Grief
Before I meet clients, I like to give them a call and chat to them about the services I offer, and I ask them are they ok to tell me what’s brought them to therapy. Rarely do people mention Grief, Bereavement or loss. I am not sure if there is a stigma around saying how bad we feel when we lose something or someone, or people genuinely don’t realise that they are feeling bad about a loss. After some probing questions I find myself reflecting to them what they have been through, and I can see the pain – we have uncovered a grief that they hadn’t connected in with. This is not to say that people ALWAYS hide grief, but generally I find they are presenting with something else.
Many questions people ask themselves as we work through grief are ‘am I normal?’ and ‘am I mad?’, and sometimes grief can feel like this, right! We need to consider that life was ‘normal’ before grief and now, in grief, we find ourselves in this space that is totally new, a different reality, and often we can feel totally immersed and overwhelmed by it. Once we open the door to grief and there is a recognition that they have been feeling bad for such a long time about this loss, sometimes, without even knowing that this was the cause, they suddenly move to asking ‘will get over this?’, sometimes stating ‘if I go through the stages of grief I will get through to it, to the other side, right?’ , ‘will I feel normal again?’, these are all fair questions, when we feel bad, we simply want it to end, we want to feel better. We want this tough part of our life to be over, because make no mistake, grief touches every part of our lives, it does not happen in silo, it isn’t something we can successfully ignore.
What can we do if a loved one is grieving?
I can feel this in my soul, the anxiety/panic/fear we have when looking at someone in grief, what do we say? How can we help? Is there anything we can do to take away their pain? We can focus on the need to say the right thing, many people can feel like this. Even when I have been through bereavement, I can share that I have not felt there is a right thing to say, or even a right thing to hear, it’s a difficult time. I remember once saying to my friends’ grandfather, at the funeral of his wonderful wife ‘sure its yourself’ and then utter silence, I am sure he has never thought of it since, but it still makes me cringe at the thoughts of it. Another time, when a friend’s mother was telling me of her loss, that her father passed away, I innocently asked ‘And how is he now?’, honestly sometimes I despair, but the reality is, we all can get it wrong, there is no right thing to say, all we can try to do is be there for the person we love. Remember, nothing we can really say is going to make someone feel better, what perhaps (I needed) and perhaps people going through grief, is just space, and the knowledge that if they need you to understand, you are there. Connecting in this space can help move away from the isolation that can come from grief, even if you don’t know what to say, maybe connect that you are there for them, that can be therapeutically beneficial in grief.
Grief Models
When working with clients, although I have awareness of models, I do not generally stick rigidly to them, the reason for this is that I feel grief is so personal to each person, even each loss a person is faced with may have a different expression of grief. However, if asked, I might offer some information on the Elisabeth Kubler-Ross Five Stage Model which shares that going through grief one can expect to travel through denial, anger, bargaining, depression and acceptance. I also share that the journey is not a linear track, we can be enriched through the experiences of grief that we have but it is not a linear passage, in fact, even if we are to look at the stages of grief, even Kubler-Ross that even she notes that we can be in multiple at any time and there can be a chaos of going through them as it is not linear.
One of the shortfalls I feel about this model are the risks that people can think that they need to go through this ‘stages process’, but in reality, grief can be a life time adaptation, yes of course we might realise (or accept) the person has gone, but does that mean that we have to work hard to ensure that the pain is no longer with us? Is this the end goal? I am not sure I believe it is, in my view, as we work through grief, maybe the goal is to bring us to a space where we can feel pain, and that we don’t face judgement in this pain. I have been told by clients in the past ‘I am coming to therapy as I have been told too, it’s been 2 years since I lost X and people think I need help’, quite often what people need is some space to take and some space to allow them to be in their grief, and perhaps to share it with people in their lives.
Another model to refer too can be the dual process. Here, Strobe and Schut share that whatever this loss is, we have two instinctive response, feel the pain, or restore, they note we can oscillate between both, we need to go through both. They mention that men tend to be restorative, they want a plan, hope to fix, whereas women can want to emote, they may want to know every piece of the puzzle. This can sometimes be a challenge in relationships with a shared loss, its important to try to be the empathy giver for each other.
Something I think is really important to remember is this: it is only the person who is grieving that can measure the loss. I love that, it means that only you are the truth of your grief and no one can that that away from you. I find, in working with people, that so often this is not observed by their loved ones, as a result they can feel disenfranchised in their grief.
