Grief

Bereavement

Once a loved one has died, the bereavement process begins and is a uniquely individual experience for all those involved.

Bereavement is an important time of transition, encompassing many responses including the wide range of emotions identified with grief and the way that we choose to live our lives following a significant change.

Family response to the death of a loved one

During the last days your family members  may want to stay with your loved one 24 hours a day.  After death you may experience relief, exhaustion and sadness.  It’s good to spend time with your loved one after he/she has died.  The doctor or nurse will be called to verify the death and the funeral home will need to be called to pick up the body.  It’s important to know that nothing needs to be done immediately and you have time to spend with your loved one to say good bye.

Common Responses Associated with Grieving

When someone experiences a significant loss, such as the death of a person they care about the process of grieving occurs.  Grief is experienced in a variety of ways, including physical symptoms, thoughts, feelings and behaviours. These are normal responses to the loss.  One person may not experience all of the symptoms listed below and the intensity and duration varies from person to person.  There is no definite timeline for the grieving process. Mourning is an individual process. Reaching a new normal is a journey unique to the bereft.  If symptoms do last for a long time or are unusually intense, professional help should be sought.

Physical Reactions can include;

  • Tightness or lump in throat or chest
  • Shortness of breath
  • Tendency to sigh
  • Hollowness/emptiness/discomfort/pain in the abdomen
  • Aching arms
  • Dry mouth
  • Over sensitivity to noise
  • A sense of depersonalization
  • Muscles weakness
  • Loss of coordination
  • Lack of energy
  • Loss of sleep or appetite
  • Over sleeping or eating
  • Shaking tremor
  • Inability to concentrate
  • Feeling heavy or weighted down

Emotional Reaction can include;

  • Feelings of loneliness
  • Anger
  • Guilt
  • Fear
  • Depression
  • Isolation
  • Sadness
  • Yearning
  • Inability to feel good or happy
  • Feeling disorganized or confused

Psychological and Social reactions can include;

  • A desire to withdraw from others
  • A desire to talk about your relationship with the deceased
  • A desire to tell stories about the deceased
  • Feeling like the person is in the room
  • Having dreams of the person
  • Hearing the person’s voice or thinking you see them
  • Not wanting to burden others
  • Difficulty with interpersonal relationships
  • Avoiding people places and things that are reminders of the deceased

Spiritual Reactions can include:

  • Losing or decreasing faith, religious connections,
  • Searching for answer to and meaning in life
  • Searching for meaning in death or for what happens after death
  • Increasing faith/religious connections
  • Reviewing your own priorities goals and beliefs
  • Abandoning spiritual practices
  • Taking up new spiritual practices

Tips to Help with Grieving

  • Be gentle with yourself and acknowledge that healing is going to take time
  • Cry, scream, yell – express your feelings as they come up
  • Talk to someone who will just listen.  Tell stories. Share memories
  • Get regular sleep – go to bed at the same time each night even if you’re not tired then get up at the same time each day (get up again if after 30 – 45 minutes you still can’t sleep – do an activity and then try again)
  • Do some physical activity each day
  • Take naps if you need them
  • Eat frequently healthy small meals and snacks – keep feeding your body
  • Drink water, juice, tea – keep yourself hydrated
  • Try a relaxation exercise, meditation, prayer, yoga, t’ai chi
  • Listen to uplifting music
  • Go for a walk or run
  • Sit with nature – by the river or in a quiet park – breathe in some fresh air
  • Follow spiritual practices (sweat, church, prayer, song, etc.)
  • Write a journal
  • Write a letter to the person who died, then bury it, burn it or put it away
  • Write a story, poem, song for the person
  • Let yourself have fun – let yourself laugh
  • Don’t judge yourself or your grieving process
  • Ask for help from friends and supporters
  • If you get stuck in a stage, or the feelings seem out of proportion, seek counseling
  • Be gentle with yourself and acknowledge that healing is going to take time

You Can Expect…  (Adapted from “Grieving: How to go on Living when Someone you Love Dies”)

  • Grief can take longer than most people think it should
  • Grief can take more energy than one could imagine
  • Grief can show itself in all spheres of your life; social, physical, spiritual, emotional, cognitive
  • Grief will depend upon how the loss is perceived.  You may grieve for many things (both symbolic and tangible) not just the death itself but also for the hopes, dreams and unfulfilled expectations held for and with that person.
  • Grief can involve a wide variety of reactions and feelings; some expected some not
  • Loss can resurrect old issues, feelings and unresolved conflicts from the past
  • You may experience some changes in your identity due to the intensity of the grieving and the changes in roles
  • You may experience a combination of anger, depression, irritability and intolerance
  • You may experience guilt in some form
  • Your sense of self-worth may be affected
  • You may experience waves or acute upsurges of grief that can occur without warning
  • You may have trouble thinking and making decisions, you may have poor memory and organization abilities at this time.
  • You sometimes may feel like you’re going crazy
  • You may be preoccupied with thoughts of the dead person
  • You may be searching for the meaning in/for life and question your beliefs
  • Society has unrealistic expectations about mourning and may respond inappropriately
  • Certain dates, events, seasons and reminders will bring upsurges in grief.

