Losing someone changes you. There is no way around that. Whether the loss is sudden or expected, a parent, a partner, a child, or a dear friend, grief arrives in ways that feel impossible to prepare for. It can be raw and loud. It can be quiet and invisible. It can hit you in a grocery store three years later when you hear a familiar song.
Grief is not a disorder. It is not a sign that something is wrong with you. It is one of the most honest expressions of love there is. But sometimes grief becomes something heavier, something that stops you from moving through daily life for months or years on end. That is when professional support stops being optional and starts being important.
At Threshold Clinic, we support Canadians navigating loss at every stage. This article walks through what healthy grief looks like, what prolonged grief disorder actually is, and how grief counselling can help when you feel stuck.
What Grief Actually Is
Grief is the emotional, physical and psychological response to loss. Most people associate grief with death, but it also follows divorce, job loss, a serious diagnosis, miscarriage, the end of a friendship, or even the loss of a version of your life you expected to live.
No two people grieve the same way. Some cry openly. Others feel numb for weeks. Some throw themselves into work. Others withdraw completely. None of these responses are wrong.
The old idea that grief follows five neat stages in a predictable order has been largely set aside by clinicians. The reality is messier and more personal. People move in and out of grief, revisit painful feelings, have good days followed by terrible ones, and slowly, over time, find ways to carry their loss rather than be crushed by it.
Most people do not need formal treatment to grieve. Time, social support, community, and meaningful connection are often enough. But for a significant number of people, grief does not ease with time. It intensifies or stays at a level of intensity that makes ordinary life feel impossible. That is a different clinical picture entirely.
Normal Grief vs. Prolonged Grief Disorder
Understanding the difference between normal grief and prolonged grief disorder matters because the two require different kinds of support.
Normal grief is painful, disruptive and exhausting. It affects sleep, appetite, concentration and mood. Waves of sadness, anger or disbelief are entirely expected. People in normal grief may struggle to function for weeks or even a few months. Over time, the sharpest pain begins to soften. People find moments of joy again. They begin to adjust to a world without the person they lost.
Prolonged grief disorder, also recognized in the DSM-5-TR, is something different. It is characterized by grief symptoms that remain intensely disabling well beyond 12 months after a loss for adults, or 6 months in children. The person remains caught in a state of acute mourning that does not ease or shift.
Key features of prolonged grief disorder include:
- Persistent and intense longing or yearning for the person who died
- Deep difficulty accepting the reality of the loss
- Bitterness or anger about the death that does not diminish
- Feeling that part of yourself has died alongside the person
- Inability to experience positive emotions or reconnect with others
- Withdrawal from social activities and relationships
- A sense that life is meaningless without the person
It is important to say clearly: prolonged grief disorder is not a moral failure. It is not a sign of weakness or of loving someone too much. It is a clinical condition that responds well to treatment, the same way depression or anxiety does.
Signs You Might Need Professional Support
Not every person who is struggling with grief meets the clinical threshold for prolonged grief disorder. But that does not mean professional support would not help. Grief counselling is not only for people in crisis. It is for anyone who feels they need a safe, structured space to process a loss they are finding overwhelming.
Consider reaching out to a counsellor if you notice any of the following:
- You feel like the grief is not getting any easier, even after many months
- You are using alcohol, substances or other behaviours to manage the pain
- You have stopped caring for yourself, eating regularly or sleeping at all
- Your relationships are suffering because you cannot engage with people
- You are experiencing thoughts of not wanting to be alive
- You feel unable to return to work or basic responsibilities
- You feel guilt or responsibility for the death that you cannot shake
- You are avoiding anything that reminds you of the person, to the point that your life has become very small
If you are experiencing thoughts of suicide or self-harm, please reach out to a crisis line right away. In Canada, you can call or text 9-8-8, the Suicide Crisis Helpline, which is available 24 hours a day, 7 days a week.
You do not have to be in crisis to deserve support. If grief is making your life smaller, that is reason enough.
What Bereavement Counselling Actually Looks Like
One of the biggest reasons people delay seeking grief counselling is that they do not know what it involves. They imagine being told to feel better faster, or being handed a list of coping tips. That is not what good grief counselling looks like.
