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Dr. Bill Webster

Grief in the Workplace

GRIEF IN THE WORKPLACE

By Dr. Bill Webster​

It became obvious in January that Ken was losing his four-year battle with cancer.  Connie, his wife of over thirty years, took her vacation month from work, and then an additional five-week leave of absence to be with him every agonizing day in the hospital. On March 17th, Ken died.

At the request of her employers, Connie returned to work on March 30th. With her Irish determination and “stiff upper lip” approach, she shut down her feelings, masking the pain of a broken heart. Customers and fellow workers alike thought she was strong and “doing fine”.

In fact, she was not fine. Five months later, Connie experienced an emotional explosion. The grief she had bottled up inside her emerged with a rush. She was totally overwhelmed, not only by the intense, uncontrollable feeling of loss but also by the “shame” of “losing it”.

Depression, fear, confusion, crying and despair swept over her in waves. Connie was unable to handle customers without falling apart. People were shocked, especially “after so long” when it had appeared she was doing so well. Her employers, though caring about Connie, faced a dilemma — not really understanding what was actually going on with her, yet having to concern themselves about the effects the situation was having on her productivity, her co-workers, and her customers.

This is grief at work. It is important to draw attention to the effect on people in the workplace of grief through death, divorce, or numerous other life changes. Bereavement can be a devastating experience. The grieving person faces an emotionally rocky journey. While it is often affirmed that grief is normal., it is nonetheless troublesome, and often leaves people like Connie unable to function at work within acceptable limits. Long after the funeral is over, the impact of loss can hit home. Months after people think we have it together, the grieving person may feel like they are falling apart. After a loss, our equilibrium, health, and well-being can be severely compromised. This affects us in every area of life, not least of which is in our work.

We have not recognized the enormous effect grief has on the workplace. Not only does it affect those who experience bereavement, but there are also many struggling to cope with and grieving over OTHER significant losses — divorce and separation; relocation; job changes; injury; being passed over for promotion; being laid off; early retirement; and unemployment. At any given time, a significant section of the workforce may be coping with a major personal loss.

Much as we would like to subscribe to the concept of a compassionate society, the real world can be cruel. The expectations of the workplace are that the employee will perform and produce, devoid of human emotions and unaffected by personal experiences.  In some work environments, the expression of personal feelings is taboo, often interpreted as weakness. Yet, if bereavement produces a necessary emotional response, a conflict between the needs of the individual and the goals of the workplace seems inevitable.

Most companies recognize death as an acceptable cause for absence from work. Many give three days off to help employees cope with the loss of a loved one, although there is often a hierarchy of loss, with three days for the loss of a spouse, child, or parent, ranging down to one day for other relatives. Sometimes there will be an informal policy regarding the death of a co-worker or a “friend” (a term we cannot assume we understand in today’s society without some knowledge of the actual relationship). Most companies respond to a death with meaningful gestures such as sending flowers or memorials and are supportive around the time of the death.

An understanding of the grief process indicates people are generally in a state of shock and numbness in the days after a loss. Confusing numbness with strength, some people feel support can be withdrawn shortly after the event. We expect or hope people will just “get on with it”. Yet, most manifestations of grief do not appear until weeks or months after the event. Because there is not much understanding of this process, this reaction catches both the individual and the employer by surprise.

Over time, the bereaved employee may experience some of the following symptoms: inability to concentrate; lack of motivation; impaired decision-making; confusion; memory gaps; anxiety; crying; social withdrawal; apathy; decreasing productivity; and other seemingly inappropriate emotional responses.  These are all the more bewildering because they are uncharacteristic of the person. As a result of these normal but dysfunctional responses, such employees often have high absenteeism, sickness, alcohol and drug use, and accident rate in the months after a significant loss.

Because of the effect a troubled employee has on productivity, which is after all the bottom line in business, many companies have responded with employee assistance programs (EAP). Such programs address many issues, such as substance abuse, marital and emotional problems, and play a significant part in helping an employee cope with a personal loss. Unfortunately, often only larger companies are able to offer such help, yet these resources are needed by all. Where there is no programe available through an EAP, arrangements could be made by businesses or other referring agencies to connect people with an ongoing grief support program through a local funeral home.

Every manager or executive will eventually be confronted with a death in the workplace.  There is a need to provide them with information enabling them to understand the grief process and so understand the grieving employee. Such understanding will enable the workplace to become more accommodating to the needs of their people. Three days of funeral leave only begins to address the grieving individual’s needs. Healing takes time, often much longer than people expect. The full impact of grief is felt long after the funeral.

Most people do not have the opportunity or the financial luxury of taking an extended leave of absence. Usually, they must keep on working while they are putting their lives together. Finding the energy to do both can be a challenge. Managers and knowledgeable co-workers can do much to support grieving people through this stressful time, and thus dramatically reduce non-productive behaviors. The ability to identify employees experiencing grief and loss and refer them to the appropriate resources can be vital to the well-being of the work climate as well as to the individual. Grief is not a mental illness nor aberrant behavior, though it is sometimes treated as such. Loss is a fact of life. Grief is the reaction to that loss and must be worked through by the individual in order to heal.

Some ideas for the business manager: organize lunchtime seminars for interested staff and employees; access community support groups often available through local funeral homes; offer bereavement counseling resources, and offer training workshops for staff on understanding grief and support for grieving employees.

Connie attended a grief support group for some time and came to me for grief counseling. It was a long journey, and she had the struggle to come to terms with her loss, but with help, she was eventually able to return to work.  But as she herself put it, “I had to take time to be a mess!” The opportunity to do so gave her the message that she was important to her company and to her friends, and that people were willing to support her through the most challenging experiences of her life.

Dr. Bill Webster

Grief after Sucide

GRIEF AFTER SUICIDE 

​By Dr Bill Webster

“You never get over a suicide. You just learn to deal with it. The worst part is not knowing WHY. If I could just say he had been depressed, or seeing a shrink, or anything that might have explained it, it would have been better. But I just don’t know why he did it”            (Julie, whose teenage son hanged himself.)

Jim’s 29-year-old son had suffered from severe manic depression for 4 years when he jumped from a high-rise apartment building. Jim DID know a reason, but found that to be of little comfort:

“It was just unbelievable to me. Why did he do this? Why didn’t he come to me for help? And then I felt anger. For four and a half years, I had done everything under the sun to help him. What else could I have done? I felt very guilty because if I could have helped my son, I would have done anything.”  

