Bereaved individuals often consider enacting some form of a grief ritual to express feelings of loss and facilitate the mourning process, and there is no shortage of well-intended recommendations for how to go about doing so. It is common to hear that a friend or family member has encouraged the bereaved to spread ashes of the deceased in a nearby body of water; therapists sometimes advise their clients to write a letter to the dead; an article on the internet might recommend lighting a candle. These ritualized activities may very well prove helpful while attempting to heal from a loss, they might contribute a sense of deep meaning, and they may even provide the bereaved with a sense of direction and purpose while navigating the mourning process, but their generic quality leaves important questions unexamined: (1) Does the grief ritual cater to the individual’s psychological needs? (2) Is the grief ritual grounded in meaning about one’s actual relationship with the deceased?

The bereaved might stand by a body of water and spread ashes so as to say goodbye … but what if they have no need to let go? They may even benefit from holding on to some semblance of an ongoing connection to the person they have lost.

Another person may wish to write a letter to the deceased … but doing so may only exacerbate one’s tendency to brood on the past and disengage from life in the present. And what about those who wish to distance themselves from an unhealthy relationship altogether?

One could light a candle … but this may simply be a meaningless and vapid gesture that inspires no particular feelings of grief or thoughts about the deceased.

What, then, can professional counselors and psychotherapists do to ensure grief rituals are healthy, cater to the bereaved client’s psychological needs, and are infused with meaning? In order to answer this question, this course begins with a general overview of the psychology of loss, grief and mourning; this will include a thorough investigation of common patterns that color how one person’s thoughts, emotional reactions, and behavioral impulses after a loss differ from the next. The course will also provide an in-depth discussion of why the experience of loss and grief can lead to complicated bereavement, how the new psychological diagnosis of prolonged grief disorder offers insight as to what this looks like for certain clients, and what neuroscience has to say about why mourning a loss can prove to be so difficult. The course will then consider the nuanced reasons why some individuals, based on their attachment style and the relationship they had with the deceased, will benefit from certain expressions of loss and acts of mourning that would fail to help others who experience their grief in markedly different ways. Lastly, the course will provide a specific outline for how therapists and counselors can assist their bereaved clients in designing a personal grief ritual that facilitates a more psychologically healthy and meaningful experience of loss and mourning. Our discussion begins with an overview of attachment theory and what it has to say about grief and mourning.

Attachment Theory: The Basics

Attachment theory is a wonderfully rich topic that boils down to something quite simple: the study of human relationships, the earliest bonds we form, and the role these relationships play in sustaining psychological health across the lifespan. Spanning over half a century, attachment theorists have pooled together a substantial array of research on patterns of behavior that help human beings form emotional bonds with caregivers and maintain proximity to these attachment figures. Whether or not these bids for closeness and affection are successful in securing nurturance during the earliest years of life has a profound impact on various aspects of psychological development throughout life: emotional regulation, one’s inclination to explore novel environments and tolerate separation, clarity of memory about relationships in childhood relationships, relational satisfaction, and self-esteem (Duschinsky, 2020).

Most adults continue to feel a strong drive to maintain warm ties to their closest relationships throughout life, but the stakes are notably higher early in life. Young, helpless children depend on the availability and nearness of their caregivers for their very survival; separation is a serious threat, and so the child monitors their attachment figures’ whereabouts with great vigilance.

The attachment figure provides the child with what attachment theorists refer to as a secure base, a dependable source of comfort that satisfies the child’s many relational needs (Ainsworth, 1963). Helpless newborns cling to their caregivers, but in due time, children master larger increments of separation if they truly trust that the secure base remains available. They explore their novel environments farther and farther away until the urge to be close to the secure base of attachment once again takes hold. Only if we grasp the child’s subjective experience of separation and their anguish upon being apart from attachment figures beyond what is tolerable can we begin to understand why grief and mourning is so painful for all of us.

Separation Anxiety and the Attachment System

Children eventually learn to enjoy the sense of mastery and autonomy that comes from small stretches of time spent playing by themselves and solving problems on their own. Nonetheless, prolonged separation from an attachment figure stokes fear and extensive time apart inhibits exploration. Such distress activates the attachment system, a collection of behaviors that aim to return to the secure base of attachment and resume trust in its availability.

John Bowlby (1973) argued that children enter the world equipped with instinctual behaviors whose sole purpose is to increase their chances of securing proximity to caregivers. First of all, newborns are inherently adept at being cute. Their adorable cooing sounds and social smiles pull attachment figures to stay near and interact with the child in a mutually adoring bond that both parties increasingly learn to love.

Secondly, infants cope with separation by resortingSecondly, infants cope with separation by resorting to another all-too-familiar attachment behavior: they make noxious noises. That a child comes into life knowing how to broadcast their distress with excruciating screams and wailing cries suggests that it is imperative to create distress in others who will then feel motivated to come close and help the child resolve their upset. This is a simple example of negative reinforcement: unpleasant sounds will end only when the caregiver resumes proximity and helps the child be calm, reinforcing the adult’s efforts to soothe the child.

Thirdly, locomotive capacities emerge and pave the way for another attachment behavior: the impulse to search. Being cute and creating noxious stimuli are essentially passive in that they entice the attachment figure to come closer, but the ability to crawl and then walk toward their caregivers give children the ability to be more actively involved in efforts to resolve the problem of separation. Bowlby’s ethnological investigations revealed that these attachment behaviors are apparent in children from cultures around the world, and though they may seem clingy at first glance, they actually suggest something healthy is taking shape within the child (Duschinsky, 2020).

The Attachment System Is Activated In Mourning

Bowlby (1980) observed that vocal expressions of suffering and the impulse to search for attachment figures all represent acts of protest. Furthermore, Bowlby drew a deeply meaningful connection between the child’s innate objection to separation from an attachment figure … and the processes of grief and mourning that ensue when a loved one dies. Just as separation activates the attachment system, outright loss reactivates behaviors designed to resume proximity. But herein lies the rub: the attachment system becomes disorganized while in mourning; the same behaviors that once helped find a solution to cope with separation anxiety are, by design, destined to fail when the attachment figure has died.

It is no coincidence that a child’s tearful pleas for reunion resemble those of someone in the throes of grief and mourning. Nor is it a coincidence that a child’s instinct to seek out attachment figures parallels the curious impulse to engage in searching behaviors after a loss. Many bereaved individuals report going to the site where a death occurred, walking through the deceased’s old haunts, or visiting a gravesite in an earnest, albeit stubborn and futile effort to make sure their loved ones are not there waiting to be found.

Bowlby (1963) argued that persistent protest, though heart-wrenching, is actually an adaptive process. He stated, “open expression of protest and of demand for the object's return is a necessary condition for a healthy outcome. Such an outcome, it seems, requires the expression both of the yearning for the lost object, accompanied by sadness and crying, and also of the anger and reproach that are felt toward the object for its desertion” (p. 504). The attachment system is a roadmap for how to proceed through mourning. Angry demands for reunion, expressions of sadness, and efforts to find the deceased all contribute to a painful but necessary process of confronting and accepting the reality that the deceased is truly gone (Bowlby, 1980; Shaver & Mikulincer, 2021).

Continuing Bonds and Attachment Schemas

Melissa, a woman in her sixties whose husband died after battling cancer for five years, says “I talk with him every night before I go to bed.” Sometimes she cries while telling her husband how much she misses his company. At other times, she shares her excitement about her efforts to make new friends in the months following his death. Regardless of what she is feeling at the end of her day, she kisses a framed photo of her husband that still sits on her dresser drawers and wishes him a good night before falling asleep. Is Melissa in a state of denial about her husband’s absence?

Ethan’s parents died in a car accident soon after he left home to attend college. Four years later, while attending his graduation ceremony, Ethan reports feeling “they were with me, and I know they are happy for me.” His voice quivers in pain as he talks about how he wishes he could ask for their guidance now that he is making a decision about what type of career to pursue. Does Ethan’s subjective experience that his parents were present during his graduation ceremony suggest he is struggling to manage grief in a healthy manner?

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Expressions of protest are common in the weeks and months that follow a loss, but in due time, the attachment system usually concedes to the horrible truth that the deceased is truly gone. Nonetheless, an impulse to maintain meaningful ties to attachment figures persists. Many people find a compromised but satisfactory solution in those behaviors that allow for a symbolic and internal connection to the deceased.

Indeed, proponents of continuing bonds theory assert that those who cope well with loss rarely relinquish meaningful connections to the deceased altogether (Klass et al., 1996; Sirrine et al., 2018). Melissa is adapting well to the loss of her husband and expressing feelings of grief without restraint … and she has illusory conversations with him that help her go to sleep in peace. Ethan acknowledges the pain of his parents no longer being alive … and he allows himself the comfort of feeling that they are proud of him. Clearly, continuing bonds can be an integral part of healthy adaptations to loss and allow mourning to unfurl without interruption or pathology (Worden, 2018).

Healthy experiences of continuing bonds allow for the essence of a relationship to remain accessible within the bereaved individual’s mind while also accommodating the reality of death and irreversible absence. This aspect of the mourning process is challenging and takes time. Within the attachment system resides the attachment schema, a framework of beliefs regarding what to expect from attachment figures and how to navigate relational needs. Therein lies an internal representation of the attachment figure that guides the individual to seek them out and find them in the external environment as always. But mourning involves a cruel process of revision to the attachment schema, as a series of efforts to achieve reunion are fated to fail. In time, these internal representations no longer represent an attachment figure who can be found in the external environment per usual; the bond with the deceased transforms into something that the bereaved can still interact with in meaningful ways, albeit entirely symbolic and within the mind. Thus, the attachment system becomes reorganized amid a healthy experience of bereavement.

Object Constancy and Self-Soothing

Many bereaved individuals access continuing bonds as a coping strategy that meets attachment needs after a loss. Be it an inanimate object once owned by the deceased that continues to provide tactile comfort, or a fond memory that leaves the bereaved feeling loved, these and many more examples of continuing bonds represent acts of self-soothing.

Margaret Mahler (1971) studied the psychological development of young children and how they develop the ability to self-soothe when separated from an attachment figure. Mahler coined the term object constancy to describe the child’s emerging capacity to allay separation anxiety by maintaining a symbolic representation of the caregiver in mind (Mahler et al., 1975). During moments of separation anxiety, object constancy serves as a symbolic substitute for the attachment figure’s actual presence, an internalization of a loving relationship that echoes past experiences of guidance and comfort and makes it easier for the young child to tolerate time apart.

Object constancy can also ease the bite of mourning after an outright death. Mental representations of the deceased help the bereaved regulate painful feelings of grief with a subjective sense of the deceased’s ongoing presence that guides them forward. Unfortunately, some individuals navigate separation, loss, and grief without the benefits of object constancy, leaving them susceptible to various courses of complicated bereavement. Whether or not one is equipped with object constancy as a means of coping with loss is often directly related to one’s attachment style, a distinct pattern of relational behaviors that crystallize early in life. Our discussion begins with a model of psychological health that promotes satisfying relationships and healthy efforts to cope with loss: secure attachment.

