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The Good in Grieving

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Much like love, grief is the most human of emotions. But we never know exactly what it is until we experience it.

When the act of mourning proves treacherous, we often abandon ship for safer shores. We want to become only “acquainted with grief,” as the early poets tell us—to endure it and live through it, but rarely become intimate with it.

Bereavement is defined as the period after a loss when acute grief and mourning occur. The death of a loved one can take an especially devastating toll on older people—especially spouses, who typically have to contend with a shrinking social circle, a new identity as a single person, and financial and medical issues.

Today’s holistic approach to looking at grief is one reason why professionals in this area draw from diverse backgrounds that include psychology, social work, family therapy, the clergy, meditation, yoga and more. Bereavement, after all, is a complicated process. “Go out to lunch with friends and ask them a random question about the grief process, and I’ll guarantee they’re going to get it wrong,” says Joseph McBride, a clinical social worker who lectures at the University of Pennsylvania.

Growing up in a family that owns a funeral home in Paulsboro, N.J., McBride became interested in how the treatment of death—and its effects on grief—has changed over the past century. In ensuing years, he’s experienced firsthand how people react differently to death, from the families of crime victims to those who lost loved ones in the 1988 Pan American jet explosion over Scotland.

The loss of a longtime spouse poses a unique set of problems. Call it the “What’s next?” dilemma. The one left behind is typically faced with an empty house, a loss of income and the dissolution of a longtime shared routine. In cases where the couple followed traditional roles, confusion and anxiety only exacerbates the difficulties of grappling with new skills and a new identity.

Isolation is one reason why counselors stress self-care, treating yourself as if you’re preparing for a marathon or an arduous journey. Simply put, you need to eat well and stay in shape.

“Speed grieving” is a popular term these days. It refers to the tendency for people to curtail their sorrow or to let others persuade them that they need to move on quickly. Grief, in turn, becomes a kind of personality defect. McBride is troubled by the way our self-help culture encourages us to live life to the fullest and yet denies death, tolerating expressions of grief only during the funeral or perhaps a few months afterward.

At issue is the difficulty people have in normalizing grief and redefining closure. “Not everyone needs therapy, but everyone goes through the process in their own way,” says McBride.

Only the bereaved knows how—and how long—to grieve. Mourners in the Victorian era were particularly adept at expressing their thoughts, but that changed over time. Indeed, experts say it was our misguided attempts to explain things in simple terms that has led us to the place where we are today.
 

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Grief throws the bereaved into a state of emotional vulnerability or hypersensitivity. But rather than follow a kind of 12-step program or even reject it, people must find their own way to mourn. That doesn’t necessarily mean therapy, but it has become integral to a new movement dubbed “meaning-making.”

The idea is to grant those who are grieving permission to fully engage in their feelings of loss, rather than resist crying, sorrow and depression. Customizing the mourning process carries over into activities for working through grief.

Typically, one is encouraged to express feelings in a personal but tangible or creative way. Writers, for instance, are encouraged to draft a letter to the deceased, expressing things that were never said.

One may wonder if such catharsis is a good thing for older folks. But consider these sobering facts: Research has shown that the surviving spouse has a higher risk of suicide and poor health due to major depression 12 months after a loss. A recent Swiss study using government mortality statistics found that one in 600 widowers and one in 2,500 widows committed suicide within a year. The National Institute of Mental Health is currently conducting clinical trials on those 60 years and older in an effort to understand how non-drug therapies can help combat “complicated” grief, defined by the inability to recover from acute stages like crying or profound feelings of emptiness and longing.

On Death and Dying, Elisabeth Kübler-Ross’ 1969 best-seller, is often cited as a culprit in many of the problems seen today. It’s the book that outlined the five experiential stages of loss: denial, anger, bargaining, depression and acceptance.

Though it was written for the terminally ill, it’s also become a popular primer for the bereaved. “It gave people a framework to understand and normalize some aspects of the process,” says Lara Krawchuk, an adjunct professor at Penn and a licensed clinical social worker. “But it’s too simple and neat. It doesn’t allow people to define their own experience.”

Krawchuk’s colleague, psychologist Sara J. Corse, is currently working on a book that outlines a unique method for treating the grief-stricken—one that involves an “open, curious, interested and nonjudgmental” mindset. Ultimately, Krawchuk and Corse agree that grief usually isn’t something you fully recover from. That’s because the loss is never regained or replaced. Only a few come to accept the pain now, knowing that it will eventually lead to happiness—and to the person they were before the loss.

To learn more, visit health.harvard.edu and councilforrelationships.org.
 

7 Ways to Look at Grief

1. Grief is universal, but no two people experience it in exactly the same way.

2. Grief is a person’s internal emotional response to loss. It can be viewed holistically, as affecting one’s physical, behavioral, emotional, mental, social and spiritual life.

3. Grief is never the same and has no predecessor.

4. Grief has no definite pattern or orderly progression.

5. Grief needs a private place to dwell, where no one can judge or censor you.

6. Grief is usually not something one “recovers” from, because the loss is never regained or replaced.

7. Grief is a necessary coping mechanism, and the only way to work through the emotions of anger, fear, longing and guilt often associated with loss.
 

Complicated Grief’s Warning Signs

Older adults are at particular risk for what is known as “complicated” grief. Seek help from a mental health professional or a bereavement counselor if you experience any of the following warning signs:

1. An overwhelming remorse or guilt over past behavior.
2. A serious lack of concentration or inability to take part in daily activities.
3. Sleeping too much or sleeping less than eight hours per night.
4. Unexplained physical distress, including shortness of breath, chest pain and muscle tension.
5. Family or friends who express concerns over your ability to cope.
6. Severe weight gain or loss.
7. Sudden changes in mood or personality that seem unrelated to crying, anger and other normal expressions of grief.
8. Grief experienced with multiple stressors like job loss or illness.
9. Thoughts of suicide or hurting others.
 

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