Program & Services

Loss & Grief Overview

Basics

"Everyone can master a grief but he that has it."
     - William Shakespeare

When people are mourning, we think they've recently suffered the death of a loved one. But in fact, people mourn many things in addition to a loved one's death:

• The end of a relationship
• The loss of a job
• A decline in health
• The loss of something important, such as a home or family heirloom
• Changes in our families or lives
• The long absence of a loved one

Mourning can begin before a loss has happened. It can also be during or soon after a loss. It can be many years later. There's no right or wrong time to start mourning. People begin according to their own needs and their own coping styles. Some people may grieve for a few weeks, a month or many months.

The grieving process includes physical changes. You might mistake these for symptoms of an illness such as:

• Fatigue or trouble sleeping
• Weeping
• Nightmares
• Body aches or trembling
• Loss of appetite
• Dizziness or headaches
• Gain or loss of weight
• Tightness in chest or throat
• Nausea or stomach ache

Key Tips

Key Tip 1

Write about your grief. Write about the person or circumstance you're mourning. Describe what you've lost. Describe how you feel about it. Express your sorrow and pain. Honor the person or object you've lost. You may never show your writing to anyone else, but that's not what it's for. It can help you through the healing process, even if you never look at it again.

It may help to create a journal or memory book. Gather pictures and other things that remind you of who or what you grieve for. These things can also help you talk about it, which you may want to do now and then. One of the signs of coping with your grief is being able to tell stories about the person you've lost. Then instead of feeling upset, you're able to smile about fond memories.

Key Tip 2

Once you're ready, take a day off from mourning. Let yourself enjoy the day without feeling guilty. It won't mean that you've forgotten. It's just that you're just trying to get your life back together again. You can move on.

Key Tip 3

Turn your thoughts to the future again. Make plans, maybe just for tomorrow at first. Soon you'll be able to think about what you want to do next week or next month. Think about setting new goals. Or pick up where you left off with old ones that still matter.

Specifics

Grief is the deepest kind of suffering. It's brought on by terrible loss, hardship or disaster. Mourning allows us to express some of our grief. It is a normal and important part of healthy living.

No two people will work through a loss in the same way. Researcher Dr. Elizabeth Kubler-Ross describes a model of the grieving process that she thinks many people go through. It involves some or all of the following five stages. But not everyone goes through these stages in the same order:

Stage 1: Denial

Denial is often the first line of defense. During this stage, people may say or think things like "This isn't happening to me" or "This is a nightmare; I want to wake up and have this all go away." Thoughts like these act as buffers. They allow people time to collect themselves. Still, grieving people probably don't fully understand what's just happened. So if they don't show strong emotions, it's not a sign they don't care. It's a sign of not being able to believe what's happening.

Stage 2: Anger

At this stage, grieving people look for someone or something to blame: A deceased husband's job, boss, doctor or anyone else, as a wife tries to make sense of the loss. Grieving people are sure that the death shouldn't have happened. Somebody is responsible (and perhaps that someone should be punished). Sometimes, someone is truly responsible, such as a drunken driver who kills someone. But sometimes it's unfounded. ("If he'd had a better doctor, his lung cancer would have been cured.") Sometimes, people blame God or fate. These are normal reactions. But in most cases they serve little or no useful purpose.

Stage 3: Bargaining and Guilt

We use this stage to "cut a deal." We bargain with God, fate, doctors or whoever we think can reverse our grief. "Cure my wife's cancer, and I'll never cheat on my income taxes again," a grieving husband will say. He pretends that he has the power do something, anything, to help his wife. Feeling guilt also gives us a sense that we actually have some control over the outcome. If we're guilty of causing this tragedy, then we should be able to make things right again.

Stage 4: Depression

Once they have worked through the first three stages, people begin to feel grief deeply enough to become depressed. As difficult as this period can get, it's a sign that mourners are coming to grips with reality. With support from others, they will be able to move on with their lives.

Stage 5: Acceptance

By this final stage, people are willing and able to accept their losses. Now they can begin to forgive themselves and anyone else they "blame," rightly or wrongly, for the losses they've suffered. People who reach this stage often go back to one or more of the previous stages of grief as they continue to work through their losses.

For example, many people experience sudden grief attacks even years after their loss. They are struck with a sudden, vivid reminder of their deceased loved one. Having attacks doesn't mean people have undone all the work it took to recover. Grief attacks usually end quickly, even though they can be deeply distressing.

People don't always experience these five stages the same way. You may find that you experience the stages in a different order. You may find that you go through one or more stages more than once. There's no typical time schedule for when the stages occur or for when the grieving process is completed.

FAQs

My father died several months ago. All of us miss him terribly. But my mother seems unable to let go of her grief. She sits in his study for most of every day. She hardly ever goes out. She rarely talks to anyone unless she's spoken to. Should we be getting her some help?

