Definitions & Types of Grief

In 1989, psychologist, educator and author Kenneth Doka, Ph.D.  coined the term “disenfranchised grief” to describe the experience of people whose grief is not acknowledged by society due to the nature of their loss. Specifically, he outlined social, political and cultural norms that determine what losses are considered “worthy” of grief and which are not. He also addressed the suffering that denying mourners a socially acceptable outlet for their grief can cause. Doka’s theory of disenfranchised grief has since become widely accepted by mainstream psychologists and grief counselors worldwide. 

Also known as unacknowledged grief or hidden grief, disenfranchised grief can result from many different kinds of loss. These include: 

Unacknowledged relationships 

Many people have close ties to others that, for whatever reason, they choose to hide from friends and family. Lingering ties may also still exist between people who are no longer close but who shared a significant portion of their lives. Some examples or unacknowledged relationships include:

• A partner that you haven’t openly acknowledged, such as the LGBTQ+ partner of someone who is not “out” or a romantic partner who is married or in a relationship with someone else. 
• An ex-spouse or partner 
• A birth mother or father of an adopted child or adult
• An unborn child

When these relationships end, the grieving person is often denied the support and understanding of others because they feel compelled by social norms to pretend the loss didn’t happen or wasn’t important to them. 

Children and people with developmental disabilities may also go unacknowledged when they suffer a loss because loved ones think they are too young or too intellectually challenged to mourn. Unfortunately, this is almost never the case. 

“Less” Significant Relationships

In our society, we tend to rank relationships in terms of their “importance.” Our relationships with spouses, siblings, children and parents are ranked high in the social hierarchy, whereas other relationships are seen as less significant. Some examples of these relationships include:

• A friend or co-worker
• A pet
• A teacher or mentor
• A cousin, niece or nephew
• A grandparent

Of course, when you love someone or something, that relationship is not insignificant to you, and your grief after their death may be intense. Nonetheless, it’s not uncommon for people who have experienced such losses to find that friends and family can’t acknowledge or relate to the depth of their pain. 

Intangible Losses

Also known as “ambiguous losses,” intangible losses are losses of things we value that are not associated with someone’s death. An ambiguous loss may seem negligible or unimportant to others, but it can cause deep pain and long-lasting disenfranchised grief. Some examples of ambiguous losses include:

• Divorce
• Betrayal by a friend or romantic partner
• Loss of health (either one’s own or that of someone you love)
• Loss of financial security (such as being laid off or fired)

• Loss of a sense of safety or security (for instance, due to domestic violence, sexual assault or being robbed)
• Incarceration of a loved one
• Addiction in a loved one
• Someone in your life is missing and can’t be found
• Infertility
• Loss of a dream (for example, a child’s divorce, having to drop out of school)
• Loss of a home (to a fire, natural disaster, or act of war)

Although uniquely painful, ambiguous losses often go unacknowledged because they lack the finality of death. But it is precisely this lack of finality that often makes intangible losses so difficult to bear.

Stigmatized losses

Stigmatized losses or stigmatized deaths include those that society views as the “fault” of the person who died. Examples of stigmatized loss include:

• Overdose deaths
• Death by suicide
• Drunk driving deaths 
• Some homicide deaths
• Abortion

Because of the stigma attached to these “at fault” kinds of deaths, the families and loved ones of the person who died are often stigmatized as well. Many people feel that they can’t reach out for support because they will be viewed in a negative light, so they hide their pain and their grief. 

Sources

“Ambiguous Loss and Its Disenfranchisement: The Need for Social Work Intervention”. SAGE Journals. https://journals.sagepub.com/doi/abs/10.1177/1044389418799937 

Collective grief occurs when a group or community shares in a mourning experience, typically after a significant loss or traumatic event. These events can include the death of a public figure, natural disasters, war or acts of violence, where the impact resonates deeply within a community. As opposed to individual grief, which is often a solitary process, collective grief unites people in their sorrow, which can help with healing as it allows people to process their emotions together with a sense of solidarity and shared experience. Shared mourning can be facilitated through communal rituals (such as candlelight vigils), public memorials (which can range from leaving notes and flowers at a specific site to large-scale monuments), and even social media expressions. These practices allow individuals to connect and support each other.

It can be challenging to let yourself feel sadness about the loss of someone you didn’t know personally. However, when grief is acknowledged on a collective level, it can provide a sense of validation, making it easier to express your feelings.

