Multidimensional Nature of Grief: A Social Health Perspective on Grief-Related Loneliness

Abstract

This narrative review focuses on the multidimensional nature of grief and examines grief-related loneliness from the perspectives of psychiatry and social work. The study is based on the premise that loneliness experienced during the grief process is not an individual deficiency but a social health problem produced and reinforced by social and institutional structures. Within this framework, grief is considered not only as an individual emotional response but also as a biopsychosocial process shaped by social support networks, social norms, and structural inequalities. The review addresses the psychiatric conceptualization of grief, the relationship between grief-related loneliness, social isolation, and mental health, and the role of social work in supporting individuals during the grief process. It also evaluates the need for integration between psychiatric interventions and social work practices and discusses the limitations of current approaches. In addition, the grief experiences of vulnerable populations and the social risks they face are examined, including individuals living alone, older adults, people with chronic or terminal illnesses, migrants and refugees, and LGBT individuals. The study highlights the similarities and differences between psychiatric and social work perspectives and proposes a framework for interdisciplinary integration. The findings suggest that comprehensive responses to grief-related loneliness require integrated intervention models that combine psychiatric and social work approaches and place social health at the center.

Keywords

• Grief
• grief counselling
• social work
• social health
• disadvantaged groups

Yasın Çok Boyutlu Doğası: Yasla İlişkili Yalnızlığa Sosyal Sağlık Perspektifinden Bir Bakış

Abstract

Bu araştırma, yasın çok boyutlu doğasını merkeze alan, yas ile yalnız kalma deneyimini psikiyatri ve sosyal hizmet yaklaşımları ekseninde değerlendiren anlatısal bir derleme niteliğindedir. Araştırmanın problem odağı; “yasın ardından deneyimlenen yalnızlığın, bireysel bir eksiklik değil sosyal ve kurumsal yapılar tarafından üretilerek pekiştirilen bir sosyal sağlık sorunu olduğu” iddiasıdır. Bu kapsamda yas, yalnızca bireysel bir tepki olarak değil, biyopsikososyal süreçler bağlamında değerlendirilmiştir. Yas süreci ve tedavisi, sosyal destek mekanizmaları, toplumsal normlar ve yapısal eşitsizlikler odağında ele alınmıştır. Ayrıca, yasın psikiyatrik kavramsallaştırması, yalnızlık ve sosyal izolasyonun yas ile ilişkisi, sosyal sağlık açısından yas, sosyal hizmetin yas süreçlerindeki rolü, psikiyatrik müdahaleler ile sosyal hizmet uygulamalarının bütünleşme ihtiyacı ve mevcut uygulamalardaki sınırlılıkları tartışılmıştır. Yalnız yaşayanlar, yaşlılar, kronik ve ölümcül bir hastalığı olanlar, göçmen ve mülteciler ile LGBT bireyler gibi farklı dezavantajlı grupların yas süreçlerindeki deneyimleri ve karşılaştıkları sosyal riskler değerlendirilmiştir. Psikiyatri ve sosyal hizmet yaklaşımlarının, yas süreçlerine ilişkin benzer ve farklı yönleri ortaya konularak disiplinlerarası entegrasyon için bir çerçeve sunulmuştur. Bu doğrultuda, yas ile yalnız kalma deneyiminin kapsamlı bir şekilde ele alınabilmesi için psikiyatri ve sosyal hizmet temelli yaklaşımları bütünleştiren, sosyal sağlığı merkeze alan müdahale modellerinin geliştirilmesi gerektiği sonucuna ulaşılmıştır.

