Loss of a Souse or Close Friend

About You

What is your first name?

Who have you lost?

A spouse or life partner

A close, lifelong friend

A sibling or close family member

A parent

Multiple significant losses

How long ago did this loss occur?

Within the last 3 months

3 to 12 months ago

1 to 3 years ago

More than 3 years ago

Where You Are in Your Grief

How would you honestly describe where you are emotionally right now?

In shock or disbelief — it still doesn't feel real

Raw — the pain is intense and daily

Coming in waves — better and then worse

Slowly adjusting — finding a new normal

Stuck — I'm not moving through it

Carrying it quietly — outwardly okay but not inside

Are you allowing yourself to grieve — to cry, to feel, to remember — or do you push it down?

Fully — I let myself feel whatever comes

Somewhat — I allow some but keep a lid on it

Not really — I try to stay strong and not break down

I feel numb — I can't fully access what I feel

Has the loss changed your daily routine, sleep, appetite, or motivation significantly?

Minimally — I'm still functioning well

Somewhat — some disruption but managing

Significantly — daily life has been disrupted

Severely — I'm struggling to take care of basic needs

Support & Connection

Do you have people around you who allow you to grieve honestly — without rushing you or minimizing your pain?

Yes — I have safe, supportive people around me

A few — but not enough consistent support

People try but they say things that don't help

Mostly alone — I'm grieving by myself

Have you talked to anyone — a counselor, pastor, grief group, or trusted friend — specifically about your grief?

Yes — I have professional or structured grief support

Talked to trusted friends or family but not a professional

No — I haven't, but I'm open to it

No — and I've been resistant to seeking help

How connected do you feel to your faith, spiritual life, or a sense of meaning right now?

Strong — my faith is a real anchor in this

Wavering — I'm questioning things I used to believe

Distant — I've pulled away from faith or community

I don't have a faith foundation

Looking Forward

Can you envision a future in which you carry this loss but also find meaning and joy again?

Yes — I know healing is possible and I'm moving toward it

I hope so — but I can't fully see it yet

I'm not sure — this loss has made the future feel uncertain

No — I cannot imagine feeling okay again

What do you need most right now?

Someone to simply be with me in this

To feel understood by others who have been through it

Permission to grieve without being told to "move on"

Practical steps for rebuilding my life

A reason to believe life still holds meaning

Hope — that this pain will not always be this heavy