- What it is Like to Grieve - bereavement and loss
- What's Normal for You May Not be Normal for Others
- The Experience of Grief for Children
- How Can I Help the Grieving Person?
- But What of Unresolved grief
- The Kubler-Ross Grief Cycle
- Places Where Help Can be Found
What it is like to grieve - bereavement and loss
The experience of bereavement can be very distressing, but for us as human beings it is an experience we have in common with the rest of mankind. Sooner or later during our lives most of us must face the death of someone we love. But it is a fact that in our day to day life we do not think and talk much about death, and it seems that it is not the thing of conversation it was in the past. Perhaps this is because we encounter it less often than our grandparents did when the death of young women in childbirth was common and many children died very young. So for them, the death of a brother or sister, mother, friend or relative, was a common experience in their childhood or teenage years. For people living today in the developed world, these losses are usually encountered later in life. As a result, we no longer learn while we are young about grieving - how it feels to lose someone we love, what are the right and proper ways to behave and things to do. We are no longer able to observe others in grieving to see what is 'normal' - or to come to terms with it. However we have to cope when we are finally faced with the death of someone we love.
The process of grieving is something we experience after any sort of loss, but is felt most profoundly following the death of someone we love. Grieving is not just one feeling, but it is a whole succession of emotions, each of which take a while to work through and it is a process which cannot be hurried.
In the natural order of things it is the young who grieve at the loss of older relatives, but some parents are faced with the loss of their children who they may have seen safely into their teens and twenties. But while we most often grieve for someone we have known for many years there are occasions when people experience the grieving process without this length of knowing. People who have had stillbirths or miscarriages, or who have lost very young babies, grieve in the same way as those who lose loved one at older ages and they need the same sort of care and consideration.
During the few hours or days following the death of a close relative, close friend or loved one, most people are left feeling stunned, unable to believe it has actually happened, even when the death has been expected and prepared for.
In this period when there are a lot of arrangements to be made following the death, this sense of emotional numbness can be helpful. Getting in touch with relatives and the deceased friends, sorting out the immediate financial affairs and organising the funeral can fill the days and is often done on 'automatic pilot' during this phase of stunned numbness. However, this feeling of detached unreality may become a problem if it lasts for too long, and for some seeing the body of the dead person may be an important way of beginning to overcome this. In former times when it was usual for the body to be in the house for both friends and close relatives to come to see the deceased there was a chance to come to terms with the reality of the loss.
Similarly, for many people, it is not until the funeral or memorial service that there is an occasion when the reality of what has happened really starts to really sink in. While it may be distressing to witness the body, or to attend the funeral, burial or cremation, taking part in these customs are ways of saying goodbye to those we love. At the time, it may seem too painful to have to go through these rituals and sometimes people avoid them. However, this can lead to a sense of deep regret in future years arising from this not coming to terms with the loss and witnessing the fact that a loved one really is dead.
Soon though, this numbness disappears only to be replaced by a dreadful sense of agitation, anxiety, and of pining or yearning for the dead person. It can feel like you need to search for the lost one, of wanting somehow to find them, even though you know this is clearly impossible. This makes it difficult to relax or concentrate and it may be impossible to sleep properly.
Sleep can be disturbed night by dreams that can be very upsetting, and in their waking moments some people feel that they 'see' their loved one everywhere they go - in the shops, at the park, or in rooms around the house, anywhere they had spent time together. People often feel very angry at this time. This anger is directed towards doctors and nurses who failed in not preventing the death, towards friends and relatives who did not do enough when the person was ill, or even towards the person who has, by selfishly dying, left them alone.
Another common feeling is guilt leading to people finding themselves going over in their minds all the things they would have liked to have said or done but didn't and now it's too late. They may even go over what they themselves could have done differently that might have prevented their loved one's death. Of course, death is usually beyond anyone's control and a bereaved person may need to be reminded over and over of this. There may be feelings of guilt if they feel relieved that their loved one has died, perhaps after a long, painful or distressing illness. This feeling of relief is natural, understandable and very common but the grieving person may find it difficult to come to terms with the conflicting feelings of loss and relief.
