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Loss and Grief

Loss and grief

Loss, a state of being without, is usually accompanied by grief, which is an emotional state of intense sadness and a reaction to the disruption of attachment.

There are many kinds of loss and each has its own kind of grief. People lose loved ones like spouses, partners, children, family members, and friends. Even pet losses can cause grief. Job or property loss can be painful. Mourning is the conventional cultural behavior for those experiencing a loss. Grief reactions are those personal reactions to a loss, independent of expected cultural standards.

The emotional process of grieving

Everyone's grief is personalized, although most people share many of the same feelings. There is no order or schedule to grieving. The process may take a few days or years. Grieving that goes on and on, such a chronic grieving resulting in severe depression , or being stuck in a certain phase of the process, like denial, is considered to indicate pathological grief, and may require intervention by a trained professional. Other signs of pathological grief include extreme guilt feelings, irrational feelings of responsibility for the loss, and excessive despondency.

How people cope with life in general often indicates how they will deal with loss. Some coping behaviors are: avoidance of painful stimuli, or triggers, (such as photographs, favorite restaurants, clothing that smells like the loved one); distraction, such as keeping busy with work; "filling up" the empty space with drugs or food or alcohol; obsessing or thinking a lot about the details of the death; impulsive behavior like moving or quitting work; praying; intellectualizing or thinking about the loss without being emotional; and attaching to other people. While these coping skills may help a person feel better until they are able to reconstruct their lives without the object of the loss.

Most psychologists identify the stages of grief and suggest that the typical emotional process of most people is as follows.

Initially, a person may feel numbness, shock, and/or disbelief. A sudden change in reality occurs when someone dies. Even if the death was expected, in the case of an extended illness, and there was anticipatory grief, or grieving before the event happened, there can still be disbelief that the person is actually gone. There may be a sense of being distant or paralyzed. Some psychologists say that this is a way of protecting oneself from being overwhelmed. People's reactions vary widely and while one person may feel listless and introverted, withdrawn and reflective, another person may burst out crying and be unable to accept that their loved one is gone. Some denial is acute, while others are more subconscious, like "accidentally" setting that person's place at the table, or hearing the deceased's car in the garage. Most people pass through the denial stage fairly quickly and accept that the deceased is not coming back.

Once the death has been accepted as real, the process of healing begins. Now a person can enter into the emotions of grief. People who have survived a loss may be preoccupied with thoughts about the deceased. A person may feel angry about their loss, or guilty that

they've survived the deceased. For some people there are unresolved issues, or regrets, that come up, like having had a disagreement as last words, or having kept a secret. Some people get depressed, feel hopeless, and believe that they cannot go on. Others experience anxiety. The risk of suicide is a real concern in some situations. Some people re-evaluate their own lives as a result of the loss.

As a person processes through his or her emotions and deals with the changes brought on by the loss, he/she begins to reorganize, re-build, and re-invest energy into different attachments. Loss of a loved one may change a person's entire social support framework. A person may have to acquire new skills to move on. For instance, married women who were financially dependent upon husbands may have to become financially educated. Partners who relied on the deceased for emotional support must find that support elsewhere. Children who have lost parents must look to other role models. Although loss leaves permanent marks on someone's life, most people do move past grief. In the final stages of grieving, a people re-establish themselves, let go of the deceased or reconciles with the loss, and begin to live in the present as opposed to the past or the transition of grief process.

Physical symptoms of grief

Sighing, sobbing, crying, and weeping are common and normal physical signs of grief. Some psychological studies show that these forms of feeling are necessary physical release of stress and sadness mechanisms. Stress and sadness that are not relieved arise in other physical effects like, not being able to pay attention to present experience, lack of concentration, poor memory , disrupted sleep patterns like insomnia, little or no appetite, abusing drugs or alcohol, and/or thoughts of suicide.

Psychologists and medical doctors have identified some common physical symptoms of grieving which include: tightness in the throat, a choking or suffocating feeling, shortness of breath, sighing, empty stomach feeling, lack of muscular power , tension, pain , and absent mindedness. These are physiological and/or biochemical reactions. Grief can have major physical health consequences. There can be (especially among older people) compromised immune function, increased hospitalization or surgeries, and/or increased mortality rates.

