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Grief, Loss, and Bereavement: From Foundations to Complexities - Chris Onderdonk

The following talk was given by Chris Onderdonk at The Sati Center in Redwood City, CA on December 15, 2025. Please visit the website www.audiodharma.org for more information.

Introduction

Host: Welcome. Thank you for joining us today. This is part of the ongoing speaker series for the Buddhist Chaplaincy Training Program at the Sati Center. Today, I am very excited to welcome Chris Onderdonk, who is a social worker at UC San Diego, where he leads one of the palliative care teams. Chris has been in the field for a long time; he has done work in hospice and in the hospital context. He is an educator, an author, and an all-around amazing guy.

I had the privilege of spending some time this summer with him and his team when I was doing my last unit of CPE¹ at UCSD. He is an incredible person to work with. I learned a ton and I'm really excited that he's willing to be with us here today and talk about grief. It is a very important topic, and as a chaplain, whatever context you may be working in, it is definitely something you're going to be contending with. Chris has a lot to say on the topic and a lot of experience. So, welcome Chris, and I'm going to hand it over to you.

Chris Onderdonk: Thank you so much. Hello everybody. I am so thrilled to be here. This is obviously something I am super passionate about. I have to assume we're dealing with a self-selecting group of folks who are willing to show up on a Sunday morning to talk about loss and grief—our favorite topic. We're going to do a deep dive, and hopefully, by the end, answer some questions.

When it comes to expertise, I want to be clear: I am bringing materials to you today, but we are all equally experts in this topic. That is what I think is very unique about this material.

Before we dive in, it is my practice that we arrive in our bodies and get grounded before we get into ideas. This is something we do a lot in palliative care before we walk into a patient's room; we have a practice of reminding ourselves where we are and what we're up to. I am going to invite us to take a moment, whatever you do, to arrive into your body and into this moment, because we are entering material that touches us all.

I usually take a breath, get my feet on the ground, and just arrive here. I want to really honor this material by showing up in that way. It annoys me when things just become ideas and next thing you know we're floating in space. It is really important for me that we honor this material.

Grief, Loss, and Bereavement: From Foundations to Complexities

What we are going to be talking about is generally referred to as loss and grief. It helps to start with some basic definitions.

We will start with Loss. Loss is basically any sort of major change or uprooting of what we are expecting. It could be death, but often it's not just death. It can be any sort of relationship change or role change. This is going to be one of the big takeaways: oftentimes when people talk about grief, they get really fixated on it being about death. Death is certainly one part of grief, but we know it goes much beyond that. There are many things in being human that invite this experience of grief. It affects every element of our bodies: physical, emotional, cognitive, social, and existential.

When it does come to death, you will often hear people talk about Bereavement. Often times these terms get conflated—loss, grief, bereavement. Bereavement is a simple term; it is just the period of time in which someone is grieving.

Mourning is the outward expression of that grief. Usually, this is what we see really shaped by our upbringing, our family, and the culture in which we live. It is the social expression.

It is important to have these terms defined.

The Fingerprint of Grief

I want to point to the image of the fingerprint. This is what is so important to name: when it comes to grief and loss, we are dealing with a paradox. It is something every human being will experience—it is absolutely universal—and at the very same time, quite literally, everyone's experience is as unique as a fingerprint.

That is really the tension that we are always holding, especially professionally. I know things about grief and loss, but as soon as I am in front of this human being, I am essentially starting over from scratch. I have beginner's mind; I have to meet this person as freshly as if I've never known about grief and loss. That is the tension that we are all holding.

Just to reemphasize the sort of losses we might be talking about in grief: divorce, job changes, any sort of attachment can be a loss. In palliative care and serious illness, we see loss upon loss upon loss pile up. "I can't go to work anymore." "I can't go to the park." Loss equals grief, and we must keep that broad scope.

A Personal Context

I am going to move this to a more personal level to make the point. I want to introduce you to Callie, a close friend. Callie died this summer of cancer. She actually ended up at the hospital where my colleagues work. Next thing you know, I am sitting in the room with my colleagues having these life and death conversations that I am usually the one leading. I have been doing this work for 25 years, but it didn't matter because we were having to move Callie home with hospice.

Next thing you know, I am in Kohl's picking out the sheets that she is probably going to take her last breaths in. I am in her room sobbing. Then she dies, and I have to go to work. I did take some time off, but it became very personal this summer. I was re-embodying how it affected every part of my experience. I would be watching a movie and suddenly the waterworks would come, and I had no idea why. Allowing that to happen probably helped me, rather than being confused about why I was crying at a kids' movie. Callie was a poet, an artist, and a beautiful human, and I miss her so much.

I am going to introduce another experience for me with grief and loss. My daughter went away to college in September. When it comes to non-death loss and grief, I was laying in my bed sobbing like a baby. Her room was across the hall and all of her childhood was flashing in my mind. It was a full, embodied experience. I feel bad for the neighbors; they must have been wondering, "What is going on over there?" It was the most intense experience, even for something that I am obviously very proud of.

