“ Grief is an acknowledgment of the deep value of our connections with others. It's a tribute to those with whom we have taken the risk to bond and to love. ”

Understanding Grief
Judy K. Betterton, LICSW

Life brings us many losses, large and small. The death of a loved one, ending of a relationship, job loss, robbery, injury, serious illness -- all of these will bring up grief, sadness, and, depending on the depth of the loss, depression. Each person's grieving process is unique and will unfold in an organic way, taking its own time. A smaller loss may resolve itself more quickly, a major loss, more slowly. However, a loss that one person might see as "small," —for example, the death of a pet— to another person may be devastating. Never judge your own or anyone else's grieving. Give yourself and others the space, time, and compassion needed to sustain and recover from a loss. This article focuses on the death of a loved one, but the information will apply to most other losses.

INITIAL REACTIONS

When you are grieving, you can expect certain changes. Some people will experience most of these, others only a few. Some effects of grieving are physical, others emotional. Initially you may experience shock, numbness, and denial of the loss. Perceptions may be off -- people may seem further away or smaller than they are, things may seem somehow distorted or warped. You may have a sensation of unreality and feel disconnected and ungrounded for a while. These sensations will fade as the grieving process resolves.

It's natural to feel angry after a significant loss - anger at the person who's died or gone away, anger at life or at God, medical personnel, family members or friends. Guilt is almost always a part of grieving - guilt for surviving, for "not having done enough," or for unresolved issues with the person who died. It's important to give all your feelings expression: talk with friends, journal it out, work with a therapist or join a support group.

DEPRESSION AND DIFFICULTY COPING

After the initial shock passes, you may feel depressed, lonely, and have difficulty coping. The death of a loved one forces us to grapple with questions about the nature of life and death and our own mortality. While the psyche is struggling to come to terms with these issues, there may not be very much energy available for anything else. Grief tends to resonate back to prior losses, stirring up older sadness: it also brings up fears of future losses. These fears are a natural part of the grieving process and will gradually diminish. Fearing further loss, you may withdraw socially. You may find yourself putting up walls with those you are closest to, in an attempt to defend yourself from the possibility of more loss and pain. On the other hand, you may feel more "needy" and want more contact and reassurance. Talking openly with your loved ones about your sadness and fears of loss can help you remain more open to receiving their love and support.

PROBLEMS SLEEPING

During a grieving period, you may have difficulties sleeping - as if the inner self cannot quite trust that there will not be another loss during sleep and stays vigilant to protect itself. Or, you may find yourself sleeping much more than usual, to take refuge from the reality of the loss. Shakespeare noted the healing power of sleep when he called it "sleep...that knits up the raveled sleeve of care..." Sleeping helps the body to replenish energy, while our dreams help us to deal emotionally with our losses. We may dream about a loved one who has died (or whom we have lost through the ending of a relationship); in the dream we are working to come to terms with the loss. Eventually, your sleep patterns should return to normal.

FATIGUE

Grief is very draining. While going through a grief reaction, you may feel exhausted, and only very gradually regain the energy level you experienced prior to the loss. Meanwhile, you need to rest as much as possible. It takes a lot of emotional energy to cope with grief. For a while, you may not have as much energy for, or interest in, things that you used to enjoy.

LOSS OF FOCUS

Memory and concentration may be affected by grief. If you have had a major loss, you may find yourself forgetting things-- you may even forget your own phone number. It may also be difficult to focus and concentrate. You may read a paragraph several times and still not absorb its meaning. These effects are normal and will pass as the grief resolves itself.

APPETITE CHANGES

Grief may cause you to lose your appetite. You may find it difficult to eat anything. Or, you may find you are eating more than you normally do. It's important to take care of yourself physically: you need all of your strength to get through this time. Your body is already stressed and depleted when you are grieving. Make the effort day by day to ensure that you're getting adequate basic nutrition. Vitamin supplements can help provide nutrients the body needs for coping with stress. In time, your appetite will return to normal.

Part Two: HEALING FROM GRIEF

REST AND REPLENISH

As much as possible, rest and focus on healing. While we are grieving, we still have to deal with life's responsibilities, but this is a time to aim for doing the best you can rather than expecting yourself to be perfect. Pace yourself, and rebuild your strength little by little. Focus on self-care, and do the things that nurture you and help you feel better. Reading a book about loss and grief can help you understand the grieving process, validate your feelings and experiences, and assist you in coping with this difficult time.

EXPRESS YOUR FEELINGS

Shakespeare put it beautifully: "Give sorrow words--The grief that does not speak / Whispers the o'er-fraught heart and bids it break." Allow yourself all your feelings, and find support in expressing them. Talking about your loss will help; grief is too weighty to be carried alone. You need to talk about it, whether with a partner, family, friends, or a therapist. For additional support, you might consider going to a support group for those who are working through grieving. It can be very helpful to hear others talk about their feelings, their struggles relating to loss and their strategies for coping. Reaching out, in whatever ways feel right to you, will lessen your isolation and give you ideas to help you manage. Keeping a journal, and writing a series of "letters" to your loved one, can be a great help in sorting out your feelings and bringing a sense of resolution.

