Dealing with Grief

How to Deal with Grief

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  • How to Find Purpose While Coping with Grief

    No one is prepared for grief. The rush of feelings, the thoughts, anxieties, and heartache can take us by surprise.  But this essential part of mourning is what allows us to live fully again. It allows us to step out of the darkness of mere existence and back into the sunshine where life is sweet again. Of course, it's a very different life than the one you had before your loved one died. Yet, healing awaits us all, and we believe the information is this section will help you begin the healing process. In addition, we can provide you a referral to a grief counselor or therapist.
    Dr. James Worden chose to see the work of bereavement as task-oriented:
    • To accept the reality of the loss
    • To process the pain of grief
    • To adjust to a world without the deceased
    Your current job is to focus your attention on achieving each of those goals. It will not occur in any logical order; each of us is different and the path we walk in the grieving process is not a straight one.
    Dealing with grief takes both courage and hard work to successfully adapt to the loss of a significant person in your life.
    Coping with grief - tree

    Help with the Grieving Process

    Six Signposts Along Your Journey
    Dr. Stephen Joseph identifies what he calls six signposts to facilitate post traumatic growth. He reminds readers too that "post traumatic growth does not imply the absence of emotional distress and difficulties in living. It does imply that it is possible through the struggle to come out on the other side, stronger and more philosophical about life."
    Before identifying these six signposts, Dr. Joseph reminds his readers of three very important things:
    • You are not on your own
    • Trauma is a normal and natural process
    • Growth is a journey
    He also provides a fundamental rule: don't do anything you might not be able to handle now. "If you experience intense emotions, become physically upset, or begin to panic...stop." He gently reminds readers that "having a sense of personal control over your recovery is important. There might be some things you do not feel ready to handle now, but in time, as you discover new strength and develop new coping skills, this will likely change."
    Sign Post #1: Taking Stock
    Are you physically well? Are you getting enough sleep and eating the right foods for optimum health? Have you received the kind of medical, legal, or psychological help you need? What is your current condition: physically, spiritually, and emotionally?
    Sign Post #2: Harvesting Hope
    People traumatized by loss often feel hopeless. It's hard to get up in the mourning and thinking about the future sparks pessimism and negativity. Find inspiration in the stories of personal growth written by others; set goals and practice hope as you set out to achieve them.
    Sign Post #3: Re-Authoring
    Learn to tell your story differently. Take the victim mentality out of the story of loss you tell yourself and others and replace it with the word survivor to return to a sense of control over your life.
    Sign Post #4: Identifying Change
    Keeping a daily diary can help you to see the small changes within more easily. You can also track those moments when you feel at your best and identify the conditions that brought them about. Identify and nurture the positive changes in your life throughout your bereavement journey.
    Sign Post #5: Valuing Change
    Review these changes, identifying the ones that you'd like to continue to nurture. Personal transformation requires it. Growth is encouraged when we take time to think about what we have gained from loved ones and when we find a way to use what we have learned to give to others.
    Sign Post #6: Expressing Change in Action
    Express your growth in new behaviors or, more simply, put your growth into action. When you think in terms of concrete actions, it helps make the growth experienced within your bereavement real to you.
    "By focusing on these six signposts," writes Dr. Joseph, "you will find that your posttraumatic growth is beginning to take root."
    Sources: 
    Worden, James. Grief Counseling & Grief Therapy: A Handbook for the Mental Health Practitioner
    Fleming, Stephen. The Changing Face of Grief: From 'Going On to 'On-Going''
    Joseph, Stephen. What Doesn't Kill Us: the New Psychology of Posttraumatic Growth
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    Finding Acceptance and Ending Denial

    Acceptance is the very first task in your grieving process.
    This is where a funeral can be very helpful for coping with grief. Traditionally, the casketed body of the deceased is at the front of the room and guests are invited to step up to personally say their goodbyes. Part of stepping up means seeing with our own eyes that death has actually occurred and that actualizing is an essential part of coming to accept the death. 
    Acceptance May Seem Out-of-Reach
    For many, acceptance means agreeing to reality. Most of us, when we lose someone dear to us, simply don't want to agree to it; we actually have an aversion to agreeing and accepting. So, let's use a different word - try adjustment, or integration. Both words focus on the purposeful release of disbelief. Someone who has integrated the death of a loved one into their life has cleared the path to creating a new life; a pro-active life where a loved one's memory is held dear, perhaps as a motivating force for change.
    It does take time. In Coping with the Loss of a Loved One, the American Cancer Society cautions readers that "acceptance does not happen overnight. It’s common for it to take a year or longer to resolve the emotional and life changes that come with the death of a loved one. The pain may become less intense, but it’s normal to feel emotionally involved with the deceased for many years after their death. In time, the person should be able to reclaim the emotional energy that was invested in the relationship with the deceased, and use it in other relationships." 
    This essential part of mourning is what allows us to live fully again. It allows us to step out of the darkness of mere existence and back into the sunshine where life is sweet again. Of course, it's a very different life than the one you had before your loved one died.
    Sources:
    Worden, James, Grief Counseling & Grief Therapy: A Handbook for the Mental Health Practitioner, 4th Edition, 2009.
    American Cancer Society, "Coping with the Loss of a Loved One", 2012
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    For Friends of a Grieving Person

