Grief
This first teaching is on behalf of Atrium Health, more specifically a dear friend Kristy Morely, who experienced the loss of her husband at a young age, went back to nursing and ended up completely rewriting Atrium’s Grief curriculum.
“Our culture sees grief as a kind of malady: a terrifying, messy emotion that needs to be cleaned up and put behind us as soon as possible. As a result, we have outdated beliefs around how long grief should last and what it should look like. We see it as something to overcome, something to fix, rather than something to tend or support. Even our clinicians are trained to
see grief as a disorder rather than a natural response to deep loss. When the professionals don’t know how to handle grief, the rest of us can hardly be expected to respond with skill and grace” (Devine, 2018, p. xvii).
“Grief is piercingly particular. There is hardly any limit to the ways loss will find us, entering into our lives not only through the death of someone we love but also through the myriad other ways life can wrest from us what we have held dear. When grief does find us—however it finds us—it shapes itself precisely to the details of our lives. It fits itself to our habits and
routines, our relationships, our priorities, what we have organized our lives around—all that makes us who we are in this world. Because of this, no one will know our grief as we do. No one will entirely understand what it is like to live with our specific shattering” (Richardson, 2016, p. xviii).
“In her later years, Kubler Ross wrote that she regretted writing the stages the way she did, that people mistook them as being both linear and universal. The stages of grief were not meant to tell anyone what to feel and when exactly they should feel it. They were not meant to dictate whether you are doing your grief “correctly” or not. Her stages, whether applied to
the dying or those left living, were meant to normalize and validate what someone might experience in the swirl of insanity that is loss and death and grief. They were meant to give comfort, not create a cage” (Devine, 2018, p.31).
“Grief is the least linear thing I know. Hardly a tidy progression of stages, grief tends to be unruly. It works with the most raw and elemental forces in us, which makes it unpredictable and wild. Grief resists our attempts to force it along a prescribed path” (Richardson, 2016, p. xvii).
“Grief is visceral, not reasonable: the howling at the center of grief is raw and real. It is love in its wildest form” (Devine, 2018, p. 10).
Layers of Grief
“We often think of grief as primarily emotional, but grief is a full-body, full-mind experience” (Devine, 2018, p 117).
Shock/Trauma
• “Time has stopped. Nothing feels real. Your mind cannot stop replaying the events, hoping for a different outcome. The ordinary, everyday world that others still inhabit feels coarse and cruel. You can’t eat (or you eat everything). You can’t sleep (or you sleep all the time). Every object in your life becomes an artifact, a symbol of the life that used to be and might have been” (Devine, 2018, p. 4).
Physical
• “Grief affects appetite, digestion, blood pressure, heart rate, respiration, muscle fatigue, and sleep—basically everything. If it’s in the body, grief affects it” (Devine, 2018, p. 118).
• “When you are in mourning, you usually feel under-rested and overwhelmed…You may feel you have no strength left for your own basic needs, let alone the needs of others. Actually, one literal definition of the word ‘grievous’ is ‘causing physical suffering’. Yes, right now your body is telling you it has, just like your heart, been ‘torn apart’ and has some special needs” (Wolfelt).
• “It makes sense that your physical body rebels: it can only hold so much” (Devine, 2018, p. 119).
Emotional
• “No one ever told me that grief felt so like fear. I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing. At other times I feel mildly drunk, or concussed. There is a sort of invisible blanket between the world and me. I find it hard to take in what anyone says” (C.S. Lewis, 2016, p. 3).
• Waves of emotion: anxiety, panic attacks, depression, anger, rollercoaster/waves of emotions, deep sadness, guilt, fear.
Cognitive
• “…cognitive changes, memory loss, confusion, and shortened attention spans are all common in early grief. Some effects last for years—and that’s perfectly normal” (Devine, 2018, p. 118)
• Daily activities take longer
• May need to have things repeated
Gender Differences
• Dads and Moms/Partners grieve differently
“There is evidence that men are more likely than women to remain silent or grieve in isolation, engage in action-oriented forms of grief expression, or lose themselves in distractions…” (Janssen).