ASK FOR HELP

Allow yourself to lean on others a bit more. Ask again if you've forgotten what someone told you. Ask for help at work or school if you need it, in filling out forms, extending a due date on a project or assignment, and so forth. At home, ask for help with daily tasks if they seem overwhelming. Hire a housecleaner for a month or two. Let friends cook you a meal or take you out to a movie. If you grew up having always to rely on yourself, it can be difficult to ask for help. However, a grieving process can have a big impact in your life -- encourage yourself to take some risks. Reaching out for support may feel awkward. Some people you reach out to may not respond, possibly from their own fears around loss. Others will be there for you if you let them. In learning to lean a bit more in times of adversity, you actually become stronger: a person who has learned how to draw on your resources and allow yourself to receive support. The bonds of love and caring you have with others can be like a safety net to support you in difficult times.

SPIRITUAL/CENTERING RESOURCES

If you have spiritual resources, use them. Prayer, meditation, reading spiritual materials, going to meetings or a place of worship, can replenish your spirit and provide support thorough the period of grieving. You may be able to feel the support and love of your "Higher Power," however you define it, if you allow yourself the time and space needed to receive it. If you are "angry at God for taking your loved one away," it will be helpful to express these feelings, whether through a written exercise, a spoken dialog, or by talking through these feelings with a friend, loved one or therapist.

ANTIDEPRESSANTS

Sometimes grief is so immobilizing that it is helpful to take antidepressants for a period of time. They can help you cope through the worst of the grieving process. Health professionals are aware that grief can be overwhelming and they know that medication can help; don't hesitate to ask. The old belief that only the "mentally ill" need medication is a worn-out stereotype. Depression is quite common, and research has established that antidepressants are a primary resource in alleviating it. For most people, a family doctor can provide antidepressants, adjust the dosage and monitor how the medication is working for you. Sometimes one antidepressant may make you too hyper or too sleepy, while another one will "fit" well with you. Sometimes people are concerned that antidepressants will block their feelings and prevent them from working through grief. The feelings will be there, but you will be a bit more detached and better able to cope as you grieve. You should also be able to sleep better, have more energy, and so forth.

Depression, if left unchecked, tends to worsen in a "spiraling-down" effect. You may not feel like reaching out and isolate, shutting yourself off from support...and then become even more depressed. Antidepressants can start the spiral moving upwards instead of down -- lifting your spirits enough that you can better manage your daily life while you come to terms with your loss. An analogy for this could be that life is a river, and that at times there are rapids. When you have to swim through a stretch of turbulent white water, it's difficult to keep your head above the surface. Antidepressants can be like a flotation device that helps you navigate the rapids. You still have to pass through the rough waters, but the flotation device keeps your head above water, helps you to see better, allows you to maneuver more effectively. Sooner or later, the waters will smooth out, the river of your life will become peaceful again. At that time, working with your physician, you can taper off of your antidepressants.

TAKING BREAKS FROM GRIEF

It can be very helpful to "take breaks" from your grieving. Children do this naturally. If they have a major loss, they cry and grieve... and then they seem to forget about the loss and get caught up in their play. After a time, they remember the loss and mourn some more. This process gives them respite from the overwhelming nature of grief. Adults also need to find ways to take "breaks" from grieving. Movies and books can help you "get away" for a while into another reality. This is not "escapism," or "running away" from the loss--it's simply a healthy time-out that helps you to relax for a little while and let go of the grief. It's important to find a balance between working through your losses and allowing yourself distractions to relieve you temporarily from the burden of grief.

COMING TO TERMS WITH THE LOSS

People may worry that if they are not in great pain, they are betraying their loved one, that feeling better gradually means they "didn't really love the person enough." This is not true. The natural course of grieving is that losses heal and resolve over time. No matter how much you have loved someone, eventually you should be able to come to terms with the loss in a healthy way. As the intensity of grieving lessens it does not mean you're betraying your loved one's memory or loving them less. The love you had for that person will continue as your grief gradually heals. You will eventually resolve the loss, although you may always miss your loved one and feel sadness when you think about them. At times, when there is an anniversary date (like the time of year when they died, a birthday or holiday) more grief may surface to be worked through.

HEALING AND GOING FORWARD

Time does heal most of our wounds from loss: "Earth has no sorrow / that Heaven cannot heal." (Thomas Moore.) Over time, you will adjust to the loss and gain greater understanding and acceptance. Energy will improve, you will feel more grounded and begin to regain former interests. You may discover that your connection with the person who died continues on in cherished memories and all that the person has meant to you -- in effect, you carry them forward with you in life. You may discover that you have a deepened compassion for others who are experiencing grief. As you integrate the loss over time you may find that while loss is painful, the experience has given you a deepened sense of the complexity, beauty and richness of life-- despite its fragility. Grief is an acknowledgment of the deep value of our connections with others. It's a tribute to those with whom we have taken the risk to bond and to love.

Judy Betterton is a former Women's Therapy Referral Service member now living in the southeastern US. She continues to practice as a psychotherapist and is also a published fiction writer.

The above article expresses the opinions of the author and doesn't necessarily reflect the views of other members of the Women's Therapy Referral Service.

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