While we often correctly say that “there is no such thing as more or less difficult, it is just different”, there are some situations that are uniquely difficult. One is the loss of a child. Another is a death by suicide. And when these two situations come together, as it did for both Julie and Jim it can be a devastating blow to “suicide survivors” (this term for the purposes of this article refers to those who have lost someone to suicide.)

It is not my intention to outline the many and varied theories of suicidal behavior, many of which are conflicting. The focus here is on how we help support suicide survivors through their unique process. There are some sobering facts, however:

  • Every day, throughout the world, over 1000 people complete suicide
  • It is estimated that for every suicide there are 15 unsuccessful attempts
  • White males over the age of 50 makeup approximately 10% of the population but account for 28% of the total suicide deaths
  • Men complete suicide three times more than women, but women attempt suicide five times more than men. Most attempts of suicide are made by women in their 20′s and 30′s
  • Suicide tends to run in families, but it is learned not genetic. Often it is unconsciously suggested as a means of coping with overwhelming moments.
  • People who talk about suicide complete suicide. Suicide RARELY happens without warning

When someone completes suicide, the mourning process for survivors is different in at least 2 ways. 1) The period of numbness and disbelief will be longer, extending the duration of the grief process; and 2) there is the added burden of understanding the motivation for the death.

For suicide survivors, the grief process is particularly long given the complexity of issues survivors struggle with. This means that one year after the death, the griever may still be in the depths of their grief, long after society expects people to be over their grief. Jim observes:

“I think before the grief really set in, it took over a year. I mean there are times when I still think this is unbelievable. But I think it took a year for me to really believe it. And I think that it was because I surrounded myself with him, looking at pictures, and talking about him to everyone that helped me come to terms with it in such a short period of time. I don’t know if a year is a short period of time or not, but it is very real to me today.” 

For this reason, patience on the part of the helper is most important. There is no way to speed up the grief process. One can only go through it! Our task as helpers is to provide a safe and non-judgmental environment where the griever can begin the telling of “the story” (of the life and of the death) and develop effective tools for dealing with their grief.

Perseverance is also required because, for many survivors, basic trust in relationships with others was broken when the person contemplated suicide. This means that it is often difficult for them to establish new relationships because they feel cautious about reconnecting or new connections.

One of the differences in the grief process after suicide is that the act involves a conscious choice, which is different than sudden death through accidents or cancer. It is this element of “choice rather than chance” that complicates the grief process.

The following is an example of some of the things survivors might say to themselves that lead to these feelings:

Shame – “What would people think of me if they knew my child completed suicide ?”

Blame – “I must have been a lousy parent if my child killed himself !”

Guilt – “I noticed she was depressed. Why didn’t I do something ?”

Anger- “How could he do this to me?” You saw your loved one’s life as viable; they saw it differently and chose to die. That is difficult to understand and impossible to bear. So often, after disbelief, the next reaction is anger and outrage. The survivor may feel the deceased acted with contempt towards them. Or perhaps they perceived themselves as unloved. Either way, we ask why they didn’t see how hurtful this would be, or why they did not seek alternatives.

Fear – “Will my other children end up killing themselves too?”

Relief – “It’s finally over !” (This feeling is more evident in cases where the person who died was abusive or had a long-standing difficult history of mental illness.)

Rejection – “I guess he didn’t really care about me or he would still be alive.”

Hopelessness- “What’s the point in going on?”

Confusion – “How could this have happened? I just saw her yesterday and she looked fine.”

Isolation – “I feel so ashamed and guilty about Joe’s death that I don’t want to see anyone. I bet they blame me for his death.”

There are four areas of discussion and counsel that are particularly helpful to suicide survivors:

  1. Listening to the story of the death
  2. Expressing and understanding feelings
  3. Anniversaries and special occasions
  4. Stress, coping, and using support systems

1.         Listening to the Story.

To facilitate the telling of the story of the death, it is important to create a supportive atmosphere through gentle probing. We have included a number of questions that we commonly ask survivors to assist them in the telling of the story. These appear in the Appendix at the end of this chapter. The suggested questions in the appendix could leave the impression of an interrogative approach, if used verbatim, without proper nuances in timing and pacing.

The point to be made in asking these types of questions is that the story needs to be protracted and spun out, through a recounting of the many details of what happened.

Many survivors feel uncomfortable talking to friends about the details of the suicide as they feel that these details are too horrific for others to absorb. Families sometimes avoid talking about difficult and painful parts of the story, even in discussions with one another. The fear is that these difficult elements may be too over-overwhelming for family members to bear because of their own grief. As bereavement counselors, it is our job to be able to tolerate the intensity of emotion and detail that the telling of the story can bring about.

The initial goal is to have the family tell the story of the death of their relative or friend. It is through recounting the details that a number of key processes are likely to occur, these being:

  1. Each person will begin to ascribe meaning to the suicide ( a beginning for the ever-present question “Why?”)
  2. Each person will begin to experience some relief through acknowledging, identifying, and working through their feelings of loss.
  3. Each person will begin to create their own understanding of what has happened.

Further relief will occur through the experience of talking in a supportive atmosphere that allows the expression of all the details, feelings, and thoughts related to the death.

One of the advantages of dealing with issues related to grief through suicide, in a group context, (familial or otherwise), is that the isolation that this grief can produce will be reduced through people coming together to talk about their experience.

From our experience, families who feel they have had an opportunity to tell the whole story, related to the death, and who feel their story has been validated, are better able to move on to issues in the present. Families who have not had assistance in understanding and making sense of the death are far more likely to get stuck in the repetitive talking about the death without resolution.

Going over the events in detail allows family members to hear each other’s perspectives, to appreciate that everyone is in pain and to realize that they may all be at different stages in their grief, with each attributing a different meaning to what has happened.

It is helpful to encourage tolerance for differences by helping members listen to each other’s different explanations and interpretations and to accept that each one’s perspective and rate of acceptance of what is happening is okay. The tendency can be for each person to want to convince others that his or her version of the “truth” is the only “truth”. Families who are struggling to understand the death, often ask counselors to answer the question of why did she or he kill themselves. The task is to educate the family through providing information based on other families’ experiences e.g. “Other families have told me but this won’t necessarily fit for you.”

As you listen to the story, it is useful to prepare yourself by having a clear understanding of your own beliefs and values to do with suicide. One way of orienting yourself to these values is to examine and explore some of the popular myths regarding suicide e.g. “A person who completes suicide is mentally ill.” Although this is considered to be more false than true, if the family has decided that their relative was mentally ill and is now free of the pain of that illness, it will be of no comfort to them if you espouse your view that John was not necessarily mentally ill when he hung himself. It is important that this understanding of one’s own values and beliefs pertaining to suicide are examined prior to working with families so as not to interfere with the process.

