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Phil Chave
Phil Chave
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Understanding Grief

A guide to coping with the death of a loved one


Martha is having difficulty sleeping lately and no longer enjoys doing things with her friends. Martha lost her husband of 26 years to cancer a month ago.

Anya, age 17, doesn’t feel like eating and spends the days in her room crying. Her grandmother in South Carolina recently died. Anya misses writing to her grandmother and their weekly phone calls.

Both of these individuals are experiencing grief. Grief is an emotion natural to all types of loss or significant change. Grief uses both physical and emotional energy. After losing a loved one, an individual may grieve not only the loss of the person, but also the hopes, dreams, needs and expectations of that person: not only what is lost in the present, but what is lost for the future, as well.

Feelings of Grief
The grief reaction that individuals experience is unique and personal. A broad range of feelings and behaviors are commonly experienced after the death of a loved one. Depending on whom or what they lose, people vary in how they experience grief symptoms, how intense the symptoms are, and how long they last. An individual may experience one or many of the following feelings:
  • Sadness. This is the most common, and it is not necessarily manifested by crying.
  • Anger. This is one of the most confusing feelings for a survivor. For example, two common themes of anger are related to frustration at not being able to prevent the death and a sense of not being able to exist without that loved one.
  • Guilt and self-reproach. Guilt feelings may involve the survivor believing that they were not kind enough or caring enough to the person who died, or that the person should have seen the doctor sooner. Most often the guilt is irrational.
  • Anxiety. This can range from slight insecurity to panic attacks. For example, an individual may fear that she won’t be able to care for herself, or a person might experience a heightened sense of his own death awareness.
  • Loneliness. Throughout the day survivors face reminders that their partner, family member or friend is gone. For example, meals are no longer prepared the same way, phone calls to share a special moment don’t happen--even simple chores during the day are a reminder that the individual is no longer there.
  • Fatigue. There is an overall sense of feeling tired. Experiencing loss is an emotional period that contributes to weariness and low energy.
  • Helplessness. For the husband whose wife cooked for 30 years, learning how to use the microwave can be overwhelming. For the wife whose husband was the handyman, figuring out how to fix a leaking faucet is intimidating. For the child who lost a parent, a range of insecurities may surface with the loss.
  • Shock. When death is sudden, shock is normal. But even when death occurs after a long illness, the caregiver may experience shock.
  • Relief. An individual may feel relief after someone close dies for a broad range of reasons. It may be a relief for painful disease symptoms their loved one experienced. For the caregiver who is exhausted, it may be relief that their responsibility is completed. If the relationship was oppressive, it may be relief that they have gained independence.
  • Numbness. Especially at first, feelings can be so overwhelming that a grieving person functions on "auto-pilot" to perform daily tasks.
All of these feelings are normal to experience and may last for a period of time.

Physical symptoms of grief
In addition to the feelings associated with grief, physical sensations are connected with the grief experience. It is important for a physician who is aware of the survivor’s loss to assess and monitor physical symptoms.
They may include the following:
  • Headaches; backaches
  • Dizziness
  • Muscle tremors
  • Empty stomach; disruptive digestive system
  • Tightness in chest
  • Over-sensitivity to noise
  • Shortness of breath
  • Weakness in muscles
  • Lack of energy
  • Sense of depersonalization--nothing seems real
The process of grief
Grief is a process that touches people in every aspect of their being. Along with physical symptoms and feelings, the way a person thinks may change or be disrupted.

The list of cognitive expressions or thought patterns surrounding grief is extensive, especially in the early period of grieving. These thought patterns can impair performance in work and school. Some may persist, and may lead to anxiety or depression. Although frequently encountered during grief, cognitive symptoms can be disturbing to experience.

Here are some signs of grief.
  • Disbelief: This occurs particularly if it was a sudden death.
  • Confusion: A person can’t seem to order their thoughts or gets mixed up easily.
  • Difficulty concentrating: The mind wanders from one thought to another or is easily distracted.
  • Preoccupation: Thoughts are obsessed with the sequence of events during the illness, accident, or cause of death.
  • Sense of presence of the person who died: The grieving individual believes the deceased is still with her/him.
  • Hallucinations: The bereaved senses, both by seeing and hearing, that the person who died is communicating with them.
The impact of a death may cause a change in behavior. Whether the death is sudden or expected, it forces an adjustment to live without that relationship.

The behavioral expressions of grief may include:
  • Sleep disturbance: This can include either trouble sleeping or a desire to sleep all the time.
  • Appetite change: Either an increase or decrease in appetite.
  • Absent-minded behavior: Forgetting small things such as where you left the car keys.
  • Social withdrawal: Turning down opportunities to be with friends or family.
  • Dreaming of the person who died: The dreams may relate to good times with the deceased or may involve a reliving or imagining of the death.
  • Searching: Trying to find "the reason" the person died.
  • Restless over-activity: Attempting to fill the void through constant activity.
  • Crying: This is a normal part of the grieving process. However, if a person cannot control the emotions after a period of time, it’s important for them to seek help from a therapist.
It is important to know that grief may continue for a considerable amount of time. It may take years to resolve a meaningful and loving relationship. Many people describe the grief experience as a roller coaster of ups and downs that is intense initially and gradually lessens as time passes.

