Coping with Grief
Grief is a natural reaction to the loss of someone or something we hold dear. Grief causes emotional suffering and overwhelming sorrow. The more significant the loss, the more intense the grief tends to be. We commonly associate grief with the death of a loved one, but a variety of losses may cause grief: divorce, miscarriage, life changing illness or injury, loss of a close relationship, addiction, death of a cherished pet, loss of a job or financial security.
How we grieve is unique and different for each of us. Each loss and relationship is unique, and expressions of grief vary from person to person. There is no set timetable for grief, nor a right or wrong way to mourn.
Elisabeth Kubler-Ross described common stages of grief, which are:
Anger- Feeling helpless, powerless, frustrated, cheated or abandoned are common. Survivors may be angry in general, or at someone specific, such as the loved one for leaving them or others who could not save them.
Bargaining- This stage involves hoping to avoid the loss or make it go away. Mourners may focus on what could have been done differently, if the loss could have been prevented or if something could have been done better. If unresolved, a sense of guilt or remorse may hamper healing.
Depression- Sadness is a fundamental part of mourning that usually occurs when we realize and acknowledge the full extent of the loss. Signs may include sleep and appetite disturbances, low energy, difficulty concentrating, crying jags, and feelings of emptiness, loneliness, and self-pity.
Acceptance- This involves accepting the fact of the loss, coming to terms with different feelings, beginning to heal and integrating the loss into our life experience.
People may go through each stage, skip some or move through a stage then return to it later.
Grief has physical and cognitive components. Disrupted sleep, changes in eating habits and exhaustion are physical components. Cognitive components include confusion, difficulty concentrating and finding it hard to make decisions. Work may be impacted while it is difficult to concentrate. The person grieving may be preoccupied by thoughts about the circumstances of the loss.
- Acknowledge the loss.
- Expect the roller coaster emotions to last awhile. Give yourself some time.
- Simplify life and defer major decisions for a while.
- Take time off when needed.
- Take care of yourself and your physical health. Eat well, exercise, and keep your doctor’s appointments.
- Keep busy, but avoid frantic activity. At first, keeping busy and taking care of details may be helpful. Later, it will be important to face the change.
- Seek and find support. Turn to others like friends, family, or support groups to help manage grief. For some, it may be helpful to speak or share with others going through loss.
- Prepare for dates and events that may trigger sadness such as holidays, birthdays, and anniversaries.
- Seek professional help if needed.
- Experience your feelings. Numbing out emotions with substances can complicate grief and create other challenges.
Even years later, periods of brief, intense sadness may occur. With the passage of time, the sharpness of painful emotions should eventually soften as you adjust to the loss and begin to move forward.
When the Loss was Sudden
Deaths which are sudden or unexpected pose additional complications. There was no chance to say goodbye. Shock is more intense and sorrow tends to last longer. Others may presume the grieving person is okay and return to their usual routine by the time the full force of the reality sinks in. Deaths by violence or suicide present extra challenges for survivors which prolong healing.
Helpful coping strategies include:
- Be patient with yourself and others around you.
- Express yourself.
- Permit yourself to have fun.
- Have a routine and structure.
- Pay attention to self-care.
- Set reasonable limits.
- Consider journaling, deep breathing, mindfulness, or meditation.
Loss of a Spouse
When mourning the loss of a spouse, note that relationships with children may change as the whole family adjusts. They are grieving too. Remember to take care of your health by eating well, exercising, trying to get enough sleep, taking your medications as prescribed, and keeping medical appointments. See your doctor if daily activities are hard to take care of. Don’t try to go it all alone. Grief support groups may be particularly helpful. Give yourself some time.
When a loved one dies by suicide, grief is complicated, confusing and challenging. The nature of the death leaves a traumatic aftermath. The grief process is often more tumultuous. Initial shock, denial and numbness are intense. Survivors often replay the final moments of the person’s life over and over in an effort to find answers, acceptance and understanding. Circumstances that make grieving a loss by suicide more challenging include stigma and isolation, mixed emotions, needing to understand why, the risk of survivors experiencing suicidal thoughts themselves and risk of post-traumatic stress disorder. Those who saw or heard the suicide will have to cope with serious trauma.
