Coping With Grief And Loss
When we speak of grief and loss, our minds immediately go to the emotional impact that the death of a loved one has on us. After two years of living through the COVID-19 Pandemic, this aspect is more salient than ever. However, death is only one type of loss that we grieve. There are many others that have debilitating, sometimes devastating effects on our mind, body and spirit, but which may not be as visible or readily called to mind.
Loss
In her latest book, Atlas of the Heart, Brené Brown breaks down grief into three basic elements: loss, longing, and feeling lost. Loss refers not only to losing a significant person through death or separation. But also more abstract kinds of loss such as “the loss of normality, the loss of what could be, and the loss of what we thought we knew or understood about something or someone.”
Let’s take a moment to validate the many types of loss that aren’t as visible, or which don’t garner as much sympathy from others because they’re shrouded in fear and shame. If you’re experiencing any of the following, you might feel isolated and in need of more support:
Loss of certainty, security, and social support due to the pandemic
Empty nest syndrome
Retirement (the loss of an accustomed identity or sense of purpose)
Aging/life stage changes (the loss of freedom or independence, vitality, sexual interest or social power)
Life transitions such as going to or graduating from college, divorce, leaving a job, or ending a relationship
Pregnancy loss
Sexual assault (losses include trust, bodily integrity, sense of safety to name only a few)
Death of a loved one by suicide
self-identity
self-esteem
adoption
One of the areas I specialize in is adopted people who are grieving the loss of their first mother from when they were separated from her prior to adoption. In addition, we adoptees must contend with the loss of the person we imagine we might have been had we not been relinquished. Everyone who is touched by adoption experiences so many losses that don’t get recognition. Adoptive parents must grieve their infertility, and the loss of the child they dreamed they might have given birth to. Birth families grieve their biological child or their sibling, cousin, niece/nephew, or grandchild that they never got to know.
Longing
Brown describes longing as “an involuntary yearning for wholeness, for understanding, for meaning, for the opportunity to regain or even simply touch what we’ve lost.” She explained that we often feel the need to hide our feelings of longing for fear of being misunderstood or judged. Anyone who has ever been through a breakup or moved to a new city understands longing, what a powerful emotion it is, and how vulnerable it makes us feel. Perhaps reminding ourselves that longing is an incredibly common and relatable part of the human experience would help us feel more comfortable sharing it with each other. When we suppress our grief feelings—because we’re ashamed or because it’s too difficult to speak about them—we only end up feeling more alone. Isolation is like a fun house mirror for emotions—it makes them appear twisted, outsized, seeming to come at us from every direction. And when we’re in that state, it’s even harder to love ourselves.
Feeling Lost
Brown states, “Grief requires us to reorient every part of our physical, emotional, social worlds. Not just adjusting to tangible change, like death or moving.” It challenges us to relearn how to navigate everyday living, our identity, relationships, and our future plans—even as familiar landmarks have disappeared.
Unfortunately, many cultures discourage the bereaved from expressing their feelings when this is exactly what they need most. Out of fear and discomfort, we tend to distance ourselves by unconsciously avoiding the conversation, or not truly listening to the bereaved. American culture systematically isolates grieving people. Sometimes we simply refuse to acknowledge that their loss exists, depriving them of the support necessary to process that loss.
The Grieving Process
Many people will be familiar with the Elisabeth Kubler-Ross’s 5-stage model of grief (denial, anger, bargaining, depression and acceptance.) But newer research indicates that grief doesn’t actually come in predictable, linear stages. Perhaps we would feel more reassured if it did. To track our progress and check off each stage as we adapt, bringing us closer to an idealized finish line is a wish that speaks to the part of human nature which hates to be out of control. However, people who have struggled with grief may be comforted to know that it’s normal to cycle through a wide range of emotions and levels of adaptation to the loss. There’s no shame in seeming to go “backwards”, or repeat stages. It’s simply the nature of how we learn to grow around loss.
Current theories describe various mental processes that we oscillate through in a non-linear way. We tend to shift back and forth between different states: crying over reminders of/longing for what was lost, thoughts of future roles and identities in the new landscape of our lives, and exploring what meaning can be gleaned from our suffering, or what memories we’ll take with us into our new future.
