Kevin Stevenson, LMHC, MCAP

Grief & Loss

Losing someone or something you love and care deeply about is very painful.  You may experience all kinds of difficult emotions and it may feel like the pain and sadness you’re experiencing will never let up.  These are normal reactions to a significant loss.  But while there is no right or wrong way to grieve, there are healthy ways to cope with the pain that, in time, can renew you and permit you to move on.
Grief is a natural response to loss.  It’s the emotional suffering you feel when something or someone you love is taken away.  The more significant the loss, the more intense the grief will be.  You may associate grief with the death of a loved one – which is often the cause of the most intense type of grief – but any loss can cause grief, including:
  • Divorce or relationship breakup
  • Loss of health
  • Losing a job
  • Loss of financial stability
  • A miscarriage
  • Retirement
  • Death of a pet
  • Loss of a cherished dream
  • Loss of a friendship
  • A loved one’s serious illness
  • Loss of safety after a trauma
  • Selling the family home
The more significant the loss, the more intense the grief.  However, even subtle losses can lead to grief.  For example, you might experience grief after moving away from home, graduating from college, changing jobs, selling your family home, or retiring from a career you loved.
Everyone grieves differently
Grieving is a personal and highly individual experience.  How you grieve depends on many factors, including your personality and coping style, your life experience, your faith, and the nature of the loss.  The grieving process takes time.  Healing happens gradually; it can’t be forced or hurried – and their is no “normal” timetable for grieving.  Some people start to feel better in weeks or months.  For others, the grieving process is measured in years.  Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.
The five stages of grief:
  • Denial: This first stage of grieving helps us to survive the loss.  In this stage, the world becomes meaningless and overwhelming.  Life makes no sense.  We are in a state of shock and denial.  We go numb.  We wonder how we can go on, if we can go on, why we should go on.  We try to find a way to simply get through each day.  Denial and shock help us to cope and make survival possible.  Denial helps us to pace our feelings of grief.  There is a grace in denial.  It is nature’s way of letting in only as much as we can handle.  As you accept the reality of the loss and start to ask yourself questions, you are unknowingly beginning the healing process.  You are becoming stronger, and the denial is beginning to face.  But as you proceed, all the feelings you were denying begin to surface.
  • Anger: Anger is a necessary stage of the healing process.  Be willing to feel your anger, even though it may seem endless.  The more you truly feel it, the more it will begin to dissipate and the more you will heal.  There are many other emotions under the anger and you will get to them in time, but anger is the emotion we are most used to managing.  The truth is that anger has no limits.  It can extend not only to your friends, the doctors, your family, yourself and your loved one who died, but also to God.  You may ask, “Where is God in this?”  Underneath anger is pain, your pain.  It is natural to feel deserted and abandoned, but we live in a society that fears anger.  Anger is strength and it can be an anchor, giving temporary structure to the nothingness of loss.  At first grief feels like being lost at sea: no connection to anything.  Then you get angry at someone, maybe a person who isn’t around, maybe a person who is different now that your loved one has died.  Suddenly you have a structure – your anger toward them.  The anger becomes a bridge over the open sea, a connection from you to them.  It is something to hold onto; and a connection made from the strength of anger feels better than nothing.  We usually know more about suppressing anger than feeling it.  The anger is just another indication of the intensity of your love.
  • Bargaining: Before a loss, it seems like you will do anything if only your loved one would be spared.  “Please God,” you bargain, “I will never be angry at my wife again if you’ll just let her live.”  After a loss, bargaining may take the form of a temporary truce.  “What if I devote the rest of my life to helping others.  Then can I wake up and realize this has all been a bad dream?”  We become lost in a maze of “If only…” or “What if…” statements.  We want life returned to what is was; we want our loved one restored.  We want to go back in time: find the tumor sooner, recognize the illness more quickly, stop the accident from happening…if only, if only, if only.  Guilt is often bargaining’s companion.  The “if onlys” cause us to find fault in ourselves and what we “think” we could have done differently.  We may even bargain with the pain.  We will do anything not to feel the pain of this loss.  We remain in the past, trying to negotiate our way out of the hurt.  People often think of the stages as lasting weeks or months.  They forget that the stages are responses to feelings that can last for minutes or hours as we flip in and out of one and then another.  We do not enter and leave each individual stage in a linear fashion.  We may feel one, then another and back again to the first one.
  • Depression: After bargaining, our attention moves squarely into the present.  Empty feelings present themselves, and grief enters our lives on a deeper level, deeper than we ever imagined.  This depressive stage feels as though it will last forever.  It’s important to understand that this depression is not a sign of mental illness.  It is the appropriate response to a great loss.  We withdraw from life, left in a fog of intense sadness, wondering, perhaps, if there is any point in going on alone?  Why go on at all?  Depression after a loss is too often seen as unnatural: a state to be fixed, something to snap out of.  The first question to ask yourself is whether or not the situation you’re in is actually depressing.  The loss of a loved one is a very depressing situation, and depression is a normal and appropriate response.  To not experience depression after a loved one dies would be unusual.  When a loss fully settles in your soul, the realization that your loved one didn’t get better this time and is not coming back is understandably depressing.  If grief is a process of healing, then depression is one of the many necessary steps along the way.