    People can be very supportive in the initial days after a death. There are lots of things for them to do: help to make funeral arrangements, notify other friends and family of the death, and take care of day-to-day chores. It's a matter of being friends: taking on the necessary tasks so survivors have the time and energy to actively mourn their loss.

    Meaningful Things You Can Do to Help:
    • Attending their loved one's funeral is just the first step in accepting the reality of their loss.
    • Empathetic listening – listening not just with your ears but with your heart. This goes a very long way in helping them to process the pain of grief. Be willing. Allow them space to express their grief. Don't jump in into their sentences - in other words don't interrupt, let them finish their thoughts.  Listen and give support but don’t try to force someone if they’re not ready to talk.
    • Accept whatever feelings the person expresses. Even if you can’t imagine feeling like they do, never tell them how they should or shouldn’t feel. The grieving person must reintegrate their sense of self while at the same time process any changes in their beliefs, values, and assumptions about the world. Again, Empathetic listening gives them a safe space to work out these significant changes in their world view.
    • They will have to learn to be functional in this new world without their loved one. You may not be in a position to offer help with everyday tasks, but if you are you could offer help to pay the bills, assist with grocery shopping, or offer your support while they learn or relearn how to do something.
    • Taking them to visit their loved one's grave or other place of interment to leave flowers or simply to spend time in conversation and contemplation continues this process. Never force them to go; only suggest and then support them when they agree to your suggestion.
    • Be there. Even if you don't know what to say, just having someone near can be very comforting.

    How to Really Help Someone Through the Grieving Process

    It's about not walking away. Granted, you may part company after the funeral but a true ally doesn't stay away long; a better-than-good ally keeps checking in with the bereaved. Being a friend in need during this time can feel very difficult. 
    Rachael Naomi Remen, M.D, wrote what she considers to be the focus of this grief work: "Grieving allows us to heal, to remember with love rather than pain. It is a sorting process. One by one you let go of things that are gone and you mourn for them. One by one you take hold of the things that have become a part of who you are and build again." You do that with a model of task-oriented bereavement.
    How to deal with grief - lake
    The Three Tasks of Mourning
    James Worden writes that the three things that must be completed in order to adjust to the death of a significant other are:
    • To accept the reality of the loss
    • To process the pain of grief
    • To adjust to a world without the deceased
    To find an enduring connection with the deceased in the midst of embarking on a new life.
    Those three tasks define the work of grieving. When you choose to become an ally to someone in mourning, it becomes your responsibility to support them in achieving those things within their time frame – not yours.
    Don't impose a limit on the amount of time their greiving takes; the only limitations you can set have to do with any negative behaviors you witness. Is your friend using alcohol or drugs to manage their emotions? Are their eating habits becoming destructive? Are they choosing to isolate themselves from the wider world? All those things should raise red flags. If you think their grief has overwhelmed them and set them upon a self-destructive course, it may be time to suggest they see a certified grief counselor or therapist.
    Author Sarah Dessen captured the nature of good listening in this passage from her book, Just Listen. What a good listener does: They “... don’t jump in on your sentences, saving you from actually finishing them, or talk over you; allowing what you do manage to get out to be lost or altered in transit. Instead, they wait, so you have to keep going.”
    Cultivate patience and the willingness to wait. You need to be watchful for signs of depression, which may include continuing thoughts of worthlessness or hopelessness, being unable to perform day-to-day activities, feelings of intense guilt, extreme weight loss, and thoughts of death or suicide. The American Cancer Society cautions that "if symptoms like these last more than 2 months after the loss, the grieving person is likely to benefit from professional help. If the person tries to hurt him- or herself, or has a plan to do so, they need help right away."
    Online Sources:
    Worden, James, Grief Counseling & Grief Therapy: A Handbook for the Mental Health Practitioner, 4th Edition, 2009.
    Bailey, J.D. "How to Help a Friend Who is Grieving", Huffington Post, 2013
    American Cancer Society, "Coping with the Loss of a Loved One", 2012
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    When Grief Doesn't Ease