Secure Attachment: The Cornerstone of Relational Health

Melissa and Ethan each present a different story about how to mourn in response to a loss. They both sustained healthy expressions of grief while also making room for continuing bonds that helped them cope. But their stories began long before the moment their loved ones died. An exploration of how they managed to mourn effectively in adulthood leads us back to the formative years of childhood where they first learned how to grieve, how to approach novelty, and how to reunite with attachment figures.

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Mary Ainsworth and Barbara Wittig (1969) pioneered research that directly observes characteristic ways that certain children activate their attachment systems. They developed the strange situation classification, a series of situations and events designed to coax out different attachment behaviors between a child and an attachment figure.

There are a few instances in this procedure when the child’s behavior demonstrates secure attachment. First, upon entering a room filled with toys, the child is eager to step away from her mother and play in this novel environment before periodically returning to the attachment figure for comfort before venturing off once more into independent play. This behavior demonstrates secure exploratory behaviors. Second, the mother leaves the room for three minutes and the child expresses emotional upset; she will also exhibit a variety of searching behaviors (following mother to the door, staring at the chair she had been sitting in, etc.). Though it is upsetting to observe the child cry and show fits of anger, these attachment behaviors indicate that the attachment system is functioning just as it should. Finally, the child crawls or walks toward her mother upon her return and the reunion soothes her distress.

Longitudinal research has shown that one’s attachment style tends to crystallize in childhood and persist well into adulthood (Antonucci et al., 2004; Fraley & Dugan, 2021; Waters et al., 2000). The child who exhibits signs of secure attachment in the strange situation paradigm will, later in life, continue to want proximity to others, express distress in response to separation, and occasionally navigate the world alone with relative ease, trusting that there is strength in both their independence and their need to rely upon others.

Theoretically, the internal working model (IWM) consists of fundamental beliefs about one’s relational needs and the likelihood of relationships being able to meet those needs. Those with a secure attachment likely had experiences throughout childhood that confirmed a positive appraisal of the drive to seek out attachment figures when upset, and a hopeful view of the other’s ability to provide soothing (Jacobsen & Hoffman, 1997). This pattern of secure attachment not only drives a person to seek out the actual attachment figure in external reality, it also contributes to the ease with which one can access childhood memories of attachment figures! Indeed, the Adult Attachment Interview (AAI) is a systematic protocol of questions that ascertain how well an individual uses mental representations of others to recall memories and express emotions about past interactions; those with a secure attachment style do both with great ease. These symbolic searching behaviors are neither inhibited nor an all-consuming distraction. Plus, retrieval of these memories represents an act of continuing bonds that provide emotional comfort and a sense of continuity in relation to the past (Bifulco et al., 2002).

Attachment style contributes mightily to the course of mourning. Having a secure attachment style bodes well for the bereaved. They express grief without excessive restraint. Object constancy makes it easier to find some degree of comfort in continuing bonds that soften the harshness of mourning (Mikulincer et al., 2002). The bereaved also trust in the complimentary value of stepping away from familiar ties and exploring life apart from the deceased. Secure attachment is a protective factor when mourning a loss.

Not all bereaved individuals are able to shield themselves against the deepest pangs of grief so naturally. Research estimates that 10% to 20% of bereaved individuals fail to cope effectively with loss and mourning (Bonanno & Kaltman, 2001). Additionally, it has been shown that complicated bereavement correlates with insecure attachment and poor affect regulation (e.g., Fraley & Bonanno, 2004; Wijngaards-de Meij et al., 2007). Seeing as how approximately 58% of adults are categorized as having a secure attachment, a significant proportion of the population is at increased risk for complicated bereavement (Bakermans-Kranenburg et al., 2009). In order to better contrast secure attachment with two different types of insecure attachment and understand how the course of mourning differs for each, our discussion turns to one more body of research: the dual process model of coping with bereavement.

The Dual-Process Model of Coping With Bereavement

Common sense and lay opinion suggest that mourning is a linear process, and that grief must be expressed in full, without interruption, before the bereaved arrive at a state of resolution. But research casts doubt on these assertions and offers the possibility that there may even be some value in avoidance.

The Dual Process Model of Coping with Bereavement (DPM) begins with an observation that bereavement involves two types of stress. Loss-oriented stress entails expressions of separation distress after the death of a loved one and reminiscences about the past. Restoration-oriented stress involves efforts to manage life after a loss and adapt to all that has changed, be it the loss of income within a marriage, family traditions that will no longer be the same, or the absence of a friend who had always been in charge of planning social outings for the entire group (Stroebe & Schut, 2010).

The other hallmark of the DPM is referred to as confrontation-avoidance oscillations. Stroebe and Schut discovered that the bereaved are better able to cope with the death of a loved one if they actively deal with one of these stresses while avoiding the other until later. There is no need to resolve one’s loss-oriented stress about the past and process feelings of grief in full before moving ahead and managing life anew without the deceased. The DPM insists that it is more advantageous to oscillate back and forth, attending to one type of stress, then suppressing that stress for a while so as to attend to the other type of stress, and so forth (Fiore, 2021). A bereaved individual whose parents died allows themselves to express sadness at one moment, then puts aside those feelings in order to take on the stress of managing their parents’ estate at another moment, and then pivots back to bittersweet reflections on the past as they look through old photo albums.

From this perspective, different types of complicated bereavement are the result of failing to oscillate between these stresses (Lundorff et al., 2019). Excessive loss-oriented stress leaves the bereaved mired in unending painful feelings and stuck in a state of chronic grief that interferes with their ability to adapt to all that has changed. Too much restoration-oriented stress represses emotional responses to loss and leads to delayed grief that bursts forth seven years later or masked grief that rears its head in physical symptoms of ill health and/or confusing psychological ailments that stymie efforts to move forward.

Ethan and Melissa both demonstrate what healthy mourning looks like because they oscillated between the stresses of processing the past and managing what lies ahead. Melissa maintained continuing bonds with her husband and cried about his absence … but also made room to take on the stress of making new friends with whom she could find company. Ethan moved forward in pursuit of education and career without his parents’ guidance … and occasionally stopped to express upset about how he wished they were with him to offer support.

Those with a secure attachment style have greater success managing the various stresses of bereavement because they are better able to engage in confrontation-avoidance oscillations (Stroebe et al., 2005). They confront loss-oriented stress with relative ease because they are not inhibited about activating the attachment system and expressing separation distress. They then step away from those feelings for a time and courageously confront restoration-oriented stress because they trust both their ability to explore the future without the deceased, and that the memory of their beloved attachment figure will always be available to them.

Complicated Bereavement and the Attachment System

The Dysregulated Attachment System and Prolonged Grief Disorder

The new addition of prolonged grief disorder (PGD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) provides a useful clinical perspective on how the grieving process can become stalled or intensified to the point that it results in complicated bereavement. Even when the pain of loss lingers, the intensity of acute grief usually diminishes over time. PGD shines a light on those instances in which the bereaved experience persistent and pervasive longing or preoccupation with the deceased that lasts more than 12 months in adults (six months in children), all under the broad heading of separation distress. Further, this protracted state of mourning is, according to diagnostic criteria, accompanied by any variety of additional symptoms, including emotional pain (sadness, guilt, or anger), difficulty accepting the death, emotional numbness, avoidance of reminders of the loss, difficulty reintegrating into relationships and activities, feelings of meaninglessness, and identity disruption (APA, 2022).

Attachment theory provides a theoretical framework for understanding how PGD develops. When an attachment figure dies, the attachment system designed to maintain closeness becomes activated once again. Under normal grieving conditions, this activation gradually subsides as the bereaved accepts the permanence of the loss and reorganizes their life without the deceased. But PGD may arise when the attachment system fails to deactivate in due time and becomes dysregulated. The bereaved continue to yearn for the deceased attachment figure and experience separation distress as if these attachment behaviors will ensure reunion. This persistent display of attachment behaviors represents something more than an emotional response to grief; it is a neurobiological signal that the attachment system is still actively seeking reconnection that is no longer available (O’Connor, 2022).

A key aspect of how this process goes awry involves a failure to update mental representations of the deceased. When grief and mourning unfold in a healthy manner, bereaved individuals gradually incorporate the reality of the death into their internal representations of the world, the people in it, and what they can expect when seeking comfort from others. The representation of the deceased shifts from a reliable physical presence in the world to one that is purely symbolic and rooted in memory. When the bereaved exhibit signs of PGD, it is often because some aspect of this process has been disrupted or is incomplete. The bereaved continue to behave, think, and display emotion as if the deceased is still present in the world as they were before; the mental model of the deceased, if not adequately revised, continues to guide the bereaved to display attachment behaviors and search for the attachment figure, leading to a chronic course of grief (APA, 2022).

Protest behaviors may be most pronounced, including intense emotional outbursts, efforts to deny reality and turn away from confrontations with all that has changed since the attachment figure, or persistent efforts to maintain some semblance of contact with the deceased through inanimate objects and substitute relationships (this will be discussed in greater detail later). Searching behaviors rooted in the attachment system may be the telltale sign of complicated bereavement that may emerge, manifesting as ruminative thinking about the deceased, or a compulsion to seek out the deceased by looking at old photos, or visiting places where the deceased could be regularly found. These behaviors are not inherently pathological in early grief, but in PGD, they become protracted and unrelenting. Thus, PGD can be understood as a failure of psychological and neurobiological systems to recalibrate in the face of irreversible loss. The attachment system remains hyperactivated and the bereaved individual remains psychologically oriented toward reunion rather than integrating the loss into a new way of orienting themselves to the world (APA, 2022).

The Neuroscience of Complicated Bereavement and the Pursuit of Old Rewards

Mary-Frances O’Connor’s research on the neurological processes of grief provides fascinating insights into how the bereaved individual’s brain and mind respond to loss. Her work highlights how the emotional experience of grief is informed by a complex network of attachment systems, memory, and reward processing. According to O’Connor (2022), the brain literally searches for the lost person in the aftermath of death, lending credence those aspects of attachment theory and the diagnosis of PGD which say that yearning, disbelief, and protest regularly color early experiences in bereavement.

Brain networks responsible for anticipating social reward and detecting discrepancies between expectations and reality are all shown to be implicated. Following the death of a loved one, the bereaved individual maintains mental representations of the deceased as if they remain present and accessible. These representations are not quickly erased simply because the attachment figure has died. O’Connor’s work shows that the brain requires time and repeated experiences of absence in order to gradually revise these internal representations, or models. Functional imaging studies suggest that in early grief, the brain continues to expect that the deceased will be found in the same locations and circumstances as before. Areas involved in social cognition, such as the anterior cingulate cortex, remain active as if preparing for interaction with the lost person. The brain slowly recalibrates over time as these expectations are repeatedly disappointed. This process of integrating the reality of loss is the neurocognitive counterpart to the emotional task of accepting the finality of the loss; the brain’s predictive models must eventually align with the new reality that the deceased is absent where they were once present (O’Connor, 2022).

