Anniversary Grief Reactions are Deeply Personal
Written for Psychology Today by Patricia Harney, PhD, psychologist and faculty at Harvard Medical School
Grief follows its own unique calendar.
The first year following trauma and loss is filled with anniversaries.
Grief is not a one-note experience, but more like a multi-tonal chord.
Annual, communal rituals validate recurrent sadness and reflection.
Anniversaries conjure to many people’s minds the scent of roses or the pop of a cork from a bottle of champagne. Not so for people in grief. Psychologists first wrote about anniversary reactions in 1972, in a study in which bereaved widows were asked to describe their level of distress as the first anniversary of their spouse’s death neared. Since then, the concept of the anniversary reaction has held a central place in studies of grief and trauma.
Many survivors of loss or trauma feel a resurgence of sadness or anxiety as a date that holds meaning approaches. The anniversary reaction idea sounds simple, but there is deep specificity in how people experience anniversaries of traumatic events, including loss. There’s also great variety in what particular anniversaries evoke more painful feelings for different people. While the date of a tragedy like September 11 is saturated with feelings in our nation, for survivors, in addition, other seasons or rituals that remind us of the loss or traumatic event can also activate pain. For survivors of school violence, for instance, the start of the school year can usher in a fresh round of suffering.
The First Anniversary
Less well known, though, are findings from research that people who’ve lost a loved one feel increased distress on anniversaries except for on the first anniversary. From my own experience, I can imagine that this arises because the first year after a traumatic event is filled with anniversaries, and emotional distress can remain high all year long.
Every moment that passes is marked by the loss. Time inches forward in seconds. Then, time gets marked by the hour and day of the week. Days of the week can take on their own feelings of dread, until weeks become months. A survivor may think, “It’s been a week since my partner died.” Later, “Now, it’s been a month.” While the season in which a loss occurred may increase distress, for people living through the first year of grief, the year is often spent marking anniversaries. The first birthday. The first holiday. To people affected by trauma or loss, a year is a very long time. Death, especially those that are sudden, violent, or unexpected, interrupts what we feel as the natural rhythm of life. The common calendar collapses like an accordion.
For many survivors, all kinds of difficult feelings continue at relatively high levels for at least the first full year. At that point, survivors can feel pressure that their grief “should be complete.” More often, though, at a year, survivors are just moving into a new phase.
In 1969, the psychiatrist Elizabeth Kübler-Ross published On Death and Dying and popularized the idea that grief unfolds in a predictable sequence. She theorized that bereavement follows five stages: denial, anger, bargaining, depression, and acceptance. Her ideas shaped the public’s understanding of mourning. In fact, there is little scientific support for the idea that people grieve in stages. Even more, Kübler-Ross’s model wasn’t based on studies with bereaved people. She studied people who faced their own death.
Grief as a Series of Oscillating States
In fact, we know now that grief is better described as a series of oscillating states, rather than a set of fixed stages. Bereavement isn’t a one-note experience that passes in sequence from one pitch to another like a scale played on piano. It’s more like a multi-tonal chord, when several tones occur simultaneously.
And some of Kübler-Ross’s labels don’t hold up at all. When we lose someone we’ve loved, we don’t usually break with reality. We know what reality is. It just doesn’t feel real. Disbelief is a better description than denial, and it holds more compassion. Denial sounds like an accusation. A bereaved person might feel disbelief, anger, and depression all at the same time, with one particular feeling more intense than another at any given moment. And most of us don’t try to bargain for a different reality. But we do yearn for the one we have lost.
Sudden or Violent Death
Grief is different when a loved one dies from natural, expected causes, compared to when death comes suddenly or from violence. Prolonged grief disorder is diagnosed more often in people who’ve lost a loved one traumatically. But, really, wouldn’t we expect people who have experienced a loved one’s sudden or violent death to often need more time to absorb the loss?
To describe a longer time of grief from an unexpected, sudden, or violent death as prolonged may be misleading. The course of grief after traumatic loss may naturally be longer and perhaps shouldn’t be compared to the course of grief after natural, expected, or developmentally appropriate deaths.
What’s more, we know that the ability to understand why someone died and to make meaning of the death can help a grief process along. If the loss is difficult to make sense of, as violent deaths can be, the amount of time passed since the death has no impact on how long suffering can last. We might expect that the amount of time passed since the loss doesn’t help us understand much about a person’s grief journey.
Role of Rituals
I’ve learned that with traumatic loss, time itself doesn’t heal. The passage of time only allows for the possibility of new experiences that can weave through old layers of feeling and help modulate pain, much like the way a minor key yields to a brighter soundscape with the help of a few well-placed major chords. Time only heals if we have the chance to know more, learn more, feel more. To be less alone.
Rituals, especially those in community, give people who are grieving a space to acknowledge the pain of their loss. Seasonal or annual rituals are a part of many religious or non-Western traditions. These rituals remind us that recurrent feelings of sadness are natural. Even if feelings evolve and suffering may become less acute, people in grief rarely want to leave their loved ones behind. Remembrance is an act of love.