When everything comes at once: cumulative loss and how to get through it

“I thought I was strong. Then, in a single year, my father died, the company closed my department, my daughter moved abroad and the dog fell ill. When the dog died, I cried for three days. Over the dog. What is wrong with me?”

I hear this sentence, in one form or another, more often than I would have expected. Someone arrives feeling that they have “fallen apart over a trifle”. When we look together at the past year or two, it turns out the trifle was not a trifle at all, but the last in a long line. It was not about the dog. It was about everything that had built up before and for which there had never been time.

We call this cumulative loss. It is not a diagnosis but a deeply human experience: losses do not always arrive neatly one after another, with enough space in between to work through each. Sometimes they come in clusters. And then the rules that apply to a single loss no longer hold.

When one loss covers another

At the end of the 1960s, the American psychologist Robert Kastenbaum described a phenomenon he called bereavement overload. He noticed it in older people who, in a short space of time, lose a partner, friends, their health and their independence. He observed something that now seems almost obvious: when losses come too quickly one after another, a person cannot grieve each of them separately. Before they have even taken in the first, the second has already struck. Grief gets stuck, goes numb or shows up somewhere else — in the body, in irritability, in sudden tears over something that seems unimportant.

Kastenbaum was writing about old age, but today we know the same thing happens at every stage of life. At thirty, a breakup, a move and a job loss can all happen at once. At fifty, a parent’s illness, the children leaving home and changes in your own body. Each of these losses would be manageable on its own. Together they create a weight that is greater than the sum of its parts.

It also matters that some of these losses are things the people around you do not recognise as losses. I wrote about this in The grief nobody acknowledges: losing a job, a miscarriage, a friendship that ended, the end of a plan. When losses like these pile up, it is even harder, because you do not even have a word for what is weighing on you. “Nobody died,” you tell yourself. And yet something has gone.

What stress research tells us

In 1967, the psychiatrists Thomas Holmes and Richard Rahe published a scale that became one of the best known in the psychology of stress. They gave life events points according to how much adjustment they demand. The death of a spouse scored 100 points, divorce 73, the death of a close family member 63, losing a job 47. Later research showed that people who accumulate many points in a single year are more likely to fall ill in the period that follows.

The scale is old and has its limitations — it does not account for how an individual experiences an event, and some of its items seem odd today. But its basic message still stands: strain adds up. The body does not distinguish between a “big” and a “small” loss the way we would like it to. What counts is the total amount of adjustment it has to make within a given time.

The psychologist Stevan Hobfoll developed this thinking further in his conservation of resources theory. In his view, stress hurts most when we lose something we had — time, money, relationships, health, a sense of control. And losses have a habit of leading to new losses. Someone who loses a job may also lose money, routine and contact with colleagues. Someone who loses a partner may also lose the friends who were “shared”. Hobfoll calls this a loss spiral. Once you are in it, you have fewer and fewer resources with which to meet the next blow.

What happens in the body

The neuroendocrinologist Bruce McEwen introduced the concept of allostatic load. He used it to describe the price the body pays when it has to adapt to stress for too long and too often. Short-term stress is useful: the heart beats faster, the muscles are ready, attention is sharpened. But when the system never gets the chance to return to rest, wear and tear sets in. Sleep becomes shallow, the immune system weakens, digestion slows down or runs wild, blood pressure stays higher.

With cumulative loss this is very concrete. People describe catching more colds during such a period, having back pain, waking at three in the morning with a pounding heart. I have written in more detail about how grief affects the body in Grief and the body: why we fall ill more often after a loss. In the knowledge base you will also find a short explanation of chronic stress and why the body cannot bear it indefinitely.

I think it is important to say this: physical symptoms are not proof that you are “weak”. They are proof that your body is doing exactly what it was made to do — trying to survive. It is just that this system was built for short bursts of effort, not for a year of uninterrupted struggle.

Why it can feel as though you “feel nothing”

One of the most confusing feelings in cumulative loss is numbness. People expect that with so many losses they will be crying all the time. Instead they notice that they feel almost nothing. They were calm at the funeral, they just nodded at the news of their redundancy, they packed boxes for the move like a machine.

This is not coldness. The psyche has its own safety switches. When there are too many emotions, it temporarily turns them off so that a person can keep functioning — look after the children, go to work, sort out the paperwork. In the knowledge base this mechanism is described under window of tolerance: as long as we are inside the window, we can feel and think at the same time. When we are flooded, we tip either into overwhelming agitation or into numbness.

The trouble starts when the switch no longer turns back on. The emotions that were put aside remain stored somewhere. And then the dog comes along. Or a film, a song, an unimportant remark from a colleague. And everything that was locked away comes out all at once. That is why people feel they are overreacting. In reality, they are reacting to everything at once.

A systemic view: the family as a vessel

In relational family therapy, in which I am training, we never see losses only as an individual’s private experience. A family is like a vessel that carries a shared burden. When a grandfather dies, it is not only his daughter who grieves; the whole family arrangement changes: who now rings round at the holidays, who looks after grandmother, who has become “the eldest”.