But in cases of complicated bereavement, when a diagnosis of PGD may be warranted, integration of a new reality can become thwarted. One of O’Connor’s more interesting research findings lies in her exploration of the brain’s reward circuitry in bereavement, particularly the nucleus accumbens, an area of the brain implicated in the motivation, the pursuit of pleasurable stimuli including social rewards, the processing of rewards, and the reinforcement of such behaviors. In grief, especially in those suffering from complicated bereavement, the nucleus accumbens remains more active than usual in response to reminders of the deceased. Rather than dampening over time, as would be expected if the reward system were adapting to the loss and to a failure to achieve the same rewards as before, the region continues to be just as active as before the loss, if not more so, when looking at reminders of the deceased (O’Connor et al., 2008).

These findings suggest that the brain circuitry of those suffering from PGD not only leaves the bereaved experiencing unrelenting and painful yearning for the deceased, but their brains also persist with old motivations and continue driving them to seek out an impossible reunion they can no longer obtain. It is additionally worth noting that the nucleus accumbens activity in complicated grief described above mirrors that seen in individuals suffering from addiction, where the brain pursues rewards that are either no longer available … or partially attainable, albeit at a great cost. The bereaved individual who is experiencing PGD is driven toward reunion despite the repetitive pain inherent in doing so.

Thus, O’Connor’s research into the neurological underpinnings of grief and complicated bereavement can be conceptualized as a form of maladaptive reward learning. The brain, caught between the old attachment schema and the reality of the attachment figure’s absence, struggles to extinguish associated reward pathways that once led them to the source of relational comfort and emotional support. This neurobiological tension sustains the ill-fated hope of reunion and prolongs emotional suffering. Her findings underscore the need for interventions that address both cognitive and affective components of grief, helping the brain revise its mental representations and attachment schemas while also learning to seek out new rewards.

The Loss of an Attachment Figure and the Loss of One’s Identity

Lastly, a note should be made about the subjective experience of self and identity amidst bereavement. The basic tenets of attachment theory assert that the loss of a primary attachment figure is so very difficult for the bereaved, not only because of the loss of emotional support, but also because these relationships provide a foundation for the development and maintenance of the self. As follows, the death of an attachment figure threatens to destabilize both the bereaved individual’s emotional regulation and their very sense of identity. This notion is tied directly to the diagnostic criteria for PGD, especially the symptom of identity disruption. Indeed, bereaved individuals often report feeling as though some part of one’s self has been lost alongside the death of a loved one (APA, 2022).

This should all come as no great surprise! We are irreducibly relational animals. Our identities are not constructed in isolation, but rather they are co-constructed vis-a-vis our most significant relationships. The roles we inhabit – spouse, sibling, child, friend – are integral to our self-concept, shaping how we see ourselves and how we find meaning. When a primary attachment figure dies, the role we played in relation to the now-deceased may fall away as well, leaving behind a vacancy within our sense of who we are. Identity disruption is not easily resolved through mere distractions or reassurances that the bereaved essentially remain the same. Healing from the loss of an attachment figure demands a gradual reconstruction of self-concept that acknowledges the loss and reclaims a sense of identity, often through efforts to actively mourn some aspect of the self that has been lost, take on new roles and new values, and embrace new experiences of one’s self in relation to other relationships and a new world.

Malleable Attachment Systems and Complicated Bereavement

Unfortunately, many children have such unsatisfying relationships with attachment figures early in life that they feel pressured to alter inborn relational instincts to cope with separation. Every aspect of the attachment system is malleable and may be minimized or magnified, ultimately crystallizing into lifelong personality traits. Some children learn to dampen emotional expression when lonely and will themselves to get on without others; later in life, they may go it alone a bit too often and inhibit themselves from drawing others in or bothering friends with what they suspect are no more than their messy feelings. Other children’s experiences teach them that hyperactivated attachment behaviors are the only way to ensure support; as adults, they cry or vent anger with whomever is nearby and find it so intolerable to be alone that they compulsively seek out others’ company. One of the great tragedies of distorted attachment behaviors is that they maintain the very separation distress they were originally designed to alleviate.

Just as the attachment system is malleable, so too are the innate processes of grieving a loss. Mourning can go awry when the attachment system remains disorganized. The entire range of healthy attachment behaviors – affective expression, searching behaviors, and continuing bonds – can be chronically deactivated for some individuals. Bowlby’s (1963) initial assertion holds true: failure to express emotional distress and a desire for reunion after a loss robs the bereaved of the crucial, albeit painful, process of confronting the reality of absence, leading to complicated bereavement because the attachment system remains unconscious, unattended to, and unrevised. But the opposite response is just as concerning: hyperactivation of the attachment system marked by amplified shows of distress and searching behaviors that do not relent (Gegieckaite & Kazlauskas, 2020). We will now consider two case studies of individuals who suffered entirely different courses of complicated bereavement with their own distinctive problems along the way, one of whom amplified attachment behaviors while coping with the loss of her husband, while the other individual seemed to tamp down his attachment system in an effort to not feel grief or convey any distress about his plight to anyone.

Insecure in Mourning: Preoccupied Attachment

Mary Ainsworth (1971) made note that many children in the strange situation paradigm did not exhibit secure attachment but instead showed signs that pointed to one of two types of insecure attachment. One such pattern of behavior was dubbed anxious-ambivalent. These children express protest upon being separated from their attachment figures … and yet they remain unhappy when reunited. In adulthood, the AAI will likely categorize these individuals as preoccupied. They often find it incredibly difficult to be apart from their most cherished relationships, inhibit acts of independence, and monitor the other’s availability for fear of being abandoned (Wallin, 2007).

Children with an anxious-ambivalent attachment style amplify attachment behaviors and often continue to do so throughout the lifespan (Harris et al., 2021; Kobak et al., 1993). Separation brings about exaggerated emotional distress. They tend to suppress any impulse to explore the world on their own and devote a disproportionate amount of time towards being in the company of others.

Research suggests that their parents were inconsistently available (Green et al., 2007). Warm at times but cold at other times, the child learns that steady activation of attachment behaviors does not guarantee access to the attachment figure. Where tears should have sufficed, an unyielding flood of weeping demands attention. The child grows to fear that any demonstration of independence will signal the attachment figure to leave now that they are no longer needed, and so the child hovers nearby and presents in a state of perpetual crisis. Their internal working models consist of a view of self as weak and others as strong bulwarks against the hardships of life (Harris et al., 2021; Kobak et al., 1993). When their attachment figures die, preoccupied individuals regularly find themselves unprepared to manage the emotional turmoil of grief.

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Serena’s husband, Sam, died ten months ago from brain cancer. She admired her husband for being educated, worldly, and for being a loving father to their two daughters. Serena cries often since her husband died and spends multiple hours a day at his burial site. She and her daughters have become disconnected from their community despite others’ invitations to schedule play dates with friends from school and attend neighborhood events together. She is bracing herself for the upcoming anniversary of Sam’s death, is feeling overwhelmed, and eventually decided to seek out grief counseling because, as she stated during the intake appointment, “I need to express more about how much I miss my husband.”

Serena reports that everything in their home remains exactly where it was when Sam died. His office is still filled to the brim with his books, professional clothing, and various objects connected to his hobbies. This has come to be a problem because Serena’s two daughters share a small bedroom and wish to have their own space and more privacy. Nonetheless, Serena is hesitant to move anything and the sight of his possessions makes her very upset.

For bereaved individuals like Serena, the acute response to loss seems to have no end. A sustained uptick in attachment behaviors (uninterrupted reflections on the past, heightened expression of separation distress, and ongoing searching behaviors) eventually gives way to chronic grief (Mancini & Bonanno, 2012). Furthermore, an internal working model marked with a negative view of one’s potential for strength and resiliency leaves these individuals inhibited and anxious about the prospect of adapting to life after losing an attachment figure. Serena is investing all her energy into doing what she can to remain close to her husband.

People who have a preoccupied attachment style are susceptible to complicated bereavement because of two additional factors: a tendency to seek out unrestrained continuing bonds (Field, 2006) and inadequate efforts to cope with restoration-oriented stress (Stroebe et al., 2005). Serena’s thoughts and feelings of grief are oriented entirely towards the past and any lingering sense of connection to her husband. While these responses to loss are healthy in and of themselves, bereaved individuals like Serena are prone to struggle because they do not put these thoughts and feelings aside and oscillate enough toward managing the stress of what follows a loss and requires adaptation.

Though it may seem counterintuitive, those with an insecure-ambivalent (or preoccupied) attachment style have a difficult time establishing healthy continuing bonds because they lack object constancy. Yes, they can certainly access internal mental representations of attachment figures, but these bereaved individuals continue to be gripped by fears of separation anxiety. Just as reunion with the actual attachment figure fails to soothe because of persistent fears of abandonment, in mourning, the bereaved struggle to derive comfort upon seeking out mental representations of the deceased because, here too, they worry that time will rob them of their memories, and so they monitor their illusory attachments for fear that these too will perish if they don’t continue to stay close and cling tight.

Insecure in Mourning: Dismissing Attachment

Leonard started grief counseling 14 years after his wife died. He seemed unaffected as he recalled her failing health and the day she ultimately died. Leonard loved his wife. Nevertheless, he insisted on moving forward after she died and devoted himself entirely to his business. He quickly got rid of his wife’s belongings and vowed to do everything within his power to not rehash the past. Leonard painted over the bright colors that he and his wife preferred with bland colors of gray and beige.

Despite efforts to move forward, Leonard remained uncomfortable. He was often confused by feelings of sadness and anxiety that emerged while in his house, spurring him to work long days at his office. Leonard found it difficult to conjure up meaningful memories about the many years he spent with his wife, though he did talk a little about the nature hikes they used to take prior to her illness. With a veneer of acceptance, he shrugged his shoulders, saying, “That was then. This is now.” During his third therapy appointment, Leonard expressed frustration with the dull colors of paint in his home. He then began mimicking the slow and deliberate technique his wife used to paint, squinting his eyes while demonstrating how she used a short handle so she could get her face close to the wall. Leonard briefly let loose a grin while imitating his wife.

Insecure attachment is not a monolith. Early research on attachment styles resulted in the observation that some children who are not secure exhibit a completely different type of insecure attachment style in children: insecure-avoidant (later in life, adults with an insecure-avoidant attachment style will demonstrate patterns of cognition, emotional regulation, and relational behavior that the AAI categorizes as dismissing). The key feature of insecure-avoidant attachment is the outward appearance of being affectless and indifferent toward other people.

