How Do I Deal With Grief?
There is a time for everything,
And a season for every activity under heaven:
A time to be born and a time to die …
A time to weep and a time to laugh,
A time to mourn and a time to dance …
Just as we rejoice when we see the buds of spring, our heart may feel sorrow as we watch the leaves of autumn fall. The same is true of ourselves as we traverse through life. Our memories of childhood and young adulthood; our first day of school, riding a bicycle, obtaining a driver’s license, graduation from high school or college, may all be memories we cherish. As we age we experience the counter part of these joyful experiences; our vision begins to decline, our hearing is not as acute, and our physical strength declines. These are all a part of our natural human existence.
Terminal illness and death of family members and lifelong friends further compound these losses. Deaths of our contemporaries, with whom we share a history, may have a deep impact. How we adapt to these losses is often reflective of our attitudes, cultural norms, belief systems, religious faith, and how we have coped with other challenges throughout our lives. Grief is the normal process of adjusting to these losses and each of us has a unique pattern of how we grieve. We use many different words to describe reactions to a death. Someone who is “bereaved” has sustained a major loss through death. Similarly, a person “in mourning” is expressing reactions to the death.
When the death has been anticipated, the dying person and the family experience grief along the trajectory of the illness. After the death, grief continues for family members but at a heightened level of intensity. When the dying process is prolonged, family members may be plagued by memories of seeing their loved one “fading away.” On the other hand when the death has been sudden, the family is unprepared and traumatized by the event. The real grieving process may not begin until after the effects of the trauma have subsided. Depending on the circumstances of the sudden death, a bereaved survivor may be at risk for complications in grief. Whether the death has been anticipated or is sudden, the grieving process brings forth a period of disruption and long-term change.
What is Grief?
Grief is a complex process that varies from person to person. When you experience a major death such as a spouse or child, there is often an initial period of shock, disbelief, and numbness. This is followed by a period of acute mourning which may include intense physical, emotional, and spiritual reactions and social withdrawal. You may experience a bewildering array of feelings. In addition to deep sadness, you may also feel anger, guilt, anxiety, loneliness, fear, or even relief, especially if the deceased had been suffering. Crying is the most common expression of sadness, especially early in grief. You may find yourself preoccupied with thoughts of the deceased and unable to concentrate, and may have physical symptoms such as loss of appetite and sleep disturbances. Surprisingly, you may also experience positive feelings such as joy, peace, or happiness as an oasis amidst your sorrow. Over time a person begins the process of adjusting to life without the loved one, and of taking on new roles and a new personal identity. You will never forget the person who has died, but your pain will be less intense over time. Even after a number of years there may still be upsurges of grief during anniversaries and holidays.
Practical steps that may help the bereaved cope with grief
It's important to have at least one other person who can be there to listen to you in a nonjudgmental way. Even though you may not feel like being with other people, consider accepting invitations to be with those people you feel comfortable with so you don't get isolated. Many grieving people have noted that it is helpful to have some structure in their life, such as volunteer activities or paid work.
Sometimes people find journaling helpful. As time goes on, you can look back to those first days and realize how you are getting better over time. Putting together a book of photographs of all the good things about your life with your loved one is one way of framing important memories.
Your immune system has been taxed because of the stress you have been under. Taking care of your physical and mental well being is also important. A regular exercise program such as walking is one way of relieving stress. Another important area is trying to eat as healthy as possible. Be gentle with yourself, find ways to relax, and see your health care provider on a regular basis.
Many people also find consolation in community. This can be through religious and spiritual beliefs, or through support groups. Having access to others who have suffered a similar loss can provide understanding, comfort, and valuable information. If you think you would prefer talking “one on one” with a counselor or spiritual advisor, you can get referrals from hospitals, funeral homes and churches.
For friends and family of the bereaved
While the death of a loved one is an inevitable part of life, grief is rarely discussed in our culture. People experiencing grief often feel like they're not recovering quickly enough, and friends of the bereaved are often uncomfortable and unsure of how to best help the bereaved person. It is important to realize that there are many different ways that people grieve and not to be judgmental.
The best way to help a bereaved person is to just be there for them and listen. Sometimes we don’t know what to say and make remarks that are not helpful. Some of these include phrases like, “It's God will,” “He/she is in a better place.” “I know exactly how you feel.” It is better to simply say, “I am so sorry for your loss” or “This must be really difficult.” Advice from others is also not warranted. What is right for you may not be right for someone else. Any act of kindness is usually appreciated including phone calls, sending cards throughout the first year, or extending an invitation to dinner.
After caring for an older adult for months or years, caregivers may develop fairly deep attachments. You may have been the only “family” that the older adult had left in this world. When these elders die you may also experience a grief response. Experiencing multiple deaths in rapid succession may leave you feeling emotionally exhausted.
You should not have to work in isolation while providing care for an imminently dying person and his/her family. Ask for help and seek the assistance of the nurse, social worker, chaplain, pastoral care, nurse’s aide, volunteers and/or physician.
After the death, it is important to talk about the person who died and your feelings. It is often helpful to have a “debriefing” session with your colleagues where you can discuss your memories of the person who died and to express your feelings of grief. If you don’t have the opportunity to debrief after a death, you may want to ask your nursing supervisor, a social worker, or pastoral care professional if this is a new practice that could be instituted. If this isn’t possible, it is important to have another colleague with whom you can talk.
It is also important that you have a healthy life outside of your work where you can exercise, eat healthy, engage in hobbies, and have supportive relationships.
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Learn about different forms of grief and how to give support
The Healing Journey: Help for the Bereaved (PDF)