Integrating grief in the body: Why talking about it isn’t always enough

Grief is often spoken about as something to get through. A stage to manage, something to overcome, and that someday it’s done. But what if grief isn’t a problem to solve, but a presence to embody and integrate into our lives rather than gotten rid of? In my work with clients, I use sound and embodied practices to help them move through their grief, not around it.

We’re seeing unprecedented levels of mental health fatigue, identity crises, and burnout, especially among high performers, caregivers, and those navigating major transitions. Whether it’s the collapse of a long-held role, a serious diagnosis, or losing someone we love, grief is at the core of many of these struggles. But many don’t realise they’re grieving. We don’t always recognise grief when it doesn’t fit into our narrow idea of mourning, and when it shows up instead as exhaustion, disconnection, anxiety, or a sense of meaninglessness it may slip by unrecognised. I have written more about this in previous articles here. 

Why grief feels stuck in our bodies

In traditional Western therapy, grief is often treated as a mental or emotional issue. We talk. We think. We analyse. However, after talking many people still feel heavy and that’s because grief is more than mental and emotional, it’s physical. It lives in the chest, jaw, and gut. It’s held in muscle tension and felt as vibration through the body. Grief activates the nervous system’s stress response, flooding the body with cortisol and adrenaline. These hormones can lead to chest tightness, nausea, muscle pain, digestive issues, and insomnia. The vagus nerve becomes dysregulated, and the parasympathetic (rest-and-digest) system struggles to respond. Illustrating that grief isn’t just psychological or emotional, it’s stored in the body.

"...many don’t realise they’re grieving. We don’t always recognise grief when it doesn’t fit into our narrow idea of mourning."

Therapeutic approaches to grief

Given the profound impact of grief on the body and brain, therapeutic interventions should focus on both emotional and physiological healing. Somatic therapies, such as Somatic Experiencing, a body-based approach that helps people gently release trauma held in the nervous system, work by guiding attention to physical sensations and supporting safe emotional processing. Other embodied practices, like yoga, conscious movement, breath-led exercise, and even creating art, can also support the release of grief. These approaches help individuals reconnect with their bodies, access buried emotion, and create space for integration and healing.

A 2024 thesis highlighted that while the physical toll of grief is well documented, its embodied dimension is still under-explored, and yet this is often where the most profound healing begins. Modern frameworks now recognise five dimensions of grieving: physical, emotional, cognitive, social, and spiritual. The goal is no longer to eliminate grief, but to integrate it into life. Rituals, including sound-based ones, are increasingly being recognised for their therapeutic potential, especially in prolonged or complicated grief. A recent scoping review found that symbolic acts, farewell ceremonies, and embodied ritual practices not only supported cultural connection but offered meaningful relief and integration for the grieving.

From silence to sound: The day the room cried together

In the palliative care ward, a group of young men sat vigil for their dying father and uncle. I could sense how much emotion they were holding in and the tension and weight of what was happening. As their Spiritual Care Practitioner, I gently offered support, but they declined. I wasn’t upset by their decision, but it stayed with me. Not because they said no, but because I had a strong sense that they were struggling to process what they were feeling. The emotions were there, just too big and too hard to put into words. That’s something I see often.

Later, after witnessing a Sound Meditation I led for the nursing staff, their curiosity was piqued. They approached me and asked if I could hold a session for their family. When we gathered, the room was dimly lit and intentionally quiet. As the sounds of my instruments began to sing and echo through the space, something remarkable happened. The sound gave them permission to feel. Where previously there was silence and shields up, now there was deep breathing and vulnerability, and within minutes, grief, fully expressed. These stoic, composed young men began to weep. Not quietly, but with raw, unfiltered howls. It was as though the sound travelled straight to the centre of their pain, the part for which there were no words, and pulled it to the surface.