With cumulative loss the vessel fills quickly. Everyone is overloaded and nobody has the strength to comfort anyone else. Partners who would lean on each other in calmer times begin to drift apart, because each of them has enough on their own plate. Children sense the tension and withdraw, or start “causing trouble”, which is often their way of expressing the same distress. Christian Gostečnik writes that unexpressed feelings in a family do not disappear but are passed on — into relationships, onto children, sometimes into the next generation.

This does not mean the family is to blame. It only means that under heavy strain it helps to look more widely: not just at how I am, but at how we are. Sometimes the greatest help is simply for someone in the family to say out loud: “This year has been really hard for us. For all of us.”

(A composite conversation, not a real person.)
“I don’t know why this is happening to me. I got through my father’s death, and now I can’t get out of bed because the car broke down.”
“What has happened since your father died?”
“Well … I moved, because I sold his flat. My mother came to live with us. Then there was that restructuring at work. And now the car.”
“When you list it out loud — how does it sound?”
“… As if someone else were describing a person who is having a very hard year.”

How to get through a period like this

When losses keep piling up, the most important goal is simple: to get through it. Not to grow, not to search for meaning, not to “work through” everything. Those goals come later. First, the load needs to be reduced as much as possible. Here are a few things that research and experience suggest can help.

Deliberate oscillation. Margaret Stroebe and Henk Schut described the dual process model of grief. According to this model, healthy grieving moves between two poles: time spent dealing with the loss (crying, remembering, feeling) and time spent dealing with life (errands, new roles, a break from sadness). Both directions are needed. With cumulative loss it is especially important to allow yourself a break as well — not as an escape, but as part of recovery.

The body first. Sleep, food, movement, daylight. It sounds trivial, but under allostatic load these are the first things to go, and the first things that tell the body the danger has passed.

Fewer decisions. If at all possible, postpone major decisions — moving house, selling, changing jobs. Not because they would be wrong, but because every new change brings new adjustment.

Help from others, made concrete. People often say “let me know if you need anything”. When you are overloaded, you have no energy to let anyone know. It helps to make a specific request yourself: “Could you pick the children up from school on Thursday?”

Exercise: an inventory of the last two years’ losses

When losses pile up, we often cannot see how many there are. Each one on its own seems too small to deserve space. This exercise takes about twenty minutes. Do it quietly, when nobody will disturb you.

1. Take a sheet of paper and draw a timeline of the last two years. The start is on the left, today on the right.
2. Write in everything that has changed or gone. Not only deaths and breakups, but also moves, illnesses, losing a job, children leaving home, the end of a friendship, changes in your body, plans you gave up. Do not judge whether it is “big enough”. If it came to mind, it belongs on the page.
3. Next to each loss, write one word for what you felt at the time — or “nothing” if you cannot remember anything. “Nothing” is important information too.
4. Look at the page from a distance. Ask yourself: if a friend brought you this timeline, what would you say to them? Would you tell them they were exaggerating?
5. Choose one loss you feel you have not given any space to, and give it a few minutes this week — a walk, a letter, a visit to a place, a conversation with someone who knew it too.

If the exercise overwhelms you, stop. You do not have to do it all at once. Even the first two steps alone can show you something you had not seen before.

Through this exercise, many people see for the first time that their tiredness is not laziness and their tears are not hysteria. They are an understandable response to a great many losses in a short time. That realisation alone can lift part of the burden — the part that shame adds.

Where this view falls short

The idea of cumulative loss is useful because it helps us understand. But it also has its limits, and it is only fair that I name them.

First, not every strong reaction is the result of accumulated losses. Sometimes a single loss is big enough to knock you down — and there is no point searching for “hidden accumulation” when the pain is simply proportionate to the loss. The death of a child or a partner needs no further explanation.

Second, the adding up is not linear. Stress scales predicted difficulties on average, but many people with high scores stay healthy. George Bonanno’s research shows that resilience after loss is more common than we long believed. You will not necessarily break just because a lot has built up.

Third, sometimes the problem is not the number of losses but something else. Depression that has been developing for some time, unprocessed trauma from childhood, a health problem such as a thyroid disorder. If you have not felt better for a long time, it makes sense to see a doctor as well. I have written about when it is time for professional help in When loss needs professional help.

When to seek help

Most people pull through a period of cumulative loss on their own, with support from those close to them and with time. Professional help makes sense when:

• for several weeks you have been unable to sleep, eat or manage basic responsibilities;
• the numbness does not lift even after circumstances have calmed down;
• you notice you are drinking more, eating more or turning to anything that deadens you;
• it feels as though there is no point in living any more.

If you are thinking about harming yourself, do not wait. In Slovenia, call the crisis line Klic v duševni stiski on 01 520 99 00 (every day from 7 pm to 7 am), the Samarijan helpline on 116 123 (24 hours) or, in an emergency, 112.

On the difference between grief and depression, you can also read Grief is not only tears, and a short explanation of grieving is in the knowledge base.

What to remember

• Losses add up. When they come too quickly one after another, there is no time to grieve each one.
• A strong reaction to “a trifle” is often a reaction to everything that built up before it.
• The body carries part of the burden — tiredness, illness and sleeplessness are common companions of such a period.
• The first goal is to get through it: look after your body, reduce decisions, ask for concrete help.
• If the distress does not lift, or thoughts of death appear, seek help — you do not have to carry this alone.