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Understanding Grief

I walked a mile with Pleasure,
She chatted all the way,
But left me none the wiser
For all she had to say.

I walked a mile with Sorrow,
And ne’re a word said she,
But, oh, the things I learned from her
When Sorrow walked with me!

The Westminster Press, 1565

Bereaved persons are like ducks:

Above the surface…
Looking composed and unruffled.

 

 

Below the surface…
Paddling Like Crazy!

 

Grief and Bereavement
Support After A Loss

DEFINITIONS OF GRIEF

Grief: 1. Intense emotional suffering caused by: loss, disaster, misfortune, etc.  2. Acute sorrow, deep sadness

Grief- One never gets over it…one just gets used to it.

 

Like a cut finger…
Grief is numb before it bleeds,
It hurts until it begins to heal,
It forms a scab and itches until
Finally, the scab is gone and
A small scar is left where
Once there was a wound.

 

Grief is the deepest wound you will ever have.

 Grief: The process of psychological, social and somatic reactions to the perception of loss.

 

Webster’s New World Dictionary, 3rd Edition, Simon and Schuster, Inc., New York, 1991
Don’t Take My Grief Away, Doug Manning, In Sight Books, 1998
Does Anybody Else Hurt This Bad…And Live? Charlene Vester Eneroth, Otis Publications, Spokane, WA, 1991
Grief, Dying and Death, Therese Rando, Research Press Company, Campaign, IL, 1984

 

Am I Grieving Normally?

Parents often ask three questions when going through grief:

• “Am I normal?” 
• “Am I going crazy?”
• “Will I ever get over this?” 

A better question is whether the grief is healthy. There is of course, no one correct way to grieve. Many of the strangest emotions and thoughts are actually quite normal. In spite of this, parents may be overwhelmed at times by these normal feelings of grief. Use the following checklist to help you see how well you are doing. As time goes on, you will see that you are able to answer, “yes” to more and more questions. If not…seek additional help.

___Am I able to laugh without feeling guilty?
___Do I pay attention to my personal appearance? (hair, clothes, makeup)
___Do I enjoy being out with friends for an evening?
___Am I feeling pleasure in sexual experiences?
___Am I able to sit quietly by myself and think of things other than the loss?
___Do I take an interest in current events and news? (TV or radio news, newspaper)
___Do I feel I can effectively parent my surviving children?
___Am I able to do the daily tasks I’m used to performing? (yard work, housework, and cooking, household maintenance).
___Do I look forward to outings, trips, and special events?
___Am I involved in activities that I participated in before I had the loss? (church work, volunteer work, clubs, sports teams, and a job).
___Can I talk about the loss without showing strong emotion? (sadness, anger, jealousy).
___Do I feel the fog has lifted?
___Do I pay attention to my surroundings? (beautiful scenery, the taste of food, the smell of perfume).
___Am I able to get a good night’s sleep and awaken feeling rested?
___Am I able to concentrate on work and conversation?
___Am I less forgetful and better able to think clearly?
___Can I recall past events?
___Do I feel stronger and more in control? (less like an open wound, better able to cope with others’ comments, better able to cope with everyday crises).
___Do I feel that there is meaning to my life?
___Can I look back at what happened and feel that something good came out of the tragedy?

Limbo, R. K. & Wheeler, S.R. (1993) When a baby dies: A HANDBOOK FOR HEALING AND HELPING. La Crosse, WI: Lutheran Hospital-La Crosse.

 

Grief and Loss

• Time does not heal all wounds…

                    

• Time only heals when a wound is not infected

 

• Unless grief is dealt with, it can reappear at another time

 

Do’s and Don’t’s in Helping Bereaved Parents
By Lee Schmidt, Parent Bereavement Outreach, Santa Monica, California

DO’S

• Do let your genuine concern and caring show
  
  
• Do be available…to listen, to run errands, to help with other children or whatever else is needed at the time
  
  
• Do say you are sorry about what happened to their child and about their pain.
  
  
• Do allow them to express as much grief as they are feeling at the moment and are willing to share.
  
  
• Do encourage them to be patient with themselves, not to expect too much of themselves and not to impose the “should's” on themselves.
  
  
• Do allow them to talk about their child as much and as often as they want to.
  
  
• Do talk about the special and endearing qualities of the child they have lost.
  
  
• Do give special attention to the child’s brothers and sisters---at the funeral and in the months to come (they too are hurt and confused and in need of attention which their parents will not be able to give them at this time).
  
  
• Do reassure them that they did everything they could, that the medical care they received was the best or whatever else you know to be true and positive about the care given, to their child.
  

DON’T’s

• Don’t let your own sense of helplessness keep you from reaching out to a bereaved parent
  
  
• Don’t avoid them because you are uncomfortable (being avoided by friends adds pain to an already intolerably painful experience).
  
  
• Don’t say you know how they feel (unless you’ve lost a child yourself you probably don’t know how they feel).
  
  
• Don’t say “You ought to be feeling better by now.” Or anything else, which implies a judgment about their feelings.
  
  
• Don’t tell them what they should feel or do.
  
  
• Don’t change the subject when they mention their dead child.
  
  
• Don’t avoid mentioning the child’s name out of fear of reminding them of their pain (they haven’t forgotten it).
  
  
• Don’t feel you have to try to find something positive (e.g. a moral lesson, closer family ties, etc.) about a child’s death.
  
  
• Don’t point out that at least they have their other children (children are not interchangeable; they cannot replace the child that has been lost).
  