“Angie and I grieved differently. For Angie it was a constant process from the time of Audrey’s diagnosis, to the time of her passing, to now; for me it comes in cycles. Angie was constantly reminded of Audrey and was so connected with her because she was carrying her. She was always mourning for her. The grieving process has not been the same for me. I think that has been very difficult for Angie because it sometimes seemed as if I didn’t love Audrey the way Angie did. It hurt her because I didn’t grieve as intensely as she did. I think sometimes she felt alone. I was frustrated and angry with myself because I didn’t grieve like she did. I felt guilty and in turn angry, I was very defensive” (Smith, 2010, p. 194).
Gender Response
• Stressor on marriages/relationships
“…grief puts a lot of pressure on a marriage. And couples have to give each other a lot of grace as they navigate the road of grief. They are two individuals grieving in different ways and on different timetables, which can lead to lots of conflict as well as intense loneliness” (Guthrie, 2016, p. 49).
“Siblings in families bereaved as a result of perinatal loss suffer in two ways: they mourn the loss of their expected sibling and they mourn the loss of the parents as they knew them prior to the loss. Parents can be so overwhelmed with their own grief that they are blind to their children’s grief” (Abstract: O’Leary and Gaziano, 2011, p. 173).
“The message that children are too young to understand, still common today, causes their grief to be ignored and influences both the emotional development of the children alive at the time of the loss and the children that follow…Nevertheless, recognition of a child’s grief has been assessed as the most important part of supporting siblings” (O’Leary and Gaziano, 2011, p. 190).
Complications/complexity of Grief
Depression
• History of Mental Illness
• Panic Attacks
• PTSD
• Lack of support
• COVID-19 (isolation in grief)
• Self-Blame
Please watch this video and follow along with the content provided below:
Most people associate the word ‘grief’ with the sadness that surrounds the death of a loved one. Yet people can experience grief after many other losses, including a breakup, losing a job or a home, having a part of the body like an arm or leg removed, being diagnosed with a terminal illness, or having to drop out of college. All of these situations can lead to a feeling of loss and may add an extra layer of complexity that therapy could address. When someone experiences the loss of a loved one they must deal with the loss AND the grief.
Types Of Loss:
https://whatsyourgrief.com/types-of-grief/ for more information on the types we talk about in the video session
Grief is Hard–Take a moment, think about something you may be grieving.
Types of Grief:
- Complicated
- Anticipatory
- Delayed Grief
- Secondary Loss/Cumulative Grief
- Link to other types/further reading (https://whatsyourgrief.com/types-of-grief/)
Immediate trauma – immediate terror – Shock is the first response to trauma. Shock is the freeze mode (fight, flight, freeze). Often in rape, they freeze, but when you freeze, that trauma is still in your system and that’s what can lead to health issues down the road. So the first most important thing to do with a trauma is to deal with the shock. It’s tricky to go treat shock trauma because you have to wind down that road to disentangle these things without disrupting that trauma again.
Fighting is setting a boundary – an aggressive way of setting a boundary.
Flight is getting out of town so you don’t have to set a boundary. Run away.
The secondary response to trauma is emotional. Guilt, shame, bitterness, fear – are all tied to grief. Over time, grief turns to anger.
Grief signal words:
- Bitter
- Resentful
- Holding grudges
- Cynical
- Pessimistic
Grief is underneath. They’re in a non-forgiving past, holding onto an emotional state.
Guilt is next – “I could have done something”.
Then shame – “I’m a bad person, a weak person, maybe I deserve to have this happen to me.”
When you’ve been more emotionally abused, you’ll tend to blame yourself.
Fear is a big feeling for many with unresolved trauma.
When you talk about it, it can be released.
Grief Emotions:
Grief is experienced in many ways. Emotions can range from anger to sadness or even numbness. Everything you feel is valid, and despite how intense your emotions maybe, you’re most likely progressing through the stages of grief: denial, anger, bargaining, depression, and acceptance; all explained below.
