A woman with broiwn hair smiling in a green t-shirt standing in the Treetops grounds

Sarah Cundill, Deputy Therapeutic Services Manager, answers some common questions about adult bereavement and how to support someone after the death of a loved one.

Author: Sarah Cundill, Deputy Therapeutic Services Manager

Date: May 2024

What is bereavement?

Bereavement is the word used to describe the death of a person. This could be the death of a husband, wife, partner, parent, sibling, child, or other relative or friend.

What is grief?

Grief is the response to a bereavement. Adults who have been bereaved may find themselves struggling with a powerful range of emotions. It’s important to remember that everyone grieves in their own unique way.

There are many different feelings and emotions that you might experience. You may also notice changes in your behaviour after a death. You might:

  • Feel more tired or not sleep well
  • Not want to get involved in everyday things such as a regular hobby
  • Be forgetful or unable to concentrate
  • Get upset by simple things like hearing a song on the radio or seeing a photo of your loved one
  • Want to be closer to your family and loved ones
  • Argue or cry more often

These are all completely normal reactions associated with grief.

Does everyone grieve in the same way? Does every loss feel the same?

Grief is unique to everyone. It's as unique as our fingerprints.

We've all got our own personalities, our life experiences, and we've all got our own coping strategies and ways of dealing with things.  

Grief can be different depending on who’s died and your relationship with them.

For example, each member of a family will have a different reaction to the death of the same family member.

Think about your own close relationships. Each person has a different significance to you.  Sometimes their importance to you may only be fully realised after a death.

Grief is a response to both the depth and significance of this unique relationship.

It's not just about the person you've lost, it's also the role they played in your life.

For adults who experience the death of a husband or wife, that person may have been the one who did all the finances. Or they always filled the car with petrol, or was the practical person within your household.  So, if that's the person that’s died, you've also lost those roles as well.

Having to adjust to do these tasks yourself, is a direct reminder of your loved one’s absence. It can also feel overwhelming when you are trying to cope with your grief.

It can be more difficult if the relationship you had was challenging, or you were estranged. You won’t have those positive memories to draw on. This is when grief becomes more complicated, and you probably need professional support.

Why don’t I feel sad when someone dies?

There is an assumption that everybody should cry when somebody dies, and that's not always the case.

It might not be part of your culture to express your feelings in this way. Or sometimes people think they will be perceived as weak if they cry and will often apologise for crying.

You might process your grief through talking and sharing their feelings. Or you may not want to talk at all and want to be on your own.

Everyone is different. There’s no right or wrong way to grieve. And it’s important not to judge the way someone reacts to the death of a loved one, and simply offer the support they need.

Why is grief so painful?

Grief can feel like the bond between ourselves and our loved one has been severed. Our response to this can be felt emotionally, mentally, physically, and spiritually and can be incredibly painful. Some people describe feeling like their heart is literally breaking.

Grief can also make you feel physically unwell or very tired, because those emotions are so intense and gut wrenching. If you experience intense and long periods of crying and yearning for your loved one, for example, this can feel physically painful and exhausting.

Why is grief worse at night?

During the day, people usually have tasks that need completing and things that keep them busy. So it is common for grief to feel worse at night when there are less distractions.

Following a bereavement, you might swing, or oscillate, in and out of feeling sad, but still have to get on with daily tasks, such as shopping for food.

At night, everything can feel quieter. So when things start to settle, emotions, thoughts and memories come to the surface. These can seem particularly intense if you are also struggling to sleep.

Does grief get worse with time?

Most people find that grief changes over time as we find ways to live alongside it and manage our emotions.

We all develop our own coping strategies, and these too can change over time.

Sometimes you might try to find ways of avoiding your grief to protect yourself from the pain. Or you might throw yourself into caring for others, particularly if they are grieving too. You also may have other things happening in your life which doesn’t allow the space for you to grieve.

However, sooner or later, we can find our grief begins to break through and we feel the need to pay attention to it.

Whilst grief is a natural reaction to the loss of a loved one, you may find it beneficial to seek support to help make sense of your reactions. This might be by talking it through with your family and friends, joining a bereavement group, or seeking out counselling.

