This philosophical inquiry has considered the significance of a grief process to address the interrelation of disenfranchised grief and mental illness. Two frames, of Neimeyer’s (2001) meaning reconstruction grief model and cultural/historical examples of lament, have articulated the relevance of this process in relation to music therapy practice. These two areas illustrate making sense of loss and internal distress through building a grief narrative and re-asserting meaning in the process. This is conceptualised in music therapy practice with the use of the model of The Mythic Artery (Kenny, 1982, 2006) and the advanced methods of Guided Imagery and Music (Bonny, 2002), and Vocal Psychotherapy (Austin, 2008), illustrating systems of creativity and co-construction that guide a process of meaning reconstruction through lament. Interpretation of significant findings reveal three interconnected areas of meaning making: giving meaning to pain, relational meaning, and a world of meaning. The implications of the research relating to practice, education, research, along with limitations are discussed.