This state of agitation is usually greatest about a fortnight after the death, but the griever seems to tire and the agitation is soon followed by times of quiet sadness, reflection, depression, withdrawal and silence. The person goes from one emotion to another, sometimes going over parts of the process again and these sudden changes of emotion, though part of the normal process of grief can be confusing to friends and relatives.
Although the level of agitation lessens, the periods of withdrawal and depression become more frequent, often reaching their peak between four and six weeks later. And it is not a steady curve of 'getting better' and spasms of grief can occur at any time, sparked off by people, places or things that bring back memories of the dead person.
Nor is it always easy when you are a friend to the grieving person as it can be difficult to understand what one has said or done, or it can be embarrassing when the bereaved person suddenly bursts into tears for no obvious reason. But friends should keep in helpful and supportive contact since at this stage it the bereaved person may be tempted to keep away from other people who do not fully understand or share their grief. However, in avoiding others they may be storing up trouble for the future. It is usually best to start to return, as best one can, to normal activities after a couple of weeks or so.
The bereaved person may spend a great deal of time appearing to just be sitting, doing nothing. This is the period when they are usually thinking about the lost one, going over again and again the positives and negatives, both the good times and the bad times they had together. This is a quiet, undemonstrative, but essential period for the person in the coming to terms with the death.
Only as time passes does the fiercest pain of early bereavement begins to fade and the depression to lessen. It begins to be possible to think about other things and even to plan and to look again to the future. There is with the death of a loved one a sense of having lost a part of oneself and although people come to terms with it, it never goes away entirely. For bereaved partners there are constant reminders of their situation and of their new singleness. Most of their previous social life has been as a part of a couple and seeing other couples together highlights what has been lost. There is a deluge of media images of happy families which are bound to bring back both happy and sad memories. After some time it usually becomes possible to feel whole again, even though the fact that there is a part is missing never goes away completely, and even many years later the remaining partner may sometimes find themselves talking as though their dead partner were still here.
Though we have shown a progression of emotional reactions, in reality these various stages of mourning often overlap and show themselves in different ways in different people. It is recognized that most people recover (if recover is the right word) from a major bereavement within one or two years. At this time they reach the final phase of grieving, the letting-go of the person who has died, and the start of a new sort of life without them. Although sadness remains, the depression clears completely, sleeping becomes easier and energy levels return to normal. All sexual feelings may have vanished for some time, but now these usually return, and though some people feel guilty over this, it is quite normal and nothing to be ashamed of.
What's Normal for You May Not be Normal for Others
We have talked about what is "normal" but there is no normal way of dealing with death, no "standard" way of grieving. We are each one of us individuals and have to find our own particular ways of grieving. And what is usual for one group of people is not usual for another since people from different cultures deal with death in their own distinctive ways, and over time the peoples of different parts of the world have worked out their own ceremonies for coping with death. So, while in some communities death is seen as just one step in the continuous cycle of life and death in others it is seen rather as a 'complete end'. For some the rituals and ceremonies of mourning can be very public and demonstrative, for others they are private and quiet. In some cultures there is a fixed period of mourning, as there was in the UK in Victorian times, in others there is no formal tradition to follow. The feelings experienced by bereaved people in different cultures may be similar, but their ways of expressing them and the support they get from their grieving process can be very different.
The Experience of Death for Children.
Even before children can have an understanding of the meaning of death which is usually thought to be at age three or four years, they do feel the loss of close relatives in much the same way as adults. Anyone who has had to do with a child who has lost a parent will know that even from infancy, children grieve and feel great distress.
