Grief & loss

To-do list for surviving spouses

Only people who avoid love can avoid grief; the point is to learn
from it and remain vulnerable to love.  John Bratner

Understanding grief

At some point in our lives, each of us faces the loss of someone or something dear to us. The grief that follows such a loss can seem unbearable, but grief is actually a healing process. Grief is the emotional suffering we feel after a loss of some kind. The death of a loved one, loss of a limb even intense disappointment can cause grief. Dr. Elisabeth Kubler-Ross has named five stages of grief people go through following a serious loss. These stages describe common emotional states that can occur following a major loss:

1. Denial and Isolation: At first, we tend to deny the loss has taken place, and may withdraw from our usual social contacts. This stage may last a few moments, or longer.

2. Anger:  The grieving person may then be furious: at the person who inflicted the hurt (even if she's dead), or at the world, for letting it the event take place, even if, realistically, nothing could have stopped it.

3. Bargaining: Now the grieving person may make bargains with God, asking, "If I do this, will you take away the loss?"

4. Depression: The person feels numb, although anger and sadness may remain underneath.

5. Acceptance: This is when the anger, sadness and mourning have tapered off. The person simply accepts the reality of the loss.

Grief and stress

During grief, it is common to have many conflicting feelings. Sorrow, anger, loneliness, sadness, shame, anxiety  and guilt often accompany serious losses. Having so many strong feelings can be very stressful. Yet denying the feelings, and failing to allow yourself to grieve, is harder on the body and mind than going through them. When people suggest "looking on the bright side," or other ways of cutting off difficult feelings, the grieving person may feel pressured to hide or deny these emotions. Then it will take longer for healing to take place.

Obstacles to healing

Grief is a misunderstood and neglected process in life. Because responding to death is often awkward, uncomfortable, even frightening for both grievers and helpers, those concerned may avoid dealing with grief. This can make the experience more lonely and unhappy than it might be otherwise.

In addition, society promotes many misconceptions about grief that may actually hinder the recovery and growth that follow loss. For example, many believe it necessary to try to change how a grieving friend is feeling and may do so by making statements such as, "You must be strong," "You have to get on with your life," or "It's good that he didn't have to suffer." Such clichés may help the one saying them, but are rarely helpful to the griever. Society also promotes the misconception that it is not appropriate to show emotions except at the funeral, and that recovery should be complete within six months. A helper needs to avoid these and other ways of minimizing a person’s grief. Those in grief need to be encouraged to recover in their own ways.

Guidelines for helping

Helpers often ask questions such as: "What should I do? What should I say? Am I doing the right thing? Did I do the wrong thing?" Here are some suggestions for helping the person in grief.

Make contact. Make a phone call, send a card, attend the funeral, bake and deliver cookies.  Don’t let discomfort, fear, or uncertainty stand in the way of making contact and being a friend.

Provide practical help. It’s usually not enough to say, "If there’s anything I can do, let me know." Decide on a task you can help with and make the offer.

Be available and accepting. Accept the words and feelings expressed, avoid being judgmental or taking their feelings personally, avoid telling them how they should feel or what they should do.

Be a good listener. Many in grief need to talk about their loss; the person, related events, and their reactions. Allow grievers to tell their stories and express their feelings. Be patient and accepting of their expressions.

Exercise patience. Give bereaved people "permission" to grieve for as long or short a time as needed. Make it clear that there is no sense of "urgency" when you visit or talk. Remember, there are no shortcuts.

Encourage self-care. Encourage bereaved people to attend to physical needs, postpone major decisions, allow themselves to grieve and to recover. At the same time, they may need your support in getting back into activities and making decisions.

Model good self-care. It’s important for you to maintain a realistic and positive perspective, to maintain your own life and responsibilities, and to seek help when you feel overwhelmed or don’t know how to handle a situation.

Men's grief

Men and women tend to grieve in different ways. 
Australian society has generally expected that men fulfill a protector/provider role, and that women fulfill a nurturer/career role. There are lots of theories and arguments about whether these roles are good or bad, where they came from, and whether they can or should be changed. What we do know for sure is that they continue to have a strong influence on our behavior and how we experience and respond to our emotions.How men and women grieve is significantly linked to these roles and the different expectations society has of us. The way in which many men deal with loss and grief can best be understood by thinking about their expected role in society. Despite many changes in our society, it is still part of a man's role to do nearly all of the dangerous, unhealthy and life threatening work. For example, 95% of deaths and permanent disabilities from workplace injuries are male. Only men are conscripted and sent to war. Men are generally expected to protect their wives, children, and the community (such as in time of war).

How do men's roles affect how they experience and respond to their emotions and grief?