What gets in the way of healthy grieving?

  • Getting stuck in one phase or feeling
  • Not wanting to appear weak
  • Believing in the myth that you should be able to just get over it
  • Societal attitudes
  • Well meaning others who say unhelpful things
  • Not letting yourself cry
  • Not acknowledging certain thoughts or feelings
  • Not allowing yourself to go through the process
  • Trying to be tough or strong for others and thereby denying your own needs
  • Drug and alcohol misuse
  • Unresolved past grief
  • Unresolved past grief includes past deaths, moves, divorces, cultural losses etc.

Some indicators of difficulty in the early days…

  • Keeping busy all the time and no time for grief.  “just get on with life”.
  • Can’t cry or won’t allow yourself to cry.
  • Continuing shock that prevents necessary functioning
  • Use of alcohol or drugs for coping

Some indicators of difficulty later on…

  • Being overwhelmed by emotions
  • Stuck with a certain aspect of what happened.
  • Going round and round without being able to resolve the issue.
  • Feeling abandoned by usual support systems
  • Inability to return to most normal routines
  • Flashback images of the death.

The Four Tasks Of Grief

George Engel, a psychiatrist, relates grief to a physiological trauma.  He maintains that the loss of a loved one is as traumatic to the psyche as a severe disease is to the physical body.  Both represent a departure from the otherwise normal wellbeing and functioning of the individual and both require a period of healing.

According to Worden (1982) in his book “Grief Counseling and Grief Therapy” there are four tasks required in the mourning process, for complete healing or bereavement to occur.  While adherence to the order of the tasks is not required, he believes it is essential that all four tasks be completed.

To Accept the Reality of the Loss

This requires the bereaved person to face his/her loss full on, with the realization that it is impossible to be reunited with his/her loved one at least in this lifetime.  To fully accomplish this task means there is no denial about the irreversibility of this loss, although at times the persons mind may play tricks (seeing the deceased in a crowd).
It is helpful for the grieving person to talk about the death.

To Experience the Pain and the Grief

The pain of grief is both physical and emotional and the grieving person needs to be supported in the expression of their pain.  Experiencing the pain involves identifying and acknowledging feelings and being honest about them. Grievers need lots of information to realize they are not crazy and they will make it.
It’s important for family and friends to maintain their support to the grieving person.

To Adjust to an Environment in which the Deceased is Missing

Loneliness is a great hurdle to overcome when someone close to you has died or some other major loss has occurred.  Even those surrounded by people feel it; they feel disconnected, are not sure how they fit or what they want now.
It helps to have support in making connections to help talk about emotions, realize you have choices, responsibilities and roles.

To Withdraw Emotional Energy and Reinvest it in other Relationships

Grief is a process of gradual adaptation to separation and change.  It may be minor or the most painful experience of someone’s life, but whichever the case it must be worked through. Until the person has reached some perspective about the loss, or let go, or said good bye, it is not possible to fully give their attention or commitment to living in a healthy way.
It helps to develop new and old talents, or interests and develop an awareness of personal abilities, strength and self – confidence.

Grief is ‘successful’ when…

  • It moves forward towards integration of the loss/death into the bereaved person’s life narrative while maintaining security of their past relationship with the person who died.
  • People reconstruct rather than relinquish the bond
  • New life goals are defined

What does integration mean?

  • Acknowledging the reality of the death
  • Maintaining access to bittersweet emotions, memories
  • Revising one’s memory of the person who died
  • Creating a new and evolving life narrative or story that incorporates the person who died and their death

One Day

“One day you wake up and realize you must have survived it because you are still here, alive and breathing.  But you don’t remember the infinitely small steps and decisions you took to get there.  Your only awareness is that you have shed miles of tears on what seems to be an endless road of sorrow.  One day… one glorious day, you wake up and feel your skin tingle again and you forget for an instant that your heart is broken ….and it is a beginning.”

Susan Borrowman, Kingston Ontario