Because the child's different experience of the passage of time they may go through the stages of mourning quite rapidly. Often bereaved early school years children may believe they did something that brought about the death and they feel responsible for the loss of a close relative. They can never be reassured too often that they are not to blame. Young people may not speak of their grief for fear of adding an extra worry to the grown-ups in the family, or for fear of upsetting younger siblings. The grief felt by children and adolescents, and their need for a period of mourning, should not be overlooked when a member of the family has died. It is often best to include them in the funeral arrangements, and to be available to listen to and to talk with them when they want it.
How can I help the bereaved person?
Try to spend time with the person who has been bereaved. While words can be a great comfort, they need to know that you will be "with them" during this time of pain and distress. And comfort does not need just words, a sympathetic arm around the shoulders or a hug will often express care and support when words are not enough.
It is important that, should they want to, the bereaved people be allowed to cry "with" somebody and talk about their feelings of pain, loss and distress without fearing they will be told to pull themselves together. Over time, they will come to terms with their loss, but first they need to talk and to cry.
You may find it hard to understand why the bereaved person has to keep talking about the same things again and again, when you think they need to move on but this is part of the process of resolving grief and should be encouraged. If you find yourself not knowing what to say, or don't even know whether you should talk about it at all, you should be honest and say so. Only by doing this will the bereaved person have a chance to tell you what they want from you. People often avoid mentioning the name of the person who has died for fear that it will be upsetting. However, to the bereaved person it may seem as though others have forgotten their loss, which further adds to their sense of isolation to their painful feelings of grief.
Festive occasions and anniversaries will be particularly painful times and friends and relatives can make a special effort to be around to support. These are usually family occasions and are bound to bring both happy and sad memories flooding back.
Practical help around the house with cleaning, shopping or with looking after young children can ease the burden for the one who is left alone, and older bereaved partners may need help with those things the deceased partner used to handle - coping with bills, cooking, the garden housework, getting the car serviced and so on.
It is important to allow them enough time to grieve, and while some can seem to get over the loss quickly, but others take longer. So don't expect too much too soon from a bereaved relative or friend - they need the time to grieve properly. Grieving fully and at their own rate will help to avoid problems in the future, and unresolved grief can be a big problem for some people.
But What of Unresolved Grief
Some people seem hardly to need to grieve at all, not even crying at the funeral, and avoiding any mention of their loss. They are able to return to their normal life remarkably quickly. If this is their normal way of dealing with loss then no harm results, but there are others who suffer from strange physical symptoms or repeated spells of depression over many years to come. For others there has not been the opportunity to grieve properly due to factors such as the demands of looking after a young family or needing to attend to business which meant there just wasn't the time.
Family members have particular difficulty in dealing with those who have lost a baby, had an abortion or had a stillbirth and as a result there never seems to be a 'proper' bereavement. There can be a very private grief that goes unregistered or unrecognized by others and frequent periods of depression may follow.
Some may start to grieve, but get stuck with and unable to get past the early sense of shock and disbelief, which continues unabated. Sometimes, even after many years, the sufferer still finds it hard to believe that the person they loved is dead and lost to them. Others may carry on their lives yet being unable to think of anything else, often making the room of the dead person into a kind of shrine to them and their memory.
Occasionally, the depression that occurs and is a feature of almost every bereavement may become entrenched and deepen to the extent that the bereaved stops caring for themselves, and food is refused and serious thoughts of suicide arise.
Sometimes the sleepless nights that are normal may go on for so long as to become a serious concern and the doctor may then prescribe supply of sleeping tablets but he will be aware of the danger inherent in deep depression and will limit the supply. If the period of depression continues and deepens further, along with loss of appetite, energy and sleep, antidepressants may be helpful or the GP may suggest an appointment with a psychiatrist.
If someone is unable to resolve their grief, medical help should be sought through their GP or one of the many voluntary organizations such as Cruise, or by contacting a religious organisation. For some in this deep grief, it will be enough to meet people and talk with others who have been through the same experience, while for others seeing a bereavement counsellor or psychotherapist is required. This can be either in a special group of fellow grievers or in individual counseling.