There are some important differences for a person grieving a death through suicide versus other types of loss. This is not to minimize the effect of other types of loss but more to raise awareness for the helper of certain processes and feelings which will be more prevalent and harder to come to terms with for family members.

Expressing and Understanding Feelings

As mentioned previously, feelings that are likely to be more intense after a suicide than after most other types of loss include the following:

Shame                 Relief

Blame                 Rejection

Guilt                  Hopelessness

Fear                   Confusion

Anger                 Isolation

Often the sheer intensity and complexity of such feelings cause concern for the griever that they might be going crazy. This intensity needs to be normalized when dealing with death through suicide.

When talking about any of these feelings it is important to validate and acknowledge how painful these feelings can be, while at the same time normalizing their intensity. One way to do this is to reassure the family that such feelings change over time both in frequency and intensity. To create a concrete example of this change over time, ask the family which feelings were most prevalent for them e.g. month ago, as compared to today.

The mix of emotions can be so overwhelming at times that it may be difficult to get people to identify just what it is they are feeling. Questions such as “What was most difficult for you over the past week?” will often elicit a recounting of a scenario that gives you a clue as to one or two specific emotions that were being experienced. This will provide you with the opportunity to explore these feelings and help them accept as well as understand the origins of these feelings.

This can be the first step towards the resolution of these feelings and moving on. This can be followed by a discussion of how to cope effectively with these feelings.

Although not everyone will necessarily be troubled by each and every feeling listed below, these are the feelings that survivors find most challenging to cope with, from our experience.

SHAME

This feeling manifests itself as a result of the family’s perception that they failed in some way.

They often feel reproached by others, think that they are held in disrepute, and can feel disgraced by what has happened.

Shame can be rooted in long-held beliefs such as it is wrong or a sin to take one’s own life. One of the experiences that families describe that increases their sense of shame, is the worry that they went through as to whether they would be allowed to bury their relative on sacred ground. Even though this unwillingness to bury those who have contemplated suicide in sacred ground is rare today many families worry about this nonetheless as it is the decision of the individual minister, priest, or rabbi to decide wheat the person will be buried on holy ground.

It is useful to draw out examples of where friends, family, clergy, and others have been strongly supportive to them, thus proving by their actions that they do not see them as disreputable or disgraceful.

BLAME

Families who lose someone to suicide often feel blamed. This perception that they are responsible for the death can come from within the family or from outside of the family. This is particularly true when the family has a history of abusive behavior. In trying to make sense of the death, people will sometimes blame (scapegoat) a relative for not having done more to prevent the suicide. This criticism may be expressed to a member who is attending the session or it may involve an absent relative.

As the helper, you need to allow expression of these thoughts but also have the person being scapegoated say how they feel about being blamed. Questions such as “what happened the time before when Joan was depressed or took pills? or “Just because Joe’s girlfriend broke up with him, did any of you expect him to take his own life?” can help bring things back into perspective.

This sense that others are saying (or thinking) that a certain relative(s) or friend is at fault for the death, can be both real and imagined i.e. “If Joe had not been so neglectful of Sally, she would not have killed herself.” is one example. This kind of thought or statement assumes that suicide is a cause-and-effect situation, meaning that one singular circumstance caused the death. Suicide is a complex phenomenon, so it is best not to oversimplify its causes.

”Jane must think I’m a terrible mother because my son killed himself” is another example of blaming self-talk often evident in survivors. How does one help families with their sense of blame for the death? Point out to the family that scapegoating is partly due to their need to have an answer – to make sense out of something that is senseless, but also that it is hurtful to the person being blamed. We find that this part of the process is initially cognitive, meaning that survivors are able to think they and others are not to blame long before they can feel this.

GUILT

“No, I can’t say that I feel any guilt” is often contradicted by the frequent use of the “should” word.

For example, “He had talked of suicide before. Therefore we should have done more to listen to him”. Another example of this type of thinking or self-talk is evident in the following statement: “We knew she was depressed and should have got her better professional help”

Although guilt serves a function for some people and is something they may need to dwell on for a while, eventually it is helpful to examine evidence to the contrary of their perceived shortcomings. Frequent reminders of the times when they went the extra distance to support their relative, will eventually assist them to move beyond this painful feeling.

Although it is important during the session to remind the family of the efforts they made to assist their relative, it is not necessary to convince the family of their, superhuman efforts to protect their relative, at times. The realization for some tends to come long after the series of sessions is completed.

ANGER

The level and persistence of this feeling make suicidal bereavement different from most other forms of loss. Although the survivor’s rage is often directed at multiple targets (incompetent doctors, demanding bosses, insensitive neighbors, uncaring relatives, an impotent God, etc.), the real source of much of the anger is the action of the person who chose to die and “abandoned, rejected or otherwise hurt me”

The work for the counselor is to help the griever identify as many people or situations with whom and about which they are angry. Anger at their relative is often the last area that survivors are able to acknowledge and work through. Permission to process this anger can be prompted with “what would you like to say to Joan if she could hear you now?” or “on a scale of one to ten, how angry are you with John?” Getting survivors to scale their feelings on a scale of 1 to 10 with one being the least intense and 10 being the most intense is often a quick and effective way for caregivers to understand the intensity of emotions survivors are feeling. Furthermore, this technique allows survivors to measure the constant ebb and flow of their emotions. The above example can be followed with a question such as “what would it take to help you move from a 9 to an 8 on the scale in terms of your anger?” If they are stuck for an answer, simple suggestions may be made such as writing a letter to the deceased or saying it out loud in private to help them move on the scale. Helping survivors recognize that their feelings change in intensity through using scaling questions gives them hope of change and relief in the future.

FEAR

Many families who have lost someone to suicide have a lot of anxiety and fear. This can be related to either of the following areas. One of these is a concern for the safety of other members.“Might they opt for suicide as an answer too?” is a question some families have.

Another fear is the worry that members cannot tolerate talking about certain aspects of the death and that doing so “will make them feel worse and they will be less able to get through each day.”

If we suspect the presence of these issues, we find that the most effective way of reducing anxiety is to address the issues directly. “Are you worried that Joan may hurt herself too?” followed by “Joan, do you have any thoughts of suicide?” gives the family permission to discuss and clarify their anxiety and fear.

The anxiety about each others’ ability to tolerate discussion of difficult aspects, is dealt with in the very early stages of the sessions by using questions that ask about all the details of the death. The usual reaction is a relief, and at times surprise, to get the unspeakable said. Listening to these fears can reduce them in size from the imagined insurmountable to the real and manageable.