  • Acceptance: Acceptance is often confused with the notion of being “all right” or “ok” with what has happened.  This is not the case.  Most people don’t ever feel ok or all right about the loss of a loved one.  This stage is about accepting the reality that our loved one is physically gone and recognizing that this new reality is the permanent reality.  We will never like this reality or make it ok, but eventually we accept it.  We learn to live with it.  It is the new norm with which we must learn to live.  We must try to live now in a world where our loved one is missing.  In resisting this new norm, at first many people want to maintain life as it was before a loved one died.  In time, through bits and pieces of acceptance, however, we see that we cannot maintain the past intact.  It has been forever changed and we must readjust.  We must learn to reorganize roles, re-assign them to others or take them on ourselves.  Finding acceptance may be just having more good days than bad ones.  As we begin to live again and enjoy our life, we often feel that in doing so, we are betraying our loved one.  We can never replace what has been lost, but we can make new connections, new meaningful relationships, new inter-dependencies.  Instead of denying our feelings, we listen to our needs; we move, we change, we grow, we evolve.  We may start to reach out to others and become involved in their lives.  We invest in our friendships and in our relationship with ourselves.  We begin to live again, but we cannot do so until we have given grief its time.  At times, people in grief will often report more stages.  Just remember your grief is an unique as you are.
The five stages are a part of the framework that makes up our learning to live with the one we lost.  They where never meant to help tuck messy emotions into neat packages.  They are responses to loss that many people have, but there is not a typical response to loss as there is no typical loss.  Our grief is as individual as our lives.  They are tools to help us frame and identify what we may be feeling.  But they are not stops on some linear timeline in grief.  Not everyone goes through all of them or in a prescribed order. The hope is that with these stages comes the knowledge of grief’s terrain, making us better equipped to cope with life and loss.
Common symptoms of grief
While loss affects people in different ways, many experience the following symptoms when they’re grieving.  Just remember that almost anything that you experience in the early stages of grief is normal – including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious beliefs.
  • Shock and disbelief: Right after a loss, it can be hard to accept what happened.  You may feel numb, have trouble believing that the loss really happened, or even deny the truth.  If someone you love has died, you may keep expecting him or her to show up, even though you know he or she is gone.
  • Sadness: Profound sadness is probably the most universally experienced symptom of grief.  You may have feelings of emptiness, despair, yearning, or deep loneliness.  You may also cry a lot of feel emotionally unstable.
  • Guilt: You may regret or feel guilty about things you did or didn’t say or do.  You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness).  After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.
  • Anger: Even if the loss was nobody’s fault, you may feel angry and resentful.  If you lost a loved one, you may be angry with yourself, God, the doctors, or even the person who died for abandoning you.  You may feel the need to blame someone for the injustice that was done to you.
  • Fear: A significant loss can trigger a host of worries and fears.  You may feel anxious, helpless, or insecure.  You may even have panic attacks.  The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.
  • Physical symptoms: We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.
Coping with grief and loss
The single most important factor in healing from loss is having the support of other people.  Even if you aren’t comfortable talking about your feelings under normal circumstances, it’s important to express them when you’re grieving.  Sharing your loss makes the burden of grief easier to carry.  Wherever the support comes from, accept it an do not grieve alone.  Connecting to others will help you heal.
Finding support after a loss
  • Turn to friends and family members: Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient.  Draw loved ones close, rather than avoiding them, and accept the assistance that’s offered.  Oftentimes, people want to help but don’t know how, so tell them what you need – whether it’s a shoulder to cry on or help with funeral arrangements.
  • Draw comfort from your faith: If you follow a religious tradition, embrace the comfort its mourning rituals can provide.  Spiritual activities that are meaningful to you – such as praying, meditating, or going to church – can offer solace.  If you’re questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community.
  • Join a support group: Grief can feel very lonely, even when you have loved ones around.  Sharing your sorrow with others who have experienced similar losses can help.  To find a bereavement support group in your area, contact local hospitals, hospices, funeral homes, and counseling centers.
  • Talk to a therapist or a grief counselor: If your grief feels like too much to bear, call a mental health professional with experience in grief counseling.  An experienced therapist can help you work through intense emotions and overcome obstacles to your grieving.
When you’re grieving, it’s more important than ever to take care of yourself.  The stress of a major loss can quickly deplete your energy and emotional reserves.  Looking after your physical and emotional needs will help you get through this difficult time.
Take care of yourself
  • Face your feelings: You can try to suppress your grief, but you can’t avoid it forever.  In order to heal, you have to acknowledge the pain.  Trying to avoid feelings of sadness and loss only prolongs the grieving process.  Unresolved grief can also lead to complications such as depression, anxiety, substance abuse, and health problems.
  • Express your feelings in a tangible or creative way: Write about your loss in a journal.  If you’ve lost a loved one, write a letter saying the things you never got to say; make a scrapbook or photo album celebrating the person’s life; or get involved in a cause or organization that was important to him or her.