How can I support myself during a significant anniversary such as Mother’s Day, Father’s Day or birthdays?

Birthdays and other anniversaries are likely to be a more challenging day than normal when you’ve been bereaved.  You may want to be on your own, being quiet and reflective. Or you may want company and to share memories. It’s important to do what feels right for you.

One of the things that can be helpful as you prepare for a significant anniversary, is the concept of continuing bonds: finding a way to continue your relationship with your loved one after their death. This could perhaps involve keeping up a tradition or developing a ritual.

This is something that you may seek to do naturally throughout the year, by emphasising connections, big or small to the things that were important to your loved one - a favourite flower, film, or place, as examples.

Consider activities that you know your loved one liked, or that you enjoyed together. You might go to their favourite restaurant, or have their favourite cake, so they still feel part of that celebration.

You could light a candle, plant something in the garden, write your feelings down in a card, or post a message or photo on social media to share with family and friends.

Be kind to yourself and compassionate towards your own feelings. It is okay to not be okay. Don’t expect too much of yourself. Where possible,  allow yourself to feel your emotions, rather than pushing them away.

Will each anniversary - the first birthday, first Christmas, or other milestone - always feel the same after the death of a loved one? 

There's an assumption that the first anniversary or first significant date after a loved one’s death will be the most challenging for you. This could be a birthday (yours, theirs, or another family member), a wedding anniversary, or something similar. 

But sometimes that's not the case. Because you expect the first anniversary will be difficult, you tend to prepare yourself for it. You anticipate it will be a hard time. You might think, ‘I’ve just got to get through this first Christmas’ or ‘I’ve just got to get through this first wedding anniversary.’

When we talk about grief at Treetops, we talk about how you swing, or oscillate, in and out of grief.

In this situation, you may swing back into your loss, and probably weren’t expecting it to be as intense, so it can feel like it’s worse.

What should I say to someone who’s grieving after losing someone they love?

It’s natural to feel anxious about talking to someone about the death of their loved one.

You might think that talking about the person that’s died is the wrong thing to do or you may be worried about upsetting them. You may be unsure about what to say or not to say. Or you might not know how to start a conversation.

Grief can feel very isolating and being surrounded by people who don’t talk about it can make this feeling worse.

Giving people an opportunity to talk about their loved one is often a good thing. The worst has already happened. You are unlikely to make them any more upset than they already are. Even if they do get upset and tearful, that’s okay. It’s important to let them connect with their memories and share them with you.

Often people say that they felt supported initially, but it is when everyone around them returns to their normal lives, that they feel most alone. Offering opportunities to talk even months down the line can help reduce this sense of isolation.

How do I know if I need bereavement counselling after a death? How can bereavement counselling help me?

Everyone will experience a bereavement at least once in their lifetime. It’s important to remember that grief is a normal reaction to loss.

Often grief can feel particularly intense and hard to cope with in the weeks and months following a bereavement, but generally, over time you should start to notice you are better able to cope with the impact of your loss.

However, sometimes for a variety of reasons this does not happen. If you find you continue to struggle with the impact of your grief on day-to-day life and things like sleep, appetite, your ability to work and your mood continue to be affected, you might benefit from some professional support.

People’s experience of grief tends to change over time as they find ways to live alongside it. Bereavement counselling can help you to integrate your grief into your life so that it doesn’t have such a far-reaching impact.

What is bereavement counselling? What is bereavement counselling like?

Bereavement counselling involves a person who’s struggling with the death of a loved one talking to a trained counsellor to help them process their grief. This is usually done through weekly sessions.

When you come for bereavement counselling at Treetops, you are matched with a counsellor. You will see the same counsellor at every session so you can build a relationship of trust. They will get to know you and understand what you need to support you.

Through this relationship with your counsellor, you will learn to understand your grief and its unique impact on you.

We also help you understand that what you’re experiencing is normal. We often hear people say that grief can make you feel like you’re going mad. One minute you feel okay and the next minute you don’t. This oscillation (swinging back and forth) can go on for a long time. This is a normal reaction and it’s helpful to have that reassurance.

During a counselling session you might want to just sit and talk, releasing your emotions. You might not feel able to do this in the ‘real world’ where people might expect you to be okay. Your bereavement counsellor can also help you explore coping strategies.