It is useful to keep in mind that feelings of rejection can still occur even when the relationship to the griever was a conflictual one. The work here is to first listen to the family’s feelings of rejection, and then invite them to eventually think about other possible circumstances that contributed to the suicide, other than that the suicide was a personal action aimed against them. Most families are only able to consider these other explanations later on in the grief process.

HOPELESSNESS

Some people express their despair that life will never improve and they can be very persistent in maintaining this perspective. The urge for the helper can be to work hard at convincing them that life will eventually get better. If you follow this approach the survivor may feel that you do not understand the magnitude of their hopelessness, which may cause them to become further entrenched in this feeling, while you feel exhausted or impatient at their inability to change.

One of the ways for the helper to avoid this situation is to ask the griever questions that will help you understand the reasons for their feelings of hopelessness. These are likely to be related to the many other losses they have experienced as a result of the suicide. We refer to these losses as secondary losses. Examples of these secondary losses include loss of companionship, status, income, role (parent, lover, child, sibling, mentor, etc. ), safety, home, etc. Questions that help explore this area include “Could you share with me what else has changed in your life since the suicide?” Validate that these many losses are hard to bear. Ask the person “what is the hardest part of the day for them and conversely which parts of the day do they find easier to deal with?” As they tell you about these experiences watch for small shifts in mood (either in duration or intensity).

An example of a small shift that we often hear is that of the survivor going on a small outing such as coffee with a friend or going to a movie. This example allows you to ask the person whether they think they would have been able to make this effort at all, e.g. three months ago. Often survivors only become aware of this improvement in their level of functioning when we point this change out to them.

Acknowledge that progress is not consistent. One way to help survivors feel their experience is not unusual or unique is to share with them statements such as the following: “ Others tell us that there are times when they feel somewhat better and then unexpectedly they feel worse again.” Gently hold out hope by explaining that things gradually do get better even though feelings fluctuate.

CONFUSION

This state can manifest itself in a number of ways. Survivors are often so overwhelmed by their emotions that they are confused about what exactly it is that they are feeling. There can also be confusion about making the simplest decisions. Furthermore, there can be confusion in their relationships with others. Often relationships that were previously stable and supportive, may no longer be so.

The main work here is to help survivors understand that this confusion is to be expected given the traumatic events they are going through; that they are not going crazy and that with time, they will regain their ability to manage daily tasks, routines, and relationships.

One woman was convinced that she needed psychiatric care when her concentration became so bad, months after the death, that she could not make a simple choice over the purchase of a cosmetic. She felt less anxious about her confusion when she was reassured that this experience is not unusual.

It is confusing when people who have been friendly and thoughtful in the past, react differently now, particularly at a time when grievers feel that they need the love and support of family and friends. This issue will be addressed further in the next section.

ISOLATION

Most survivors feel extremely isolated after losing someone to suicide. The reasons for this are several. Firstly, a suicide in a family can lead to blaming one another for not preventing the suicide. Thus rifts can occur between family members, distancing them from one another and exacerbating feelings of isolation.

Feelings of isolation also result from secondary losses. For example, if a woman loses her husband to suicide and their social context was comprised of themselves and other couples, she may feel very isolated and alone when in the presence of couples. Added to this, loss by suicide often causes overwhelming feelings of grief for long periods of time, resulting in grievers finding it hard to engage in social activities leaving them more isolated. Often, friends and family feel strained in the presence of someone who is depressed and grief-stricken and inadvertently stops inviting this person to events.

This can feel like a further rejection for the griever and it is important to process these secondary losses.

Grief is a selfish process and friends need to understand that the ability of the survivor to give equally in a relationship is limited for long after the actual death. Recently a friend who lost her eldest child, recounted that she and her husband were having difficulty sharing their feelings of loss. Although she has a very strong marriage, she explained that if her husband was having a “good day” while she was having a “bad day”, she hesitated to tell him about her anguish in case it “brought him down”. This dilemma is very common amongst couples and family members and can create feelings of aloneness for the griever.

As well as difficulty in sharing thoughts and feelings within the immediate family, isolation can be perpetuated by the griever not knowing whom to tell what and how much to reveal to whom.

It is better to not assume that it is a good idea to “get everything into the open” by telling everything to all. Rather, help them to identify who they feel most supported by, and encourage them to share their pain with this person, disclosing at their own pace.

Anniversaries and Special Occasions

These can be particularly difficult to deal with, especially in the first year after the death, when all the anniversaries and special occasions are a first. Anniversaries can be particularly challenging if they represent festive occasions, such as Christmas, Hanukkah, etc., which are remembered as times of joy. A further issue to contend with regarding anniversaries is that various family members may want to celebrate these occasions in different ways.

Finally, survivors are often reluctant to create rituals that honor the person who died, as they worry that people might think this is weird or abnormal. We recently worked with a woman whose daughter had died in the Spring. On her daughter’s birth date in June, she wanted to gather up her daughter’s friends and spend an evening with them reflecting on her daughter’s life. She was worried that others would misunderstand her actions and see them as weird or abnormal.

We supported her wish to celebrate this special day in her life, in this way. Much to her surprise, her daughter’s friends were thrilled to have the opportunity to participate in the occasion and cherished the fact that this mother had thought of including them.

In reviewing this event with her, she talked about what a wonderful evening it had been. This client highlighted to us that our support helped her embrace the significance of that date in her life, rather than disregard the meaning of her daughter’s birth date.

Each family member will need to decide how they wish to recognize these special occasions. In cases where family members are unable to agree on a particular way of honoring the deceased on anniversaries, we try to get them to agree to disagree, thereby modeling the need to tolerate differences in the grief process.

Stress, Coping, and Using Support Systems

Grief is an exhausting process – both physically and mentally. Although we often hear about the emotionally exhausting part of grief, we hear less often about the physical toll grief can take on someone.

When dealing with grieving individuals, it is important to ask survivors how they are doing physically as well as ask them about their emotional well-being. Changes in eating, sleeping, concentration, energy level, etc. can all be strongly affected when dealing with grief.

Most survivors are good at recognizing what coping strategies do not work.

Ask survivors to think about a time recently when they felt less overwhelmed by their grief.

What were they doing at this time?

Support does not always have to be in the form of talking. Talking is a limited view of what constitutes support. Support and coping strategies, as we have come to recognize them, can include task-oriented activities as well as talking. It can be helpful to point out to the family that the person who comes by with food or helps with chores or baby-sitting for a while, is also offering support in their own way. Families can interpret these other offers of support as a lack of caring because the person did not talk about the death. Ask questions that help highlight what friends and neighbors have done that all add up to support.