Keywords

• Yas
• yas danışmanlığı
• sosyal hizmet
• sosyal sağlık
• dezavantajlı gruplar

References

1. Aksöz İ (2014) Kayıp ve yas. In Afetler, Krizler, Travmalar ve Psikolojik Yardım (Eds Ö Erdur-Baker, T Doğan):43-61. Ankara, Türk PDR Derneği.
2. Aoun SM, Breen LJ, White I, Rumbold B, Kellehear A (2018) What sources of bereavement support are perceived helpful by bereaved people and why? Empirical evidence for the compassionate communities approach. Palliat Med, 32:1378-1388.
3. APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Washington, DC, American Psychiatric Association.
4. Apaydın S (2021) Kayıp ve yas. In Yas Danışmanlığı (Eds Ö Erdur-Baker, İ Aksöz-Efe):1-50. Ankara, Anı Yayıncılık.
5. Archer J (2008) Theories of grief: past, present, and future perspectives. In Handbook of Bereavement Research and Practice: Advances in Theory and Intervention (Eds MS Stroebe, RO Hansson, H Schut, W Stroebe):45-65. Washington, DC, American Psychological Association .
6. Asch RH, Esterlis I, Southwick SM, Pietrzak RH (2021) Risk and resilience factors associated with traumatic loss-related PTSD in US military veterans: results from the national health and resilience in veterans study. Psychiatry Res, 298:113775.
7. Ataman E, Barış İ (2019) Sosyal sermaye ürünü olarak taziye kültürü ve kurumsal bir hizmet olarak yas danışmanlığı: Türkiye-Almanya örneği. Artvin Çoruh Üniversitesi Uluslararası Sosyal Bilimler Dergisi, 5:93-112
8. Bağcaz A (2017) Ankara'da yakın kaybı sonrası yas belirtilerinin yaygınlığı ve yordayıcı etmenler (sosyodemografik özellikler, yakın kaybının özellikleri, anksiyete duyarlılığı ve yetişkin ayrılık anksiyetesi ile ilişkisi) (Doktora tezi). Ankara, Hacettepe Üniversitesi.