Survival guilt is common and sometimes overwhelming. Survivors question why, if there was something else they could have done or something that could have changed the outcome. It is natural to blame oneself when experiencing traumatic loss before accepting painful things beyond our control. Questioning can last a long time while the mourner tries to put the puzzle pieces together. Some pieces will remain missing, some questions unanswered. Anger, blame and a sense of abandonment are how hurt feelings express themselves.
Loved ones often encounter stigma and isolation and may fear telling others what happened. Mental health issues are a factor in most suicides. Substance concerns are sometimes a factor. If the deceased suffered severe mental illness or life was a daily struggle, there may be a sense of relief or that the death was inevitable. This is hard to discuss and often accompanied by feelings of guilt. Sharing about the loss may be difficult. What you share or don’t is totally up to you. Consider what you are comfortable discussing and how you might respond to questions. It may seem difficult to connect with and share with others who’ve not experienced this kind of loss.
Over time survivors come to accept the loss and incorporate both happy and sad memories. Strategies that might help include:
- Reach out and seek support.
- Be patient with yourself and others.
- Take time to heal and sort through feelings. Express yourself.
- Establish a routine.
- Do something distracting before bedtime.
- Take moments and feelings as they come. Tears and laughter both have healing powers.
- Give yourself permission to have fun.
- Establish new traditions.
- Plan for painful reminders and difficult days.
Suicide survivors are more likely to take advantage of resources like individual therapy or support groups. Seek professional help if needed. Signals of such a need may include recurring thoughts of suicide, depression, or unrelenting anguish over time.
Here are some tips for friends who want to offer support to a friend who has lost someone to suicide:
- Make contact and keep in touch. This can help break up the sense of isolation survivors often experience.
- Be there on a longer term basis to offer support.
- Avoid well-meaning reassurance. It may be perceived as hollow.
- Share memories or stories of the person’s life.
- Ask before broaching sensitive topics. Don’t ask if you don’t want to hear the details.
- Listen instead of asking questions or asking for explanations about the suicide. Questions may be painful as the grieving person tries to put the pieces together.
- Let the grieving person free to share their pain, grief and stories. Some may be shared over and over.
- Send a card or call on tough days like birthdays, holidays, or anniversaries.
When a loved one dies through violence, survivors face additional deep emotional wounds, slowing the healing process. Reactions are more intense and wide-ranged. With other kinds of losses, mourning usually lasts 1-2 years, but recovering from this type of loss takes longer.
Fear is common. Survivors may experience panic, anxiety, suspicion of others, be easily startled, find it hard to leave home and be concerned the perpetrator may return. Their sense of security and trust is shattered. The situation seems too unreal to grasp.
As survivors grapple to try to understand why this happened, self-blame and imagined guilt may arise. Wondering if something could have prevented this is common, yet these events occur in circumstances we can’t predict or control. Seek professional assistance if you need help dismissing imagined guilt over time.
Anger may be directed at the person or persons believed to be responsible, at the justice system or involve daydreams about revenge. These feelings lessen over time as healing begins. If the person suffered or no suspect is caught, the recovery process is more difficult. Those who saw or heard the murder will have to cope with serious trauma.
Things that may be helpful include getting help, talking with people you trust about what happened, and professional counseling. Other things that may help ease your pain include helping others in small ways, writing about feelings in a journal or diaries, calling a friend when experiencing panic and making a list of things that give you hope to read again on tough days. If sleeping is difficult, avoid upsetting things before bedtime, listen to relaxing music and designate at time to worry in the morning. Don’t expect much of yourself for a while, and try not to swallow your feelings since this can prolong grief.
For confidential assistance with any problems affecting your personal or professional life, please contact the Missouri Lawyers’ Assistance Program at 1-800-688-7859.
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