Loss 101

1 Grief Math Lesson + 5 Types of Loss

Photo by K. Mitch Hodge on Unsplash

I am a grief evangelist.

I want to normalize grief as a concept. Grief is happening to us and all around us, but we don’t have the language to talk about it. It is my hope that with a shared vocabulary around loss, this can be a more natural conversation for all of us to have - even around the dinner table! 

My manifesto is that grief is constant. At any given time, everyone is grieving something. 

Right now, as you read this, there is something you are currently grieving. You may not realize it; you may think things are going well and nothing major has happened to you recently; you may even have just spent a day filled with joy and laughter and all of your favorite things; but I tell you - there is still grief there. Just scratch a little below the surface and you will find it.

The reason is simple. Every change means that something is gained and something is lost. And every loss brings grief. If we agree that change is constant, then loss is constant. And therefore, grief is constant.

Change = Loss = Grief

I am not very good at math, but this is a formula that holds true for me in my life and work. If it is not adding up for you, it may be because you’re used to thinking that loss only stems from major negative life events. But there are many forms of loss, and thus many opportunities for grief. 

Even with a happy change like a marriage, a new job, or a new baby, there is a significant change and therefore a loss that needs to be grieved.

As a wedding officiant, I recall sitting at the rehearsal dinner with the mother of a bride who was bawling. They were not happy tears. I worried she might not like the groom. When I asked what was going on, she sobbed, “I just realized, I’m no longer her emergency contact. Someone else is in that spot now.”  This celebratory change meant a loss for the mother and hence her grief tangled in with her joy. 

I teach about different types of loss to my chaplaincy and seminary students. This is usually surprising to them, because much like thinking they know the sequential stages of grief - they typically only associate loss with death. Death is certainly a major type of loss, but it is not the only type of loss. We need to expand our understanding of what constitutes loss. 

In the process of learning about the different types of loss, my students begin to recognize all of the losses they didn’t know they were holding. Giving a name to a loss allows us to recognize it and the impact it could be having on our lives. Just as with our feelings we must “name it to tame it”. 

Below is an overview of the different types of loss I teach about. It is not an exhaustive list, but one that can give us a framework to get started. These types of loss are adapted from All our Losses, All our Grief by Kenneth R. Mitchell & Robert Anderson and the definitions below are theirs. It is a good primer (and short read!) for anyone looking to learn more.

Types of Loss

Relationship Loss

The ending of opportunities to relate oneself to, talk with, share experiences with, make love to, touch, settle issues with, fight with and otherwise be in the emotional and/or physical presence of a particular human being.

This is the most obvious one. When people think about loss and grief, they usually think of the death of a loved one.¹ Of course death is included in this type, but relationship loss can include a romantic breakup or a friendship that fizzled out. Maybe we moved away and miss neighbors from a previous apartment complex or co-workers from an old job  – all of these are relationship losses. 

Material Loss

Loss of a physical object or familiar surroundings to which one has an important attachment.

This is usually the earliest loss that we experience as children. It might be a beloved stuffed animal or a baby blanket. Even later in life, it’s not usually about the object that is lost, but the meaning we have attached to it. It’s the difference between losing a pair of earrings that I bought from Target that are $10 and a pair of studs that are a family heirloom, given to me by my great-grandmother who has long since passed away.²

Several years ago, I was summoned to an interdisciplinary meeting with a patient representative to discuss a missing blanket. A patient always had a tie-dyed felt blanket with them, and it somehow got lost in the laundry. The hospital could not locate it and the family was upset.

The patient representative tasked with service recovery was flummoxed. “I don’t understand the problem. We offered them a gift card to replace it and then I found the exact same blanket in Duane Reade and bought it for them. But they still aren’t happy.”

In meeting with the patient’s family, they shared that this was the blanket that had accompanied the matriarch of their family on all her chemo sessions. To them, it was irreplaceable. They had just been given the news that their loved one was not going to make it. It was only then that it dawned on me. This was not about the blanket. It was everything that it represented. The tie-dyed fleece was an easy scapegoat for their anger at their anticipatory grief of losing their loved one. They were angry at the chemo for not working, angry that their loved one was dying, and all that anger was displaced on the missing blanket. 

The meaning that we attach to the object is often greater than the object itself.

Functional Loss

Loss of some muscular or neurological functions of the body

I think this is the most straightforward type of loss, as it is biological in nature. It is the loss of one’s hair to chemotherapy, the amputation of a limb because of an accident, or the cognitive impairment after a stroke. This is the loss of not being able to trust our bodies the way we once could have, without even thinking. It is the breakdown of our own physicality and cognition.

Sometimes these losses are about more than the function.  The loss of the control of one’s bladder or need for a colostomy bag frequently impacts patients I work with. These types of losses add a stigma on top of the logistical issues that prevents them from leaving the house as much as they would like. 

Role Loss

Loss of a specific social role or of one’s accustomed place in a social network.

