Complementary Approaches to Supporting Grief

Complementary Approaches to Supporting Grief

Grief is a journey that everyone of us will go on. One that may take several twists and turns and have many highs and lows. According to the Center for Grief Recovery and Therapeutic Services, “Grief is the natural, healthy, spontaneous, unlearned, normal emotional, healing process that occurs after a significant loss.” (Fireman, D., 2021). Grief is commonly experienced as waves of emotions, thoughts, and memories. There are unique physical, social, and spiritual/religious responses to grief. These responses come and go in terms of intensity, duration, and a person’s reactions to the loss. While there are universal aspects of grief, grief responses are often learned through culture, family of origin, and personal experiences. Simply put, grief is a unique experience for each person.

According to Dr. Theresa Skaar (2021), “It may seem straightforward: loss happens. A person experiences a loss due to death, grieves, and support is given and received (hopefully). However, loss is not a clearly delineated experience.” Dr. Skaar explains that most people adjust relatively quickly to the death of a loved one, generally within 2-12 months from the time of loss, which is categorized as “normal grief”. She also describes complicated grief (aka traumatic grief, prolonged grief, or pathological grief), which is grief that is experienced that does not decrease with time. This response to grief is disruptive to the person’s daily life, and the person has a difficult time moving forward. In addition, they may exhibit symptoms of separation distress and traumatic distress. Dr. Skaar further explains that grief is often discussed in dichotomous terms. For example, normal vs. problematic, common vs. pathological. She states that because of the diverse and wide range of experiences within the grief process, it is best understood as a continuum with a wide range of responses.

Grief support interventions (i.e., community-based support programs, therapy, and other grief interventions) can be viewed as a primary prevention for people with non-disordered grief, secondary prevention for people at risk of developing disordered grief, and tertiary prevention for people experiencing disordered grief (Knowles, Lindsey M et al., 2021). As we look at ways to support individuals on their grief journey, there are several evidence-based complementary approaches, that are supportive for the grieving process.

Mind-body medicine is a complementary approach to supporting grief. Mind-body medicine focuses on the complex interaction between the mind and the body, and the powerful ways that an individual can support their own health and healing. Thoughts, feelings, beliefs, and attitudes all have an impact on biological function. Mind-body medicine restores a person’s agency for their own healing through a variety of practices that include meditation, guided imagery, biofeedback, writing and drawing. We’ll explore three practices today: mindfulness, progressive muscle relaxation and expressive writing (Gordon, 2019).

Mindfulness and Grief

Mindfulness training focuses on simply observing internal and external experiences in a curious, nonreactive, and nonjudgmental manner.  Mindfulness training has been shown to reduce maladaptive repetitive thoughts. Mindfulness training showed reduced grief severity and yearning (Knowles, Lindsey M et al., 2021)  In a previous blogpost, Mindfulness and Grief: Helping Behavioral Health Clients Navigate the Path Through Loss, Dr. Skaar explained how  “Mindfulness doesn’t take grief away, it helps people respond to it differently. Rather than being swept away by the experience of grief, or trying to avoid the feelings associated with it, mindfulness helps people to become aware of what they are feeling so that they are able to respond rather than react.”

Progressive Muscle Relaxation and Grief

Progressive muscle relaxation (PMR) is a practice that increases activity in the parasympathetic nervous system (rest and digest), and decreases activity in the sympathetic nervous system (fight, flight, freeze). Within the practice of PMR, a person develops awareness of tension in the body, as well as, any psychological stress. Through muscle relaxation techniques and attention to pleasant relaxing sensations, PMR has been shown to have a physiological and psychological relaxation response. In a study conducted by Knowles, PMR training showed a reduction in grief severity and yearning and decrease in grief rumination. (Knowles, Lindsey M et al., 2021)

Expressive Writing and Grief

There is significant research supporting the practice of expressive writing. Writing about traumatic, stressful, or emotional events has been shown to improve both physical (i.e., increased immune function) and psychological health (i.e., decreased depressive symptoms). Within the practice, individuals are typically asked to write about the experience for 15-20 minutes on 3-5 separate instances (Baikie and Wilhelm, 2005). When it comes to grief, expressive writing has been shown to decrease rumination (Gortner., et al., 2006). Expressive writing helps participants to disclose and recognize emotions, as well as interpret the wisdom they gained from the experience of grief (Setiawati et al., 2019).