A wide range of intense feelings may arise in the first year, and then gradually diminish. It is not unusual for a bereaved person to experience episodes of intense feelings from time to time, especially at holidays, birthdays, anniversaries, and other important dates in the relationship.

Gender differences in the grieving process
Men and women often experience the grieving process differently as we are socialized differently in our society. Although this is changing, the idea that men don’t cry, still exists.

Men have a tendency to want to solve the problem and become more active in work and leisure activities when grieving. They are less likely to reach out and talk to others and express their grief openly.

Men are more likely to share their sorrows and fears with their wives and not friends. They are more likely to take action than to express grief. For example, men are more likely than women to return to work after the loss of a spouse, and then remarry. They are also more likely to turn to destructive or avoidance behaviors, such as using alcohol.

Women, on the other hand, are more likely to express their grief and receive support from others. Women are more likely to reach out to others, and to attend grief support groups. Women often have fewer health consequences after losing a spouse than do men.

As members of a family go through the grieving process it may help them to know that there are some differences in how men and women grieve. Perhaps men and women can learn from each other that expressing emotion, seeking support from others and taking action to return to routines are all helpful.

Children and grief
Society today tends to shield children from death. The process of caring for the deceased has been moved out of the home to the funeral home. Yet children need an opportunity to grieve.

Children express their grief differently from adults due to children’s limited cognitive development. Young children do not understand what causes death or that it cannot be reversed. Between the ages of three and four, children begin to understand the idea of death, but it is not until they reach age nine or 10 that they understand that death is permanent and inevitable for all living things.

Children are often confused about grief. They may not understand why they feel sad, have no appetite, or cannot sleep. The result is that they often misbehave because of their confusion. Parents and other adults can help children better understand the grief process.

Here are some ideas for parents.
  • Prepare children for the reality of death by discussing deaths on television, in movies, or books.
  • Use the death of animals or pets as opportunities to introduce the concept of death.
  • Avoid using vague terms such as "she went away" or "Grandpa is sleeping now."
  • Understand that the disruptions caused by grief will confuse children.
  • Be patient if a child regresses to an earlier behavior--such as thumb sucking, wetting the bed, or sleep walking--during grief.
  • Understand that children may ask the same questions over and over.
  • Reassure children that the loss is not their fault - children may feel guilty, believing that something they did caused the death.
  • Be aware that young children cannot understand that the grief will become easier over time, as they do not understand the future.
  • Be clear and honest about death in answering children’s questions.
  • Talk to children at a level that is appropriate for their development --- a very young child will not be able to understand death in the same way a teenager will.
  • Allow children to attend funerals if they wish.
  • Prepare children about what will happen and what they will see at the funeral.
  • Model appropriate grieving by allowing the child to see you cry and express your sadness.
  • Preserve the memory of the deceased by sharing stories about him/her.
Every family member will experience grief, regardless of his or her age. It is important for adults to understand that children grieve and that they look to adults for guidance. How a parent or other adult handles grief affects how children are able to cope.

Helping others who are experiencing grief
When a friend, loved one, or co-worker is experiencing grief - people often have a hard time -- how can they help? It helps to understand that grief is expressed through a variety of behaviors.

Reach out to others in their grief, but understand that there will be various reactions. Some may not want to accept help and will not share their grief.

Others will want to talk about their thoughts and feelings or reminisce. Sometimes a simple gesture of sympathy, such as a bunch of flowers will provide some comfort, and shows you are thinking of them.

Be patient and let the grieving person know that you care and are there to support him or her. If the grieving person becomes despondent to a point where you are concerned for their safety, or the safety of others, contact a mental health professional, medical doctor, or emergency personnel immediately.

Conclusion
Grief is a normal reaction to loss, and affects individuals differently. Both the young and old experience grief when they experience loss.

Be understanding of others as they work through their grief. If you are experiencing grief, be gentle and patient with yourself.

Do not try to rush the process, there is no specific timeline for grief. The feelings of loss may never totally disappear. However, over time it becomes manageable.

If grief becomes overwhelming and you or someone you know cannot continue with normal activities, seek counseling.

Acknowledgements
We would like to thank the following individuals for reviewing this guide:
• Kate Comstock
• Connie Olson, MSW
• The Reverend Carol Simms, ED.D., LCPC
• Mary Zartman, MSU Extension Director of Personnel

My sincere thanks to Peggy Amaral-Lombard, MA, LCPC Park County Extension Agent and Sandra J. Bailey, Ph.D., CFLE, Family & Human Development Specialist, and to the MSU Extension Service, for allowing me to recreate this article. Their copyright is acknowledged and retained.


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DISCLAIMER: This information is not presented by a medical practitioner and is for educational and informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read.

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