9. Bonanno GA (2019) The Other Side of Sadness: What The New Science of Bereavement Tells Us About Life After Loss. London, Hachette UK.
10. Bonanno GA, Papa A, Lalande K, Westphal M, Coifman K (2004) The importance of being flexible: The ability to both enhance and suppress emotional expression predicts long-term adjustment. Psychol Sci, 15:482-487.
11. Bowlby J (1969) Attachment and Loss: Volume I - Attachment. New York, NY, Basic Books.
12. Bristowe K, Marshall S, Harding R (2016) The bereavement experiences of lesbian, gay, bisexual and/or trans people who have lost a partner: a systematic review, thematic synthesis and modelling of the literature. Palliat Med, 30:730-744.
13. Bronfenbrenner U (1979) The Ecology of Human Development: Experiments by Nature and Design. Cambridge, MA, Harvard University Press.
14. Bronfenbrenner U, Morris PA (2006) The bioecological model of human development. In Handbook of Child Psychology: Theoretical Models of Human Development, 6th ed. (Eds RM Lerner, W Damon):793-828. Hoboken, NJ, Wiley.
15. Brown EG, Gallagher S, Creaven AM (2018) Loneliness and acute stress reactivity: a systematic review of psychophysiological studies. Psychophysiology, 55:e13031.
16. Cirhinlioğlu Z (2024) Sağlık Sosyolojisi. Ankara, Nobel Akademik.
17. Cramer KM, Barry JE (1999) Conceptualizations and measures of loneliness: a comparison of subscales. Pers Individ Dif, 27:491-502.
18. Currer C (2013) Loss and Social Work. London, Sage.
19. Çolak GV, Hocaoğlu Ç (2021) Kayıp ve yas: bir gözden geçirme. Kıbrıs Türk Psikiyatri ve Psikoloji Dergisi, 3:56-62.
20. Dogan S (2000) The historical development of counseling in Turkey. International Journal for the Advancement of Counselling, 22:57-67.
21. Doka KJ (2002) Disenfranchised Grief: New Directions, Challenges and Strategies for Practice. Champaign, IL, Research Press.
22. Drenth CM, Herbst AG, Strydom H (2013) Complicated grief in the South African context: a social work perspective. Br J Soc Work, 43:355-372.
23. Duffy M, Wild J. (2023) Living with loss: a cognitive approach to prolonged grief disorder - incorporating complicated, enduring and traumatic grief. Behav Cogn Psychother, 51:645-658.
24. Duyan V, Özgür-Sayar Ö, Özbulut M (2008). Sosyal Hizmeti Tanımak ve Anlamak: Sosyal Hizmet Uzmanları ve Sosyal Hizmet Alanında Çalışanlar İçin Bir Rehber. Ankara, Sosyal Hizmet Uzmanları Derneği.
25. Dyregrov A, Dyregrov K (2008) Effective Grief and Bereavement Support: The Role of Family, Friends, Colleagues, Schools and Support Professionals. London, Jessica Kingsley.
26. Freud S (1917/1957). Mourning and melancholia. In The Standard Edition of the Complete Psychological Works of Sigmund Freud (Vol. 14) (Ed & Trans J Strachey):243-258. London, Hogarth Press.
27. Goldsworthy KK (2005) Grief and loss theory in social work practice: all changes involve loss, just as all losses require change. Aust Soc Work, 58:167-178.
28. Hawkley LC, Cacioppo JT (2003) Loneliness and pathways to disease. Brain Behav Immun, 17:98-105.
29. Hawkley LC, Cacioppo JT (2010) Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med, 40:218-227.
30. Hayslip B, Page KS (2013) Family characteristics and dynamics: a systems approach to grief. Fam Sci, 4:50-58.
31. Hernández-Moscoso BS, Torralba-Roselló JM (2025) “What about your social worker?” Professionals and families’ perceptions of pediatric palliative care social work: a qualitative study. J Soc Work End Life Palliat Care, 21:132-149.
32. Hewson H, Galbraith N, Jones C, Heath G (2024). The impact of continuing bonds following bereavement: A systematic review. Death Stud, 48:1001-1014.
33. Hill PE (2012) Support and counseling after maternal death. Semin Perinatol, 36:84-88.
34. Holt-Lunstad J (2018) Why social relationships are important for physical health: a systems approach to understanding and modifying risk and protection. Annu Rev Psychol, 69:437-458.
35. Holt-Lunstad J, Smith TB, Layton JB. (2010) Social relationships and mortality risk: a meta-analytic review. PLoS Med, 27:e1000316.
36. Jakoby NR (2014) Talking about grief: conversational partners sought by bereaved people. Bereave Care, 33:13-18.
37. James JW, Friedman R (2009) The Grief Recovery Handbook. New York, NY, Harper Collins.
38. Johns L, Blackburn P, McAuliffe D (2020) COVID-19, Prolonged Grief Disorder and the role of social work. Int Soc Work, 63:660-664.
39. Jones BL (2005) Pediatric palliative and end-of-life care: The role of social work in pediatric oncology. J Soc Work End Life Palliat Care, 1:35-61.
40. Jordan JR, Neimeyer RA (2003) Does grief counseling work? Death Stud, 27:765-786.
41. Kainama JV, Riasnugrahani M, Rohinsa M (2023) The effect of social support and religiosity against bereavement. Al Qalam: Jurnal Ilmiah Keagamaan dan Kemasyarakatan, 17:2763-2774.
