to an individual dealing with grief.

When feelings of depression and anxiety related to grief are chronic and impacting everyday life, steps should be taken to reduce such negative experiences by contacting a licensed mental health professional for further guidance.

Contributed by: Tori Steffen

Editor: Jennifer (Ghahari) Smith, Ph.D.

REFERENCES

1 James, J. and Friedman, R. (2009) The Grief Recovery Handbook: The Action Program for Moving beyond Death, Divorce, and Other Losses including Health, Career, and Faith. New York: Harper Collins Publishers.

2 Briana MacWilliam. (2017). Complicated Grief, Attachment, and Art Therapy : Theory, Treatment, and 14 Ready-to-Use Protocols. Jessica Kingsley Publishers.

3 Ibid.

4 Tolle, E. (2004) The Power of Now: A Guide to Spiritual Enlightenment. Novato, Canada: Namaste Publishing.

5 Kessler, D., and Kubler Ross, E. (2022). Five stages of grief by Elisabeth Kubler Ross and David Kessler. Grief.com. https://grief.com/the-five-stages-of-grief/#:~:text=The%20five%20stages%2C%20denial%2C%20anger,some%20linear%20timeline%20in%20grief.

6 MacWilliam (2017)

7 Ibid.

8 Ibid.

9 Ibid.

10 Ibid.

11 Tapper, M. L. (2016). Radical acceptance. MedSurg Nursing, 25(1), S1.

12 Ibid.

13 Theriault, B. (2012). Radical Acceptance A Nondual Psychology Approach to Grief and Loss. International Journal of Mental Health & Addiction, 10(3), 354–367.

14 Tapper (2016)

15 Goerg, N., Priebe, K., Bohnke, J. R., Steil, R., Dyer, A. S., & Kleindienst, N. (2017). Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse. BORDERLINE PERSONALITY DISORDER AND EMOTION DYSREGULATION, 4, UNSP 15.

16 Cuncic, A. (2022). What is radical acceptance? Verywell Mind. https://www.verywellmind.com/what-is-radical-acceptance-5120614 

17 Try these practices daily for radical self-acceptance. (2019). Yoga Journal, 311, 20.

18 Ibid.

19 Ibid.

20 Ibid.

21 Cuncic (2022)

22 Ibid.