But it wasn’t just about individual release. It brought them together. For the first time, they grieved not separately, but as one family. They huddled closer together, or put an arm over the other’s shoulder. The session became a shared ritual, a threshold they crossed together. In that space, grief became visible, audible, and collective. I have no doubt that something shifted in them that day, not just anticipatory grief, but their relationship with each other, and with the loss that was approaching. This was an example of how being witnessed in a safe space, enables one to completely embody their grief.

What talk therapy can’t reach

Therapy and conversation absolutely have their place in grief work, and as a Spiritual Care Practitioner, I’ve witnessed the power of deep listening, holding space, and therapeutic dialogue time and again, but some feelings are pre-language, too deep, old, or raw for words as in the previous example. 

This is where breath, voice, prayer, and ritual come in. A hum, a sustained tone, even the resonance of a tuning fork can reach places the intellect can’t. I’ve witnessed clients soften, tears fall, and deep breathing return, all through non-verbal practices.

"The goal is no longer to eliminate grief, but to integrate it into life."

Another patient had experienced a life-changing illness and had been hospitalised for months, with no clear indication when, or if he would ever, be discharged. He found it difficult to talk about what he was going through. When we first met, he told me he didn’t like people, yet, over time, he continued to welcome me to sit by his bedside, often in silence.

One day, he noticed an instrument I was carrying and asked about it. He asked me to play it. I did, and thought little of the moment at the time. But on my day off, I got a call from my manager: his two daughters were at the office, saying their father had asked for me to come back and play the instrument again, it was the only thing, he said, that brought him peace.

He was later discharged and went on to live for another year. When he later died, those same daughters asked me to play that instrument at his funeral. That moment brought everything full circle, weaving a thread between the living and the dead. The sound of my instrument, as I played it around his coffin, filled the funeral space with a sacred presence, and the entire room was moved to tears. It created a sense of connection and comfort, not just for the family, but for everyone there. For them, that sound became a living link to their loved one, and something they could return to again and again.

Sounds of grief in ancient cultures

The practice of sounding grief is not new. Across many ancient cultures, sound has been a vessel for mourning, from chanting, to didgeridoos, where grief was vocal, sounded, communal, and embodied.

In the hospital setting I witnessed many traditional Greek mourning rituals, where families would gather shortly after a loved one’s death to keen or wail together, an act known as moirologia. These were laments often led by women and they involved rhythmic crying, chanting, and howling, giving shape to sorrow through collective sound. Far from being dramatic or indulgent, these rituals offered an essential release, a way for grief to be heard, witnessed, and metabolised through the body.

Similar practices appear in Irish keening, Middle Eastern zaghareet, and Indigenous death songs. They remind us that silence around grief is the exception, not the rule.

Signs you are holding grief and its impact on brain, body and nervous system

We carry grief in the places no one can see, we have spoken about the physiological responses to grief, caused by the spikes in stress hormones and vagus nerve dysregulation, but there are also neurological changes occurring. 

Research shows grief affects brain areas such as:

• Prefrontal cortex, overburdened during emotional regulation

• Amygdala, hyperactive with fear, sadness and anxiety 

• Hippocampus, often shrinking under prolonged grief, affecting memory 

  
  

An EEG during acute grief shows hyperactivity in prefrontal regions; longer-term grief weakens connections across emotion-cognition neural pathways. 

Sound and ritual as healing balms

Sound moves us where thought and intellect cannot, and ritual gives shape to what is shapeless, both help to mark a significant event.

What the evidence shows:

• A study on music in farewell ceremonies with twelve participants found music helped recall loving memories, foster active participation in grieving, and offered solace before, during and after loss .

• A survey of 2,547 grieving adults showed 94 per cent intentionally used music in their grief journey, demonstrating music’s natural therapeutic roles (emotional expression, memory, ritual) aligned with the Dual Process Model .

• Weekly group singing in a choir setting improved well‑being, self-esteem and self-efficacy amongst those bereaved from cancer, compared to control groups.