Experiencing Loss

I'm going to invite you all to take a moment. Knowing what I've just shared, become connected to a significant loss that maybe you've experienced. It doesn't have to be the most intense loss of all time, but bring it to mind. It could be a death loss or a non-death loss. Choose something manageable.

As you hold that loss in your awareness, just notice what arises. An emotion, a sensation in the body, a memory, an image. Maybe very little comes up. Just notice without judgment, without trying to change anything, what that loss feels like.

It is good to start with the body. In our culture, we often separate the body. See if there is any sensation in your body—a softening, a tightness. What might be coming up there?

Then, of course, our mind and our heart. Often I put my hand on my chest as a way of bringing connection and compassion to myself. What might be coming up? As I talked about Callie, she immediately comes into my experience. Maybe sadness is coming up for you, or gratitude.

I'm going to honor whatever that loss is for you. I'm going to honor the depth and the sacredness of that experience. As we go through all these materials and ideas, just know that all of us here are acknowledging that. Even though we're on Zoom, perhaps on a truly cellular level, we honor our shared humanity and our shared experience of this.

The Complexity of Grief

In social work, and I know in spiritual care it is the same, we have a deep understanding that we are such complex humans. We are so deeply shaped by the cultures in which we are raised and the contexts in which we exist. This material is rooted and grounded in the fact that across the world, the way this is experienced and expressed is bound by our cultures. It is important that we acknowledge that. Some people might engage in loud wailing, while others might value stoicism. We must get out of binary thinking about right and wrong.

I wanted to invite you to embody your own grief because people get really confused in grief. "Why am I so freaking tired? Like I literally cannot move right now." It can become very confusing. Having some awareness that grief is happening on every single level of who we are helps.

• Physical: Tightness, sleep issues, appetite changes.
• Emotional: The whole range of emotion. This can include positive or transformative experiences as well, not just what we typically view as negative.
• Cognitive: After Callie's death, I was not sharp at work. I would be staring off into space. I told my team, "Look, I'm in grief. Just be kind because my brain is not working as it normally would."
• Social/Behavioral: People invite you out and you just want to get in your pajamas, sit on the couch, eat ice cream, and watch a bad movie.
• Existential/Spiritual: Of special interest to this group is the question: What does it mean to be human? Questions about purpose arise. In palliative care, we encounter folks questioning, "Why would God do this to me?" or "Why is this happening?"

One of the big concepts in neuroscience is that our brains hate surprise. The Loss of the Assumptive World describes this. Whatever I thought my life was going to be, the dreams I had—when that is shattered, it frames the experience. We see this when people have worked their whole lives, just retired, bought the RV, and are then diagnosed with a terminal cancer. This was not the world they were imagining.

Frameworks of Grief

Let's shift into the theory—the frameworks and how scientists and researchers try to understand this phenomenon.

1. Kübler-Ross Stages

Everyone has heard of Elisabeth Kübler-Ross². I am just going to name the fact that I am allergic to this understanding of grief and loss. This is what you see in the movies: Denial, Anger, Bargaining, Depression, Acceptance. What happened was that people experiencing grief would say to themselves, "I wonder what stage I'm in." People began trying to shove themselves into this model, and it led to a very narrow view for a while.

When Kübler-Ross came up with this model, it was about people who were dying, not necessarily folks who were grieving a loss. Even she said towards the end of her life that it had been misinterpreted.

There is truth in this—we absolutely get angry, we absolutely can get depressed—but our current understanding doesn't capture the complexity with this model. It is too rigid and too linear. We must flex to fit the person and not force the person to fit the model.

2. Worden's Tasks of Mourning

William Worden³ is very well respected and he talked about tasks versus stages. These still very much hold true.

• Accepting the reality of the loss. This is tough; our brains struggle to accept it is really happening.
• Feeling and processing the pain. This is an important part. It is shocking how deeply it hurts and how primal it is.
• Adjusting. Finding a way to integrate and adjust because we have to go on living our lives.
• Finding an enduring connection. This represents a big shift. Early theories said you have to "let go" and "move on." The understanding has shifted, partly coming from cross-cultural and indigenous wisdom. It is not about letting go; it is about finding an enduring connection.

3. The Dual Process Model (Oscillation)

The most up-to-date and accepted research comes from Stroebe and Schut⁴. This model describes oscillation. It honors the fingerprint of grief.

It describes an oscillation between a Loss-Oriented focus (thinking about the person, sobbing in bed) and a Restoration-Oriented focus (getting back to work, watching bad TV, eating ice cream). Neuroscience backs this up as a very natural human process.

For a while, people feeling the restoration orientation would feel guilty. "Why am I having fun? Why am I laughing? My loved one just died." The power of naming this is giving us permission to trust the very organic process of integration that our bodies naturally put us in. So when you are at your holiday parties, you can tell people, "It's oscillation. Stroebe and Schut."

Continuing Bonds and Growth

This idea of Continuing Bonds gives people hope. We are going to find a way to stay connected. Love does not just disappear when someone dies; it lives on a cellular level in our bodies.