An insecure-avoidant (or dismissing) attachment style can be hard to notice. The individual presents a calm demeanor to the world, and when they are separated from attachment figures, their persistent facade of ease and contentment suggests they remain well and unaffected. Adults are led to believe that the child is merely demonstrating the ability to navigate life with a healthy degree of self-reliance, autonomy, and a mature desire for independent exploration. Though they present with a veneer of peace, medical research makes it painfully apparent that children with an insecure-avoidant attachment style are only tamping down their physiological symptoms of separation anxiety when apart from attachment figures; a chronic state of stress carries on unabated outside of conscious awareness (Hill-Soderlund et al., 2008; Sroufe & Waters, 1977). Stress hormones flood the nervous system. One’s heart rate remains precariously high. What’s more, children who have an insecure-avoidant attachment style are at a greater risk for developing various illnesses typically brought on by stress because they have largely deactivated attachment behaviors that should remain intact as relational solutions to the stress of separation: conveying distress through negative emotions and searching behaviors that lead to support and comfort (Ehrlich & Cassidy, 2021; Kotler et al., 1994).

The child who displays behaviors in the strange situation paradigm that are consistent with an insecure-avoidant attachment style will most likely continue to exhibit down-regulated attachment behaviors across the lifespan and through adulthood (Mikulincer & Shaver, 2022). He or she may find it more comfortable to venture out into the world unattached to others. When they do experience emotional distress, they will probably err toward going it alone and repressing any drive to seek out others for support. As a whole, it is common for these individuals to keep emotional expression to a minimum and insist that they are doing fine.

For children who develop an insecure-avoidant attachment style, their relationship with primary caregivers during the earliest years of life was likely colored by either insufficient availability or an excess of such. In some instances, the child’s attachment behaviors invited too much responsiveness from an attachment figure, leaving the child overwhelmed and unable to practice exerting a healthy amount of autonomy. In other instances, the child’s cries and searching behaviors yielded very minimal response and left them to manage their upset alone. Whether one extreme of this continuum occurs or the other, the child learns that it is preferable to abandon attachment behaviors. The parent who is too readily available reacts to every single whimper. One’s mother or father is always present, frustrating the child’s motivation to slowly master autonomy. The child learns that tamping affective display carves out a little space to explore the environment around them without a caregiver hovering overhead. Conversely, the parent who is not reliably available and responsive teaches the child a lesson in learned helplessness: exerting energy towards getting others to meet relational needs will only disappoint and frustrate. The child with an anxious-avoidant attachment style starts to favor autonomy and personal strength over connection and healthy reliance upon others.

Those with a dismissing attachment style view their self-sufficiency and self-reliance as a strength, but this component of the internal working model does not guarantee high self-esteem; repeated interpersonal rejections from attachment figures may burden them with the belief that their interpersonal needs are ineffective and/or a nuisance that others don’t want to tend to (Larose & Bernier, 2001). Searching behaviors and the impulse to express distress are buried and remain repressed during stressful times, including moments of loss and grief, because other people are believed to be unavailable or, if present, impinging and ultimately unhelpful (Mikulincer & Shaver, 2022).

Leonard’s particular struggles present a different picture of what complicated bereavement looks like. People who have a dismissing attachment style often appear to be adjusting to life after a loss and managing bereavement without brooding on painful feelings. But their general tendency to repress attachment behaviors only postpones inevitable mourning processes and leaves them vulnerable to a delayed or masked course of mourning down the road. The true depths of their pain eventually emerge in dysfunctional behaviors and confusing physical or psychological ailments. Leonard attempted to sidestep his feelings of grief. He attempted to avoid any sustained reflections on the years he had with his wife or any desire to feel an ongoing sense of connection to her. Nonetheless, buried attachment behaviors burst forth through behavioral inhibitions and disquieting feelings he did not understand.

There are two additional reasons why people who have a dismissing attachment style are susceptible to complicated bereavement: an absence of continuing bonds (Field, 2006) and avoidance of efforts to cope with loss-oriented stress (Stroebe et al., 2005). Reticent to express vulnerable emotions about their losses, these individuals are too eager to separate from the past, expending an unhealthy amount of energy toward managing restoration-oriented stress, without pausing to address thoughts and feelings about who they lost.

A dearth of continuing bonds leaves them unable to find comfort in memories of the deceased or any meaningful, ongoing connection. Here too, a lack of object constancy is to blame, but it is a completely different problem from that which hinders individuals with a preoccupied attachment style. A dismissing attachment style not only entails minimal expression of negative emotions, it is also marked by a struggle to access thoughts of, and memories about, attachment figures (Meier et al., 2013). Those who do not seek out internal mental representations of relationships will, very similarly, hesitate to seek out continuing bonds that could have afforded some measure of comfort in mourning.

If the bereaved learned early in life that searching behaviors and expressing separation distress do not serve them well, they will enter bereavement with an assumption that loss-oriented stress and continuing bonds will offer no relief. Furthermore, their internal working model will render them anxious about activating the attachment system, which would be a vulnerable admission of dependence on others that would betray the independence they fought so hard for. People like Leonard attempt to wear a brave face in mourning, but it is only a thinly veiled facade behind which they suffer a sad and detached existence. He tried to bury his feelings of grief beneath coats of paint, but painful feelings still managed to poke through and send him running to work to distract himself. If the attachment system remains repressed after a loss, it rears its head in failed attempts to adapt and move on, quiet whimpers of protest that should have been given more volume immediately after losing a loved one.

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The psychological study of loss makes it clear that different individuals are prone to experience grief in different ways, and some are more vulnerable to bouts of complicated bereavement than others. Furthermore, different individuals are at a greater risk for different types of complications. What follows is a call for individualized approaches that cater to one’s unique psychological experiences and needs.

Culture has always provided members of society with opportunities to participate in grief rituals that aim to facilitate the process of mourning. Steeped in prevailing beliefs about what is most healing, cultural grief rituals aid many, but they undoubtedly hinder others whose personal needs are in conflict with the collective zeitgeist. When culture fails the individual, personal grief rituals present a viable alternative that can be better tailored to what the individual needs and what they would find most meaningful. What follows is a thorough discussion of (1) a cultural anthropological understanding of what constitutes a ‘grief ritual’, (2) why cultural rituals can facilitate or hinder the mourning process, (3) the benefits of using personal grief rituals, (4) how to assess the individual's unique psychological needs, and (5) how to help clients design personal grief rituals.

Grief Rituals Facilitate Mourning

Humankind has long turned to grief rituals to invite emotional expression. These rituals encourage the bereaved to step away from the relationship they once enjoyed with the deceased in this world, and to maintain continuity and help a community move forward after death. Rituals allow ‘life as we knew it’ to screech to a halt, allow for continuing bonds, and the ongoing sense that loved ones remain present in spirit and mind. Despite these important functions, many people harbor deep misgivings about the potential benefits of performing a grief ritual.

Simply mentioning the word ritual is sure to turn a few heads. Ritual may bring to mind strange ceremonies performed in the dark, absurd efforts to engage in sorcery or witchcraft or barbaric animal sacrifices. Psychologists and other mental health professionals have equated ritual with pathological symptoms of obsessive compulsive disorder: meaningless compulsions that repeatedly attempt to neutralize unpleasant thoughts, images, impulses, and feelings. Even the everyday use of “ritual” among lay people describes a fixed routine carried out with minimal thought so as to ensure efficient use of time. But it is these elements of introspection, emotion, meaning, and memory that are to be stoked, not sidestepped, by participating in a grief ritual. Traditional grief rituals have always involved carefully planned gatherings in the community that encourage bereaved individuals to be in the here-and-now and tap into feelings of grief, to express a deep desire for reunion, to move forward with purpose and collective organization, and to contemplate the deceased spirits’ journey after death.

Most definitions of ritual are too simple, suggesting that a ritual is a solemn ceremony, or that ritual entails no more than a series of actions performed in prescribed order. While these definitions are partially satisfactory, the narrow affective range suggests that the emotional experience of participating in a ritual is only sad and somber, and that all actions are decided upon ahead of time with no room for spontaneity or for individual choice. Therese Rando (1985) offered a far more open definition of ritual: “a specific behavior or activity which gives symbolic expression to certain feelings and thoughts of the actor” (p. 236). Equipped with Rando’s definition, we can start to understand how grief rituals use orderly and predictable behaviors to coax out a wide array of thoughts and feelings related to a bereaved individual’s subjective experience of loss. Anger, anxiety, relief, sadness, or joy may emerge during the performance of a grief ritual.

Rando also gave credence to the crucial role of symbolism in meaningful acts of mourning. The lighting of a candle, the clanging of a bell, or words spoken during a ceremony provide external representations of what is internal and give shape to that which is otherwise nebulous and inchoate amid the bereaved individual’s disorienting experience.

There is one more important piece to fold into our understanding of what constitutes a grief ritual: meaning-making. Schnell (2009) thinks of rituals as formal sequences of behavior that aid in the process of constructing meaning around events in one’s life, including the death of a significant relationship. They may very well be designed to fit within pre-existing structures of meaning about death, subsequent grief, and the process of mourning. But according to Robert Neimeyer’s (2002) constructivist perspective, loss often challenges the bereaved to reconstruct core beliefs and assumptions one uses to make sense of the world after a loss, to make meaning anew and rebuild that which death has left in ruins.

This amalgam of ideas comes together to form a more robust understanding of all that a grief ritual is: “a specific series of actions, grounded in meaning about death and mourning, that gives symbolic expression to thoughts and feelings about a particular loss” (Martin, 2023, p. 4). Indeed, a survey of cultural grief rituals around the world reveals a wildly disparate array of actions, systems of meaning about death and mourning, emotional experiences of loss, and use of symbols.

Consider All Saints’ Day in Poland, which is steeped in a Christian worldview. The abundance of candles that are lit during All Saints’ observances serve to acknowledge that loved ones are not gone forever, that the light in their hearts continues to shine in the presence of God. The action of lighting candles … is grounded in meaning about the afterlife and God … and gives symbolic expression to the comfort derived from a sense of the deceased’s ongoing presence. The objective is to hold on.

Over in the Philippines, we find a notably different type of grief ritual. Often referred to as The Hanging Coffins of Sagada, practiced by the people of Sagada, coffins are hung and suspended along cliffs in plain view for all to see. Why, one might ask, do they do this? It is these people’s belief that the higher the dead are placed, the greater the likelihood of their spirits reaching a higher nature in the afterlife. In this corner of the world, the goal in mourning is not to hold on but to do what is needed to let go.