You might spend some time focusing on memories of your loved one. By capturing these, we can grasp the importance of our loved one to us and the bearing they had on our lives.

Grief can be an assault on the body, affecting you physically, mentally, emotionally and spiritually. The shock of a bereavement can trigger a ‘fight or flight’ response and these symptoms can have a far-reaching effect. Your bereavement counsellor can help you learn to manage these symptoms and reduce their impact.

Over time, you can learn to make sense of what has happened, develop a narrative that is meaningful to you and integrate this into your life. You become more able to understand, and talk about your loved one’s death in a way that allows you to better manage your day-to-day life, without being thrown too far off track by reminders of them.

Where does bereavement counselling take place at Treetops?

Bereavement counselling sessions for adults take place in our bespoke counselling centre at the hospice based in Risley, Derbyshire.

The rooms are designed to help you feel relaxed, and all rooms have views of our beautiful grounds.

Our counselling centre is not clinical in any way. It’s a calming, helping, supportive environment.

How many bereavement sessions will I need?

We offer bereavement counselling sessions for as long as you need them. We normally offer an initial 12 sessions bu this can be extended where needed.

If you do need more bereavement support, we have an open door policy. This allows you to come back for more support if something happens in life that re-triggers your grief.

Is everything I talk about during bereavement counselling confidential?

Everything you talk about during a bereavement counselling session is highly confidential.

Generally, the only time where a counsellor will break that confidentiality, is if they had a concern around your safety or that of someone else. For example, if they had a concern that you or somebody else was being harmed in any way.

But they would do this in collaboration with you wherever possible. If they felt the need to take some information outside the counselling room, you would be informed. They would explain what they need to do and what will happen next.

How much does bereavement counselling cost?

Bereavement counselling at Treetops is completely free and not means-tested.

How can I access adult bereavement counselling?

You must refer yourself to bereavement counselling at Treetops.

Other people may recommend you contact us, such as your GP or another health professional, but you must contact us in person.

Counselling is not right for everyone and to benefit from it you must have the capacity to engage with the weekly sessions. Approaching us when the time feels right, and you are able to commit to the process, is an important part of accessing help.

Do you have a grief support group? Where can I meet other adults who’ve been bereaved?

We offer a weekly peer support group for bereaved adults called Tears to Laughter where you can meet other people who have experienced bereavement.

The group is a safe space to share how you truly feel after a bereavement, without fear of upsetting family members or friends.

This group does not offer bereavement counselling. If you need additional emotional support, we will signpost you to our bereavement counselling team, where you can access further help.

How can I become a bereavement counsellor at Treetops?

At Treetops, we have a bereavement counselling team made up of qualified counsellors, student counsellors, and trained support volunteers.

We are always looking for qualified counsellors (with a minimum of a Diploma in Counselling) to join us on a volunteer basis.

This is an ideal opportunity for newly qualified counsellors looking to gain valuable experience, or for those who are building up their hours towards accreditation. Counsellors in any stage of their career would be most welcome.

Do you offer counselling placements for students?

We run a student placement scheme for students in the second year of their training. We have two intakes a year, in spring and autumn.

All our counsellors have an interview and attend two-day counselling induction training which includes sessions on working with bereavement, loss and life-limiting illness.

All volunteers work with at least two clients a week. We provide supervision, monthly workshops, insurance and DBS checks.

There is additional training specifically to support work with children and young people. We also offer training in working from a trauma-informed perspective.

How can I support my child/ren after a bereavement?

You can find answers to a wide range of questions about supporting a child after the death of a loved one on our website.

Where do we support?

Our counselling service is available to all users of Treetops Hospice services, and adults and children registered with a GP practice in Derby city, Southern Derbyshire or Erewash.

Your bereavement may have occurred at any time in the past. Many of our referrals are in relation to unexpected and/or traumatic bereavement. The service is available for as long as you need it in relation to dealing with your loss.

Care and support outside our catchment area

If you live outside our catchment areas, you can find other sources of help and advice about adult bereavement on our website.

You could also try contacting your local hospice for more bereavement support for adults and children.