Some survivors we worked with found watching movie videos took their minds off their pain, at least for a while. This can be a good coping strategy for those having trouble sleeping as it provides an alternative to tossing and turning in the middle of the night when it is harder to find someone to talk to.

Given the many physical challenges grief can create, regular contact with a family doctor is important to monitor weight loss or gain, sleeplessness, etc. Medication to help people sleep can often be useful for short periods of time. If someone is not sleeping properly, their ability to deal with other aspects of grief can be severely impeded.

Physical activity can also be useful during the grief process as it stimulates the part of the brain that helps fight depression. If physical exercise has never been part of the survivor’s lifestyle, this strategy may not be realistic, but even short walks can be helpful.

Many survivors feel suicidal during their grief process. This period can be frightening for caregivers. Survivors can be supported through this difficult period by having caregivers understand the reasons someone is feeling suicidal. It is imperative to provide survivors with the names and numbers of emergency clinics they can reach out to if they feel that they might act on their suicidal thoughts.

Generally, we end every session with clients by predicting that they may initially feel worse after a session (talking about feelings can bring troublesome emotions to the fore) and in the event of an emotional emergency, i.e. “I think I might act on my suicidal thoughts” – we assist clients to create a safety plan, which involves helping them identify what they will do if they become overwhelmed by their thoughts and feelings. These safety plans always involve non-destructive coping strategies such as doing something positive for themselves, calling a friend, seeing the doctor, calling the Distress Center, seeing their “priest,” or going to the nearest hospital emergency department.

Conclusion

Our goal when providing grief counseling is to supply family members with tools to help them in their grief journey. Given that the grief process can continue for long periods of time, particularly in death through suicide, it would be impossible and counter-productive to see families throughout this period of time. The goal of these sessions is to help families work towards achieving a normal level of personal, interpersonal, and day-to-day functioning.

In much the same way, by providing you with some of the topics and questions, to cover with families, we hope we have provided you with some of the preliminary tools you will need to do this work.

Dr. Bill Webster

Dealing with Special Days

DEALING WITH SPECIAL DAYS AND HOLIDAYS

By Dr. Bill Webster

You probably heard the expression “Some days are diamonds, some days are stones”.

When you are grieving, there is no question that some days are more difficult than others. Many people don’t realize that grief comes and goes. Let me illustrate. If you get a sore throat, it is painful for a few days; then the discomfort diminishes till it gradually disappears.

Grief does not work in a similar way, though many people seem to think it will. When someone dies, people expect that your “pain level” will be very high in the first few days, over the funeral, or at worst for a few weeks. But often at first, we feel quite numb. People confuse numbness with strength and expect the pain of grief to ease and diminish soon after, just as in the case of a sore throat.

Not so! Sometimes a few weeks after the event, the pain is more intense. When the numbness wears off, we often feel worse rather than better.

Grief is like a roller coaster… one day can be a good day, and the very next day a rotten day, followed by a better day, and then … well you get the picture. We feel better for a while and then find ourselves back in the depths of despair. Just when we think we are getting over it, we are hit by another wave of grief, and we suffer what seems a devastating setback.

Certain days are more significant than others inasmuch as they remind us more specifically of the person who died. These can be especially difficult. Sundays often represent family days; anniversaries; holidays such as Christmas and others when the person’s absence is felt. The person’s birthday for example can be a hard day, as you think back on special parties that were held, gifts you gave them … a birthday after someone’s death is usually not a happy one. But it can also be difficult on YOUR birthday, as you realize that they are not there to participate in your celebration.

You will be able to identify many occasions on which you miss your loved one, for the list is long. Think of all the days in particular throughout the year that could be hard because you miss the person: Valentine’s Day, Mother’s Day, Father’s Day, Easter, the first day of spring, or the opening of the football or sports season; the first weekend at the cottage or trailer; the summer holidays; Christmas. Then add all the special occasions like weddings, family get-togethers, weekends. These can be difficult because they remind us of better days when the person was here, as compared to THIS day where they are not.

When you don’t seem to be “getting over it” or when it feels like you are getting worse than better, it can be discouraging to those who do not understand the process. But may I remind you, grief comes and goes. Some people call these experiences “Grief Attacks”. I call them TUG’s, for they are Temporary Upsurges in Grief.

There are so many triggers, usually simple everyday things: being in a familiar restaurant you frequented with your loved one; the scent of an aftershave or perfume; hearing a song on the radio that was special. So many things that remind us of the person who has died and each one has the potential to suddenly compel us to miss them again.

Coping with Difficult Days

What can we do about such difficult days? Firstly, it is important not to regard them as “setbacks” for as tough as they may be, they are actually an invitation to come to terms with our loss a little more. But when we ask ourselves, as much as I will miss the person, what can I do on that noteworthy day to commemorate their death and celebrate their life. How can I make that day meaningful though difficult? This gives us some measure of control.

So what can we do? May I make several suggestions? Most importantly, I think we need to remember. Grief invites us to remember, not to forget. To try to ignore the occasion, or pretend that it is just like any other day is unnatural, and actually increases the tension. It takes more energy to avoid the situation than it does to confront it.

Observe these holidays and special occasions in ways that are comfortable for you. Feel free to make some changes if they feel comfortable for you. \Remember, there is no right or wrong way of handling these times. Once you have decided how to observe the time and what you can handle comfortably, let family and friends know.

Allow yourself to feel and to express your feelings. Those special days often magnify feelings of loss. Share your concerns, apprehensions, and feelings with a friend or in a support group. Recognize that the need for support is often greater during holidays. Try to get enough rest, because those occasions can be emotionally and physically draining.

Acknowledge your loved one’s presence in the family. Consider lighting a memorial candle at the dinner table or in the house to quietly include your loved one. Listen to music especially liked by the deceased or look at photographs or videos if it is not too difficult to do so.

DON’T BE AFRAID TO HAVE FUN. It is natural to feel sadness, of course, but it doesn’t have to be all sorrowful. Laughter and joy are not disrespectful.  Give yourself and your family members permission to celebrate and take pleasure in one another. Can you get together with family and friends and take some time to share special memories or tell stories about the person. What made them special and what do you miss about them? Humorous incidents recalled can have a special healing quality to them.

Your loved one died, it is true, but they also LIVED. Make their birthday a celebration of their life. What could you do to honor their life on that day? Make that wedding or other anniversary a time to be thankful for what you had, as well as an opportunity to grieve what you have lost. Take time on that day to remember and be thankful for the person, even though their absence will be keenly felt.