The Task Model of Mourning

William Worden’s (2018) task model of mourning is a non-linear model that highlights four separate tasks that the bereaved must tend to in order to manage grief and mourning as effectively as possible. Interestingly enough, cultural grief rituals across the world and throughout history often provide members of their communities with a framework for approaching at least one of these essential tasks.

Task I: To Accept the Reality of the Loss

The bereaved are both acutely aware that someone has died … and simultaneously in a protracted state of shock and disbelief in the early goings of mourning. Denial, however quiet, murmurs beneath every thought and feeling and memory about the deceased. Task I in Worden’s model points toward how imperative it is that the bereaved actively do away with denial and turn toward the harsh reality that a loved one has died and is no longer present in the form they once assumed.

Many cultural grief rituals either actualize the reality of loss or provide an opportunity to say goodbye to the deceased. For instance, the Irish wake and its trademark open casket drive home the finality of loss when the bereaved observe, in no uncertain terms, that the deceased’s body remains motionless well after death has been pronounced (Grainger, 1998). And in the Sanyuan village of China, those who are moments away from their last breath are held upright near an open window; children of a dying parent are compelled in that precise moment to bid farewell (Chen, 2000).

Task II: To Process the Pain of Grief

It comes as no surprise that Worden’s task model makes room for the emotional component of grief that rears its head in varied painful feelings. Grief impinges upon the bereaved, but they are encouraged to assume some semblance of control and actively find ways to process their feelings in whatever form and intensity they assume.

Some cultural grief rituals serve to coax out emotional expression. Affects as disparate as sadness, anger, and joy may find an outlet in a social milieu and within a contained amount of time. The American funeral encourages a solemn display of sorrow (Metcalf & Huntington, 1991). Australian Aborigines embody the raw anger of grief through acts of self-injury (Farrelly & Francis, 2009). And younger generations in South Africa welcome expressions of happiness and a zeal for life when the bereaved gather after a funeral to listen to music and dance during an after-tears party (Abruzzini, 2017).

Task III: To Adjust to a World Without the Deceased

Sigmund Freud (1917) once observed that the acute state of mourning leaves the bereaved with a sense that the world has been rendered empty. Indeed, when death rips away a member of a family or a community, roles once filled by the deceased are left vacant, there is an unmistakable void in the bereaved individual’s surrounds. Sources of emotional support are suddenly gone. Familiar meals are no longer prepared. The survivors of loss must reassign and assume new roles and responsibilities. They must invest in new relationships and activities. Worden’s third task emphasizes all the adjustments that must be made when the bereaved find themselves living in world without the deceased.

Other cultures’ grief rituals are less concerned with confronting the past and are, instead, more concerned with efforts to goad the bereaved into all that awaits them after a loss. Romanoff & Terenzio (1998) stated that one of the most important functions of funerals is that they mark a transition in time, apart from what had come before and towards what lies ahead. In the Philippines, during the babang luksa ritual, nonvaluable items that once belonged to the deceased are burned at the death anniversary in a symbolic gesture representing the bereaved community’s efforts to let go, draw mourning to a close, and encourage the community to embrace new life (Santiago, 1993).

Task IV: To Find a Way to Remember the Deceased while Embarking on the Rest of One’s Journey Through Life

The process of mourning is an inherently paradoxical endeavor. The bereaved fix their gaze on what lies ahead but regularly pause to look back at the past. They create new memories with loved ones while reminiscing about the good old days. And for many, mourning is most meaningful when simultaneously letting go and holding on. William Worden’s task model of mourning not only allows for an ongoing connection to the memory of those who have been lost, its fourth task draws attention to the importance of remaining tethered to one’s history even as the bereaved move further into the future. A subjective sense of presence and connection to the relationship they lost provides many bereaved individuals with an abstract sense of comfort and continuity that satiates relational and emotional needs.

Proponents of continuing bonds theory echo this notion (Goss & Klass, 2005; Klass et al., 1996; Worden, 2018). Furthermore, there are numerous cultural grief rituals whose aim is to establish and maintain an ongoing connection to the dead, thus strengthening crucial ties to one’s most cherished relationships after they have departed this world. Archaeologists Lewis-Williams & Pearce (2005) have suggested that prehistoric tombs carved out space for the bereaved to revisit the dead and maintain a meaningful relationship. The Mexican holiday of Dia de los Muertos marks three days every year to invite spirits of the dead back to the world of the living so that families can celebrate life alongside their deceased loved ones yet again.

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These varied expressions of grief and mourning across different cultures may tempt one to wonder which group of people has it right. Whose customs guide the bereaved down a healthy course of mourning? Whose beliefs lead bereaved members of their society astray? But lo and behold, there is no singular correct way to process grief and mourn a loss. Worden’s task model offers a framework for appreciating the multi-faceted demands of the mourning process and the meaning behind different cultures’ grief rituals in terms of their focal points and the psychological needs they attempt to meet.

Where one culture’s acts of mourning will hone in on how crucial it is to recognize the reality of a loss (task I) and adapt to life without the deceased (task III), another group’s rituals emphasize a wish to maintain continuing bonds with the deceased (task IV).While yet another group of people may have prioritized ritualized behaviors that aim to open up emotional expression of grief (task II). Each culture’s attempts to make meaning out of loss and cope with the pangs of grief facilitate some strand of mourning, all important in and of themselves, that contribute to a complex and multi-faceted process.

Why Cultural Grief Rituals May Fail the Individual

Metcalf and Huntington (1991) expressed concern about whether the performance of a death ritual actually aids in the psychological processes of grieving a loss: “Whatever mental adjustments the individual needs to make in the face of death, he or she must accomplish as best as he or she can through or around such rituals as society provides. No doubt the rites frequently aid adjustment. But we have no reason to believe that they do not obstruct it with equal frequency” (p. 62). The kaleidoscopic variations between one individual’s subjective experience of loss and the next cast doubt on any culture being able to accommodate all its members and provide rituals that satisfy everyone’s psychological needs. What factors cause cultural rituals to fail the bereaved individual who participate and, instead, create discontent and dissonance?

Cultural Grief Rituals Inhibit Emotional Expression

Cultural anthropologists (Durkheim, 1965; Hertz, 1960; Radcliffe-Brown, 1964) have long argued that the main function of cultural rituals is to ensure social solidarity by encouraging members of a community to come together and participate in activities that bind them together through shared experiences. With grief rituals, the gathering of individuals aims to align everyone into a collective experience of death and mourning. This is why the bereaved are regularly expected to express a specific emotion during the ritual, sometimes under collective pressure to convey compulsory shows of emotion in unison. Grief emerges in all bereaved participants in pre-scripted sequences, and the entire display of emotion grinds to a halt in lockstep among all members.

In Hawaii, after cleaning and dressing the body of the deceased, the bereaved broadcast loud cries of anguish, signaling family and members of the community to gather around the home of the bereaved and join in on this collective upwelling of sorrow (Green & Beckwith, 2009). South African youth feel joy together at an after-tears party. Australian Aborigines are expected to display an obligatory show of painful emotion, called sorry business, that includes piercing cries and fits of anger that gain fullest expression and release of pain only by self-inflicted sorry cuts and bloodletting (Farrelly & Francis, 2009).

Those who participate in such rituals may actually be airing some internal state of grief they truly feel, but there is reason to be concerned that many individuals partaking in collective acts of mourning are simply expressing what their culture expects them to feel in solidarity with one another. Anthropologists and psychologists agree this is a problem because the subjective experience of grief, of what loss feels like, is not uniform! Surely not all Hawaiians feel sorrow, not every person at an after-tears party feels joy following a loss, and not all Australian Aborigines feel anger prior to engaging in compulsory acts of self-injury.

Anyone who observes people participating in grief rituals will likely conclude that the bereaved are releasing feelings of grief that had been pent up, that the subjective emotional experience of grief is one and the same as its behavioral expression. However, a deeper investigation into cultural grief rituals invites the opposite interpretation: participation in a grief ritual precedes the emotional experience of grief. Culture regularly imposes rigid expectations about the appropriate emotional experience of loss, grief, and mourning; whatever affect emerges in the ritual – sorrow, fear, joy, or anger – is often assigned by culture rather than emerging spontaneously. Bereaved individuals who take part in a cultural grief ritual may manage to fend off loneliness, but they do so at the expense of risking repression, of swearing off their genuine feelings for the sake of group cohesion.

Cultural Grief Rituals Impose an Uncomfortable Pace of Mourning

It is tempting to assume all cultures perceive life and death as a simple binary: a person is alive … and then dead. In Western societies, this transition is conceptualized from a medical perspective as a notably quick progression from one biological state to the next; what follows are societal pressures placed upon the bereaved to progress at a rapid pace through mourning. But some cultures are more patient and do not consider the deceased to be truly dead until the body has completely decomposed, giving rise to elaborate rituals that embrace a much slower process of death, and in turn, a slower process of mourning.

Cultural anthropologists such as Arnold van Gennep (1960) have long noted that rites of passage are organized around a three-part structure: an initial phase of separation from one state is followed by a transitional period and concludes with reincorporation into a new state of existence. This second, intermediary phase has been called liminality, highlighting the ambiguous quality of no longer feeling attached to what came before, but not yet feeling like one has fully arrived at what is new. Many cultures’ grief rituals address liminality and how the deceased’s soul separates from life and eventually arrives at a new destination.

Victor Turner (1967) built upon van Gennep’s observations with brilliant insights into the sense of liminality that is built into any culture’s grief rituals. Turner noted that many cultures see the decaying body and its changing form as a crucial metaphor for both the deceased and the bereaved. There is a liminal phase in which the deceased is believed to be steadily separating from this world and transitioning into whatever awaits them, and similarly, a community of mourners is also thought to be slowly detaching from their physical attachments and getting ready for a new life without the deceased. Certain cultures believe that the proper course of mourning, like the steady dissolution of the body, is a long process.

Whether slow or fast, the culturally dictated pace of death carries enormous implications for the amount of time the mourning process is expected to take; one’s journey through liminality can be expected to take as little as three days or seven years. But herein lies the problem: the bereaved individual is always at risk of needing a slower or faster pace of mourning that conflicts with the speed at which culture tells them to separate from the past.

Quick pronouncement of biological death can push some individuals to move through the mourning process too quickly, especially those already prone to psychological defenses of avoidance and repression. But extensive time spent in mourning is not always ideal either. In those cultures that embrace prolonged liminality, some will be pressured to sustain painful feelings of grief or attachment to the past. This could be disastrous for someone already susceptible to a chronic, unrelenting course of mourning. Some, often women, experience outright repression as a result: drawn out shows of grief in which it is compulsory to dress in mourning garb, stay within the home, or refrain from dating. Clearly, some individuals would benefit from moving forward with their lives sooner than later.