Mind-body practices are a supportive tool for learning how to surf the waves of grief. While these are only a few mind-body interventions, additional practices will be explored in our upcoming Live webinar series, titled Navigating the Grief Experience.

Ready to learn more? Join Dr. Theresa Skaar and her colleague Dr. Matt Zytkoskee in a 3-part LIVE webinar series.

Session 1: Mindfulness and Grief, Tuesday, February 1 (2 CEU’s)

Session one of the navigating grief series combines current grief research and mindfulness practices to bring tools and strategies to the practitioner’s toolkit. Practitioners will be able to use this knowledge to better support themselves and their clients.

Learning Objectives:

  • Learn about research pertaining to meditation, mindfulness, and grief
  • Understand how mindful practices can support you personally and professionally
  • Explore ways to support the experience of grief through mindful practices
  • Practice mindful techniques

Session 2: Ritual and Ceremony, Tuesday, February 8 (2 CEU’s)

Session two of the Navigating Grief series introduces ritual and ceremony pertaining to grief and gives participants the opportunity to discuss, share and learn about these aspects of supporting grief.

Learning Objectives:

  • Learn about different cultural approaches to the grieving process
  • Understand the differences between ceremony and ritual
  • Explore the relative absence of grief ritual and ceremony in U.S. culture
  • Consider how ceremony and ritual could be applied in personal and professional contexts.

Session 3: Supporting Grief, Tuesday, February 15 (2 CEU’s)

Session three of the Navigating Grief Series provides an experiential approach in supporting grief including art, music, movement, and writing.

Learning Objectives:

  • Learn a variety of practices to support grief
  • Experience writing exercises and art techniques
  • Practice expressive meditation in the form of shaking and dancing
  • Connect with co-participants through the sharing of experiences

Your Turn: What grief support practices do you integrate into your work?

Additional resources may be found on the CASAT OnDemand Resources & Downloads page.

This article was developed by Heather Haslem, M.S, in collaboration with Dr. Theresa Skaar at CASAT. Feel free to use, link to, or distribute this information. A link to our site and attribution would be much appreciated.


Baikie, K. A., & Wilhelm, K. (2005). Emotional and physical health benefits of expressive writing. Advances in Psychiatric Treatment11(5), 338–346.

Fireman, D. (2021, March 17). The Center’s Holistic Grief Scale: The center for grief recovery. The Center for Grief Recovery and Therapeutic Services. Retrieved January 19, 2022, from

Gordon, J. S. (2019). The transformation: Discovering wholeness and healing after trauma. HarperOne, an imprint of HarperCollinsPublishers.

Gortner, E.-M., Rude, S. S., & Pennebaker, J. W. (2006). Benefits of expressive writing in lowering rumination and depressive symptoms. Behavior Therapy37(3), 292–303.

Knowles, Lindsey M et al. (2021). Supplemental material for a controlled trial of two mind–body interventions for grief in widows and widowers. Journal of Consulting and Clinical Psychology.

Savitri, S. I., Takwin, B., Ariyanto, A. A., & Aribowo, R. T. A. (2019). Expressive writing changes grief into meaning – a sequential explanatory design approach. COUNS-EDU: The International Journal of Counseling and Education4(3), 102.

Skaar, T. B. (2021). The Experience of Grief: The Role of Mindfulness, Communication, and Social Support (Doctoral dissertation, University of Nevada, Reno).

Suggested Citation:

Haslem, H. (2022, January 20). Complementary approaches to supporting grief. CASAT OnDemand. Retrieved January 20, 2022, from

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