42. Keyes CLM (2002) The mental health continuum: from languishing to flourishing in life. J Health Soc Behav, 43:207-222.
43. Kogan I (2021) Yas Tutmama Mücadelesi (Çev S Yücel, AA Köşkdere). İzmir, Odağ Yayınları.
44. Konrad SC (2010) Relational learning in social work education: transformative education for teaching a course on loss, grief and death. J Teach Soc Work, 30:15-28.
45. Kübler-Ross E (1969/2024) Ölüm ve Ölme Üzerine (Çev S Soner). İstanbul, Profil Kitap.
46. Külahçıoğlu E (2021) Yas danışmanlığı. In Yas Danışmanlığı (Eds Ö Erdur-Baker, İ Aksöz-Efe):113-148. Ankara, Anı Yayıncılık.
47. Laub D, Lee S (2003) Thanatos and massive psychic trauma: the impact of the death instinct on knowing, remembering, and forgetting. J Am Psychoanal Assoc, 51:433-464.
48. Leigh-Hunt N, Bagguley D, Bash K, Turner V, Turnbull S, Valtorta N et al. (2017) An overview of systematic reviews on the public health consequences of social isolation and loneliness. Public Health, 152:157-171.
49. Lepore SJ, Silver RC, Wortman CB, Wayment HA (1996) Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers. J Pers Soc Psychol, 70:271-282.
50. Lindemann E (1944) Symptomatology and management of acute grief. Am J Psychiatry, 151(Suppl 6):155-160.
51. Lloyd M (1997) Dying and bereavement, spirituality and social work in a market economy of welfare. Br J Soc Work, 27:175-190.
52. Mallon B (2008) Dying, Death and Grief: Working with Adult Bereavement. London, Sage.
53. McCoyd JLM, Walter CA (2016) Grief and Loss Across the Lifespan: A Biopsychosocial Perspective. New York, NY, Springer.
54. Mortazavi SS, Assari S, Alimohamadi A, Rafiee M, Shati M (2020) Fear loss, social isolation, and incomplete grief due to COVID-19: a recipe for a psychiatric pandemic. Basic Clin Neurosci, 11:225-232.
55. Murray V (2012) Grief and bereavement in contemporary society: bridging research and practice, by RA Neimeyer, DL Harris, HR Winokuer, and GF Thorton. Soc Work Health Care, 51:479-482.
56. Murty SA, Sanders S, Stensland M (2015) End of life care as a field of practice in the social work curriculum. J Soc Work End Life Palliat Care, 11:11-26.
57. Muskat B, Brownstone D, Greenblatt A (2017) The experiences of pediatric social workers providing end of life care. Soc Work Health Care, 56:505-523.
58. Muskat B, Greenblatt A, Anthony S, Beaune L, Hubley P, Newman C et al. (2020) The experiences of physicians, nurses, and social workers providing end of life care in a pediatric acute-care hospital. Death Stud, 44:105-116.
59. Neimeyer RA (2001) Meaning Reconstruction and the Experience of Loss. Washington, DC, American Psychological Association.
60. Neimeyer RA, Harris DL, Winokuer HR, Thornton GF (2011) Grief and Bereavement in Contemporary Society: Bridging Research and Practice. New York, NY, Routledge.
61. Neimeyer RA, Klass D, Dennis MR (2014) Mourning, meaning and memory: individual, communal and cultural narration of grief. In Meaning in Positive and Existential Psychology (Eds A Batthyany, P Russo Netzer). Cham, Springer.
62. O’Connor MF (2025) Yas Tutan Beyin (Çev U Mehter). İstanbul, Diyojen Yayıncılık.
63. Olsson M (1997) Social support in bereavement crisis - a study of interaction in crisis situations. Soc Work Health Care, 25:117-130.
64. Özer-Ağırbaş Ü, Yıldırım E (2015) Komplike yas ve komplike yas tedavisi. Dusunen Adam, 28:281-282.
65. Özmen O (2014) Yas ve kültür. In Afetler, Krizler, Travmalar ve Psikolojik Yardım (Eds Ö Erdur-Baker, T Doğan):63-74. Ankara, Türk PDR Derneği.
66. Parkes CM, Prigerson HG (2013) Bereavement: Studies of Grief in Adult Life. New York, NY, Routledge.
67. Payne M (2014) Modern Sosyal Hizmet Kuramı (Çev K Karataş). Ankara, Nika Yayınevi.
68. Pearlman LA, Wortman CB, Feuer CA, Farber CH, Rando TA (2014) Treating Traumatic Bereavement: A Practitioner's Guide. New York, NY, Guilford Press.
69. Pérez HCS, Ikram MA, Direk N, Tiemeier H (2018) Prolonged grief and cognitive decline: a prospective population based study in middle aged and older persons. Am J Geriatr Psychiatry, 26:451-460.
70. Pomeroy EC (2011) On grief and loss. Soc Work, 56:101-105.
71. Prigerson HG, Boelen PA, Xu J, Smith KV, Maciejewski PK (2021) Validation of the new DSM-5-TR criteria for prolonged grief disorder and the PG-13-Revised (PG-13-R) scale. World Psychiatry, 20:96-106.
72. Prigerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, Goodkin K et al. (2009) Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Medicine, 6:e1000121.
73. Prapunoto S, Soetjiningsih CH (2024) Grief due to loss of significant others: the role of social support, spiritual intelligence and wellbeing life satisfaction. Bulletin of Counseling and Psychotherapy, 6:1-11.
74. Rando TA (1986) Loss and Anticipatory Grief. Lexington, MA, Lexington Books.