Cultural Grief Rituals Are at Odds With One’s Need for Continuing Bonds

Continuing bonds provide many with a helpful and meaningful way to cope with the pain of loss, but many will end up participating in cultural rituals and customs that thwart any impulse to remain connected to the deceased. In the Western world, accepting blunt reality of permanent absence after death, along with efforts to move forward and adapt to life without the deceased, are seen as the benchmarks of healthy mourning. Scientific reductionism and reason reign supreme are over subjective perceptions of reality; such stoicism is indifferent to or outright rejects the value of incorporating continuing bonds into a grief ritual. Conversely, in Mexico, Japan, and Indonesia, the bereaved are expected to interact with the deceased, but it may be that some would prefer to definitively separate from the dead, especially in those cases where the relationship was a source of great pain and misery.

Cultural Grief Rituals Are Not Always Available

Many bereaved individuals simply do not have direct access to the grief rituals their community offers or recommends. First, grief rituals are often incredibly expensive. The Toraja people of Tana Toraja often need multiple years to accumulate enough money to arrange an elaborate ceremony they feel adequately honors the deceased and reflects their status in the community (Budiman, 2013). Whether the bereaved are planning a funeral in America, Haiti, or Indonesia, those with greater financial resources have more access to intricate and flashy ceremonies, and those of lower socioeconomic status are regularly limited in their ability to use cultural grief rituals to fully express feelings of loss grief in a meaningful way. Some individuals may be barred from attending because they cannot afford the travel expenses or the loss of income if they were to take time off from work.

The specifics of where, when and how a cultural grief ritual is performed may be what stymies efforts to grieve. In the Sanyuan village of China, as described above, kin of a dying family member gather around to bid goodbye to their soon-to-be deceased loved one, all in an effort to release their soul and propel them towards the afterlife. Quite often, family members who live far away from home are not able to make it in time to participate in this ritualized send-off (Birx, 2006). In many cultures, the tradition may state that only certain family members may participate in meaningful rites. For example, in Hindu grief rituals, the eldest son is given a torch with which he ignites the funeral pyre of a deceased parent, whereas everyone else watches passively and is offered limited opportunity to participate in community-based shows of grief (Laungani, 1997).

Minorities and immigrants may not be able to find an appropriate space for meaningful rituals in an unfamiliar country. For instance, they often find themselves far away from important geographical locations. At other times, a group’s practices and beliefs conflict with those of the dominant culture. Laungani, talking about the difficulties that Hindus face when attempting to grieve in Britain, states, “The Ganges does not flow through Behtnal Green; the law does not permit bodies to be paraded through the streets without a coffin and burned on public pyres; and Western business customs do not allow a son to take twelve days off work in order to fulfill his obligations to a dead father” (pg. 67).

Moreover, another reason why the bereaved may not have access to cultural rituals is that most people now live in an increasingly nomadic society and are insufficiently connected to community. Groups of people who live together and share beliefs about death, loss, grief, and mourning have been the cornerstone of grief rituals throughout human history. But as the bereaved individual increasingly finds themselves displaced for the sake of career, education, and a life separate from their family of origin, many people now mourn in isolation, distant from those who also knew the deceased and far away from familiar customs.

Cultural Grief Rituals Impose Rigid Gender Roles

Whichever emotional responses one’s culture prescribes, assumed expressions of grief are regularly steeped in a culture’s rigid gender roles, with women typically expected to express loud and painful shows of mourning while men are to remain quiet, stoic, and strong. This is a grave disservice to all parties attempting to mourn a loss, as options for how to feel are significantly narrowed. A complex array of potential grief reactions is reified and bifurcated into a passive, effected female response and an active male stance which resists any pull to emote or allow feelings of loss to emerge. In the times of Ancient Greece, female singers were hired to perform theatrical funeral dirges that conveyed heart-aching lamentations for the dead. Emotionally evocative by design, only the females were permitted to weep, while men were prohibited from exhibiting any semblance of a natural response to loss and grief (Alexiou, 1974; Johnston, 1999).

It has also been reported that the Nyakyusa people of Tanzania and Malawi were regularly subjected to gender-based restraints on emotional expression. Men were permitted to cry only one time prior to participating in a dancing ceremony. Both women and men were expected to partake in amorous and seductive play throughout their funerary events, but it was primarily the men who were expected to embody sexual vitality and strength by means of energetic dancing for all to see, so as to fortify courage among mourners. Women, on the other hand, were expected to sustain a prolonged state of emotional pain and anguish within the home where the corpse was temporarily stored until burial. Here too, men were cast into an active role while the women, relegated to the confines of the home and in proximity to the deceased, were pressured to embody fear (Wilson, 1939).

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Let us return to our discussion of Melissa and Ethan and consider the numerous ways cultural rituals might fail to help them grieve their losses and may even ironically complicate the mourning process further. Melissa needed to maintain a close connection to her husband as her life moved forward; thus, she developed a personal grief ritual that involved her speaking with him and addressing him by name every night before she went to sleep. But what if Melissa lived within a culture and community who, not unlike the Japanese ritual of kaimyo (Swarts, 2001), actively advised against ever saying her husband’s name aloud for the rest of her life? Ethan processed his grief in a healthy manner in part because he regularly put aside time to look at family photos and vent painful feelings. But what if Ethan were in a tribe whose customs barred him from emotional display and only allowed him, a man, to embody strength?

Human beings are too unique in personality and temperament, emotional experiences, interests, beliefs, values and life experiences for a single ritual to facilitate healthy mourning for all individuals within a particular culture. Certain bereaved individuals within a community will struggle to manage their grief because their unique psychological needs require more or less of what society makes available for the collective: more or less confrontations with reality of what has been lost, more or less expression of grief, a different emotional timbre altogether, more or less continuing bonds with the deceased, an extended phase of mourning, or a faster clip toward moving forward.

The Benefits of Personal Grief Rituals

When cultural grief rituals frustrate the individual, the design of a personal grief ritual may prove more helpful and meaningful. One of the greatest advantages to using personal grief rituals is they can be tailored to meet the individual’s unique psychological needs while in mourning (Fiese et al., 2002; Martin, 2023; Romanoff & Terenzio, 1998). It is certainly healthy to express the emotional component of grief, but some bereaved individuals are overwhelmed with unrelenting sorrow, and still others remain a bit too reticent and restrained. It is absolutely crucial to pursue new experiences and embrace life after loss, but some move forward too fast while others seem to freeze in place and resist the present moment. Continuing bonds can be a meaningful part of mourning that provides comfort, but some bereaved individuals either cling anxiously to past relations with the dead … or they never afford themselves even a moment to find comfort in the felt presence of a deceased loved one. Personal grief rituals can be shaped to counter whatever is impeding an individual’s mourning process.

Personal grief rituals can aid in affirming what the deceased meant to the individual and enacting how they wish to hold on or let go of different elements of the relationship they lost. Coleman and Neimeyer (2010) have stressed the importance of meaning-making in the mourning process and how early efforts to establish or reaffirm a meaning predict overall adaptation and better psychological functioning many years after a loss. The bereaved individual can exercise creativity to design a personal grief ritual that embodies something specific about the unique relationship they had with the deceased. This more individualized approach to grief rituals can also help the bereaved articulate novel thoughts and emotions and incorporate unique behaviors into a more in-depth understanding of what their loss means. Also, the use of unique symbols that have meaning for that individual and no one else lays the groundwork for a richer experience of mourning than the generic symbols one often interacts with while participating in a cultural show of grief (Martin, 2023).

Personal grief rituals provide an opportunity to actively participate in mourning. Rather than the individual waiting for culture to tell them to passively sit down or stand up, stay silent or speak, personal grief rituals allow the bereaved to choose when and how to embody the experience of mourning. Furthermore, designing and taking part in one’s own ritualistic behaviors gives the bereaved the chance to exercise some control over an otherwise chaotic experience that has left them feeling helpless (Castle & Phillips, 2003; Martin, 2023; Rando, 1985; Romanoff & Terenzio, 1998; Wyrostok, 1995). Research by Norton and Gino (2014) confirms that personal grief rituals give participants compensatory feelings of control that help push against helplessness and passivity.

Lastly, personal grief rituals can be performed at a specific location and within a specific amount of time, all with a clear beginning and end. This spatio-temporal framework provides the ideal container for otherwise diffuse experiences of grief that can bleed into all areas of life and at all times. The bereaved can process their loss, separate from the deceased (Van der Hart & Ebbers, 1981) and express grief within the ritual’s structure rather than being flooded with painful feelings or having uncomfortable conversations at inopportune times (Romanoff & Terenzio, 1998).

Ongoing research confirms the value of letting out grief … and then drawing it to a close. Advancements in the dual-process model (DPM) of coping with bereavement have given greater focus to the problem of stress overload amid mourning (Stroebe & Schut, 2016). This model and its researchers recommend that the bereaved take breaks from coping with loss altogether so as to avoid burnout and restore energy before resuming the challenging process of coping with loss. Personal grief rituals encourage healthy mourning by allowing the individual to demarcate time and space for active coping and subsequent respite upon its completion. Plus, the individual can return to the ritual as many times as he or she sees fit when convenient.

Assessing Unique Psychological Needs in Psychotherapy

For the past four decades, psychotherapists have been advocating for the benefits of incorporating grief rituals into psychotherapy with bereaved clients (Al-Krenawi, 1999; Doka, 2012; Romanoff & Terenzio, 1998; Van der Hart, 1983). Numerous scholars from the fields of both psychology and sociology have emphasized the importance of working with clients to develop rituals that cater to the individual’s needs (Grimes, 2004; Martin, 2023; Platvoet, 1995; Schachter & Finneran, 2013; Wojtkowiak et al., 2021; Wouters, 2002). Therese Rando (1985) was one of the first to argue for highly personalized grief rituals, saying, “the judicious creation of rituals in the therapy of the bereaved offers uniquely efficacious methods of addressing “grief work” and constitutes a potentially powerful adjunct to traditional forms of counseling and psychotherapy” (p. 236). Grief rituals have the potential to supplement traditional psychotherapy interventions, too often limited to verbalization alone, with more embodied engagement with grief and a more active and empowered experience of the mourning process (Martin, 2023; Reeves, 2011).

Many people seem to move through mourning with few, if any, complications; for these individuals, personal grief rituals can still help them cultivate a deeper sense of meaning about the loss they are enduring. These auxiliary acts of mourning might augment what has already been beneficial about participating in cultural grief rituals: expressing emotions once again within fixed boundaries and time limits; more opportunities to establish continuing bonds; more opportunities to say goodbye to deceased loved ones. Many of the bereaved are not so fortunate and seek out professional support because efforts to cope have failed to help and sometimes complicate the course of bereavement further.

