GriefThe author of Grief Is a Journey explains how some of our most cutting losses can go unrecognized by friends and family—and even ourselves. 

1) The Loss of a Person We Once Knew

Sometimes the people you love change in significant ways. They are still in your life—but not in the way you remember or once knew them. Illness often changes people, especially mental illness or dementia. In dementia, a person still is with us, but is not like the person we previously knew. The ties that bind us to one another, the shared memories and even the personality are no longer accessible. Sometimes the changes can be startling. The mother of one of my clients grew up in the segregated South. Yet her daughter was proud that her mom had been active in the civil rights movement, even though her mom lost friends and alienated family. Her mother would proudly tell the story of how, as an adolescent girl, she shamed her all-white church into integrating services. Yet, as her mom lapsed into dementia, she began using racial epithets. Her mother’s language not only shocked her daughter but also called into question her mom’s true beliefs. Was her mother really the progressive person she believed her to be?

Other illnesses can create a similar sense of loss. A traumatic brain injury generally affects all levels of mental function. We may grieve people as they sink into mental illness, alcoholism or drug use. Positive changes can also engender grief, when a person becomes different from the individual we knew and loved. For Tristan, it was the religious conversion of his brother. He was initially delighted that his brother found some faith, even if it was more intense than his own beliefs. But Tristan soon found it difficult to relate to his born-again brother who no longer wanted to share a beer and was always witnessing to Tristan and his family.

Similarly, Abigail was proud that her husband joined Alcoholics Anonymous after a long struggle with addiction that nearly ruined their marriage. Yet she misses the “people, places and things”—especially the pub-based dart club that was a shared activity—that her husband now avoids in order to remain sober. They celebrate New Year’s Eve at an alcohol-free party sponsored by his local AA chapter in a church basement. Abby is proud of her husband and supportive of his efforts at sobriety, even as she grieves aspects of her former life.

2) The Loss of a Person We Haven’t Yet Lost

Anticipatory grief is a term that refers to the grief felt about someone with a life-limiting illness; friends, family and caregivers often experience it in anticipation of an eventual death. These losses are significant. The loss of health—even the prediction of loss—contained in a diagnosis can be a source of grief not just for the person diagnosed, but also for his or her loved ones. We lose our assumptive world. All our plans, thoughts, our sense of the future— even our sense of safety and security—are now challenged. The future we know is not the one we once imagined. For Craig, his wife’s diagnosis of pancreatic cancer dashed their retirement dreams of travel and possibly relocating to Tuscany. As any illness progresses, we continue to experience additional losses and grieve each one.  Continue reading

By Kenneth J. Doka, PhD, Repost from

Tags: Grief, Oprah, OWN, O Magazine