  • Look after your physical health: The mind and body are connected.  When you feel good physically, you’ll also feel better emotionally.  Combat stress and fatigue by getting enough sleep, eating right, and exercising.  Don’t use alcohol or drugs to numb the pain of grief or lift your mood artificially.
  • Don’t let anyone tell you how to feel, and don’t tell yourself how to feel either: Your grief is your own, and no one else can tell you when it’s time to “move on” or “get over it.”  Let yourself feel whatever you feel without embarrassment or judgment.  It’s okay to be angry, to yell at the heavens, to cry or not to cry.  It’s also okay to laugh, to find moments of joy, and to let go when you’re ready.
  • Plan ahead for grief “triggers”: Anniversaries, holidays, and milestones can reawaken memories and feelings.  Be prepared for an emotional wallop, and know that it’s completely normal.  If you’re sharing a holiday or lifecycle event with other relatives, talk to them ahead of time about their expectations and agree on strategies to honor the person you loved.
When grief doesn’t go away
It’s normal to feel sad, numb, or angry following a loss.  But as time passes, these emotions should become less intense as you accept the loss and start to move forward.  If you aren’t feeling better over time, or your grief is getting worse, it may be a sign that your grief has developed into a more serious problem, such as complicated grief or major depression.
Complicated grief
The sadness of losing someone you love never goes away completely, but it shouldn’t remain center stage.  If the pain of the loss is so constant and severe that it keeps you from resuming your life, you may be suffering from a condition known as complicated grief.  Complicated grief is like being stuck in an intense state of mourning.  You may have troulbe accepting the death long after it has occurred or be so preoccupied with the person who died that it disrupts your daily routine and undermines your other relationships.
Symptoms of complicated grief include:
  • Intense longing and yearning for the deceased
  • Intrusive thoughts or images of your loved one
  • Denial of the death or sense of disbelief
  • Imagining that your loved one is alive
  • Searching for the person in familiar places
  • Avoiding things that remind you or your loved one
  • Extreme anger or bitterness over the loss
  • Feeling that life is empty or meaningless
When grief returns
Certain reminders of your loved one might be inevitable, especially on holidays, birthdays, anniversaries and other special days that follow your loved one’s death.  Reminders aren’t just tied to the calender, though.  They can be tied to sights, sounds and smells – and they can ambush you.  You might suddenly be flooded with emotions when you drive by a restaurant that you and your loved one frequented or when you hear a song that reminds you of your loved one.  Even memorial celebrations for others can trigger the pain of your own loss.  Anniversary grief reactions can also evoke powerful memories of the feelings and events surrounding your loved one’s death.  You might in great detail remember where you were and what you were doing when your loved one died.
How to cope with reawakened grief
  • Be prepared: Anniversary reactions are normal.  Knowing that you’re likely to experience anniversary reactions can help you understand them and even turn them into opportunities for healing.
  • Plan a distraction: Schedule a gathering or a visit with friends or loved ones during times when you’re likely to feel alone or be reminded of your loved one’s death.
  • Reminisce about your relationship: Focus on the good things about your relationship with your loved one and the time you had together, rather than the loss.  Write a letter to your loved one or a note about some of your good memories.  You can add to this note anytime.
  • Start a new tradition: Make a donation to a charitable organization in your loved one’s name on birthdays or holidays, or plant a tree in honor of your loved one.
  • Connect with others: Draw friends and loved ones close to you, including people who where special to your loved one.  Find someone who’ll encourage you to talk about your loss.  Stay connected to your usual support systems, such as spiritual leaders and social groups.  Consider joining a bereavement support group.
  • Allow yourself to feel a range of emotions: It’s ok to be sad and feel a sense of loss, but also allow yourself to experience joy and happiness.  As you celebrate special times, you might find yourself both laughing and crying.
The difference between grief and depression
Distinguishing between grief and clinical depression isn’t always easy as they share many symptoms, but there are ways to tell the difference.  Remember grief can be a roller coaster.  It involves a wide variety of emotions and a mix of good and bad days.  Even when you’re in the middle of the grieving process, you will have moments of pleasure or happiness.  With depression, on the other hand, the feelings of emptiness and despair are constant.
Other symptoms that suggest depression, not just grief:
  • Intense, pervasive sense of guilt
  • Thoughts of suicide or a preoccupation with dying
  • Feelings of hopelessness or worthlessness
  • Slow speech and body movements
  • Inability to function at work, home, and/or school
  • Seeing or hearing things that aren’t there
When to seek professional help for grief
Recognize any of the above symptoms of complicated grief or clinical depression, talk to a mental health professional right way.  Left untreated, complicated grief and depression can lead to significant emotional damage, life-threatening health problems, and even suicide.  But treatment can help you get better.
Contact a therapist or grief counselor if you:
  • Feel like life isn’t worth living
  • Wish you had died with your loved one
  • Blame yourself for the loss or for failing to prevent it
  • Feel numb and disconnected from others for more than a few weeks
  • Are having difficulty trusting others since your loss
  • Are unable to perform your normal daily activities

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                    Kevin Stevenson, LMHC,CAP