I will share that my dad and my grandmother get me parking spaces. Last night I went to La Mesa Village, which was crowded, and found a beautiful parking space. "Thanks, Dad. Thanks, Bobo." That is one way I have kept a connection.

We are meaning-making machines. Finding a way to make sense and repurpose ourselves is a huge part of this process. In social work, we are about the strength perspective. The arc of humans is going toward healing and transformation. This is Post-Traumatic Growth. When things get hard, we find our way through. I am a better social worker because of the death of my father and my friend Callie. I am a better human. We get so bogged down in the heaviness that we have to remind ourselves there is so much growth and transformation coming from this. It is about integration—our brains reorganizing and finding ways to relate to the world so that we are not stuck.

Types of Loss

We need to get nuanced in the types of losses we most commonly encounter.

Anticipatory Grief: This is grief before the actual loss occurs, often called preparatory grief. You start having the symptoms of grief before the person dies: feeling confused, sad, overwhelmed. It is part of the cellular way we try to make sense of what is happening. People feel like they are going crazy, and validating that this is grief helps. However, experiencing anticipatory grief does not necessarily shift the after-effects.

Ambiguous Loss: Pauline Boss⁵ is the main researcher on this. It is defined in two ways:

1. Leaving without goodbye: The person is supposed to be at the table but is missing. We see this in war, missing persons, suicide. The person is gone, and we did not have a chance to say goodbye.
2. Goodbye without leaving: I will bring this to a personal level. My father-in-law, Steve, was a powerful attorney. He had a catastrophic stroke in 2022 and can no longer speak. He is no longer the brilliant man he was, but he is still here. It is very confusing. We see this with dementia, addiction, and extreme mental illness. The person is here, but they are not.

Disenfranchised Grief: This is important to be aware of when you are not getting the social vibes you would expect. People aren't reaching out, or you feel like you aren't allowed to grieve. Examples include pet loss, miscarriage, divorce, or losses involving infidelity or suicide. It can be very isolating if not recognized. We need to give folks acknowledgment and legitimize their loss. When I hear someone's dog died, I meet that loss with the same level of care: "Oh my god, tell me about them."

Complicated Grief (Prolonged Grief Disorder): In the DSM⁶, they now have something called Prolonged Grief Disorder. There are people who experience grief that is debilitating and requires professional help. It affects a small percentage of folks. Symptoms include persistent, severe yearning and inability to function for a prolonged period (typically defined as over a year). Risk factors include pre-existing mental health issues, traumatic loss, or lack of support. The main sign is being stuck.

Resilience and Support

Here is a big takeaway: research by George Bonanno⁷ has found that most people adapt well without therapy and without grief counseling. People typically heal through family and community support, not clinical intervention. We want to avoid over-pathologizing something natural. We don't want to intrude in that process by reflexively saying, "Go see a counselor."

So, how do we support each other? Companioning. Just intuition and presence. Listening, no fixing. Just hanging in that discomfort and not running the other way. Some need conversation, others don't. Some need to "do" (instrumental grieving), others need to process.

Do not do it alone. Leverage supports and bring people together.

How to Companion the Bereaved

• Listen. Companioning is about being present to another person's pain. It is not about taking away the pain.
• Companioning is about going to the wilderness of the soul with another human being. It is not about thinking you are responsible for finding the way out.
• Companioning is about honoring the spirit, the mystery, the essence. It is not about focusing on the intellect.
• Companioning is about listening with the heart, not analyzing with the head.
• Companioning is about bearing witness to the struggles of others, not judging or directing them.
• Companioning is about walking alongside, not leading or being led.
• Companioning is about discovering the gifts of sacred silence, not filling up every moment with words.
• Companioning is about being still, not frantic movement forward.
• Companioning is about respecting disorder and confusion, not imposing order and logic.
• Companioning is about learning from others—compassionate curiosity. It is not about expertise.

Presence matters. Compassion, compassion, and more compassion. That is how we show up with people.

Take-Home Messages:

1. Grief is both universal and unique.
2. It is multifaceted.
3. Many don't need counseling; referral is key only when symptoms are persistent and severe.
4. We need each other.

Q&A

Host: Chris, that was incredible. Let's take some time for questions.

Leslie: When you asked us to bring up a loss, what really blew me away was a loss of myself. I don't know what the hell that's about, but I couldn't believe how intense it was. Thank you for that opportunity.

Chris Onderdonk: Thank you, Leslie. I want to make a comment about that. I have been in therapy for 25 years. I have Complex PTSD and adverse childhood experiences that I've had to heal from. What you are speaking to—that grief, the wailing that I have done grieving parts of my life, especially my childhood—is profound.

I do a lot of Internal Family Systems (IFS)⁸ work, which involves working with younger parts of yourself. So when you mention "self," the way I relate to it is about multiplicity—there are many parts of myself. I think that grief related to yourself is some of the most profound grief. It is a whole other subject, but I want to validate that. So much of the grief I've experienced has been related to my own healing. I can't go back and relive my childhood. I am absolutely grieving the things that I didn't experience, and that is absolutely deeply healing and transformative.