Different kinds of losses

All loss can be painful and different kinds of losses bring up particular issues. For instance, a child's death brings up grief about the loss of what the future might have brought and a feeling of the loss of innocence. Parents may also feel like major parts of themselves are gone and feel overwhelmingly guilty for surviving their child.

Losing someone to suicide or a drug overdose can be confusing and shocking. Survivors often feel guilty, shameful, helpless, and angry. Multiple losses are also more complex. People who have lost a group of friends or a number of family members, or who have witnessed a mass loss, may feel strong urges of wanting to go too, or guilt for being a survivor. Others, like people who have lost many loved ones to AIDS or old-age, must contend with separate issues of becoming desensitized to loss, or feeling completely isolated.

Therapies and tasks of grieving

Millions of people work through grief without therapy, but it can be invaluable to have psychological counseling during times of major stress. Understanding friends and family can be essential in these times. Support groups may also prove beneficial.

Grieving is an important process in which people learn to accept their losses. Althought some people grief rather easily and naturally, not allowing oneself to grieve can lead to unresolved grief. There are many forms of unresolved grief, like not grieving at all, blocked grief, delayed or conflicted grief, unanticipated grief that comes up later, and/or chronic grief. The symptoms of unresolved grief are numerous, including but not limited to: over-activity, having the symptoms of the deceased, psychosomatic (imagined and possibly created) illnesses, drastic changes in social network, hostility towards people connected with the death, self-sabotage, severe depression, suicidal tendencies, over-identification with the deceased, and/or phobias about illness or death. Unresolved grief can come about because of guilt, the new loss awakening an old loss, multiple losses, an inability to cope, or resistance to the process of mourning. Any unresolved grief holds up growth in life and can lead to serious mental or physical problems.

Psychologists have many specialized ways of dealing with grief. Sometimes they suggest that a client write a letter to the deceased, or they may use psychoanalysis in order to aid in the detachment process. Traditional cultural and/or religious customs may help, too. For psychologists the core of their job in helping someone grieve is: reaching out, being a physical presence, being empathic and providing emotional support, giving permission to grieve, making sure the griever doesn't isolate him or herself, and assessing the grief so as to help the process along.

Dealing with grief or helping someone deal with grief-work involves taking the steps of the grief stages. Accepting and facing the reality of loss, functioning in a healthy way like eating right and sleeping well, working through the pain of memories and missing someone, dealing with all the emotions that arise, coping with social and life changes brought on by the loss, detaching from the deceased, accepting support, re-investing energy, letting go, and making a new identity for oneself which includes having lost someone and being a survivor.

Lara Lynn Lane

Further Reading

Leick, Nini and Marianne Davidsen-Nielsen. Healing pain: attachment, loss and grief therapy. London and NY: Tavistock Routledge, 1991.

Deits, Bob. Life after loss: a personal guide to dealing with death, divorce, job change and relocation. Tucson, Arizona: Fisher Books, 1992.

Bowlby, John. Attachment and loss. New York: Basic Books, 1980.

Kubler-Ross, Elizabeth. On death and dying. New York: Macmillan, (1969)1971.

Kastenbaum, Robert J. Death, society, and human experience. New York, Oxford, Singapore, Sydney: Maxwell Macmillan International Publishing Group, 1991.

Kato, Pamela M. and Traci Mann. "A synthesis of psychological interventions for the bereaved." Clinical Psychology Review, vol. 19, no. 3, 275-296, 1999.

Rando, Therese A. Grief, dying, and death: clinical interventions for caregivers. Illinois: Research Press Company, 1984.

Further Information

National Mental Health Association. 1021 Prince Street, Alexandria, VA, USA. 22314, 800-969-6642. http://www.nmha.org.

Grief Recovery Institute. 8306 Wilshire Blvd., Beverly Hills, CA, USA. 90211, 800-445-4808.

Self Help & Psychology Magazine. http://shpm.com/articles/loss/griefcontinuum.html.

The Grief Continuum: Three Stages of Grief Work. http://shpm.com/articles/loss/griefcontinuum.html.

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