If you’re human, you will experience loss in your life. Loss of loved ones, loss of work, friends, money, dreams, youth, and sometimes purpose and meaning in life. Natural developmental milestones moving from infancy all the way through to old age brings many significant changes, which can also feel like a loss. For those of us who have already climbed and surpassed the summit of middle age we often are looking backwards to more miles traveled than miles to be traveled. This can certainly remind us of all our collective losses, which can bring grief. In fact, these losses tend to “tether” together; especially if we have not properly grieved our previous. So what is grief? Is it different than depression? What are the symptoms of grief and are there really stages of it? How do we grieve well? Can we get over the losses and live happily and freely?
If you’re human, you will experience loss in your life. Loss of loved ones, friends, loss of work, money, dreams, youth, and sometimes purpose and meaning in life.
What is Grief?
Grief is a normal and necessary response to significant life change and loss. It is the absence of attachment and familiarity to people, objects, and conditions. Grief is also very personal and unique to each person in not only how each person gives meaning to their loss, but how one comes to deal with it.
Grief vs. Depression
Grief may feel like depression at times, but it is much more complex and sometimes difficult to identify. Depression can usher in feelings of sadness, low mood, a lack of motivation, confusion, and negative self-evaluation or deprecation. Appetite, sexual libido, and sleep are also affected by depression and grief. Guilt and sometimes shame are also on the list for depressive symptoms. Grief, on the other hand, seems not to involve so much shame or self-deprecating thoughts, as in depression; although blame can show up. The most recent and 5th edition of the Diagnostic Statistical Manual (DSM 5) for mental disorders includes Persistent Complex Bereavement Disorder (PCBD), formerly called complicated grief. This is not a formal disorder, and requires further research before it is fully canonized into the DSM 5 as diagnosable and covered by insurance and managed health care.
Symptoms of Grief
It is important to understand that not everyone expresses grief in the same way. Children are prime examples, as they do not understand change and loss in the same way. Often, when children grieve, they do so in fragmented periods between being sad for a little while, then returning to play and just being a child. As they age into adolescence, their developing minds begin to recognize loss in a different way; able to think more abstractly and existentially. There is no specific cause of PCBD; however, there are some biological and environmental factors associated with it:
Poor social support
Trauma or traumatic grief
Serving as a caregiver to the deceased prior to death
Depression is a mood issue that can manifest itself in grief, and is often improperly diagnosed for grief after someone experiences a significant life change or personal loss.
In losing a loved one, you might experience:
Continued disbelief in the death of the loved one, or emotional numbness over the loss
Inability to accept the death
Feeling preoccupied with the loved one or how they died
Intense sorrow and emotional pain, sometimes including bitterness or anger
Unable to enjoy good memories about the loved one
Blaming oneself for the death
Wishing to die to be with the loved one
Excessively avoiding reminders of their loss
Continuous yearning and longing for the deceased
Feeling alone, detached from others, or distrustful of others since the death
Trouble pursuing interests or planning for the future after the death of the loved one
Feeling that life is meaningless or empty without the loved one
Loss of identity or purpose in life, feeling like part of you died with the loved one
Dreams and/or nightmares about the loved one, the loss, and/or themes related to helplessness and loss
Visual and/or auditory hallucinations of the lost loved one
In fact, grief was experienced more like a spiral, or natural “tide”, as individuals moved in and out of their grief, over a span of time that could not be generally designated.
Are There Stages of Grief?
One of the research pioneers on death and dying was Dr. Elisabeth Kubler-Ross. Elisabeth Kübler-Ross was a Swiss-American psychiatrist, a pioneer in near-death studies and the author of the groundbreaking book On Death and Dying, where she first discussed her theory on the five stages of grief, also known as the “Kübler-Ross model”. In her later years before her own death Dr. Kubler-Ross retracted her original notion that grief contained five clear stages of grief: Denial, Anger, Bargaining, Depression, and Acceptance. Other researchers and psychotherapists dedicated to the study and healing of grief realized that these stages of grief were more about anticipatory loss, with those facing their near death, that all studied subjects did not experience all the stages once prescribed, and in their respective order. In fact, grief was experienced more like a spiral, or natural “tide”, as individuals moved in and out of their grief, over a span of time that could not be generally determined.
How Do We Grieve Well?
This question is often asked by many of the clients that I work with in therapy and would take an entire book to explore the answer. It might sound strange, but many people often do not know that they have even lost something when asked. This could be because they have suppressed the emotional loss, their natural avoidance in feeling pain, their own denial, or simply that they do not consider their loss an actual loss.
The first need towards a healthy grief process, I believe, is becoming aware of the loss(es). We must first realize and be validated for our losses, but also what that loss means to each of us personally and contextually. Becoming educated on what healthy grief is; its normalcy, and common symptoms are just as important as becoming aware of them. For most Americans, we do grief very poorly. We find out that someone we care about or love dies; we might cry, deny it happened, lash out in anger, or remain stoic and detached in our response. After learning about the cause of death, funeral arrangements are made. The funeral is held…then on to the meal. After everyone who attended has gone home, we return to work the next day and try to cope with our loss. Now, this might sound like a simplified version of what actually occurs, but it is not far from the truth of how we grieve in America. Every culture around the world has their own process for handling personal loss and grieving. In my personal experience, and professional opinion, the cultures that grieve collectively allow for a safe and empathic space, time, ceremony, and recovery are much healthier in their grief process. The necessary healing and closure that grief can bring helps to move in a direction of new relationships or attachment, renewed purpose, and personal growth.
Addressing the myths of the grief process is also important. In the Grief Recovery Handbook, written by John W. James and Russell Friedman, both identify some American myths that actually cause more emotional pain and possible halting of the grief process. Two primary myths are:
Don’t feel bad
Replace the loss
Loved ones or caring friends often imply and sometimes verbalize to the griever not too feel bad. Some of the reasons are:
· They often do not know what to say.
· They are afraid of the griever’s feelings.
· They want to change the subject of the grief.
· They intellectualize, staying away from emotions.
· They do not hear the griever.
· They do not want to talk about death.
· They want the griever to keep their faith.
· They have not allowed themselves to grieve in the past.
Replacing the loss is also poorly recommended as a substitute for the loss. It is not uncommon to find grievers seeking intimate relationships right after the death of a partner, or pet owners getting a new pet right after the loss. Both myths actually invalidate the emotions felt when grieving and can be used as a distraction in lieu of feeling pain. This suppresses the grief process and disallows for proper healing and closure.
Can We Get Over the Loss?
Experts in the field of grief and those who have grieved agree that it is possible to move past the most difficult losses; even the loss of children. Often, the griever believes that if they successfully grieve, they will forget the ones they love; somehow leaving them behind, which may churn up fear and guilt. However, this could not be further from the truth. As long as their memory is intact, they will never and should never forget. What changes is the relationship towards the lost person or attachment; making room for newly added relationships and experiences. This is something that the griever must work out in their own process and should never be forced. Keeping the “Three T’s” in mind: Tears, Talking, and Time, grievers must allow and be given a safe and non-judgmental space to grieve. Grieving can be done alone, but it is best if it is done with someone else, or in a group. Seeking individual or group therapy is important as close to the loss event as possible. Waiting long periods before moving into the grief process can be harmful and in some cases develop into full blown clinical depression, suicidal thoughts, or posttraumatic stress disorder (PTSD). Avoiding our own natural suffering to personal loss; only brings more suffering over the long term.
Call me today and let me know how I can walk alongside you if you are grieving alone.