I could write a whole separate post on what it’s like for people who work in healthcare to become patients, to be in the bed instead of beside the bed administering care. When a healthcare provider is the patient, their role is reversed. They feel helpless not being able to control the situation.

Even a positive role change will include a loss, and so will include grief . People may count down the days until retirement and yet something unexpected happens when that pinnacle is reached. Many retirees (almost 1 in 3!) experience depression after retiring. They are out of their rhythms and routines. They might lack purpose or meaningful connection with others. Furthermore, people I have talked with have trouble acknowledging this and seeking help, because they thought retirement was supposed to be good and feel ashamed they aren’t happy. 

Systemic Loss

A loss that occurs in an interactional system in which patterns of behavior develop over time.

My go-to example of systemic loss used to be the loss we all experienced during 9/11. Now I receive applications for my internship program from students who were not yet born when that happened! (I probably don’t need to tell you how old that makes me feel!) 

Of course today that example is the Covid-19 pandemic. It impacted us all. We each had unique experiences and our specific losses tied to it might have varied (relationship, functional, material, etc). But the fact that the global population was all experiencing losses tied to the same event makes it systematic in nature. 

Systemic loss can also happen when a work environment changes. Mergers and lay-offs can impact the culture for years. Maybe you’ve seen this in congregations that have had members/clergy leave or other changes occur. Another way to think of this loss is any change that relates to a larger institution. 

Intrapsychic Loss

The experience of losing an emotionally important image of oneself, losing the possibilities of ‘what might have been,’ abandonment of plans for a particular future, the dying of a dream. Although often related to external experiences, it is itself an entirely inward experience.

This type of loss is the hardest to define. That’s why I always describe it last. If you are thinking of a loss in your own life and it doesn’t seem to fit anywhere else – it’s probably intrapsychic.  

I think of it as a shattering of one’s idea of how the world is supposed to be. It is the breaking of a dream, a life or a strongly held belief. What can make intrapsychic loss even harder is the isolation, as others do not always know you are undergoing this loss. Intrapsychic loss often accompanies trauma (whether that’s considered “big T” or “little t” trauma).³ It is a forced rewriting of the narrative of one’s story.

• It happens when a middle schooler who wants to be an NBA player is cut from their middle school basketball team and realizes he probably needs a different career path. 

• It happens when a college student, who thought of themselves as invincible, gets into a major car accident. In addition to their injuries, they are now wrestling with the realization that they are mortal. 

• It happens when a husband finds out his wife is having an affair with his best friend. It is a betrayal of a marriage and a friendship. 

A funky aspect of this loss, is that it can stem from something definitively good. Mitchell & Anderson cite Buzz Aldrin, walking on the moon and then feeling amiss, realizing that he would never feel anything like it ever again. This version of malaise can be hard to identify. Just the other day, I was talking with someone who’s husband just finished an Ironman Triathlon and had been melancholy ever since.⁴ Intrapsychic loss can be the dejection you experience after reaching the pinnacle of something significant.

Overlapping Losses 

All of these types of losses frequently overlap with one another. That is part of what makes grief so difficult. We are often navigating so many losses at once.

For example: A patient is hospitalized for something minor, like a broken foot. Perhaps he has to stay overnight for observation because of the medication he is on. Even for a one or two day stay in the hospital, he is separated from his wife, who he has slept next to almost every night of their 20 years together (relationship loss). He won’t be able to use his foot or walk well for quite some time (functional loss). He works in construction and won’t be able to perform his job duties with a broken foot (material loss). And this is to say nothing of all the other losses that he was holding before entering through the doors of the hospital. 

I tell my students that I want them to be loss detectives. The losses are there in all the patients/families/staff they encounter. They need to listen for clues about the losses and investigate how they are impacting the individual in our care. Maybe you can investigate your own life for the losses that would fit into these categories. 

This is just a brief survey of different types of loss. My hope is that it gives you a foundation and maybe some new language to understand yourself and your losses. There will be more to come about types of grief, resources for grief, and anything you (n)ever wanted to read about grief.⁵ But for now, I encourage you to contemplate examples of these losses. 

As you read over the list, which losses come up for you that you may not have realized were there? 

Can you now recognize losses that others are going through more easily? 

1. To read some accounts of deaths of loved ones, you can check out these previous posts

A Rare Heart

One Last Gift

2. Not a true story, as sadly my family does not have any heirlooms, or if they do, they never made their way to me.

3. If you’re not familiar with this concept, this article gives a summary about it - https://www.psychologytoday.com/us/blog/trauma-and-hope/201703/different-types-trauma-small-t-versus-large-t

4. And this is why my triathlons will not be longer than sprint or olympic distances. Well that and I don’t like running that much!

5. I take requests! Let me know what types of posts about grief would be helpful for you. Feel free to leave a comment below or email me directly at journeyingalongside@substack.com.