  
• Don’t say that they can always have another child (even if they wanted to and could, another child would not replace the child they’ve lost).
  
  
• Grief over the loss of a child does not discount the parents’ love and appreciation of their living children.
  

GRIEF AND MOURNING

            Excerpts from talks by Glen Davidson, PhD

Grief is all of the emotions we feel following the loss of a significant person, thing or event in our lives.

Mourning is the process by which we work through these feelings and emotions following the loss.

Signs of grief before the 1960’s were considered pathological. The average person seems to expect that grief be completed or resolved within 48 hours or two weeks—according to polls taken on the street. This is an indication of the lack of understanding of the bereavement process and the reason for lack of support beyond the initial period. Bowly, Parkes and Holmes conducted a 10-year study of 1200 bereaved adults to determine “normal responses.”  They discovered four phases of bereavement.

PHASES OF MOURNING

1. Shock and Numbness This happens initially and may last 48-hours to two-weeks. The numbness is a healthy and normal defense. During this time the emotions may be uncontrollable. Often it is difficult to “take information in.” The appetite may disappear. They often feel completely exhausted, yet unable to sleep. The reverse may also occur, where they are sleeping most of the time. Feelings may range from fear and anxiety to guilt and depression. There are times that they may feel they are going crazy. It is healthy to express their true feelings in this stage.
   
   
2. Searching and Yearning This phase may last for months. During this time, the bereaved search for what was lost. It is during this period that the most bizarre behavior occurs. Guilt and anger are often a part of this phase, as they search for answers. They test what is real, become restless and impatient, along with the experience of a rising sensitivity to stimuli. For parents with a newborn death it is helpful to see, hold, and touch their baby at the time of the loss. Pictures of the baby are comforting and help them to perceptually confirm what it was they lost. It is important that the bereaved express feelings, including anger at God—if they have those feelings—jealousy and other strong emotions. They need not be ashamed of their feelings. Anger inward becomes guilt, and this leads to depression.
   
   
3. Disorientation and Disorganization This is the longest phase for mourners. During the 4th-6th months it becomes the most severe. The dominant emotion is depression. The appetite is poor and motivation lags, they have impaired judgment and experience insomnia. Once they do begin to sleep, it can be difficult to awaken them. A physical examination is encouraged during the 4th to 6th month to diagnose any disease process in the early phases, because of their lowered resistance to disease at this time. Tranquilizers and sedatives delay the process and cloud thinking. As the bereaved struggle to be relieved of disorientation there is a search to find the answers that feel right to them—our role is to search for those answers with them, rather than to give them the answers. By the 18th or 24th month they begin to resolve some of those questions. Our tendency is to try to answer questions that aren’t even being asked. Clichés cause more disorientation. A listening ear is our greatest gift to the bereaved. Anniversaries are very difficult. Society expects mourners to be healed quickly, and support is often lacking after a short time. Others tend to avoid talking about the person who has died, when that is the thing that helps the bereaved the most. During disorientation the self-image is lowered and the mourner often isolates himself/herself from others. 

4. Reorganization This phase does not occur quickly. It begins around the 18th to the 24th month. Here they begin to sort out suspicions and attempt to identify what was lost. There is a sense of release, renewed energy, more socialization, better judgments and more stable eating and sleeping habits. It is at this time that they begin to enjoy themselves and have a good time without guilt feelings. There will still be momentary crises and reliving of the loss, especially at anniversaries and holidays. Re-adaptation to the loss does not mean forgetting the loss.

The normal degree of disorientation diminishes in duration and intensity gradually. Disorientation is facilitated by companionship with others who help the bereaved sort through what happened as they work through reorientation. Mutual help groups can be important, however the best time for directing a mourner to a group is in the searching and yearning phase.

It is important to give the bereaved permission to experience a wide range of emotions. Each person responds differently in bereavement and it is important that we do not put expectations on them to imply that they need to go through the various phases. Each emotion has a function. Joy is related to the creative impulse, depression protects the major organs by slowing us down, guilt occurs when we are beyond our capacity to cope and beyond the sense of what is right, while anger serves to warn others that they are intruding on our ability to survive and that we feel violated by the system. As stated earlier, mentally healthy mourners have a wide range of emotions to choose from and they need find appropriate ways to express those feelings.

TYPICAL BEHAVIORS OF GRIEF

1. Expressed frustration
   1. Direct-couldn’t see the baby, etc
   2. Indirect-picking clothing, and other signs of restlessness and insomnia
2. Bizarre searching-playing with a doll, cucumber, or any object that can be held; hearing the baby cry from the grave-reaches intensity with 2-4 months
3. Preoccupation with the experience- delivery and/or prenatal period analyzed and focus placed on how they feel they were treated prior to and after the delivery; may peel carrots into nothing during their preoccupation
4. Disorganized-unable to accomplish ordinary activities  
5. Residual anger-anger focuses on spouse and refusal to talk about the baby to others, e.g. mother-in-law, etc.; hostility directed toward the dead person may be present.

     SIGNS OF NORMAL GRIEF

1. Sighing
   
   
2. Tightness of throat
   
   
3. Dullness of perception (touch them to keep them aware of reality) 
   
   
4. Volatile emotions (those who don’t cry need more attention)
   
   
5. Guilt feelings 
   
   
6. Aloofness (do insignificant things to avoid contact and distract themselves)
   
   
7. A marked change in behavior and/or taking on the behavior of the deceased.