Express what you need to feel-hard emotions don’t mean “bad” (soda bottle example)
- Ways to feel in healthy ways (coping skills ideas/link to tools)
- Finding Support (Grief Share and Individual Counseling–church counseling center, BetterHelp, TalkSpace, OnSite for intensive work)
https://www.psychologytoday.com/us/therapists
Specific help for pregnancy loss or infant loss: https://mendwell.app/
Stages of Grief:
Understanding the stages of grief (i.e., denial, anger, bargaining, sadness, acceptance, meaning) can help us name, not numb, our feelings. The stages are neither perfectly linear nor orderly. You may experience the stages of grief in any order and any number of times. You may feel sad at the beginning, move on to anger, and then return to sadness. Take your time to grieve. Allow yourself to do it in your unique way.
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- Denial, Anger, Bargaining, Depression, Acceptance
- Stages are not linear and can go back and forth
- “6th stage”-finding meaning-David Kessler
https://brenebrown.com/podcast/david-kessler-and-brene-on-grief-and-finding-meaning/
Denial:
is necessary to help you survive a loss. You’re in a state of shock because the world as you knew it no longer exists. You might start to deny the news of whatever loss you experienced. In this stage, you’re clinging to a “preferred” reality, instead of the true reality of the situation.
Anger:
might present itself in feelings of “why me” or “life isn’t fair”. It might present as blame toward others that the loss occurred or as a redirection of perceived slights. People of religious faith will often find they’re angry with God for letting this happen to them.
Bargaining:
is a form of false hope. It’s a form of “negotiation” with yourself or with a higher power that serves as a way to try to avoid the grief. It’s a willingness to make a major change in your life to bring things back to the way they used to be.
Depression:
is the phase where you accept that your attempts at avoidance and bargaining are futile. Reality begins to set in, and grief tends to enter your reality in a major way. The grief is often much deeper and persistent than you could have imagined and often feels like it’s never-ending. It could manifest in feelings of wanting to withdraw from life, feelings like nobody could possibly understand what you’re going through or help you feel better, and feelings of pure sadness.
Acceptance:
should not be confused with everything suddenly being “all right.” In fact, most people never again feel “all right” after a major loss. The acceptance stage is simply about coming to terms with the fact that your current loss is a permanent reality (the loved one who died will never come back, the terminal diagnosis will not go away, etc.). It’s not about learning to like the new reality. It’s about learning to live with this new norm. It’s about learning to readjust to life by taking on new roles or assigning them to others. It’s not about replacing the loved one, but instead about making new connections and relationships.
Finding Meaning:
is taking the next step in adjusting to your new reality. That may be celebrating your loved one’s life with love instead of just focusing on their death with pain, re-assessing your career path after losing a job, deciding what you do and do not want in a relationship after a break-up, etc.
Grief + Healing:
When you can work through your grief and trauma, there’s gifts to be received.
When we hold onto bitterness and resentment it can hurt us more than the other person. It doesn’t mean forgetting. It’s a misnomer that we think we should be able to make these feelings go away. But you don’t get over things, you get through them.
If we have unresolved trauma we are going to see threat in places where it’s not really there, but we’re not going to be able to recognize that it’s not there.
The way to forgiveness is to make sense of the impact and the meaning that those life experiences had. Extract the good, and then we can move towards a place of forgiveness. Then that’s the point where people can really let go.
Dealing with our traumas takes a high level of awareness and courage. Unfortunately for some the grief associated with trauma is too much to bear. It can lead to self harm to suicide.
So often we feel like victims when we’re in grief. But the difference between being a victim and being empowered is understanding that you have choices.
There’s value in going through and feeling those bad feelings, because we come out stronger on the other side. Over time we need to move more towards the positive aspects and what we learned, how we grew, what we can take away from this experience to facilitate healing.
Grief doesn’t go away, it just changes.
https://www.youtube.com/watch?v=khkJkR-ipfw
Verses for Encouragement
Psalm 73:26 “My flesh and my heart may fail, but God is the strength of my heart and my portion forever.”
John 14:27 “Peace I leave with you; my peace I give to you. Not as the world gives do I give to you. Let not your hearts be troubled, neither let them be afraid.”
Romans 15:13 “May the God of hope fill you with all joy and peace in believing, so that by the power of the Holy Spirit you may abound in hope.”
Psalm 34:18 “The Lord is near to the brokenhearted and saves the crushed in spirit.”
Worksheets for Grief Processing:
https://www.therapistaid.com/therapy-worksheets/grief/none