These are some of the states we tend to cycle through in the grief process:
Acute, intense emotional distress
Repression of the emotional pain or numbness
Anxious longing for what we’ve lost
Guilt pangs
Separation distress (yearning, preoccupation with loss)
Apathetic or anxious attention to the basic activities of daily living
Loss of weight, concentration, short term memory or appetites (for food, sex, or socializing)
Irritability and depression
Disorganization and despair
Ruminating about loss related events
Thoughts of what we might have done to prevent the loss
Anger or questioning why this has happened to us
Hypnagogic hallucinations (occurring between the transitional phase between sleep and waking) of the person we lost
Over time we experience these states less often and less intensely. But they may return around anniversaries and significant occasions such as holidays. After the first year or two, we may notice that we’re recovering and new inner conflicts may arise around feeling better and returning to normal life. We may feel guilty moving forward into the world of new identities and roles. This is natural, and it’s important at this point to remember that strength is a good thing. That we deserve to make the most of our lives. Growth is natural, and it’s a way of making meaning out of adversity.
Most people manage to recover from the most intense and painful period of grief within 6 months. This is an average, so remember that individual experiences differ. The process is painful but necessary in order to move forward and adjust to a new understanding of the world, and your identity in it. This is not to say that you’ll no longer experience waves of grief, just that your life will no longer so disrupted by it. There is even evidence that loss can foster maturity and personal growth, so it’s not necessarily inherently harmful.
This is not to minimize the devastating impact of loss. Each person’s grief is unique, and deserves respect as such. The unifying factor is the need for grief to be witnessed. We may be tempted to try to lessen, or reframe the experience when talking to a bereaved person. But we should try to recognize when we’re attempting to make ourselves feel better, or avoid discomfort, rather than support them. The best thing we can do is be fully present to the magnitude of another person’s loss without giving feedback.
When Adapting to Loss is Disrupted
About a third of people who experience grief will need professional help to work through it. Grief can have real effects on our bodies. For example, our immune response is temporarily impaired. The endocrine and cardio-vascular systems are also affected, leading potentially to what’s known as broken heart syndrome. This is perhaps the most dramatic of all the grief responses. It’s when the stress of loss results in cardiomyopathy during the six months following the death of a partner. You may have seen this occur in older couples who die within a few months of each other.
Less dramatic, but still very difficult is what happens to us when we don’t adjust naturally to a major loss. We can experience any of the following:
Persistent separation distress
difficulty accepting the loss
feeling one has lost a part of oneself
anger regarding the loss
guilt
difficulty engaging with social/other activities
There are typically two opposing patterns of what experts call complicated grief. First, the tendency to avoid all thoughts of the loss, and suppress the emotions. And second, the tendency to ruminate or obsess over the loss, to the point where it eclipses the rest of our lives.
When we avoid grief related emotions and thoughts, to paraphrase Carl Jung, what we resist persists. In other words, interrupting the natural flow of grief only prolongs the adjustment process. This can cause further complications down the road, like anxiety, depression, poor concentration, lack of sleep, and intrusive thoughts related to the loss. It’s common to fear that we’ll lose control if we allow ourselves to feel painful emotions, but just the opposite is true. Acknowledging and expressing them is like a release valve that restores balance.
When we ruminate over a loss, we get stuck in a loop of thoughts like, “Could I have done something to prevent it?” or “Why did this happen to me?” It may seem counterintuitive, but this is actually a form of avoidance. It’s about repetitive thoughts that are focused on causes and consequences of the loss and loss-related emotions. They keep us stuck in the same place and leave no room for oscillating to the opposite kinds of thoughts, regarding the future and reimagining our identity, which allow us to begin to grow.
It’s no surprise that many of us respond to loss with avoidance or rumination. It’s hard to imagine a more difficult thing to face than loss. There are significant social obstacles to adjusting to it. And each person is going to experience it against the backdrop of their own unique life experiences. It frequently happens, for example, when a bereaved person has pre-existing depression or anxiety, they had a conflictual relationship to the deceased, a lack of social or financial support, or when the death was untimely or traumatic.
How Can I Help?
Most people want opportunities to tell the story of their loss, without others withdrawing into silence or platitudes. To connect with others through telling and honoring the story, is healing. We’ve probably all been in situations where we want to support someone who is suffering from a loss, but don’t know what to say. Providing comfort in a parental way, such as a touch or hug, does more than words. There are no words that are ever going to make everything all better, so let go of that pressure. It’s helpful to normalize the grief, and show that it’s OK to express emotions. And it’s fine to cry along with them if you feel so moved. Let them know that it’s acceptable to become emotional, experience anxiety, stress, or to withdraw for a while.
It’s also important to have realistic expectations for adjusting to loss. Even once you’ve adapted to the loss, grief is not over. This doesn’t mean we’ll feel sad the rest of our lives, just that grief finds its natural place in our lives. Dr. Lois Tonkin, in her 1996 article Growing Around Grief: another way of looking at grief and recovery, presented an idea that many bereaved people can relate to: “Grief doesn’t shrink as you move forward in your life. Instead, your life expands around it. You still spend time within your grief, which is large as ever. Learning to live with it, you go to new places, meet new people, and try new things. You may not want to, but life gives you little choice. Life goes on. You move forward. You learn to carry your grief with you.”