Try to remember the good memories that you shared with the person. You know, a birthday is a celebration of LIFE. So what could you do that would celebrate the person’s life, even as you remember their death. What would you have done if they had still been here … could you do something similar, as if they were saying, make the most of the day.

Be proactive, not reactive. In other words, do something to take charge of the day. See it as another opportunity to grieve, to miss the person, to peel back another layer of sorrow. To pretend that nothing has happened is so unnatural and actually increases the tension.  Do something to remember and to grieve.

Try to balance sorrow for their death with celebration for their life, and it will make those difficult days more meaningful.

Can you be thankful for SOMETHING?  Of course, you are sad because someone you care about is absent, and that is natural and it is right.  But can you be thankful for the years you did have and the memories you still share?  I believe we can be thankful for what we HAD as well as grieve what we have lost.  And are there people who WILL be there this year for whom you can be thankful?

Don’t allow looking back at the past to spoil what you have in the present.  Yes, you miss the person who will not be there, but is there children, relatives, and friends you can enjoy today?  It may not cancel out your sadness but it certainly makes it easier.

You only have one of two choices when it comes to grief at difficult times. Do you let the day control you, or do you control the day? Either we allow the grief to dominate us, or we try to control it. By doing something … anything … to acknowledge our sadness that they are no longer here while at the same time celebrating the fact that they WERE here, will make a difference.

Remember, the choice is that you can shed tears that they have gone, or you can smile because they have lived. Or maybe you can do both at the same time. Be prepared for difficult days, anticipate them and prepare for them, and then do what you can to make it a fitting day to remember.

Dr. Bill Webster

How to Help Someone who is Grieving

HOW TO HELP SOMEONE WHO IS GRIEVING

By Dr. Bill Webster

I’d love to help but I just don’t know what to say or what I should do.  I am sure many of us can identify with such sentiments.  We hear that a friend or a neighbor has had a loss.  Our hearts immediately go out to them and us long to be of some comfort or assistance but we just don’t know what to do or what to say.  Often because we are afraid or unable to raise the subject we may say nothing. To the grieving person, it may seem as if there is little understanding or support.

Here are eight practical suggestions as to how we can help in a positive and constructive way people who have a loss and support them in their time of need.

1)      Be there.

Our initial reaction is often “What can I do?” and it is a wonderful one. Most of us want to do something to help take away the pain of loss. People will offer all kinds of practical help such as bringing in food, looking after children and many other examples. Yet often what is needed is for people to be not just to do.  As helpers, we should take the initiative and make contact.  Remember the griever is in shock and isn’t functioning very well. They may not be able to respond to your sincere offers to “Let me know if there’s anything I can do?”  They may not know what they need.  The first thing is to reach out, establish contact and be there. Don’t worry about what you’re going to say or do.  It may come as a surprise but I actually remember very little of what was said to me at the funeral home.  What I do remember is that certain people were there and their presence made all the difference.  Just be yourself. The gift of presence is most important to people in grief.

2)      Please listen.

One of the healthy things in the days before a funeral is the opportunity for people to talk about the dead person and the events surrounding the death. Unfortunately, that process often ends shortly after the funeral service. Research has shown that the most significant factor in the failure of grief resolution is the absence or inappropriateness of social support. Put simply people need to talk … which means others need to listen. In fact, it is better to say people need to talk and talk and have repeated opportunities to review and relive the person’s life and death. You may find they repeat the same story over and over. Encourage this. Difficult as it may be for the listener because each reliving of these events is another strand of the chord that is cut. Care enough to find out about the person’s grief. Give them permission to talk with questions like: Can you tell me a little about the death? What happened? Tell me about him/her. How did you meet? What was he/she like? What has been happening since the death? How have you found things? How are you feeling? What are some of the struggles or challenges? Know when to close your mouth and when to open your ears.  Simple listening skills such as maintaining eye contact, leaning forward, and nodding your head can encourage the griever to open up.  The unspoken messages “You’re important and what you are saying is important, and I want to hear everything you’re telling me.”

3)      Interpret “Normal” Behavior.

It is important to understand what grief is and how it manifests itself. Only then will we know what is normal. Grief is an emotional response to a significant loss.  It manifests itself in many different ways, in greater or lesser degrees, and in various combinations. In simple terms, grief is unpredictable. This is what makes normality so difficult to define or neatly package. What is normal? Why can two different people react to grief in completely different ways and both be considered normal? Our grief response is a unique blending of numerous emotions. Some of these include shock, disbelief, numbness, crying, confusion, anxiety, depression, guilt, anger, loneliness, despair, sadness, helplessness, frustration, irritability, resentment, fatigue, sleep disruptions, physical symptoms, and lowered self‑esteem. All these emotions are normal. People in grief, not understanding this emotional explosion they may be experiencing often think they are going crazy. They aren’t! They are normal. They may need some help to work through all their feelings, but that’s OK. You may not be a doctor or a psychologist, but if you can help people to see they are normal in their feelings of grief, you will bring the best medicine. By the way there are other messages in this series that will help you understand the grief process more fully.

4)      Legitimize Grief Feelings:

I try never to say “I know how you feel” to anyone because I don’t. How can I know how they feel. All I know is how I felt when grief touched my life. People say these words with good intentions, but the grieving person often does not appreciate them. To say I know how a person feels somehow minimizes their experience. The loss is unique to the griever. The feelings of grief are unique, influenced by many factors around the relationship, and the circumstances. Sure, I lost my wife, and I remember how that felt…but someone else may be feeling something quite different, and we need to validate that. We need to let the person know it is OK to grieve. Grief is confusing to people for many reasons. It manifests itself in some seemingly unusual and uncharacteristic behaviors. The message people sometimes get is that they should “be strong”. They may be looking for permission to grieve. They are asking us in hidden ways if it is safe to express to us what they are REALLY feeling. To tell a person NOT to cry when tears fill the eyes is to deny permission to grieve. To say that they must be strong, or that life must go on, or even to quickly change the subject to something more cheerful, gives the message that the grief and the feelings are not acceptable to us. Maybe we are simply saying we can’t handle it, which is fair enough. But if we do want to be a support, we need to assure them that we don’t mind if they cry, or rant and rave, or show anger, or display any of the emotions associated with grief. Let people know that you accept them as they are in this time…that you accept their weakness and vulnerability…that you are not trying to “fix” them or indicating they should be doing better. There is often a critical moment between friends when the voice cracks, the mouth quivers, and tears come to the eyes. In that moment, Say little or nothing, but reach out, touch the person, perhaps by a gentle hand on the arm, and let them know that it is OK to let it go and express the grief that is being felt.