Sources

“Collective Grief”. Cruse Bereavement Support. https://www.cruse.org.uk/understanding-grief/grief-experiences/collective-grief/ 

Cumulative grief, also known as bereavement overload or compounded grief, refers to the intense, layered distress that develops when an individual experiences multiple losses in a short period of time, often before earlier losses have been fully processed. The term “bereavement overload” was introduced by psychologist and gerontologist Robert Kastenbaum to describe the reality faced by many older adults who endure a relentless succession of deaths among peers and loved ones, but the phenomenon can affect people at any age.

When losses accumulate rapidly, the grieving person may feel they are not adequately prepared to absorb and process each new loss because they are still consumed by the ones that came before. This overlap can overwhelm normal coping mechanisms, making each subsequent loss feel heavier and the mourning process more complex and prolonged. Although cumulative grief is most often described as a consequence of closely spaced losses, it can also result from losses that build more gradually over a lifetime, as unresolved sorrow is repeatedly reawakened.

One of the most painful features of cumulative grief is that a new loss can bring the grief of previous losses rushing back, so that sorrow feels fresh again on multiple fronts. Over time, individuals may come to feel as if they exist in a state of unrelenting emotional pain, exhausting them, leaving them feeling perpetually vulnerable, and making it difficult to reach a place of acceptance after any single loss. This experience can erode resilience and, for some, increase the risk of developing prolonged grief disorder, depression, anxiety, or physical health problems.

It is important to understand that cumulative grief is not a disorder in itself but a normal human response to an extraordinary load of sorrow. However, because it can overwhelm a person’s ability to cope, thoughtful intervention is often beneficial. Experts recommend making space to honor and mourn each loss individually through ritual, memory sharing, or private reflection rather than allowing them to blur together into an undifferentiated mass of pain. Giving each loved one their own grief provides emotional definition and can prevent the accumulation of unprocessed sorrow.

Self-care practices that help regulate the nervous system, such as mindfulness, gentle physical activity, adequate rest, and structured routines, can soothe the intense internal reactions that fresh loss often triggers. Because steady support is essential and may be harder to find naturally over time, joining a grief support group or working with a grief counselor or therapist can be especially valuable. In therapy, individuals can learn to separate overlapping losses, develop healthy coping strategies, and address any disenfranchised or unresolved grief. Modalities such as cognitive behavioral therapy (CBT) or complicated grief therapy can be tailored to help someone manage bereavement overload without severing the bonds that remain.

Ultimately, cumulative grief thrives in silence and isolation. Naming each loss, seeking consistent support, and allowing grief to be witnessed, one loss at a time, can help a person move from feeling perpetually submerged toward a place of integrated, sustainable mourning.

Sources 

“How to handle an overload of grief”. Vox. https://www.vox.com/even-better/23445017/cumulative-grief-loss-overwhelming-cope-mental-health 

“What is compounded grief?”. Very Well Mind. https://www.verywellmind.com/compounded-grief-symptoms-causes-diagnosis-and-coping-6979518 

Climate grief, also referred to as climate anxiety, ecological grief, or, in specific contexts, solastalgia, describes the psychological and emotional distress caused by climate change and environmental degradation. While these terms are sometimes used interchangeably, they carry subtle distinctions: climate anxiety centers on fearful anticipation of future harm; ecological grief focuses on mourning ecological losses already occurring; and solastalgia captures the distress of witnessing the degradation of one’s home environment while still living in it.

Climate grief emerges from both experienced and anticipated losses: disappearing ecosystems, accelerating biodiversity loss, species extinction, the transformation or loss of beloved landscapes, and the growing frequency of natural disasters and extreme weather events. It is characterized by despair, sadness, fear, anger, anxiety, hopelessness, and a deep concern for the well‑being of the planet and future generations. Many people also report a deep sense of helplessness when confronted with the scale and speed of these changes.

A defining feature of climate grief is that it is not a pathological condition but a reasonable, empathic response to a real and escalating crisis. Recognizing this moral and emotional dimension is essential: the distress reflects a deep valuing of life and the planet. Yet when it becomes overwhelming—interfering with daily functioning, sleep, or relationships—support from a mental health professional familiar with climate-related distress can be helpful. Climate grief can contribute to anxiety disorders, depression, or burnout, particularly in young people who report growing fears of an uncertain future.

Because human activities like the burning of fossil fuels, industrial agriculture, and deforestation are the dominant drivers of warming and ecological breakdown, many individuals experience guilt or a sense of personal responsibility. The weight of knowing that everyday choices (transportation, consumption, diet) contribute to a global problem can produce eco‑guilt or eco‑shame. This guilt is often amplified in people striving to adopt sustainable lifestyles, who may feel hopelessness when they see that individual efforts can seem fruitless without systemic change. The gap between personal action and collective impact can lead to demoralization and activist burnout.