75. Rothaupt JW, Becker K (2007) A literature review of western bereavement theory: from decathecting to continuing bonds. Fam J, 15:6-15.
76. Rubin S (1981) A two track model of bereavement: theory and application in research. Am J Orthopsychiatry, 51:101-109.
77. Savi-Çakar F (2020) The role of social support in the relationship between adolescents’ level of loss and grief and well-being. International Education Studies, 13:27-40.
78. Savi-Çakar F (2023) Kriz, travma ve yas ile ilgili kavramsal çerçeve. In Çocuk ve Ergenlerde Travma, Kayıp ve Yas Danışmanlığı Kuram ve Uygulamaları (Ed F Savi-Çakar):4-18. Ankara, Pegem Akademi.
79. Selvili ZZ, Klass D (2025) Continuing bonds or ongoing attachments? Exploring the distinction. Death Stud, 1-13.
80. Schaefer JA, Moos RH (2001) Bereavement experiences and personal growth. In Handbook of Bereavement Research: Consequences, Coping and Care (Eds MS Stroebe, RO Hansson, W Stroebe, H Schut):145-167. Washington, DC, American Psychological Association.
81. Shear K, Frank E, Houck PR, Reynolds CF (2005) Treatment of complicated grief: a randomized controlled trial. JAMA, 293:2601-2608.
82. Smith KV (2018) Memories, appraisals, and coping strategies in prolonged grief disorder (Doctoral dissertation). Oxford, Oxford University.
83. Smith KV, Wild J, Ehlers A (2020) The masking of mourning: social disconnection after bereavement and its role in psychological distress. Clin Psychol Sci, 8:464-476.
84. Stroebe M, Schut H (1999) The dual process model of coping with bereavement: rationale and description. Death Stud, 23:197-224.
85. Stroebe M, Schut H (2020) Bereavement in times of COVID-19: a review and theoretical framework. OMEGA, 82:500-522.
86. Stroebe M, Schut H, Boerner K (2017) Models of coping with bereavement: An updated overview. Estudios de Psicología, 38:582-607.
87. Stroebe W, Schut H (2001) Risk factors in bereavement outcome: a methodological and empirical review. In Handbook of Bereavement Research: Consequences, Coping, and Care (Eds MS Stroebe, RO Hansson, W Stroebe, H Schut):349-371. Washington, DC, American Psychological Association.
88. Stroebe W, Stroebe M, Abakoumkin G, Schut H (1996) The role of loneliness and social support in adjustment to loss: a test of attachment versus stress theory. J Pers Soc Psychol, 70:1241-1249.
89. Stroebe W, Zech E, Stroebe MS, Abakoumkin G (2005) Does social support help in bereavement? J Soc Clin Psychol, 24:1030-1050.
90. Thieleman K, Cacciatore J (2013) When a child dies: a critical analysis of grief-related controversies in DSM-5. Res Soc Work Pract, 24:114-122.
91. Thompson N (2011) Grief and Its Challenges. Basingstoke, Palgrave Macmillan.
92. Valtorta N, Hanratty B (2012) Loneliness, isolation and the health of older adults: do we need a new research agenda? J R Soc Med, 105:518-522.
93. Vedder A, Stroebe MS, Schut HAW, Boerner K, Stokes JE, Boelen PA (2021) Loneliness in bereavement: measurement matters. Front Psychol, 12:741762.
94. Volkan VD (2022) Göçmenler ve Mülteciler: Travma, Sürekli Yas, Önyargı ve Sınır Psikolojisi (Çev A Alp). Ankara, Pusula Yayınevi.
95. Volkan VD (2023) Büyük Grup Psikolojisi: Irkçılık, Toplumsal Bölünmeler, Narsistik Liderler ve Şimdi Biz Kimiz? (Çev MB Büyükkal). İstanbul, Bağlam Yayıncılık.
96. Volkan VD, Zintl E (2017) Kayıptan Sonra Yaşam (Çev M Kocadere, I Vahip). İzmir, Odağ Yayınları.
97. Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S (2018). Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry, 18:156.
98. Wilson J (2013) Supporting People through Loss and Grief: An Introduction for Counsellors and Other Caring Practitioners. London, Jessica Kingsley.
99. Worden JW (1982/2018) Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner. New York, NY, Springer.
100. WHO (2012) ICD-11 Beta: Mental and Behavioural Disorders. Geneva, World Health Organization.
101. WHO (2025) Mental disorders. https://www.who.int/news-room/fact-sheets/detail/mental-disorders (Accessed 17.02.2026).
102. Xiang YH, Chi X, Jiang YQ, Wang RF, Mo L (2016) Psychosomatic status, personality traits, and coping styles of bereaved and non-bereaved survivors of the 2008 Wenchuan earthquake, China. Front Psychiatry, 7:17.
103. Yanguas J, Pinazo-Henandis S, Tarazona-Santabalbina FJ (2018) The complexity of loneliness. Acta BioMed, 89:302-314.
104. Yelboğa N (2023) Ölüm, Yas ve Sosyal Hizmet: Geride Kalanların Yas Yolculuğu. Ankara, Nobel.
105. Yelboğa N (2024) Ölüm ve yas ritüelleri: din, modernizm ve batı medeniyetleri ekseninde bir değerlendirme. Kültür Araştırmaları Dergisi, 20:323-344.
106. Yelboğa N, Gündağ GG (2025) Eşini kaybeden yaşlı kadınların kayıp ve yas deneyimleri üzerine bir araştırma. Dicle Üniversitesi İktisadi ve İdari Bilimler Fakültesi Dergisi, 15:319-349.