    Sometimes it feels as if your bereavement will never end. You feel as if you’d give anything to have the pain go away; to have the long lonely hours between nightfall and dawn pass without heartache. You are not the only grieving person who has longed for some measure of relief.
    Grief counselors and therapists tell us that the length of time it takes anyone to grieve the loss of someone they held dear to them is dependent on the situation, how attached you were to the deceased, how they died, your age and gender. So many variables exist and there’s absolutely no way to predict how long it will take for you to adapt to your loss.
    The Difference between Normal and Complicated Grief
    Research findings have led experts to come up with many differing categories of grief experience ranging from normal to complicated. Normal (or uncomplicated) grief has no timeline and encompasses a range of feelings and behaviors common after loss such as bodily distress, guilt, hostility, preoccupation with the image of the deceased, and the inability to function as one had before the loss. All are normal and present us with profound – and seemingly endless – challenges. Yet, Katherine Walsh says, “Over the course of time, with average social support…most individuals will gradually experience a diminishment of these feelings, behaviors, and sensations.”
    So, how can you know if your grieving is no longer within the range of normal? Ms. Walsh goes on to say, “While there is no definitive time period by which this happens, if an individual or members of a family continue to experience distress intensely or for a prolonged period – or even unexpectedly years after a loss – they may benefit from treatment for complicated grief.”
    A Useful Model for Assessment: Worden’s Four Tasks of Mourning
    There are certain tasks that when achieved during your grieving, can successfully allow you to emerge on the other side of loss as a better, stronger, and more resilient individual. James Worden proposed these four tasks:
    • To accept the reality of the loss
    • To process the pain of grief
    • To adjust to a world without the deceased
    • To find an enduring connection with the deceased in the midst of embarking on a new life
    Instead of focusing on your bodily discomforts, feelings, and common behaviors, this model allows you to better see where you may be stuck or stalled in the adaptive process. Fortunately, Worden also gives us a list of indicators advising that "any one of these clues in and of itself may not be sufficient" for a diagnosis of complicated grief. "However," he continues, "any of these…should be taken seriously, and the diagnosis of complicated grief should be considered when they appear."
    12 Clues…12 Insights
    While grief educators and theorists tell us that a diagnosis of complicated grief should not even be attempted until after the first anniversary of the death, if any one of the following symptomatic clues exists for longer than six months, you may want to consider grief counseling or grief therapy:
    • You cannot speak of the deceased without experiencing intense and fresh grief long after the loss.
    • A relatively minor event triggers an intense grief reaction.
    • Your conversations with others are littered with references to loss. In other words, loss is an ever-present motif in your world view.
    • You have issues related to your loved one's possessions. Keeping everything the same as before their death could indicate trouble just as tossing out everything right away can also be a clue to disordered mourning. (You also need to factor in your cultural and religious background)
    • You have developed physical symptoms similar to those of the deceased before their death. Sometimes these symptoms recur annually, on the anniversary of the death, or on holidays. An increased susceptibility to illness or the development of a chronic physical complaint can also be an indicator.
    • If you have made radical changes to your lifestyle, or excluded friends, family members, or even activities associated with the deceased, it may indicate unresolved grief.
    • A long history of depression, often marked by guilt or low self-esteem, can reveal disordered mourning. The opposite is also true: a person experiencing a false sense of happiness or elation could be experiencing unresolved grief.
    • A compulsion to imitate the deceased, in personality or behavior, can be a sign of complicated mourning.
    • Having self-destructive impulses or exhibiting self-destructive behaviors can be significant. These can range from substance abuse, engaging in self-harm, developing eating disorders and suicidal tendencies.
    • A sense of unexplained sadness occurring at a certain time each year (holidays, anniversaries, or birthdays) can also be a clue to unresolved grief.
    • Developing a strong fear about dying, especially when it relates to the illness that took the life of your loved one, is an important clue.
    • If you have avoided visiting your loved one's grave or if you are still unwilling to discuss the circumstances of their death, this could indicate complications in your bereavement.
    There are many types of complicated grief; it can be delayed, masked, exaggerated, or chronic. Self-diagnosis is without purpose. A year after the death, if you feel your grief symptoms worsening, we advise that you seek a referral from your family physician for  professional grief counseling or therapy.
    Sources:
    Walsh, Katherine, Grief and Loss: Theories and Skills for the Helping Professions, 2nd Edition, 2012.
    Worden, James, Grief Counseling & Grief Therapy: A Handbook for the Mental Health Practitioner, 4th Edition, 2009.
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    When Grief is Unacknowledged

