Bereavement often takes our sense of self – but it can be regained

‘[Our] defences are an important anaesthetic in the early stages of grief – without them, the reality of the loss would be too overwhelming.’ Photograph: Ian West/Alamy

The experience of grief following bereavement is ubiquitous and falls within the normal range of human experience. We therefore need to be careful not to pathologise it, although the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has recently – and for some controversially – added a diagnosis of prolonged grief disorder. Nevertheless, just because the grief associated with death and dying is generally normal, this does not diminish how acutely distressing it can be, and sometimes the experience of grief can exacerbate other, more long-standing psychological issues.

Grief is painful partly because it involves an unavoidable reckoning with reality and the limits to our control. Elisabeth Kübler-Ross, an eminent researcher of reactions to loss, proposed a five-stage model of grief. While the idea of stages has been challenged by the idiosyncratic, cultural and non-linear nature of the experience of loss, her work highlights the common employment of defences such as denial and bargaining.