• may tend not to be as self caring emotionally as women
• often do not want to be seen to care too much about their own emotional pain
• may have to connect more consciously with their emotions or grief than women need to do
• are often reliant on women for a sense of emotional stability
• may need privacy and a sense of being personally safe before they can face their emotions
• may need time away or alone to think things through, or to express their emotions
• may exhibit and express more anger than women appear to do
• will likely not respond favorably to being expected to be more public or obvious in their emotions than they feel comfortable with
• may tend to move in and out of their grief issues and emotions more than women appear to do
• can often achieve the same progress in grieving through ritual activities (such as doing or making something) as women, who may talk and cry out their grief
• may be more comfortable expressing their grief through action and activity (including thinking things through)

How can grieving men best help themselves?

• By showing courage in allowing themselves to experience the painful emotions of grief (rather than pushing them underground)
• By communicating clearly to others their need to be alone and to deal with their feelings in private
• By not shutting others out, but keeping communication open in their relationships
• By tuning into their bodies (because feelings that have built up can often be discovered there and released into experience)
• By consciously using rituals and activity through which to express and work with their grief
• By slowing down and making time for being reflective and to connect with their grief (making time to grieve in order for there to be time to heal)
• By staying close to reliable friends and talking to them
• By making time to garden or be out in the natural environment
• By keeping up good health through moderate exercise, good food and plenty of sleep and not consuming too much alcohol

Coping with the reactions of others

You are now painfully aware that most people in our society struggle to insulate themselves from the ways in which we all remain vulnerable to injury and death. Know that it will be very difficult for acquaintances and strangers in your daily life to be comfortable putting themselves in your shoes now. Many individuals struggle to deal with bad things that happen to others, often using humor as a defense. You may become aware (in a new way), of the tasteless jokes that often circulate after a tragedy. Another common reaction of acquaintances and even friends is to try to manage or criticize your manner of reacting to this event. The fact is that each of us is an individual. We like different foods, wear different clothing, and choose unique lifestyles. It stands to reason that, at the most painful times in our lives, we would also grieve in our own way. How we choose to grieve is determined by things like our heritage (including religious, cultural, and family issues that we have learned), our society's views of death, and our individual personalities and beliefs.

Family 
When a tragedy happens to a family, you might expect it to pull the family together. This is not always the case. It is not unusual for counselors to see families separate, both physically and
emotionally, following a major stress like this kind of sudden loss. At a time like this,
communication is very important. Work hard to express your feelings within your family
and with your supportive friends.

Friends
When you hurt, you often turn to people outside your family who have always been there for you - your friends. But, where are they a month, six months, or a year after the death? Often, they have gone back to focusing more on their own lives, even though you still need to talk.

If you bring up the death (or the circumstances surrounding it), they may change the subject. Many people do not want to listen to the details of the tragedy, although it is very important for survivors to continue to talk about those details. It is tough for many people who have not been through it, to talk about something this frightening. They may fear they will not say the right things or they will not be good listeners on a subject that it so emotionally charged. They may also feel hopelessly inadequate. Remember that the loss of your loved one(s) probably hit them with the stark reality that, if this happened to you, it can just as easily happen to them, turning their world upside down, just as it has done to you. You may notice that people you have known for years now avoid you on the street or in a store.

Your co-workers may avert their eyes and "not see you," as though you have suddenly become invisible. This is because they usually have no idea what to say and they do not realize that, for you, this feels like rejection. This, in turn, adds to your grief because now you are losing your closest circle of friends, in addition to the person(s) who died.

This new problem can be faced in a variety of ways. You can write these friends off and stop seeing them altogether. You can continue to have contact with them but avoid the subject that you most need to discuss. You can raise the issue directly with your friends and try to deal with it openly and honestly with them. You can also add to your circle of friends by spending more time with those whom you find ready to respond in the ways that are most helpful to you. Support from others who have been though similar events (e.g., talking with survivors from a previous accident) can be extremely valuable because they know how important it is to talk about the experience rather than avoid it.

Coping with birthdays, holidays & other special times

Holidays and other special days like anniversaries, birthdays, etc. can be very difficult. This is especially true during the first year following the death. These days usually are steeped in traditions and customs created by families and meant to be shared. When a member of the family is no longer there to share a cherished tradition, the "special day" often becomes a painful reminder of the loss, rather than a time of joy. The first time you experience holidays or other memorable occasions after the death, it may seem to be a nightmare. Gifts that once were ripped open immediately may sit for days. Thanksgiving will seem to be a hollow rentiment as you find yourself asking, "What do I have to be thankful for?" New Year's Days and birthdays, which formerly were times to "celebrate another year of life," are now disturbing reminders of death. It will be helpful to plan to include your lost love one(s) in each occasion in a very deliberate way: evoking their memory, for example, creating a toast to them, or a prayer in their honor; imagining for the group what they would be saying or doing were they still among you; and acknowledging their ongoing presence among you but in a different way now. You may find the need to develop new traditions. For some, a trip out of town or going to someone else's home at holiday time can be very helpful. For others, buying a gift for someone less fortunate, and doing so in the name of the lost loved one(s), provides some relief. Making birthday donations to charitable organizations, in their name, or creating some similar, new traditions, is often a meaningful way to channel some of the feelings at these difficult points in the year.