5)      Tolerate Angry Responses:

Be prepared for the fact that you may be the focus of some angry reactions or outbursts. It is not necessarily a reflection on you or the things you are attempting to do. Don’t get angry in return or give up on the person when this happens. The problem with anger is that it doesn’t always get focused in the right direction. Grievers may be angry with doctors, ministers, funeral directors, friends…in fact almost anyone. And they are angry for one simple reason. We cannot give them what they want the most. Namely the return of the person they have lost. Something has happened that cannot be changed, much as we would like to. The feelings of helplessness around such a situation lead people to be angry. They are angry because they have been left. But where do they focus that anger? On whoever happens to be in the line of fire when the frustration overflows. We have to be clear here. The person is not angry at us, hard as it may be to be objective. We have to be realistic about the help we can offer. We cannot take the pain away from the person. Despite our best efforts, we cannot rectify the situation to their satisfaction. That does not mean we can do nothing…it just means we have to be realistic.

6)      Give the Griever Hope:

While not minimizing the pain and difficulty of grief, we need to give the griever hope. Hope that someday the pain will subside. Hope that life will have meaning again. Hope that God has a purpose in all this, even though we may not see it right now. Hope that someday life will make sense again. Such a feeling of hope will bring comfort, the realization that things will get better, and that they will find the grace and the strength to carry on.  This is why support groups can be so helpful. They show people whose loss is recent that others have survived the anguish and the agony, and are finding new meanings for their life. While the newly bereaved may not feel it at the time, seeing that there is a possibility of recovery is a glimmer of hope at the end of the tunnel. Giving the mourner hope involves constantly reassuring them that as long as they work at it with courage, the pain will subside and life will go on. It may be a reminder that strength is often made perfect in weakness. But the confidence we place in the person that they will make it will give them courage and confidence in times when self-doubts assail.

Always remember that Grief Takes Time.  Not everyone goes through the same process and none at an identical pace. More often than not, grief takes much more time than society has realized or allowed. We have often forced unrealistic expectations on people who have had a loss. We expect them to be “over it in a relatively short time. While it is commonly accepted that the intense reactions of grief will subside within six to twelve months, it is also widely acknowledged that some things may take years to be resolved. It is up to the grieving person to set the pace for their own journey. We of their friends and family can only walk with them on that journey. We can’t fix people or try to make their decisions for them or try to set the pace for their journey. But we can be with them. We can walk alongside and let them know they are not alone. They have a friend, and they will be thankful for that and for us. We will have made a difference in someone’s life.

And, after all, that is the greatest reward.

Dr. Bill Webster

Helping Children Cope with Grief

HELPING CHILDREN COPE WITH GRIEF

By Dr Bill Webster

  • It is important to note that children have many questions about death, and these are usually different than the ones that occur to adults. Children’s questions deserve simple, straightforward answers. The first task of a grieving child is to make sense of the factual information about how the loss occurred. A caregiver’s direct, concrete explanation of the facts surrounding the death will help the children begin to come to terms with what has happened. They may ask to hear the facts a number of times. They may also want to share the story with many others … friends, teachers, strangers … to try to comprehend the unimaginable that has happened.
  • Children’s perception of loss and their grief has to be understood according to their developmental levels. Death, or indeed any loss, means different things to children of different ages. Enquire and try to figure out what this loss means to this child at this particular time in life. What they feel they have lost will be a determinate of what they are missing, and what needs to be.
  • Dispel any fears the child may have. Children are often afraid that someone else in the family, or they themselves will die also. They need to have the reassurance that these fears are unfounded. Every child is afraid of being abandoned, so if one parent has died, the remaining parent can assure the child that he/she expects to live a long time and will take care of all the child’s needs.
  • Children need to teach adults about their grief. Every child and every response is unique. Rather than assuming that we know what the child is feeling, we must allow the children to be our teachers. As children share their grief with others they trust, they tell us what they are feeling and experiencing. As adults communicate respect, acceptance, warmth and understanding, the child will sense that they are being taken seriously and be more open to the stabilizing presence of that individual as they reach out with meaningful support.
  • Children express themselves in a variety of ways after a loss. Some of the most widely recognized include: an apparent lack of feelings; acting out behavior, due to feelings of insecurity and abandonment and often expressed by behaviors which provoke punishment, for children would rather be punished than feel ignored; regressive behavior; fear; guilt and self-blame; “Big Man” or “Big Woman” syndrome, (often encouraged by those who with good yet unwise intentions tell a 10 year old that he has to be the “man of the family”); disorganization and panic; loss and loneliness; explosive emotions.
  • Simple ceremonies such as lighting a candle next to a photograph; placing a letter, picture or special memento in a casket; or releasing a helium balloon with a message attached for the person who died, can be effective rituals of farewell. Children can be wonderfully creative with these kinds of meaningful, symbolic ideas.
  • Speak in simple language: Ask the child what he/she thinks, knows, and feels, and respond specifically to these concerns. Do not give excessive detail, and make sure you check how the child is putting the information all together.
  • Be honest. Avoid half-truths. Never tell a child something he/she will later have to unlearn. Don’t avoid the word death, because sometimes the alternatives (asleep, gone away, in a better place, etc.) create worse difficulty in a child’s mind.
  • Be open about the situation: When my wife died, my boys were 9 and 7 years of age. As much as I might have wanted to, there was no avoiding the questions that arose. “Why did Mommy die?” “Where is she now?” “What will we do if you die too?” I tried to answer the questions they asked simply and honestly, without giving too complicated responses. They discerned that I was making them a part of it all, and was being open about everything, and accepted that.
  • Initiate the conversation: Children may not ask questions because they are not sure if they will upset we adults. They may not know what to ask or be able to put their uncertainties into words. They know that something unusual is happening, and are scared by it. Instead of asking questions, they may turn to whine or other negative behaviors, which add to your emotional stress. In response, rather than helping them cope, adults may get upset or angry and this adds to the reluctance to talk. Try to be sensitive to opportunities to ask children how they feel. We might ask, “You’ve probably been wondering about …. ”, and pose the question that the children may be asking.
  • Sometimes our concern for the children can mask a deep need to resolve our own adult grief issues. Sometimes it is easier and more socially acceptable to say, “I am concerned about the children,” than it is to say, “I’m having a hard time dealing with this myself.” So be careful not to transfer your own fears and anxieties onto the children.
  • Often a child may benefit from a support program. Talk to your doctor, spiritual leader, or other community resource people to see what programs are available for your children.
  • Above all, let the child know that these feelings of grief are natural and a necessary part of the grieving process and that their grief will pass. Assure them they are not alone, and that others, including you yourself, feel sad as well. Assure the child, however, that these feelings will pass with time, and that life will return to normal.