A Personal Note
With my mother’s permission, I’ll share that my own family suffered the deaths of two of my mother’s siblings in the last five months. It was impossible for us to safely travel to the funerals of my mother’s siblings. Watching the memorial service on Zoom last month was something we were all tremendously grateful to be able to do, but it left me feeling strange to be sitting at home, alone with my husband, unable to have extended family witness my emotions and support for them. Family dynamics created a situation where my aunt’s surviving husband is not communicating with her siblings about what to do with her ashes. I can’t help but feel that if we were able to be together, discussing these things in real time, a consensus could be reached that would satisfy everyone, or at least a workable compromise. My mother feels keenly the inability to go to the family burial plot and visit the graves of her siblings.
When a loss occurs and we’re unable to engage in traditional methods of grieving, such as funerals, or when there’s no cultural precedent for mourning, what can we do? A ritual can be something that comes from cultural or religious tradition, or it can be an idiosyncratic thing that we create ourselves. Setting up a small shrine, getting a tattoo, donating to a cause in a loved one’s name are some examples. The important thing is to have a means of expressing emotion, having it witnessed.
My family is exploring possibilities for unique personal rituals, things that are within our control to do. Such as creating a shrine in a corner of the house with photos. I joked with my conservative septuagenarian mother that she ought to get a tattoo to memorialize her siblings and parents. Coming from a family of 15 children, 10 of whom have passed, she would have enough names for two full sleeves! Although I’m quite sure she will not be getting a tattoo ever, we did have a good laugh about it. The bright spot in all of this is that it has prompted my cousins - who are legion - to organize around sending surprise holiday cards to all the remaining siblings and their surviving spouses, and to each other, which was greatly appreciated.
Some tips for managing grief and loss:
Don’t avoid thoughts and feelings, acknowledge them and allow yourself to express them.
Remember each person has unique needs, so grieve in your own way.
Accept that you’ll have a wide range of feelings, and all feelings are OK. Talk to people who understand that.
Grief is exhausting physically and emotionally, so know your limits.
Listen carefully to your body. Be sure to get enough sleep and eat balanced meals.
If you’re not ready to do something, don’t feel pressured to do it.
Expect unexpected surges of grief. It’s normal. It helps to have someone to call on to talk it out.
Ritual helps, and it’s not limited to a funeral. Lighting a candle is a good example.
Whatever your spiritual background, feel free to draw from that. Conversely, if you feel angry or have a lapse of faith right now, that’s normal. Find people to talk to who understand that.
Searching for meaning is natural. You might ask yourself questions like, “Why did this happen?” Some questions have answers, some don’t. Don’t accept platitudes.
Treasure your memories of your loved one. Don’t try to ignore them.
Growing around your grief is natural and will happen in time. It’s a process, and it’s not linear.
Understand that you have a right to heal and move forward, and that you’ll always carry your grief for this person. You’re not leaving them behind.
How Do I Know If I Need Therapy?
Complicated grief happens when the adaptation process is disrupted and it’s unlikely to get better without the help of a therapist who is specially trained in that area. If you’re dealing with the following, you should definitely seek out a therapist who specializes in complicated grief:
You can’t stop feeling that the person might somehow reappear
You don’t see a way to move forward
Facing the future without the lost person seems dismal and unappealing
Grief dominates your thoughts and feelings and you can’t see it changing
Your relationships suffer
Life seems pointless as if nothing matters but the person who is lost
If you’ve been struggling with grief and loss, but it doesn’t rise to the level of complicated grief, how do you know when it’s time to reach out for professional help? The simplest answer is: if you’ve been wondering for a while if you should find a therapist, you probably should. Because there’s no harm in talking to a professional about it, and you’ll probably grow from the experience.
Seeing a therapist can give you the space you need to talk about your most difficult thoughts and feelings of loss with objectivity. In a way that sometimes friends and family aren’t able to accommodate because they’re too close to it. A therapist will help you sort out confusing feelings and guide you in adapting to your loss. They can help you build coping skills that will work for you, so you can stop relying on behaviors that may not be so helpful, like avoidance, rumination, and numbing out.
Loss is truly one of the most significant things that can happen in our lives, and it affects everyone in some way at some time. If you’ve been hesitating to seek therapy because you’re not sure if you need it, consider this: working on yourself is never self-indulgent. It’s actually like a gift you give to your loved ones and to your future self. Loss will inevitably be a part of life, and therapy can put you in a better position to cope when it happens.