Coping with grief

Death or loss can feel overwhelming for the people left behind. The grief which accompanies or follows loss can be complicated, unpredictable, and scary. The good news is that this sort of experience usually means that a person is making progress with their grief. In contrast, when life seems very normal after a loss it could mean that the grief has been suppressed, only to surface sometime later in a destructive fashion.

In other words, if a mourning or grieving person can allow themselves to be a "basket case" from time to time, they will likely do all right with their grief. It's when a person tries too hard to keep it all together that problems can result.

Over the years, the grief experience has been described by some as unfolding in stages. However, this concept is too narrow. A more encompassing framework would be reactions, which can include the spectrum of emotions.

The grief process usually needs a lot longer to play itself out than most people realize. One year is seen as a minimal time for healing from a death or significant loss. A person has to pass through all the special anniversaries and memory days in a year without the loved one, and with each event the grief will reawaken strongly. For many bereaved people, the most important anniversary date tends to be Christmas.

Healthy grief reactions

Every aspect of a person is involved in the grief process, including the physical, social, spiritual, and psychological (logical thinking and emotional) elements. Different reactions can be looked at within each category.

Physical reactions: These include shock or numbness, periods of intense anxiety (perhaps leading to hyperventilation or an anxiety attack), shaking, or tremor. Other physical reactions may be a tightness in the throat, lethargy, or ongoing tiredness or insomnia. In some, oversleeping, loss of appetite, or overeating (as if to fill a void) may occur. Specific pains may also be present, such as a stiff neck, back pain, abdominal discomfort, or surgical site sensitivity. These physical reactions tend to show up in early grief and then gradually begin to disappear.

Social reactions: The key word here is loneliness. Early on, there are lots of people around, yet because of the shock and numbness one is detached in the midst of a crowd. Later, old friends may abandon the mourner, which causes new pain. This likely happens because the friends or family are not sure what to say or do, and so avoid contact. Often, widows and grieving parents will complain of being abandoned.

Spiritual reactions: Confusion may take the place of what seemed to be a secure and stable belief in God. This often happens when the deceased person is young and the loss seems so senseless. Some believers become angry with God and abandon their faith. However, others who previously did not believe begin to do so.

Psychological (logical thinking) reactions: The initial shock of a loss also affects the thinking processes of the mourner. There can be a sense of unreality. Memory is disrupted, as is concentration. For those who like to be in control most of the time, these reactions are particularly troublesome. Confusion and irrational thinking are common for a period of time. Apathy or hyperactivity can also occur.

Psychological (emotional) reactions: For a short time after the loss there is frequently numbness or anxiety, and an absence of emotion. However, this soon changes, and a rich array of emotions begins to surface. Classic grief emotions include sadness, yearning or craving for the lost person, anger, and guilt. Yet any other feeling is also appropriate. Anything goes. The analogy that many people find comfortable is that of a roller coaster ride (in the dark). The grieving person is suddenly and unexpectedly up and down with their feelings, without quite knowing what will come when.

The feelings of grief are chaotic and strong, particularly in the early months after a loss. If bereaved persons understand that this is normal and give themselves permission to "ride the roller coaster," they do not become fearful of the grief experience.

Getting better

Getting better involves sharing the reactions of grief with others who will listen and offer support without advice. The grief experience is constantly unfolding and needs to be shared repetitively over time. It can also be very helpful to write about what is happening. C.S. Lewis wrote A Grief Observed after his wife died and offers a firsthand witness to the journey of grief.

Denis Boyd, MA, 
in association with the MediResource Clinical Team 

Good grieving

What can you do to grieve well? The following suggestions have been used by many, and will help anyone who has experienced a major loss. Even though grief feels overwhelming, you do not have to sit by and suffer helplessly.