Children and grief
I know in my family when my grandfather died (we called him Bobo – no idea why – a family mystery to this day) none of the children of the family could go to the funeral. It seemed weird that we could not be able to say our goodbyes, but we were told firmly ‘a funeral is no place for a child’, but we loved him, all my brothers and sisters will still talk about him even though he died in 1993. Some of the older generations in my family still think like this but let me be clear – children grieve as much as adults; we should not protect them from this pain as death is a part of life. Of course, we can engage with them using different conversation, it is important to support them and not offer the ‘there there’ attitude, children are allowed to grieve and should be encouraged to connect in with the feelings and conversations they need to in order to move through their loss.
Moving forward in grief
Anyone who knows me personally, or professionally, knows I have a bugbear with the term ‘move on’, this sounds to me that we are stagnant where we are and are unwelcome, more importantly it says to me that if we are mot ‘moving on’ we are failing. Instead, I like to think about move forward, move forward in grief, move forward in the knowledge of your love for what you have lost. Moving forward sounds less painful to me, almost like we can bring our love and loss with us and we don’t have to leave our loved one behind just because they have died. When we are grieving there are not set lists of things that can ‘get us through it’, maybe its important to look at, what would make you feel more free to grieve? What so you feel you need in order to grieve? What permission do you need to grieve? What steals your grief? Spending time in this space might be more beneficial than judging ourselves by saying things like ‘I should be better’, ‘I should be over this by now’.
People can turn on themselves in grief, this limits self-compassion and flies in the face of what I mean when I say ‘be kind to yourself’, what this means in reality is – what is something you can do that is going to make you feel better right now? Rest? Sleep? Food? Crying? Watching something on TV? Speaking about your loss? I once read that ‘its often not grief, but the things done to avoid grief which can cause the damage’ this really stayed with me as in Irish society can be avoidant, we do death well, but what then? How do we grieve, even more, how do we do it correctly? - blocking yourself in grief can be so detrimental to recovery.
When should I look for help?
I know that the stigma surrounding mental health is shifting (however slowly) but I like to share with people that we do not need to reach to a critical point of grief before we reach out for support. There is a value in finding a support network in place to help you through your grief, to use an old saying, ‘its better to be looking at it than for it’, and this is true of support, especially in times of difficulty. Whilst there is no check list, there are certainly some indicators that you might feel better with additional support; prolonged low mood, increased anxiety (often these can go hand in hand), consistent thoughts of death, thoughts of suicide or self-harm (if you have had these before, they might be more present for you). If you experience these after grief it is important to speak to someone, I have resources available for you at the end of this blog that might help.
I think its important to recognise that grief is chronic, it doesn’t just happen for one day, it can touch many different areas of our lives. It can feel as though life is really hard to manage and what were once every day things, like shopping, or dropping the kids to school, can now seem like gargantuan tasks. It is ok to recognise that ‘I am finding it difficult to cope’, and ‘this is not just the grief’, and it is also ok to check in with yourself and be honest about what is it you need to feel better.
Covid and Grief
During the times that covid has been in our life its so important to recognise the impact it has had on grieving: its dramatically interrupted capacity to grief, the first part, and even the ritualistic elements have been taken from people. I know my friend lost her beautiful sister during covid, it was gut wrenching not to be able to be there in the way we know how, with a hug, by even being present at the funeral, I cannot image how difficult it was to be on the other side, trying to process their loss in a time of isolation. Love and connection to others help the task of accepting loss, but these tools are no so different to how we would traditionally engage in them, not having our traditions can bring up so many questions surrounding our pain and all of the ‘what ifs’ of grief can derail the experience of loss.
Honouring milestones can play a large part in moving through grief, at the moment this may not be possible for people, in addition to this much grief support is moved online, this can be jarring for people who are looking for human connection to help move through their loss. As a result people are doing the heavy work a lot by themselves, they are not getting the full grief support that they want and or need, they are not only grieving the loss, but also the fact they cannot get the support they need during this period of grief. Right now, there is the absence of presence and this can further isolate people in their loss which can really compound the grief.
What’s our role in someone else’s grief?
