Coping with grief

Losing a loved one to blood cancer can be a difficult and distressing time, but you don’t have to go through it alone. In this article, Philip Alexander, a Senior Haemato-Oncology Psychotherapist, gives his advice on coping with grief.

As a psychotherapist, counsellor and social worker, I have worked with ill people and bereaved people for seventeen years. My thinking on grief has been informed by my training and a number of theoretical perspectives, but my bereaved clients have been my greatest teachers on the subject.

Perhaps the most important thing I’ve learnt is that we will all grieve in our own unique way; there is no right way – or wrong way – to grieve. Contrary to some of the earlier theories about grief, it is not a linear process. Bereaved people do not pass through a neat sequence of stages (e.g. denial, anger, acceptance). Grief is a messy and unpredictable business. It can feel rather chaotic at times, like an ‘emotional rollercoaster’.

Grief has many aspects to it, other than weeping and feeling sad. At times bereaved people feel numb and at other times they feel extremely distressed. Emotions can range from sadness, to anger, to guilt. Stress, fatigue and feeling disconnected at times are also common symptoms, as is an intense yearning for the lost person. This is all normal.

As time moves on, people tend to shift or oscillate between being very much in their feelings of grief, and then feeling relatively OK – perhaps engaging with normal things at times, even enjoying life. Having more positive feelings or looking to the future makes some people feel guilt, an understandable but unnecessary, negative emotion. Shifting between different states and having lots of complex thoughts and feelings can be confusing or even frightening, but this is normal, and it reflects the reality of grief more accurately than the idea of going through stages.

Many of the bereaved people I have worked with have mentioned feeling pressure to “move on” and “let go”. Yet this has been completely at odds with their experience and not something that has felt realistic or do-able. In fact, what they have often sought to do is maintain an enduring connection to the person who has died. Thankfully, contemporary approaches to grief have acknowledged the need for people to maintain a relationship, a continuing bond, with the deceased; this is now accepted as normal and healthy.(1)

A continuing bond will mean different things to different people, of course. Sometimes it is reflected in the way we still have a conversation with the person who has died, even though they are not physically present. Perhaps a place is still laid at the meal table for them. Wanting to leave their bedroom or things undisturbed for a while after they’ve died is normal and is actually a reflection of the need for an ongoing relationship with them, as are the various rituals of mourning and memorialising. What I am describing here is not an obsessive preoccupation with the deceased that goes on for years; common sense tells us that, over time, this would not be helpful. But to maintain a relationship with them – however symbolic this might be – as we engage with the various aspects of our ongoing lives – is often a necessary and important aspect of grieving.

Ultimately, the continuing bond with the deceased is about the extent to which we have ‘internalised’ them. This means that they have become a part of us. In other words, they have shaped who we are, what we believe and how we behave, and that we are able to ‘access’ or experience their personal qualities and their values, the things about them that we’ve loved and admired so much when they were physically present.

In my experience, loss isn’t so much something we ‘get over’, but rather it is something we adjust to. It is something we learn to accommodate and live with, like a rather unwelcome guest, something we learn to incorporate into our ongoing lives. Although grief – the loss of our most important attachment figures – is often traumatic, I would like to end on a hopeful note by saying that I am always struck by people’s tremendous capacity for coping with their loss, over time; by their ability to adjust and adapt to what has happened, and in most cases to continue with meaningful lives that honour the person they have lost.


Philip Alexander

Senior Haemato-Oncology Psychotherapist, King’s College Hospital



  1. Klass, D., Silverman PR., Nickman, S. (1996). Continuing Bonds: New Understandings of Grief (Death Education, Aging and Health Care). Abingdon: Routledge.

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