Bereavement turns our world upside-down and is one of the most painful experiences we endure. It can be strange, terrible and overwhelming. In spite of this, it is a part of life that we all go through and usually does not require medical attention. At Absolute Discretion Counselling Therapy we can help people get through their bereavement and loss in a caring, respectful and confidential way.
The Kubler-Ross Grief Cycle
Understanding Grief
For those going through grief it can be very hard to understand what is going on, why do they feel like this, why do other people act so strangely, will this ever pass? The Kubler-Ross grief cycle is a representation of the stages through which many grieving people pass and re-pass. Some people, grievers and their supporters, find this representation helpful in understanding their mixed emotions.
Background
For many years, people with terminal illnesses were an embarrassment for doctors. Someone who could not be cured was evidence of the doctors' fallibility, and as a result the doctors regularly shunned the dying with the excuse that there was nothing more that could be done (and that there was plenty of other demand on the doctors' time).
Elizabeth Kübler-Ross was a doctor in Switzerland who railed against this unkindness and spent a lot of time with dying people, both comforting and studying them. She wrote a book, called 'On Death and Dying' which included a cycle of emotional states that is often referred to (but not exclusively called) the Grief Cycle.
In the ensuing years, it was noticed that this emotional cycle was not exclusive just to the terminally ill, but also other people who were affected by bad news, such as losing their jobs or otherwise being negatively affected by change. The important factor is not that the change is good or bad, but that they perceive it as a significantly negative event.
The Grief Cycle
The Grief Cycle can be shown as in the chart below, indicating the roller-coaster ride of activity and passivity as the person wriggles and turns in their desperate efforts to avoid the change.
The initial state before the cycle is received is stable, at least in terms of the subsequent reaction on hearing the bad news. Compared with the ups and downs to come, even if there is some variation, this is indeed a stable state.
And then, into the calm of this relative paradise, a bombshell bursts...
- Shock stage: Initial paralysis at hearing the bad news.
- Denial stage: Trying to avoid the inevitable.
- Anger stage: Frustrated outpouring of bottled-up emotion.
- Bargaining stage: Seeking in vain for a way out.
- Depression stage: Final realization of the inevitable.
- Testing stage: Seeking realistic solutions.
- Acceptance stage: Finally finding the way forward.
Sticking and cycling-Getting stuck
A common problem with the above cycle is that people get stuck in one phase. Thus a person may become stuck in denial, never moving on from the position of not accepting the inevitable future. When it happens, they still keep on denying it, such as the person who has lost their job still going into the city only to sit on a park bench all day.
Getting stuck in denial is common in 'cool' cultures (such as in Britain, particularly Southern England) where expressing anger is not acceptable. The person may feel that anger, but may then repress it, bottling it up inside.
Likewise, a person may be stuck in permanent anger (which is itself a form of flight from reality) or repeated bargaining. It is more difficult to get stuck in active states than in passivity, and getting stuck in depression is perhaps a more common ailment.
Going in cycles
Another trap is that when a person moves on to the next phase, they have not completed an earlier phase and so move backwards in cyclic loops that repeat previous emotion and actions. Thus, for example, a person that finds bargaining not to be working, may go back into anger or denial.
Cycling is itself a form of avoidance of the inevitable, and going backwards in time may seem to be a way of extending the time before the perceived bad thing happens.
Places Where Help Can Be Found
If you feel stuck in your grief or you are someone worried about a grieving loved one we hope the above information will have been of help.
As a next step you should look in our Useful Contacts section for telephone help-lines and web sites, and under our Helpful Books section for available literature.
And further help should be sought from a counselor such as Absolute Discretion Counselling Therapy.
* Please also see the section Stress, Change, Grief and trauma on this Website.
** See also the section on Depression on this Website.