Climate grief also has a collective dimension, especially in communities whose identities, livelihoods, and cultural practices are inseparable from the natural world. Indigenous peoples, coastal and island communities, and farming populations often experience ecological losses as direct assaults on their heritage, spirituality, food sovereignty, and ways of life. The disruption of ecosystems through urbanization, extractive industries, and large‑scale construction severs these deep bonds, producing a layered grief that encompasses both immediate environmental damage and the erosion of traditions and rituals tied to the land. In such contexts, climate grief is not just about the loss of nature; it is about the loss of self, community, and continuity.

It is important to note that climate grief can coexist with hope, agency, and meaning. Many people channel their distress into collective action, advocacy, community resilience projects, and nature‑connectedness practices, which can alleviate feelings of powerlessness. Validating these emotions rather than dismissing them as overreactions is a crucial first step, and emerging fields such as climate psychology are working to develop tools that help individuals and communities navigate this terrain while remaining engaged in protecting what they love.

Sources

“Is climate grief something new?” American Psychological Association. https://www.apa.org/members/content/climate-grief 

“What is Climate Grief?” Climate & Mind. https://www.climateandmind.org/what-is-climate-grief 

“Climate grief is real – and I cannot keep watching images of our dying planet”. The Guardian. https://www.theguardian.com/commentisfree/2023/jul/05/climate-crisis-grief-is-real-solastalgia-dying-planet 

Preparatory grief is a term used to describe the grief process that is experienced by terminally ill individuals who are facing their own death. It is a type of grief that people experience to prepare themselves for their final stage of life. Although these individuals will grieve the reality of the inevitable loss of life during this period, they will also grieve other upcoming losses, such as the loss of physical or cognitive ability, loss of mobility, or the loss of autonomy and independence. Many individuals also grieve over the loss of experiences, such as missing out on milestones like a family member’s wedding or the birth of a grandchild. 

There are five stages to the preparatory grief process: shock, chaos, introspection, re-adaptation, and restitution. Most people who are dying will experience at least one of these phases. The phases do not have to occur in any specific order and it is possible to skip phases or experience multiple phases at the same time. Other people may not realize that the terminally ill individual is experiencing preparatory grief since some of the behaviors or emotions associated with these phases may be mistaken for mood swings or emotions resulting from a chronic medical condition. 

Individuals in the shock phase tend to struggle with a sense of disbelief and misery. They may have minimal energy since they are deeply focused on the news they have received regarding their prognosis. In the chaos phase, they may refuse to accept time constraints or limitations associated with their disease. People in this phase may try to force themselves to participate in activities or an old routine that they maintained prior to receiving their prognosis. Eventually, disease progression and the related symptoms will force them to accept the truth about their mortality.

With disease progression, the phase of introspection often begins. Individuals in this phase may experience frustration due to the gradual loss of their ability to complete simple tasks and the sensation of their body becoming weaker. They may begin to question why they became terminally ill or if they brought this outcome on themselves somehow. Although these can be difficult and emotional questions to reflect on, most individuals will eventually move past this phase and begin to focus on how they can make the most of their remaining time prior to death. 

The re-adaption phase is when individuals focus on what they can accomplish in what remains of the future. Some may still reflect heavily on the past, but many will consider goals or activities that they would like to complete before they die. This is often the phase where they will start forming a bucket list of things they’d like to do prior to death. 

In the restitution phase, dying individuals may still experience occasional bursts of emotion, but they have generally accepted the truth of their fate.

Understanding and acknowledging preparatory grief can be important in fostering the healing process following difficult news. It enables dying individuals to confront their emotions and fears regarding their circumstances, reach out for support, and explore different methods for coping with their loss. In doing so, they can more effectively navigate their grief journey and use the remainder of their time to focus on crafting a legacy that aligns with their beliefs and core values. 

Sources 

“Assessing Preparatory Grief in Advanced Cancer Patients as an Independent Predictor of Distress in an American Population”. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC6436024/ 

“Dying and Preparatory Grief”. American Family Physician. https://www.aafp.org/pubs/afp/issues/2002/0301/p897.html 

Over the past decade, researchers have found that some bereaved people suffer more intensely and for longer periods of time than people experiencing “normal” grief. While still emphasizing that grief is an individual and unpredictable process, they have noted that these people have much more trouble coping with their reactions to a significant loss. Despite the passage of what is typically considered to be an adequate period of time (6 months to 2 years) they do not recover physically or emotionally and continue to experience intense, disabling distress. These people are said to be suffering from prolonged grief disorder or complicated grief.. 

Prolonged grief occurs in about 10% of people who have experienced the loss of a loved one, and appears to be unrelated to the circumstances of the person’s death. 

