Grief/Loss Issues

Grief counselors feel that everyone experiences and expresses grief in their own way, often shaped by culture. They believe that it is not uncommon for a person to withdraw from their friends and family and feel helpless; some might be angry and want to take action. Some may laugh.

Grief counselors hold that one can expect a wide range of emotion and behavior associated with grief. Some counselors believe that in all places and cultures, the grieving person benefits from the support of others. Further, grief counselors believe that where such support is lacking, counseling may provide an avenue for healthy resolution. Grief counselors believe that grief is a process the goal of which is “resolution.” The field further believes that where the process of grieving is interrupted, for example, by simultaneously having to deal with practical issues of survival or by being the strong one and holding a family together, grief can remain unresolved and later resurface as an issue for counseling.

What is grief?

Grief is a natural response to loss. It’s the emotional suffering you feel when
something or someone you love is taken away. You may associate grief with the death
of a loved one – and this type of loss does often cause the most intense grief.
But any loss can cause grief, including:

Divorce or relationship breakup Loss of health Losing a job Loss of financial stability A miscarriage

Death of a pet Loss of a cherished dream A loved one’s serious illness Loss of a friendship Loss of safety after a trauma

The more significant the loss, the more intense the grief. However, even subtle losses
can lead to grief. For example, you might experience grief after moving away from home,
graduating from college, changing jobs, selling your family home, or retiring from
a career you loved.

Everyone grieves differently

Grieving is a personal and highly individual experience. How you grieve depends on
many factors, including your personality and coping style, your life experience, your
faith, and the nature of the loss. The grieving process takes time. Healing happens
gradually; it can’t be forced or hurried – and there is no “normal” timetable
for grieving. Some people start to feel better in weeks or months. For others,
the grieving process is measured in years. Whatever your grief experience, it’s
important to be patient with yourself and allow the process to naturally unfold.

Myths and Facts About Grief

Are there stages of grief?

In 1969, psychiatrist Elisabeth Kübler-Ross introduced what became known as the “five
stages of grief.” These stages of grief were based on her studies of the feelings
of patients facing terminal illness, but many people have generalized them to other
types of negative life changes and losses, such as the death of a loved one or a break-up.

The five stages of grief:

• Denial: “This can’t be happening to me.”
• Anger: “Why is this happening? Who is to blame?”
• Bargaining: “Make this not happen, and in return I will
  ____.”
• Depression: “I’m too sad to do anything.”
• Acceptance: “I’m at peace with what happened.”

If you are experiencing any of these emotions following a loss, it may help to know
that your reaction is natural and that you’ll heal in time. However, not everyone
who is grieving goes through all of these stages – and that’s okay. Contrary
to popular belief, you do not have to go through each stage in order to heal. In
fact, some people resolve their grief without going through any of these stages.
And if you do go through these stages of grief, you probably won’t experience
them in a neat, sequential order, so don’t worry about what you “should” be
feeling or which stage you’re supposed to be in.

Kübler-Ross herself never intended for these stages to be a rigid framework
that applies to everyone who mourns. In her last book before her death in 2004, she
said of the five stages of grief, “They were never meant to help tuck messy emotions
into neat packages. They are responses to loss that many people have, but there
is not a typical response to loss, as there is no typical loss. Our
grieving is as individual as our lives.”

Grief can be a roller coaster

Instead of a series of stages, we might also think of the grieving process as a roller coaster, full of ups and downs, highs and lows. Like many roller coasters, the ride tends to be rougher in the beginning, the lows may be deeper and longer. The difficult periods should become less intense and shorter as time goes by, but it takes time to work through a loss. Even years after a loss, especially at special events such as a family wedding or the birth of a child, we may still experience a strong sense of grief.

Source: Hospice Foundation of America

Common symptoms of grief

While loss affects people in different ways, many people experience the following
symptoms when they’re grieving. Just remember that almost anything that you experience
in the early stages of grief is normal – including feeling like you’re
going crazy, feeling like you’re in a bad dream, or questioning your religious
beliefs.

• Shock and disbelief – Right after a loss, it can be hard to
  accept what happened. You may feel numb, have trouble believing that the loss really
  happened, or even deny the truth. If someone you love has died, you may keep expecting
  them to show up, even though you know they’re gone.
• Sadness – Profound sadness is probably the most universally
  experienced symptom of grief. You may have feelings of emptiness, despair, yearning,
  or deep loneliness. You may also cry a lot or feel emotionally unstable.
• Guilt – You may regret or feel guilty about things you did
  or didn’t say or do. You may also feel guilty about certain feelings (e.g.
  feeling relieved when the person died after a long, difficult illness). After a
  death, you may even feel guilty for not doing something to prevent the death, even
  if there was nothing more you could have done.
• Anger – Even if the loss was nobody’s fault, you
  may feel angry and resentful. If you lost a loved one, you may be angry at yourself,
  God, the doctors, or even the person who died for abandoning you. You may feel
  the need to blame someone for the injustice that was done to you.
• Fear – A significant loss can trigger a host of worries
  and fears. You may feel anxious, helpless, or insecure. You may even have panic
  attacks. The death of a loved one can trigger fears about your own mortality, of
  facing life without that person, or the responsibilities you now face alone.
• Physical symptoms – We often think of grief as a strictly
  emotional process, but grief often involves physical problems, including fatigue,
  nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

Coping with grief and loss tip 1: Get support

The single most important factor in healing from loss is having the support of other
people. Even if you aren’t comfortable talking about your feelings under normal
circumstances, it’s important to express them when you’re grieving. Sharing
your loss makes the burden of grief easier to carry. Wherever the support comes from,
accept it and do not grieve alone. Connecting to others will help
you heal.