Those who are struggling with complicated bereavement may wish to formulate a personal grief ritual on their own, but doing so hinges upon the assumption that one’s instincts about how to mourn will actually usher in health. The same instincts that put them on a course of complicated bereavement (avoidance of places and people that remind them of the deceased, excessive energy spent expressing emotional pain, adherence to old roles, refusal to cultivate a meaningful ongoing bond with the deceased) may inform the pursuit of activities that only exacerbate dysfunction and misery. These individuals will likely benefit from the assistance of a professional who can help them design a personal grief ritual that corrects for what has gone awry. Rabkin (1977), advocating for strategic psychotherapy, remarked, "patients attempt to master their problems with a strategy which, because it is unsuccessful, the therapist changes" (p. 5).

The client and therapist hope to carve out a healthier path through grief and the mourning process; to do so, the therapist must determine what impediments are preventing the bereaved from moving forward. A personal grief ritual can then help to put aside time and space to partake in healing activities and expressions of grief that the bereaved client might not think to do for themselves otherwise. Some, like Leonard, are misinformed in their belief that repressing emotions is necessary in order to adapt to life after a loss, whereas others, like Serena, are hobbled by complicated bereavement because they feel that the path toward healthy mourning demands an unending walk down memory lane marked by ceaseless expression of painful feelings. The reserved and repressed individual will benefit from a personal grief ritual that draws out more emotion about who they lost. The person flooded by nonstop grief will benefit from acts of mourning that slowly move them away from preoccupations with the past and more towards the stresses of living a new life.

Martin (2023) advises that, prior to helping clients design a personal grief ritual, therapists should assess whether the bereaved is struggling with too much or too little of any of these measures of psychological health: (1) a balance of tasks, ala William Worden’s task model, that allows for acceptance, efforts to adapt to life without the deceased, expressions of emotions pertaining to grief, and continuing bonds; (2) oscillations between coping with loss-oriented stress about the loss itself and restoration-oriented stress about everything that changes after a loss; and (3) temporality, that is, of the pace at which mourning is progressing.

Acceptance and Forward Movement

For bereaved individuals struggling to fully accept the reality of their loss, grief rituals are most helpful when they are designed to confront one aspect or another of this harsh truth. It is worth noting that the denial is often subtle, far from a wholesale delusion that the deceased is still alive. Rather, certain behaviors or thoughts suggest that the bereaved is holding on to some tendril of the past which they refuse to relinquish lest the full brunt of reality sets in. Bedrooms are preserved exactly as they were when the deceased still occupied those spaces. Homes with no residents continue to be left off the marketplace as if the thought of someone else living there is unimaginable. Burial sites and gravestones are rarely visited and neglected over time. In these cases, personal grief rituals can be designed around acts of separation, opportunities to bid farewell, and confrontations with aspects of life that look and feel different since the deceased died.

It is also critical to ascertain if the bereaved is confronting the reality of loss too much and too often, leaving them exhausted and overwhelmed. The end result often finds the bereaved struggling to make appropriate adjustments to all that has changed and failing to find any joy in life. Cultural anthropologists have observed how different cultures around the world use grief rituals to facilitate transition to something new … for all parties! The deceased’s soul or spirit must ascend beyond this world, while the bereaved must carry on with the lives they still have and adapt to all that has changed. Some struggle mightily to do so. Life, in both the present and the future, waits patiently, but the individual remains bogged down, unable to wrest themselves free from the past, and never quite manages to show up. Rituals that encourage greater exploration of life after loss provide unique and meaningful opportunities to actively step into new experiences and more fully accept the reality that life and the world as a whole now look and feel different.

Emotional Expression – Containment and Expansion

Van der Hart and Ebbers (1981) highlighted important differences between rites of separation that actualize the reality of loss and those that coax out painful emotions that need to be expressed. When the emotional component of grief is the cornerstone of a grief ritual, it is imperative to determine if grief is repressed and bottled up or if emotions are already pouring out excessively. Many bereaved individuals suffer from complicated bereavement simply because they shelter themselves from painful feelings; they stand to benefit and heal by designing a personal grief ritual that opens up and expands emotional expression. This type of ritual is often well-suited for those with a dismissing attachment style and/or those whose IWM leads them to believe that emotional expression will fail to help or may even make their pain worse. Conversely, those with a preoccupied attachment style often suffer from a complicated course of bereavement because their emotional distress is incessant and unceasing, only upsetting them further and affording little if any relief; they would benefit instead from personal grief rituals that contain and limit emotional expression.

Lastly, when designing a personal grief ritual, all parties should be open to a discussion about the potentially wide array of feelings that need to find an avenue toward expression. The meaning behind certain emotions may defy assumptions about why someone is feeling sadness, guilt or anger. Sadness may be a simple response to the loss of a loved relationship, but a gloomy mood may also stem from the loss of opportunities to grow closer with the deceased and regret for having never cultivated the kind of relationship one would have liked to have with a loved one while they were still alive. Guilt is a regular part of the bereaved individual’s emotional array, and while it often stems from an irrational and unfounded sense of personal culpability for a death having occurred, there are times when the bereaved needs to forgive themselves for some degree of negligence or responsibility for a death. Anger, in its simplest form, is an expression of protest about the deceased having died, but anger is sometimes experienced in relation to the deceased and some aspect of the relationship that was a great source of frustration or resentment. Personal grief rituals can be designed to invite or contain a broad range of emotions, but some individuals would benefit more if they work through a specific feeling and the personal meaning behind one’s tears, their angry gaze, or the smirk on their face.

Continuing Bonds

Acts of mourning that help the bereaved cope with the deceased’s absence can exist in concert with those that cultivate a greater sense of presence. Some personal grief rituals need do nothing more than to carve out space for an already-existing connection to the deceased … while also acknowledging they are no longer in the world as they were before. But some individuals find they have no means by which to shore up a comforting sense of the other’s presence amidst an experience of grief marked by nothing other than the blunt reality of loss. In some cases, this is due to a dismissing attachment style that shuts down searching behaviors, including any impulse to “look for” the deceased on a symbolic level. For others, a lack of continuing bonds is due to a general pattern of rarely pausing to access memories of the deceased. In either case, these bereaved individuals often find great comfort and meaning in creating rituals that help them feel closer to the deceased (Romanoff & Terenzio, 1998).

Others, especially those with a preoccupied attachment style, suffer more from overabundance of continuing bonds. They are hypervigilant about ensuring that the memory of the deceased remains front and center in their mind, always afraid that the mental representation will fade away if they stop for a moment to think about or interact with someone else. The healthy instinct to explore novel environments is tamped down and leaves the bereaved feeling stuck. In these cases, personal grief rituals can aim to loosen ties to the deceased and place greater emphasis feeling more connected to other relationships in their lives.

This clinical assessment will highlight whether the bereaved individual needs more continuing bonds or less. It will also be important to inquire into any particular activities or objects that carry the potential to create a more meaningful sense of ongoing connection that aids in the mourning process. Therapists can ask their clients any of the following questions: Are there any activities you used to enjoy doing together? Do you have any household items or other possessions that represent something unique about your relationship? Did your loved one have any characteristic behaviors or outlooks on life you would like to take on for yourself? Answers to these types of questions will point the therapist and client toward meaningful objects and actions that symbolize some important aspect of the relationship that can be included in a personal grief ritual, whether the aim is to strengthen or loosen the intensity of continuing bonds after a loss.

Finally, any therapist encouraging clients to design a personal grief ritual that focuses on continuing bonds should have a thorough conversation to ensure the client will actually derive some degree of comfort from an ongoing connection to the deceased. Continuing bonds can sometimes keep the bereaved attached to unhealthy aspects of a relationship that had been a great source of pain. Thus, minimizing continuing bonds after a loss may represent a healthy effort to adapt when there was little of value within the relationship to hold on to in the first place. For example, those grieving the loss of a relationship that was unhealthy or outright abusive, it may be best to separate oneself from continuing bonds altogether.

Dual Process Model Oscillations

An individual experiencing an uncomplicated course of bereavement can benefit from activities that either encourage more loss-oriented stress or more restoration-oriented stress in part because they are already managing to alternate between and attend to both. But research on the DPM finds that a failure to oscillate between these different types of stress predisposes the bereaved to complications. Personal grief rituals can be crafted to intentionally oscillate away from whichever stress has been tended to in excess and more towards different stresses that have been neglected.

On one hand, the individual weighed down by non-stop expression of grief about the relationship they lost and excessive reflection upon the past – a preoccupied attachment style may be to blame – requires more efforts that aim to focus on adaptation to restoration-oriented stresses after a loss; this type of stress commonly includes taking on new responsibilities in the family, assuming new roles within a wider community, or devoting fresh energy to novel interests and projects. On the other hand, the bereaved individual who has invested an excessive amount of time and energy toward adapting to all that has changed after a loss – individuals with a dismissing attachment style are more susceptible to this pattern – should consider designing personal grief rituals that encourage more loss-oriented stress, that put aside time to reflect upon the past, and that inspire more feelings of grief about who and what was lost (Stroebe et al., 2005).

Temporality, the Liminal Phase, and Sustained Ambiguity

In the context of loss and grief, temporality refers to the bereaved individual’s subjective experience of time moving forward after a loss. Just as different cultures assume a distinctive pace through liminality, so too does the individual carry a distinct sense of how much time is needed to fully mourn, and whether or not it is progressing at a desirable speed. The ambiguous transition through the liminal phase of mourning must be sustained long enough to sufficiently step away from the past and gradually ease into the future.

Some bereaved individuals struggle to mourn in a healthy manner because their pace is too hurried; they race towards life after a loss without devoting sufficient time to slowly process grief and separate from the past; this is often the case with those who have a dismissing attachment style. Others, including those with a more preoccupied attachment style, find themselves mired in an unending state of chronic grief, never reincorporating themselves into a new life without the deceased. Thus, a personal grief ritual can either promote an extended liminal phase of mourning during which the bereaved take more time to slowly separate from the past, or the ritual can aim to decisively draw mourning to a close.

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Let us return to the cases of Leonard and Serena to practice assessing balance, oscillations, and temporality prior to helping clients design a personal grief ritual that will meet their clinical needs. Leonard’s experience of grief demonstrates numerous imbalances, including few continuing bonds and minimal emotional expression. He quickly detached himself from any ongoing attachment to his wife (task IV) and never seemed to express much emotion about his wife’s death (task II). These imbalances point toward a down-regulated attachment system that represses separation distress and overemphasizes efforts to adapt to a new life after loss (task III).

Regarding oscillations, Leonard’s experience of mourning was marked by too much restoration-oriented stress while avoiding loss-oriented stresses almost entirely. He attempted to dodge feelings of grief by hiding behind intense devotion to work, bland coats of paint in the home, and a renewed interest in dating. In terms of temporality, Leonard’s efforts to rush into the future only left him stuck to a past from which he never truly separated; he felt anxious in his redecorated house and could never feel any real enthusiasm about dating someone new.