  • Accept the turmoil. Normal, healthy grief is chaotic and complicated. Emotionally, you are riding a roller coaster and it is scary at times. If you know you are on a roller coaster and that you will be riding it for a time, you can relax a little and not fight it. You do not have to like the turmoil, but it is helpful to give yourself permission to experience it.
  • There's no rush. There is a tendency to feel that grief needs to be rushed. This is particularly the case for people who are usually in control of their feelings and dislike being in turmoil. Friends will unrealistically expect a mourner to get over the loss quickly. This expectation is based on a lack of knowledge of what grief involves, and represents a wish to avoid the discomfort. It takes at least a year to feel normal again, as there is a need to face the seasons and anniversaries for the first time without the loved one.
  • Write down your experiences. Take some time, especially late in the day, to write about your grief. Keep this journal for a time and look back. This is a good way to realize that, over time, there is indeed a slow healing process taking place. Writing is valued by some because it is private, and no one has to see what is being expressed.
  • Consider writing a letter or two. At some point in the healing process it might be helpful to write to the person who has left or died. This is a chance to say what was left unsaid. One person wrote to a parent and shared their anger, sadness, and love after the parent took her own life. Such a letter can be read at a gravesite and eventually burned, or dealt with in some other meaningful fashion.
  • Coach those close to you on how to help you. We live in a culture that continues to deny or ignore death. This means that many people do not know what to say or how to interact with a grieving family member or friend. These people may avoid you or say dumb things, yet they often do not know any better. It can be very helpful to take a few of these people aside and give them some idea of what you need: "I want to talk with you from time to time, and all I want you to do is listen and not to give me feedback or advice. Just let me sound off a little."
  • Speak openly and frequently with others. Healing your pain may be helped by repetitively sharing it with a friend or two. The hurt feelings will surface and be released, and eventually will shrink. If you do not want to wear out your listener, substitute writing. Talking about your loss is not what upsets you. The pain is already within you and only surfaces through the conversation.
  • Go for long walks. Hans Selye, a famous pioneer in the field of stress, wrote about the neuromuscular tension that can be created by stress in the body. Walking is a simple, effective exercise that allows the body to release tension. Such outings are also good for the mind in that you can think or simply tune out and enjoy the surroundings or even talk with a friend.
  • Distract yourself regularly. Any type of activity will help, such as work, reading, hobbies, music, or sports. Spending a lot of time focusing on your loss will not speed up the healing process. In fact, grief can become overwhelming without a break from it. Thoughts and feelings about the loved one can permeate all aspects of the day. Therefore, it is good to let yourself focus on something completely different for a block of time each day. Returning to work may be hard at first, but it usually provides a good change from the reality of the loss. You have to be careful, however, not to become too distracted, as this will drive the grief underground.
  • Go where you fear to go. There will be any number of places that will remind you of the one who is gone, such as a favourite park or restaurant, or an activity you frequently shared. Even thinking about these shared times and places will cause pain, and the natural tendency will be to avoid them. If you do this, you will only perpetuate the hurt you feel when you contemplate these places. Going to the park, for instance, may sting at first, but each subsequent visit will be easier to handle.
  • Expect "anniversary upset." The anniversary day your loved one died will cause the turmoil to return. Also, Christmas is often the toughest season for a bereaved person, as it is a festival of family, with many colourful memories. Birthdays, wedding anniversaries, and other special days will reawaken the grief, making you think that you have slid backwards. However, you are experiencing a normal "anniversary reaction" to your loss.
  • Nurture yourself. Women in particular are accustomed to taking care of others in their lives and sometimes forget to do the same for themselves. When you are mourning a big loss, it is very important to do things for yourself that will allow you to feel pampered from time to time. Special foods or activities may be part of your self-nurturing. Other special, worthwhile things may be as simple as taking time to listen to meaningful music or going on extra long walks.

Denis Boyd, MA, 
in association with the MediResource Clinical Team 

Unhealthy grief: symptoms

Grief is paradoxical. In other words, when you feel most unhealthy you are probably fine. However, if you feel fine a lot of the time it could mean that your grief is being repressed. This means that it will come out in a distorted form down the road. When the grief becomes unhealthy it can be very scary, and even affect your physical or psychological health.

Absent grief
You don't really feel that different than before the loss. Yes, there are times when you feel on the verge of getting upset, but you stop it before it happens. You avoid sadness even when you are alone. It seems that you are doing fine, yet all you have done is drive the grief reactions underground. This method of dealing with grief will likely eventually affect your health because the buildup of stress is immense.

What to do: Open up a little on your own or with a friend. Do not let the pain scare you. It will pass if you let it out by talking or writing. Other things such as long walks can help as well.

Delayed grief
At the time of the loss you were very busy, and you have not slowed down since. Other times you simply crash and sleep for long periods before getting up and going again, nonstop. You may have had a few sad moments and thought you were over it. Then out of nowhere you have a very strong "wave of grief" where you feel intense feelings of sadness or anger or other emotions. You may have been shocked at the intensity of your upset, since you thought you were doing so well.

What to do: Slow down and allow yourself to feel upset from time to time. Keeping busy can be good, but it can also be a way of avoiding the hurt that comes with a loss. Consider how your parents dealt with grief. Were they open and supportive?

Prolonged grief
It has been over a year since the loss, yet too often you are still feeling very upset. At times, you have a sense that your grief is just getting worse, and this is scaring you. Most likely, you have not let go of the person who died or left, and there are some things you wish you'd said to them.

What to do: Write the lost person a letter and say all the things you did not get a chance to share while they were around. Let out your feelings as well. Try to forgive them for what they did to hurt you, then do something symbolic to let them go, such as reading the letter at a gravesite and then burning it.

Exaggerated ("stuck") grief
The normal flow of grief is like a roller coaster ride, with lots of ups and downs. If you are not experiencing this variety of emotion, your grief may be "stuck." In other words, one emotion is often distorted and you find yourself feeling it frequently, such as anger or depression. This could be happening because you are not accustomed to sharing your feelings openly, and you simply need to learn to do so. The other possibility is that you have unfinished business, as described above.

What to do: Allow yourself to open up more and see if you get some variety in your feelings. Think about unfinished business with the lost person and consider writing a letter.

Denis Boyd, MA, 
in association with the MediResource Clinical Team