Finding support after a loss

• Turn to friends and family members – Now is the time to lean
  on the people who care about you, even if you take pride in being strong and self-sufficient.
  Draw loved ones close, rather than avoiding them, and accept the assistance that’s
  offered. Oftentimes, people want to help but don’t know how, so tell them what
  you need – whether it’s a shoulder to cry on or help with funeral arrangements.
• Draw comfort from your faith – If you follow a religious tradition,
  embrace the comfort its mourning rituals can provide. Spiritual activities that are
  meaningful to you – such as praying, meditating, or going to church – can
  offer solace. If you’re questioning your faith in the wake of the loss, talk
  to a clergy member or others in your religious community.
• Join a support group – Grief can feel very lonely, even
  when you have loved ones around. Sharing your sorrow with others who have experienced
  similar losses can help. To find a bereavement support group in your area, contact
  local hospitals, hospices, funeral homes, and counseling centers.
• Talk to a therapist or grief counselor – If your grief
  feels like too much to bear, call a mental health professional with experience
  in grief counseling. An experienced therapist can help you work through intense
  emotions and overcome obstacles to your grieving.

Coping with grief and loss tip 2: Take care of yourself

When you’re grieving, it’s more important than ever to take care of yourself.
The stress of a major loss can quickly deplete your energy and emotional reserves.
Looking after your physical and emotional needs will help you get through this difficult
time.

• Face your feelings. You can try to suppress your grief, but you
  can’t avoid it forever. In order to heal, you have to acknowledge the pain.
  Trying to avoid feelings of sadness and loss only prolongs the grieving process.
  Unresolved grief can also lead to complications such as depression, anxiety, substance
  abuse, and health problems.
• Express your feelings in a tangible or creative way. Write about
  your loss in a journal. If you’ve lost a loved one, write a letter saying the
  things you never got to say; make a scrapbook or photo album celebrating the person’s
  life; or get involved in a cause or organization that was important to him or her.
• Look after your physical health. The mind and body are connected.
  When you feel good physically, you’ll also feel better emotionally. Combat stress
  and fatigue by getting enough sleep, eating right, and exercising. Don’t
  use alcohol or drugs to numb the pain of grief or lift your mood artificially.
• Don’t let anyone tell you how to feel, and don’t tell yourself
  how to feel either. Your grief is your own, and no one else can tell you
  when it’s time to “move on” or “get over it.” Let yourself
  feel whatever you feel without embarrassment or judgment. It’s okay to be angry,
  to yell at the heavens, to cry or not to cry. It’s also okay to laugh, to find
  moments of joy, and to let go when you’re ready.
• Plan ahead for grief “triggers.” Anniversaries,
  holidays, and milestones can reawaken memories and feelings. Be prepared for an
  emotional wallop, and know that it’s completely normal. If you’re sharing
  a holiday or lifecycle event with other relatives, talk to them ahead of time about
  their expectations and agree on strategies to honor the person you loved.

When grief doesn’t go away

It’s normal to feel sad, numb, or angry following a loss. But as time passes,
these emotions should become less intense as you accept the loss and start to move
forward. If you aren’t feeling better over time, or your grief is getting worse,
it may be a sign that your grief has developed into a more serious problem, such as
complicated grief or major depression.

Complicated grief

The sadness of losing someone you love never goes away completely, but it shouldn’t
remain center stage. If the pain of the loss is so constant and severe that it keeps
you from resuming your life, you may be suffering from a condition known as complicated
grief. Complicated grief is like being stuck in an intense state of mourning.
You may have trouble accepting the death long after it has occurred or be so preoccupied
with the person who died that it disrupts your daily routine and undermines your other
relationships.

Symptoms of complicated grief include:

Intense longing and yearning for the deceased Intrusive thoughts or images of your loved one Denial of the death or sense of disbelief Imagining that your loved one is alive

Searching for the person in familiar places Avoiding things that remind you of your loved one Extreme anger or bitterness over the loss Feeling that life is empty or meaningless

The difference between grief and depression

Distinguishing between grief and clinical depression isn’t always easy, since
they share many symptoms. However, there are ways to tell the difference. Remember,
grief can be a roller coaster. It involves a wide variety of emotions and a mix of good
and bad days. Even when you’re in the middle of the grieving process, you will
have moments of pleasure or happiness. With depression, on the other hand, the feelings
of emptiness and despair are constant.

Other symptoms that suggest depression, not just grief:

Intense, pervasive sense of guilt. Thoughts of suicide or a preoccupation with dying. Feelings of hopelessness or worthlessness.

Slow speech and body movements Inability to function at work, home, and/or school. Seeing or hearing things that aren’t there.

Can antidepressants help grief?

As a general rule, normal grief does not warrant the use of antidepressants. While
medication may relieve some of the symptoms of grief, it cannot treat the cause, which
is the loss itself. Furthermore, by numbing the pain that must be worked through eventually,
antidepressants delay the mourning process.

When to seek professional help for grief

If you recognize any of the above symptoms of complicated grief or clinical depression,
talk to a mental health professional right away. Left untreated, complicated grief
and depression can lead to significant emotional damage, life-threatening health problems,
and even suicide. But treatment can help you get better.

Contact a grief counselor or professional therapist if you:

• Feel like life isn’t worth living
• Wish you had died with your loved one
• Blame yourself for the loss or for failing to prevent it
• Feel numb and disconnected from others for more than a few weeks
• Are having difficulty trusting others since your loss
• Are unable to perform your normal daily activities