After a great deal of consideration and debate (much of which is still ongoing) in 2022, the authors of the Diagnostic and Diagnostic and Statistical Manual of Mental Disorders or DSM added Prolonged Grief Disorder to its list of diagnosable mental health conditions. This decision “officially” differentiated prolonged grief disorder from “normal” grief and categorized it as a pathological process requiring intervention and treatment. 

According to the American Psychiatric Association, the criteria for diagnosis of prolonged grief disorder includes:

• The loss of a loved one that occurred at least one year ago for adults and 6 months ago for children and adolescents
• At least three of the following symptoms for at least one month:
  • Identity disruption (e.g., feeling as though part of oneself has died).
  • Strong disbelief that the person has died
  • Avoidance of reminders of the death
  • Intense emotional anguish, such as sorrow, anger, bitterness
  • Difficulty engaging with friends, pursuing  interests or planning for the future
  • Emotional numbness
  • Feeling life is meaningless or not worth living
  • Extreme loneliness or feelings of isolation from others
  • Difficulty managing painful emotions

The symptoms should be consistently present and cause disruption in the person’s day to day functioning at home, school, and/or work. 

Predisposing Factors 

Prolonged grief disorder can occur in anyone who has experienced a loss. However, research shows that certain individuals are more likely to develop PGD. This includes:

• A history of depression, anxiety or bipolar disorder
• Perceived lack of social support
• Poor physical health 
• Being a caregiver for the person who died, especially those who were caring for a spouse or partner
• Family conflict or difficulties at end-of-life
• A lack of education 
• People whose loved one died a sudden or traumatic death

It is also important to note that prolonged grief disorder may co-occur with other mental health conditions, which may make diagnosing and treating the condition more challenging. Specifically, researchers have found that a significant percentage of individuals with prolonged grief disorder also suffer from major depressive disorder, anxiety disorders and PTSD. 

If you believe you need help coping with your grief, use this tool from the Center for Prolonged Grief at  Columbia University to find a therapist in your area. If you want to locate additional resources, the CCG offers a number of self-assessment tools and handouts in the Resources section of its website. 

Sources

“Complicated Grief and Related Bereavement Issues for DSM-5”. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC3075805/ 

“Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)”. American Psychiatric Association. https://www.psychiatry.org/psychiatrists/practice/dsm 

“Prolonged Grief Disorder”. American Psychiatric Association. https://www.psychiatry.org/patients-families/prolonged-grief-disorder 

“Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment”. Psychiatry Online. https://psychiatryonline.org/doi/10.1176/appi.focus.20200052 

“Find a Therapist”. The Center for Prolonged Grief. https://prolongedgrief.columbia.edu/find-a-therapist-contact-us/ 

Anticipatory grief is a term used to describe the emotional reactions that loved ones experience prior to a terminally ill person’s death. It frequently involves many of the same feelings that occur after a death, such as sadness, anxiety and fear of the unknown. Both family and caregivers may experience anticipatory grief. A similar type of grief experienced by the dying person is referred to as preparatory grief.

Anticipatory grief can be useful and therapeutic. During a period of anticipatory grieving, both the person who is dying and their loved ones have the chance to complete “unfinished business” and say goodbye. This sometimes helps to diminish the intensity of the grief that friends and family members experience after the death occurs. But this is not always the case. In fact, knowing that a loved one’s death is imminent sometimes intensifies a person’s attachment to them. This can cause their grief following the person’s death to be more intense. 

Family caregivers are especially susceptible to anticipatory grief because their attachment to the person who is dying is so intimate and, in most cases, long-term. Many people in this situation feel conflicted and even ashamed because they don’t want to lose the person they love, yet desperately want their suffering to end. Some caregivers experience such chronic, long-term anticipatory grief that it leads to depression, which can make caregiving more difficult and grief after the death occurs more intense. 

With that said, some experts believe that true anticipatory grief is actually very rare because it is impossible to truly mourn someone’s death while they are still alive. Nevertheless, people often mourn other losses before a death occurs. For example, they may grieve for the loss of their loved one’s companionship; the loss of the future they planned together; or the sense that their own future was certain and secure. These are all components of anticipatory grief. 

Like all grief, anticipatory grief varies greatly between individuals. It’s important for family members to understand this, and accept that their loved ones are likely in different places in their grief journey during the period before a loved one dies. Some people may not have grieved at all, while others may have begun to separate themselves emotionally from the person who is dying. Neither reaction is right or wrong. 

Sources

“Grief and Mourning”. MedicineNet. https://www.medicinenet.com/loss_grief_and_bereavement/article.htm 

“Dementia Grief: A Theoretical Model of a Unique Grief Experience”. National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC4853283/