These findings mirror what’s known in the Dual Process Model of grief, which suggests that healthy grieving involves an ongoing oscillation between confronting the pain of loss (loss-oriented coping) and engaging in life again (restoration-oriented coping). Music, in particular, supports this natural swing,  poignant songs invite sorrow to the surface, while uplifting ones help restore energy, joy and foster recollection of happy memories.

This idea also aligns with the Tripartite Model of Grief (which I have referenced in previous articles here and here), which includes: the emotional pain of separation, adjusting to a changed life and sense making or spiritual/existential understanding. Sound and ritual can support all three layers, giving structure to sorrow, anchoring people through change, and opening space for something meaningful to take root.

What does integrating grief sound like?

Grief integration doesn’t require grand gestures, it can be understated, simple and heartfelt, but conversely it can also be loud, angry and messy, you are in control of how you choose to embody, release and integrate your grief. 

A simple sound ritual to try: 

1. Sit comfortably in a quiet space.

2. Choose a small singing bowl, other sound therapy instrument, or your own voice.

3. Begin with a welcoming bowl strike.

4. Take a deep inhale and hum on the exhale, allowing the vibration to travel through your chest, throat and belly. Repeat this inhale, and hum on the exhale for a few minutes continuously. If it feels natural, open the hum into an Ahh, or Oooh. Notice the shifts in your body, emotions that may arise, and any quieting of your mind.

5. Close the experience by again striking the bowl or expressing your voice out aloud. Notice what arises, are there tears, stillness, or a deep sigh?

Another option could be to create a playlist with songs that reflect who your loved one was, or who you once were. Listening to the list can open tears, release emotion and reconnect you.

It’s time to let grief be heard

Grief is not a pathology, it’s love finding a way to be expressed. When we honour it with sound and ritual, we give grief a path through us. We don’t just need to talk it out. We need to feel it, sound it and integrate it. 

If you’d like deeper tools or support for grief, be it death of a loved one, or loss of identity, sign up for my newsletter, email me to register your interest in attending an upcoming retreat, or book a private session. 

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References and suggested further reading

• Fancourt, D., & Steptoe, A. (2019). Community group singing and mental health: Evaluating effects on bereaved individuals. BMJ Supportive & Palliative Care, 9(1), 30–34. https://doi.org/10.1136/bmjspcare-2015-001073

• Johnson, B. (2024, December 9). The neuroscience of grief: How loss impacts brain chemistry and electrical activity. Houston Brain Center. Retrieved from https://www.houstonbraincenter.com

• Levine, P. A. (2010). In an unspoken voice: How the body releases trauma and restores goodness. North Atlantic Books.

• Neimeyer, R. A. (Ed.). (2001). Meaning reconstruction and the experience of loss. American Psychological Association. https://doi.org/10.1037/10397-000

• Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton & Company.

• Schellekens, M. P. J., van den Hurk, D. G. M., Prins, J. B., Donders, A. R. T., Molema, J., & Bleijenberg, G. (2017). Grief and music therapy: A literature review and a pilot study on the effects of music therapy on the bereaved. The Arts in Psychotherapy, 55, 44–51. https://doi.org/10.1016/j.aip.2017.04.003

• Stroebe, M., & Schut, H. (1999). The dual process model of coping with bereavement: Rationale and description. Death Studies, 23(3), 197–224. https://doi.org/10.1080/074811899201046

• Tillman, K. (2019). Keening and the body: Irish ritual lament as embodied grief. Journal of Folklore Research, 56(3), 77–102. https://doi.org/10.2979/jfolkrese.56.3.04

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This article is authored by Nicole Sultana, who holds a Post Graduate Degree in Spiritual Care, a Post Graduate Certificate in Business (Marketing), and a Bachelor of Applied Science in Sports & Exercise. In addition, she is a Certified Therapeutic Sound Practitioner and a Death Doula. Nicole is the founder of Sound Consciousness, a company that offers wellbeing strategies and therapeutic sound practices to help individuals achieve peak performance in their professional lives, sporting endeavours, relationships, and personal aspirations.

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