Bereavement counselling is a structured therapeutic process led by a trained Registered Counsellor or Licensed Clinical Doctor. It is built around one core principle: you need space to grieve fully before you can begin to integrate the loss.
Some of the approaches used in bereavement counselling include:
Narrative Therapy
You explore the story of your relationship with the person you lost, and the story of your life going forward. Narrative therapy helps you find meaning and reclaim identity after a significant loss.
Complicated Grief Treatment (CGT)
CGT is an evidence-based approach developed specifically for prolonged grief disorder. It combines elements of cognitive behavioural therapy with grief-focused techniques like imaginal revisiting of the loss and working through avoidance behaviours. Our clinical team at Threshold Clinic draws on these methods when appropriate.
Emotion-Focused Therapy
This approach helps you understand and process the emotions tied to your loss, including secondary emotions like guilt or anger that often complicate grief.
Mindfulness-Based Approaches
Mindfulness practices can help clients sit with painful feelings without being overwhelmed by them. They are often integrated alongside other therapeutic approaches rather than used alone.
Sessions are typically 50 minutes, held weekly, and conducted in a private and confidential setting. At Threshold Clinic, we offer both in-person and virtual sessions across Canada, so access to support does not depend on your location.
Finding Grief Support in Canada
Canada has a range of resources for people navigating grief and bereavement. Knowing what is available can make reaching out feel less daunting.
Canadian Mental Health Association (CMHA): The CMHA operates chapters across all provinces and territories and offers information, referrals and some direct support services for those experiencing grief and mental health challenges. Visit cmha.ca to find your local branch.
Centre for Addiction and Mental Health (CAMH): CAMH provides mental health resources and information for Canadians, including guidance on grief and loss. Visit camh.ca for up-to-date mental health information.
Provincial Health Lines: Most provinces offer health information lines staffed by registered nurses and counsellors. In Ontario, you can call Health811. In British Columbia, call 8-1-1. In Alberta, call Health Link 811. These lines can direct you to local bereavement resources.
Bereaved Families of Ontario: A peer support organization offering grief groups and referrals across Ontario.
Threshold Clinic: Our Registered Counsellors and Licensed Clinical Doctors offer individual bereavement counselling for adults across Canada. We work with people grieving all types of loss, not only death. Learn more about our clinical team and approach.
If cost is a barrier, ask about sliding scale fees when contacting any counselling service. Many clinics in Canada offer reduced rates based on income. Employee Assistance Programmes (EAPs) through your workplace may also cover bereavement counselling sessions at no cost to you.
What to Expect From Your First Session
The idea of walking into a counsellor's office and talking about the hardest thing that has ever happened to you can feel enormous. That makes sense. It takes courage to begin.
Your first session is not about fixing anything. It is about your counsellor getting to know you, and about you getting a feel for the space and the relationship. You will likely be asked some questions about the loss, your current situation, what brought you in, and what you are hoping to get from the process.
You do not have to share everything right away. You set the pace. A good counsellor will follow your lead and never push you into territory you are not ready for.
It is also normal to feel worse before you feel better. Grief counselling sometimes opens up feelings that have been suppressed or avoided. That is actually part of the process. Moving through the pain, rather than around it, is what creates lasting relief.
Many clients tell us that just having one hour a week where someone is fully present with their grief, without judgment or discomfort, is itself profoundly healing. In our experience at Threshold Clinic, the therapeutic relationship is often the most powerful part of grief work.
Grief Does Not Have a Deadline
One of the most harmful things our culture does to grieving people is give them a timeline. Six weeks of bereavement leave. A few months of sympathy. Then the quiet expectation that you should be moving on.
Grief does not work on a schedule. Some losses reshape a person's entire sense of identity and it takes years to understand who you are on the other side of them. That is not pathological. That is human.
The goal of grief counselling is not to make you grieve less or faster. It is to help you grieve fully. To process what happened, honour what was lost, and slowly find a way to carry that loss without it consuming your entire present life.
You are allowed to take as long as you need. You are also allowed to ask for help while you do.
If you are not sure whether grief counselling is right for you, start by speaking to someone. A single conversation with a Registered Counsellor at Threshold Clinic can help you figure out what kind of support would serve you best. Reaching out is not a sign that your grief is too much. It is a sign that you are taking it seriously.
Loss is permanent. Suffering without support does not have to be.