    In Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice, Kenneth Doka offered a very simple definition of disenfranchised grief as an experience when "survivors are not accorded a right to grieve". Can others really deny us our right to feel sorrow and pain? Can they set limits on our bereavement? The answer is, at least in some cases, yes. It happens all the time.
    In Disenfranchised Grief Revisited: Discounting Hope and Love, Dr. Thomas Attig claimed this right entitles a grieving person to grieve when he or she needs or chooses to, and in the manner in which they choose. In response, others are obligated to honor the right and refrain from interfering in the experiences and efforts of grieving. 
    It's more than "a matter of indifference to the experiences and efforts of the grieving person. It is more actively negative and destructive as it involves denial of entitlement, interference, and even imposition of sanction. Disenfranchising messages actively discount, dismiss, disapprove, discourage, invalidate, and delegitimize the experiences and efforts of grieving. In this way, the people around the bereaved withhold permission, disallowing, constraining, hindering, and even prohibiting the survivor's mourning.”
    When Can Disenfranchised Grief Occur?
    Author Jonathan Vatner shares examples of situations where disenfranchised grief can result:
    • Your ex-husband passes away, for example, and your friends don't see why it matters.
    • A spouse, brother, or son is missing in military action.
    • When death has occurred due to socially unacceptable causes such as AIDS or suicide.
    • A beloved dog, cat or other pet has died.
    What Does Disenfranchised Grief Sound Like?
    When you are mourning an unrecognized or undervalued loss, you may hear statements like this:
    • When things like this happen, all you can do is give it time and wait it out.
    • Eventually, you’ll get over this.
    • The best thing is to try to put what happened behind you and get back to normal as soon as possible. Try to go on as if nothing has changed.
    • There’s no point in looking for meaning in something like this. Suffering brings us face to face with absurdity. The best thing is to try to forget.
    • Face reality. She is dead. You will have to fill her place with something else.
    Sometimes those dealing with grief disenfranchise their own grief with inner talk that sounds like this:
    • Somehow it feels disloyal to laugh or try to be happy. I sometimes feel that I owe it to him to live in sorrow.
    • What can I possibly have to look forward to?
    • I’m kind of embarrassed to admit that in some ways I seem to have grown from the death of my child.
    • How can I ever let myself love again if it all comes to this?
    Suffer in Silence No More
    The stress of grieving in isolation can be unbearable. If we listen to Dr. Lani Leary, even if you endure the ups-and-downs of bereavement on your own, the grief work you do will still be compromised. She tells us that it is not time that heals. Instead, healing comes with validation: "All grief needs to be blessed. In order to be blessed, it must be heard. Someone must be present, someone who is willing to hold it by listening without judgment or comparison."
    In the article mentioned above "Mourning Becomes Neglected: 4 Healthy Ways to Grieve", author Jonathan Vatner shares these four ways you can reclaim your right to grieve and get much-needed support:
    • Recognize that there is nothing wrong with you. Whatever your feelings are, they're legitimate.
    • Find people who will understand. Search online—there are bereavement support groups for just about any type of loss.
    • Be honest about how you feel. If a well-meaning friend cracks a joke about your deceased ex-husband, explain that this loss is painful for you.
    • Develop a ritual or ceremony to commemorate the person's passing. Visit the grave after the funeral or hold a private one when you can take as much time as you need to express your anguish.
    Speak Up and Speak Out
    Whatever you do, if you feel those around you are not supportive of your grieving: seek a support group, a grief counselor, go online and find helpful information about grieving. All losses are worthy of recognition and acknowledgement. And, all of us have the right to grieve.
    Online Sources:
    Doka, Kenneith, Disenfranchised Grief: New Directions, Challenges, and Strategies for Practice
    Attig, Thomas, Ph.D, "Disenfranchised Grief Revisited: Discounting Hope and Love"
    Vatner, Jonathan, "Mourning Becomes Neglected: 4 Healthy Ways to Grieve"
    Leary, Lani, Ph.D., "No One Has to Grieve Alone: Validation is the Key to Resolving Grief", 2012.
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