What can we do to support grieving people and what holds us back? The outcome of ‘feel better’ can set the bar too high. So often, we need to remember making people happy or distracting the from their grief is not our role, and also it might be too much to ask as the person may not want to feel better, they might just want the permission and space to feel what they are feeling. I wonder what it would be life instead, to take the pressure off, we say something like ‘if you could tell me anything about you loss right now, what would that be’ ‘what do you feel you need right now?’, Is it ok to be asked what it is what you need or want?
Listening and validating, saying that what people in loss are experiencing makes total sense, remember that we don’t really have the full insight into someone else’s grief to give them what they need, sometimes we need to ask, and when we get the answer, to simply accept it for what it is.
The positive side of grief
Is there anything positive on the other side of grief? For me I think there is, it starts with the paradox of grief, allowing yourself feel the pain, and getting support you need during this pain, which allows you to face the pain of what you never want to happen can foster growth. This can sometime be referred to as ‘post traumatic growth’, this does not deny the level of the loss or pain, but people who find they have grown through traumatic or deep losses, may become more resilient, more empathetic and gain deeper perspective into the loss ad grief of others. Growth comes through adversity. There is no denying of course, that this is a high price to pay, another way to consider it is that people don’t stop feeling the pain, but they may feel more robust in their life after loss.
My final thoughts on this are around life after loss, grief is not a test, its not a homework assignment, and it is not a pass-or-fail experience, it is life. There is no right way to do it and whist we can connect in with the theory, the reality of it is that there is someone in pain. Being there for someone in that pain, simply being there, might be all we can do, and it might be all that they need.
If you have been effected by anything covered in this blog piece please see areas of support below, I have also included some of the articles and books that I have used in formulating this article.
Support services
Grief Counselling: https://clearviewcounselling.ie/
Emergency Support: https://www.pieta.ie/contact/
A lot of reading material: https://www.mariecurie.org.uk/get-involved/day-of-reflection/grief-resources
HSE Library: https://hse.drsteevenslibrary.ie/bereavementgrief/understanding
References
Boer, L., Daudey, L., Peters, J., Molema, J., Prins, J., & Vercoulen, J. (2014). Assessing the Stages of the Grieving Process in Chronic Obstructive Pulmonary Disease (COPD): Validation of the Acceptance of Disease and Impairments Questionnaire (ADIQ). International Journal Of Behavioral Medicine, 21(3), 561-570.
Bolden, L. A. (2007). A Review of On Grief and Grieving: Finding the Meaning of Grief Through the Five Stages of Loss. Counseling & Values, 51(3), 235-237.
Bretherton, I. (1992) The origins of attachment theory: John Bowlby and Mary Ainsworth. Developmental Psychology (1992), 28, 759-775.
Chapman, A. (2013). Elisabeth kübler-ross - five stages of grief. Kubler-ross model for death and bereavement counselling, personal change and trauma. Retrieved from http://www.businessballs.com/elisabeth_kubler_ross_five_stages_of_grief.htm
Connelly, M. (2016, November 23). Kubler-Ross Five Stage Model. Retrieved from http://www.change-management-coach.com/kubler-ross.html
Holmes, J. (2014). John Bowlby and attachment theory. London: Routledge, Taylor & Francis Group.
Kübler-Ross, E. (1995). Death, the final stage of growth. Tehran: Payk-e Bahar.
Kübler-Ross, E., & Kessler, D. (2014). On grief & grieving: finding the meaning of grief through the five stages of loss. London: Simon & Schuster.
Kübler-Ross, E. (2010). The wheel of life: a memoir of living and dying. London: Bantam.
Neimeyer, R. A. (2016). Techniques of grief therapy assessment and intervention. New York: Routledge.
O’Rourke, M. (2010, February 01). Is there a better way to be bereaved? Retrieved from http://www.newyorker.com/magazine/2010/02/01/good-grief
Pass, O. (2006). Toni Morrison's Beloved: A Journey through the Pain of Grief. Journal Of Medical Humanities, 27(2), 117-124.
Stang, H. (2016). Dual Process Model of Grief: Navigating the Spiral. Retrieved from http://mindfulnessandgrief.com/dual-process-model-of-grief/
Walker, R. J., Pomeroy, E. C., McNeil, J. S., & Franklin, C. (1996). Anticipatory Grief and AIDS: Strategies for Intervening With Caregivers. Health & Social Work, 21(1), 49.
Williams, Lisa (2017, March 28). Rando’s Six R Processes of Mourning. Retrieved from http://whatsyourgrief.com/randos-six-r-processes-of-mourning/