What Does it Mean to Grieve

“I was there, standing in the soup aisle of the grocery store, when I heard our song. I thought that I was managing, but I couldn’t help myself, the tears just came”. Change the location, change the trigger, but for most people who have experienced some sort of loss, this example of a grief reaction will likely sound familiar.

Loss is not uncommon, and while at some point nearly everyone will experience an important loss; we are often left to try and manage our feelings alone and encouraged to “move on” or “just forget about it” While good intentioned advice nothing could be harder to accomplish. This also totally bypasses the grief reaction, which is there to help us cope and learn from life. However, by understanding the grieving process, it can help us work towards healing.

Understanding Grief

In one of my earlier careers, as a social worker in a busy HIV/AIDS program in Washington State, one of my roles was to test those at high risk from acquiring the virus and inform them if they were indeed HIV positive. I quickly learned not to be surprised by any of the reactions I observed from giving the news: anger, sadness, guilt, fear, and disbelief were all common responses. While, of course the news lead to many other questions about “how, why, who, when, what will happen to me?”; some of which could be solved with education, some of it with time, and some of it couldn’t be solved at all; what I really was witnessing was someone who just experienced an immense loss and had started their grieving process.

I was reacquainted to these same reactions some time later, after moving to California, and had begun working in the hospice and palliative care field. The story line had perhaps changed, but the anger, sadness, guilt, fear and disbelief were all too familiar. Again, I was on a journey with my patient’s grieving process.

Whether it is from a loss of a person, of health, of dreams, of a marriage, or even smaller subtle losses, like retirement, grief is a natural response for when something significant that once used to be there is now absent.

The Grief Experience

In 1969, Elizabeth Kubler-Ross, a Swiss-American psychiatrist, broke ground with her book “On Death and Dying”, in which for the first time she discussed her theory on the “five stages of grief”. While her focus was primarily on end of life, her work transcends many other loss experiences, including trauma.

The Five Stages of Grief

Denial

“It is not happening.”

“This can’t be happening to me”. Often I have heard this being described as numbness or shock. Denial can serve as a self-protecting factor. It is a natural way of only allowing in as much as we can handle piece by piece, buffering us from becoming overwhelmed with a loss. When working with families where a loved one has just been given a life-limiting illness, I often hear from a well-meaning family member, “she’s in denial”. My response is often to educate about the benefits of denial and it’s use in pacing our grief. Clearly, if taken to the extreme, denial can cause hindrances and professional help should be sought.

Anger

“Why is this happening?”

You may question who is to blame for this and express frustration at others, or even at yourself. Anger can also be used to help with action and can give us something to hold on to while we get through the initial stages of pain.

Bargaining

“If you just stop ____, I will in return do ____”.

Bargaining can come both before and after a loss. Perhaps we use it to bargain our pain away after we have ended a marriage or experienced a death. While this stage is often laden with feelings of guilt, it is also a time that can later bring some clarity; the

“If only we had sought medical attention earlier”
“Why didn’t I say something”
“Why didn’t I try harder to stop it”

These negative thoughts may turn eventually in to, “We did everything we could once we found out something was wrong”.

Depression

“I am too sad to do anything”.

Feelings of emptiness, lack of hope, even questions of “why go on?” can be normal during this phase. Depression is not something that can be “snapped” out of and is a large, important part of the grief process. Our society has a difficult time understanding and coping with depression and sadly I can count on more than one hand when those grieving have been told “it is time to move on” by a well-meaning but lacking in understanding loved one. But depression can serve a purpose; it can be a time of focus, reflection, and recognition of value where we can work on our own inner healing. Of course, if someone is feeling suicidal and has a plan of acting upon it, professional help should be sought.

Acceptance

“This is my new reality”.

Acceptance does not mean that a person is “ok” with what has happened but rather that they accept that things are different and adjust to their new normal. Acceptance may be as simple as “only thinking about it 10 times today” rather than every second of the day. It is not a time of replacement but a time of growth and evolution.

Take Aways

The important thing to understand about the stages of grief is that there is no right or wrong way to experience them. It is not like a set of stairs where one leads to another, it is more like a vortex swirling around you. You may experience three stages of grief within an hour, or feel you are accepting of the loss then immediately go back to depression, such as the example at the beginning of the article.

On more than one occasion, I have heard the analogy of “waves” or “an ocean” to describe grief. For each loss, how those waves crash around you, how big the waves are, and how long they last is as unique to the individual as their thumbprint. Many complex factors can play into how the grieving live though and survive their loss. One day you may feel like you are drowning, while on a different day it may seem like a millpond. The important part is to understand that the feelings are erratic and can vary in magnitude from minute to minute.

Complexities of Grief

While the grieving process is unique to each loss, there are several factors that can play into making the process more complex. While this is not an all-encompassing list, I want to highlight a couple of important areas to consider when going through a loss:

Anticipatory grief – This is when the loss is yet to happen but the grieving process may have already begun. For example, feeling sadness about imagining what life will be like when the divorce happens.

Disenfranchised grief – This is when we are grieving but perhaps society or our circumstances prevents us from acknowledging the grief to the extent that we would feel we want to. For example, the loss of a spouse to an affair, or death of a loved one to an overdose.

Psychological Factors – Other unique circumstances impact the meaning of the loss such as the role someone occupied, mental health, prior losses, or cultural implications.

Managing Through Grief

As discussed, the grieving process is distinct to each human experience; however, there are some general ways to seek support through loss:

Talking to friends or a counselor. Having someone who is a good listener who can “bear witness” to your loss is helpful;
Getting exercise or movement at a level appropriate to you;
Getting enough rest;
Giving yourself permission for “down time”, whether it be silence, meditation, journaling.
Being conscious of what you are eating and drinking, help nourish and support your mind. Avoid too much alcohol or sugar.

Final Thoughts

Loss is a normal part of our journey through life.
The way you grieve is an individual experience; there are no rights or wrongs.
Understanding the process helps you recognize what you are experiencing.
You will never “complete” the grieving process but you will adapt to a new normal.
Seeking support and practicing self-care are essentials in working towards healing, especially if you are experiencing some of the complexities of grief.

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Information provided on this site does not constitute a patient therapist relationship, and should be used under the guidance of a licensed mental health professional.

Information presented on this page was written by Victoria Carding, LCSW Counselor at Lions Heart Counseling Sacramento and found in materials written by Elizabeth Kubler-Ross, a Swiss-American psychiatrist, in her book “On Death and Dying