Because everyone grieves differently, there are no ironclad rules that separate normal from abnormal grief. And the sense of mourning can linger for a long time, even in people who are back to their usual daily routines. However, mourning can become obsessive. This may be the case with your mother. If she has any of these conditions, you should help her to see a professional:

• Seeing or hearing things that aren't there
• Severe depression; talking about suicide
• Nothing matters but reminiscing, dreaming, and a total surrender to the trauma
• Greatly heightened reactions over an extended period of time
• Total lack of any reaction
• Feeling too crippled emotionally to carry on everyday activities after a month

We recently lost our grandmother. But I don't think the rest of my family is grieving like I am. I'm really angry with them. Why can't they honor her memory?

Many factors influence how we grieve, for how long, and how intensely. People in the same family won't grieve in the same way just because they're related. There are many factors that determine how we grieve:

• Life experiences
• Coping style and personality
• Support system and being prepared for death
• Relationship with the person mourned

Some people grieve more openly than others. So don't assume that the rest of your family doesn't care anymore. They're all coping in their own ways, just as you are, with a very difficult loss.

Our son was killed in a car accident a month ago. It's been very hard for us all. But we're really worried about his younger sister. She keeps asking when he's coming back. We try to explain why he can't. Now she's been carrying around a blanket and sucking her thumb. She stopped doing this two years ago. Should we get counseling for her?

Young children usually don't understand death. They don't grieve the same way adults do. Children sometimes fear that something they did brought on the death of someone close like a brother. If she's said anything like this, don't dismiss her concerns. Talk to her about them. You might even say that sometimes you're afraid that you might feel the same way. But then you realize that death is something we can't control or command.

Children often use baby talk or do other things that we thought they'd grown out of when someone they love dies. It's probably a way of reaching out for more comfort and refuge at a time when they and their families are grieving.

Your daughter will probably continue to ask questions. She might talk about her brother's death for some time to come. Be open to what she has to say. Speak honestly about what you're feeling. Let her know that you understand her sorrow and fears. Above all, keep showing your love for her. Make sure she understands that you're hurting, too. Then together you can start to heal.

My parents and I had a terrible time deciding whether or not to have a funeral for my sister. I was against it. I don't believe in grieving publicly. Why do people want to have funerals?

Many people find funerals a key part of coping with the death of a loved one. The rituals of mourning seem to provide comfort. Having friends and family there can help those who are deeply grieving. But some people don't want to mourn in public. That's perfectly acceptable, too. Try to understand your parents' wishes in this case. Losing a daughter is an especially difficult loss.

I know it's important to attend funerals. It shows your support and honors the dead. But I always feel so uncomfortable. I never know what to say. Can you help?

When someone you care about is mourning, it's hard to know what to do or say. But just by being there, you can help. You can listen carefully, acknowledge his loss, and respond genuinely. Don't worry about what's "right" to say. Even if you say something like "I don't know what to say, but I want you to know that I think of you often and I care," you can provide some real comfort.

You can talk about the deceased. You can remember how much you loved hearing about her love for racehorses. Or you can say how much he meant to you as you were growing up. Someone in mourning can draw real comfort from knowing how much their loved one meant to others.

Resources

Web Sites

Links to sites, articles and lists of books on terminal illness and grief are at:
www.growthhouse.org

Online support groups, memorials and resources can be found at:
www.griefnet.org

Widows and widowers can find information about grief and bereavement at:
www.widownet.org

The Compassionate Friends provides support for bereaved parents and siblings; visit:
compassionatefriends.org

Books

Rando, Therese A., How to Go on Living When Someone You Love Dies. Bantam, 1991.

Fitzgerald, Helen, and Elizabeth Kubler-Ross, The Grieving Child: A Parent's Guide. Simon & Schuster, 1992.

Kubler-Ross, Elizabeth, On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy and Their Own Families. Simon & Schuster, 1997.

Davis, Deborah L., Ph.D., Empty Cradle, Broken Heart. Fulcrum Publishing, 1996.

Friedman, Rochelle, and Bonnie Gradstein, Surviving Pregnancy Loss: a Complete Sourcebook for Women and Their Families. Citadel Press, 1996.

Kluger-Bell, Kim, Unspeakable Losses: Understanding the Experience of Pregnancy Loss, Miscarriage and Abortion. W.W. Norton, 1998.

Sheehy, Gail, Passages: Predictable Crises of Adult Life. Bantam, 1977.

Akner, Lois and Catherine Whitney, How to Survive the Loss of a Parent: A Guide for Adults. Quill, 1994.

Fitzgerald, Helen, The Mourning Handbook: The Most Comprehensive Resource Offering Practical and Compassionate Advice on Coping With All Aspects of Death and Dying. Fireside, 1995.