Based on this assessment, Leonard would benefit most from designing a personal grief ritual that invites a greater balance of continuing bonds and expressions of grief, more oscillations toward loss-oriented stress, and a slower pace of mourning with sustained efforts to separate from the past. He might choose to take part in activities he and his wife once enjoyed together so as to reflect on the past and coax out painful feelings of grief that have been buried for too long. He could revisit locations where they spent time together in order to strengthen continuing bonds and a sense of her ongoing symbolic presence. Leonard could create a recurring ritual in which he lets go of items that represent the life he and his wife spent together at a slower and more patient pace.

Serena presented with entirely different imbalances in her experience of mourning, including excessive continuing bonds (task IV) and extensive emotional expression (task II). The disproportionate amount of time and energy she devoted to managing loss-oriented stress made it nearly impossible to ever oscillate toward restoration-oriented stressors. She was so preoccupied thinking about the past and remaining attached to the memory of her husband that she ultimately prevented herself from adjusting to her new circumstances (task III). Serena remained frozen in place, struggling to move steadily through time beyond the moment of her husband’s death.

Serena’s experience of grief and mourning is completely different from Leonard’s experience, and so she would benefit from creating and enacting a personal grief ritual that limits emotional expression and continuing bonds, that oscillates away from loss-oriented stressors, and that quickens her pace through the liminal phase of mourning. Serena could let out emotions within a framework that draws intense grief to a close and shifts her focus towards something that isn’t so laden with intense grief. She could devote time to pursuing new relationships or nurturing older relationships. Serena might find it healing and deeply meaningful to declutter space within the home, including her husband’s office space and the clothes that still filled the closets. Any or all of these types of personal grief rituals could focus on what she needs to mourn in a healthier and more meaningful way.

Creating Personal Grief Rituals That Are Unique and Meaningful

The discussion above about Leonard and Serena is mostly clinical. It is imperative that we conduct a thorough assessment of the bereaved client’s experience of loss, whether or not they are coping well with grief, and the specific struggles that may be contributing to one form of complicated bereavement or another before helping them design a personal grief ritual that will hopefully guide them toward a healthier processing of mourning. But it is also important to consider centering a ritual around symbols, activities, places, and times of year that are most meaningful to the bereaved individual and that speak to something about the specific relationship they lost.

Research shows that bereaved clients, including those struggling with prolonged grief, benefit the most from therapy if the grief rituals they develop are unique and personally meaningful to them (Wojtkowiak et al., 2021). Wyrostok (1995), many years prior, stated that rituals designed to be helpful for one client will likely have elements that make it irrelevant or entirely unhelpful for another person. The ritual’s shape and form must be informed by an exploration of personal history, important memories, and the objects and activities that defined the relationship the bereaved once had with the deceased. To do so, Martin (2023) has recommended inquiring into the following variables that can be incorporated into the design of a personal grief ritual: Who? What? Where? When?

The “Who” of a Personal Grief Ritual

The bereaved individual should decide who they would like to participate in the personal grief ritual they are designing. Many will opt to perform their grief ritual alone, completely separate from the pressures of collective practices that limited their ability to express or act upon something genuine in the first place. Others may choose to invite a small group of people to join them; a close family member could take part in an activity that both parties find meaningful; trusted friends can meet at a special location where their entire group had once spent time together. The bereaved client can also consider asking their therapist to be present during the ritual, provide support and bear witness. Personal grief rituals can certainly be performed alone, but the social benefits of traditional ceremonies need not be lost entirely if the bereaved would like to process their loss alongside the company of those whose values or beliefs do not get in the way of what would be most meaningful.

The “What” of a Personal Grief Ritual

Personal grief rituals can be made so much more meaningful for the bereaved if they include activities and objects that symbolize some aspect of what their loss feels like and what the relationship with the deceased meant to them (Sas & Comen, 2016). Cultural anthropologists such as Turner (1967, 1969) and Geertz (1960) travelled the world to explore how different cultures enrich their death rituals by incorporating deeply meaningful activities and objects, what Durkheim (1965) called sacred symbolism. The Jewish practice of tearing cloth, or even one’s own funeral garb, is meant to represent the subjective feeling of a loved one being torn away. During the Hispanic tradition of Dia de los Muertos, food is shared with the dead so as to feel connected to deceased family members. Taoists will sometimes burn written announcements of a death because they believe the resulting smoke will ascend to the land of the dead and inform their deceased ancestors of another loss.

Whereas cultural grief rituals are built around symbols presumed to be meaningful to the entire community, the bereaved individual may prefer a personal grief ritual built around symbols that hold special meaning for them in regard to the specific relationship they lost: household utensils and tools the deceased used on a daily basis, items reminiscent of their hobbies, mementos that remind the bereaved of cherished times spent together, favorite pieces of clothing, gifts and letters from important moments in the relationship, or photographs that capture fond memories. Some important symbols cannot be held in one’s hands but can still be incorporated into a personal grief ritual: locations where important moments in the relationship occurred, a song that both parties regularly enjoyed together, or those activities that reliably brought them together again and again.

Psychotherapists and counselors can certainly help their bereaved clients identify those objects and activities that will be most meaningful (Palazzoli et al., 1978; Van der Hart, 1983; Wyrostok, 1995), but they should make sure to invite the client’s active participation when choosing what symbols to use. A personal grief ritual must center on what is truly meaningful to the individual and not merely what the therapist believes is clever, ultimately shouldering the bereaved with yet another generic symbol that fails to stir up anything felt to be meaningful.

Whatever item or symbolic behavior is selected, all parties must consider the following question: does the symbol represent positive continuing bonds that facilitate healthy mourning, or does it conjure up a negative and unhealthy continuing bond that should actually be relinquished through ritual? For those who struggle to establish a healthy and satisfying level of such continuing bonds, symbolic items and behaviors may be incorporated into a personal grief ritual so as to encourage an illusory connection to the deceased that provides comfort while also making room for the bereaved to adapt to life after a loss and move forward. But for those already clinging to concrete objects with unrelenting separation anxiety, symbolism within the ritual must emphasize acts of separation from certain objects; the ritual must magnify absence.

Certain symbols may bear a fetish quality that serves to deny reality, what Volkan (1972) referred to as linking objects. Keeping these objects nearby and interacting with them frequently amounts to a psychological defense; they are used not to truly mourn a death, but to deny loss and manage separation anxiety by perpetually touching and looking at an item that represents the deceased and may be felt as an ongoing sense of their presence. All sorts of tangible items associated with the deceased can morph into pathological linking objects: the deceased’s personal possessions, clothing once worn by the deceased, objects connected to their hobbies, photographs, something emblematic of the relationship itself, or an item directly associated with the death of a loved one. These symbols threaten to perpetuate a complicated course of bereavement and should either be left out of a personal grief ritual or included only if the ritual aims to help the bereaved distance themselves from such unhealthy ties to the deceased, often through activities that center on destroying the item or bidding it farewell.

The “Where” and “When” of a Personal Grief Ritual

The bereaved individual has many options to consider regarding when to enact a personal grief ritual. Certain times of year are rich with meaningful ties to the deceased: anniversaries, holidays, birthdays, and family traditions. Seasonal changes can bring forth distinct sights and smells and sounds that serve as the backdrop for emotionally laden memories. After choosing a meaningful date, a specific timeframe clarifies when the ritual will begin and when it will end. Some will find that no more than ten minutes is needed, whereas others will plan to begin at sunrise and end at sunset. Lastly, as Therese Rando (1985) recommended, those designing and performing a unique grief ritual can decide to make it a one-time event or a recurring act performed annually or during different times throughout the year.

The bereaved individual often possesses strong instincts that point them toward where they would like to enact a personal grief ritual. Common locations include places they spent a significant amount of time with the deceased, a place that was important to the person they lost, or the site where a death occurred. Naturally, personal grief rituals can certainly be played out within the comfortable space of a therapist’s office. The bereaved may feel a strong pull to mourn outdoors and in nature. Some will gravitate toward a particular element of nature, be it the cleansing symbolism found in lakes or rivers, using wind and the open sky to let go of ashes or release balloons, the cathartic energy of a controlled bonfire, or an urge to touch the Earth and bury symbolic objects beneath the dirt.

Risks to Consider

When conducting any psychological assessment of a client in psychotherapy, the aim is to both ascertain whatever struggles are bringing the client into therapy in the first place and, subsequently, determine which course of action is best suited to the client’s needs. Professionals should also be thoughtful about those approaches that may be unhelpful and those that may make matters worse. The design and implementation of a personal grief ritual is one such course of action that may be contraindicated for some bereaved individuals.

Ritualistic behaviors and activities can evoke powerful and strong expressions of grief that may be too difficult for some to manage at a given moment in their experience of bereavement, seeing as how the experience of grief can already bring overwhelmingly intense emotions. The professional counselor or psychotherapist should be aware of any psychological disorders that present further complications amidst the mourning process. When this is the case, the design and execution of personal grief rituals should be done at a later time when the bereaved is healthier or used with caution as an addendum to the primary therapeutic treatment.

Sadness is a common feature of normal, uncomplicated processes of mourning, but when regular bouts of crying and intense feelings of sadness consume the majority of one’s mood, major depressive disorder (MDD) may signal a complicated course of bereavement. This is especially concerning if accompanied by poor concentration, feelings of guilt, low energy, recurring thoughts of death, or disrupted patterns of sleep and appetite. Any bereaved individual suffering from MDD should be wary of any activities that amplify painful emotions they are already struggling to manage.

Anxiety disorders (generalized anxiety disorder, agoraphobia, specific phobia, social anxiety disorder, panic disorder) or post-traumatic stress disorder regularly involve symptoms of avoidance, and in the case of bereavement, this may pertain to avoidance of certain memories of the deceased, including the moments leading up to their loved one’s death. Clients diagnosed with any of these disorders might be hesitant to take part in personal grief rituals if the underlying symptoms of avoidance are not prioritized and treated first.

Lastly, any bereaved individual suffering from schizophrenia or any other psychotic disorder might experience the symbolism embedded in a personal grief ritual as confusing and disorienting, blurring distinctions between reality and symptoms of a delusion or hallucination. As discussed above, many activities performed during a personal grief ritual serve to establish and maintain continuing bonds with the deceased and prove to be psychologically healthy and meaningful. But for those struggling with symptoms of schizophrenia, illusory conversations with the deceased or visiting old haunts they once frequented together may only blur reality and aggravate delusions that the deceased never truly died.

The emotionally evocative and symbolic elements of personal grief rituals are often what allows these acts to facilitate a healthier and more meaningful experience of mourning. But when the bereaved individual is burdened by severe psychological ailments, abstractions and intense emotion may only complicate efforts to cope with loss further. Any professional who is thinking about working with their clients to design a personal grief ritual should consider these risks and think through them with their bereaved clients to mitigate said risks and ensure that any grief ritual to be performed is implemented with care and rigorous preparation.

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