Dealing with Death & Dying in Medical Education and Practice
© 2001 Kirsti A. Dyer, MD, MS
AMSA Convention March 30, 2001
Phases of Grief/Understanding Mourning

Phases of Grief

The bereavement process is divided into four phases

1. Shock and numbness - the initial phase when survivors may have difficulty processing the loss.
2. Yearning and Searching - this phase combines an intense separation anxiety and disregard or denial of the reality of the loss.
3. Disorganization and Despair - those in this phase often report being depressed and have difficulty planning future activities. These individuals are easily distracted and have difficulty concentrating and focusing.
4. Reorganization and Recovery - This is the phase when one begins to rebuild their life and reconcile the loss. 
Understanding Mourning

Three things are fundamental to an understanding of mourning. 

  • First, each loss launches us on an inescapable course through grief. 
  • Second, each loss revives all past losses. 
  • Third, each loss, if fully mourned, can be a vehicle for growth and regeneration.
1. Parkes CM, Markus A. Coping with Loss. London: BMJ Books, 1999
2. Vamik D. Volkan, MD Life After Loss: The Lessons of Grief. Maxwell Macmillan International, 1994

Compilation of resources for this presentation © 2001 Kirsti A. Dyer, MD, MS. Journey of Hearts,