A few practical guidelines:

  • When describing the death of a loved one, use simple direct language.
  • Be honest. Never teach a child something they will later have to unlearn.
  • Allow children to express all their emotions
  • Listen to children, don’t just talk to them
  • Don’t expect the child to react immediately. Be patient and available
  • Understand your own adult feelings about death and grief, for until we have come to terms with it for ourselves, it will be difficult to convey a positive attitude to children.

An important influence on children is watching how adults are responding. Caring adults can help guide children through this difficult time and make it a valuable part of personal growth and development. When you support children through these difficult life transitions, they will know without a doubt they are not alone. There is no greater gift we can give our children.

Dr. Bill Webster

Loss from a Child’s Perspective

LOSS FROM A CHILD’S PERSPECTIVE

By Dr. Bill Webster

“My mother died when I was 5 years old. I felt like I was insignificant as if I was getting smaller and smaller … so unimportant that I might disappear. It’s very hard to explain, but I believed I was wrong, somehow. For years I felt like I was on the outside of things, even though others would not have thought I was.”Sally, 35, lost her mother.

Sally’s words teach us that a child’s feelings resulting from the death of a parent or sibling may not be obvious to others. Because the child thinks the universe revolves around them, a death can produce an anxiety that translates into a “fear of losing myself”. Sally, at 5, felt like she was getting “smaller and smaller” and that she might “disappear”.This fear of being lost, and the related anxieties about being on the outside of things is common among children of all ages.

It should be obvious that any child old enough to love is old enough to grieve. Children of age are affected by any significant loss, and often very deeply because their coping mechanisms are just developing. To understand the complexity of how each situation affects a child, we should ask ourselves:

“What does THIS loss mean to THIS child, at THIS time in his/her life?” 

However, it is important to recognize that a child’s comprehension and response to a death varies, depending on their age and developmental levels. Death means different things to children of different ages.

For Infants, awareness of their world is limited, so the death of a mother is perceived as “unavailability” or “absence”. An infant’s needs are for physical contact, warmth, and consistency, which creates security. The absence of a nurturer poses a threat to survival, resulting in fears.

Between about 2 – 4 years, a child still has no concept of the permanence of death, but their fears are more numerous. Cartoons suggest that characters can be blown up, run over, hurt, but then simply get up and go about their business. Likewise, the young child may believe that “Mum will come back” and may continue to act as if the dead person is still alive. Death is just a “sleep” from which they didn’t wake up.

Between ages 5-9, a child’s understanding of death undergoes another change. This is often the age of “magical thinking”. They see death as coming from an external source … a bogeyman, or an angel who comes to take people away. They regard it as some kind of enemy or assailant. Thus children may regard death as something to outwit, rationalizing “if I am good or do the right things I will be able to reverse this.” If we do not make children a part of what is happening, or keep it “a secret”, they assume that somehow they are responsible, which mistaken perception merely adds complications to their mourning.

Again remembering that we are talking developmental levels as well as actual ages, between 9 – 12 the child begins to understand that death is the end of life, irreversible, and is a natural part of life rather than an enemy who steals people away. They become more concerned with the consequences of death … “who will take care of me? will we have to move? will Dad marry again? (and if so what will happen to us?)” Because they are no longer thinking of themselves as “little children”, they may present a façade of independence and coping. They want to comfort a surviving parent or family member and may try to assume the role of the person who has died. They want to be helpful, which can be OK, but caution is required. All too often younger children have a terrible burden placed on them by some well-intentioned person who says, “You need to act grown up. You’re the father/mother of the family now.” The child will assume the role to attempt to master their pain and deny their helplessness, but it is unrealistic to expect a child to be anything other than a child.

Older children often need help to express their grief, especially over the loss of a parent. Research clearly shows that teenagers have more intense grief, but struggle desperately not to show it. Adolescents are suspended between the dependency of childhood and the adult responsibility they hope to earn. The young person may fear that expressing deep sadness or grief displays a return to childhood vulnerability, which they resist stoically. But also, it is part of the teenage role to be in conflict with parents, and so when a parent dies during this transition between reliance and self-determination, there can be a struggle. Besides, it is not regarded as “cool” to be talking about missing your parents. Teenagers are exceedingly concerned about the acceptability of their responses to others, particularly their peers. Thus the teen may find it difficult to express the feelings the death of a parent can raise.

Any death confronts teenagers with their own mortality. They could die. Angry at the death, they may adopt a “Why should I care” attitude. Perhaps as a defense, or maybe in defiance, young people sometimes engage in reckless or dangerous behaviors to show they don’t care or to try to prove they are immortal.

As we have mentioned, a child who has been personally affected by death will have multiple fears, among which might be:

  • Fear of losing the other parent (then what will happen to me)
  • Fear that he or she too will die
  • Fear of going to sleep (lest I never wake up, like Mum)
  • Fear of being separated from a parent or sibling
  • Fear of being unprotected
  • Fear of sharing feelings or emotions with others

One teenager says: “I was afraid to talk about how I felt to my mother because I knew she would start crying. Then my older brother would get mad at me for upsetting mom. So I kept my feelings to myself, and pretty soon I was afraid to say anything to anyone.” 

Guilt often comes from four common beliefs expressed by surviving children:

  • Death is a punishment for my bad behavior.
  • I wished the other person was dead. (The child is thinking that their wish that the person would “drop dead” or similar sentiment has caused it to happen.)
  • I didn’t love them enough. (…so that is why they left.)
  • I should have died. (Often with the death of a sibling, the child may hear the parents talk of the deceased in glowing terms, and feel like they preferred the sibling to the surviving one; or maybe would wish that they had died and the deceased had survived.

Special care is necessary when talking to children about death:

  • Children tend to mourn little by little, bit by bit, and should be allowed to process their grief in child-sized segments. Do not expect the child to respond in an “adult way”.
  • Use language that is appropriate to the age of the child. Try to use concrete rather than abstract language. Initiate the conversation. Children may not ask questions because they are unsure if they will upset us, adults. Ask, “You’ve probably been wondering about ….”  and then try to pose the question the child may be asking. Answer the child’s questions openly and honestly, and even if there is no answer, be upfront about that.
  • Observe how the child may be feeling. Dispel any fears, including the anxiety that someone else in their family, or they themselves will die also.
  • Reassure the child about HIS/HER place in the family; that the family still exists and their place in it is just like always.
  • Ceremonies such as lighting a candle; placing a letter or special memento in a casket; or releasing a helium balloon with a message attached for the person who died, can be effective rituals of farewell for children.

A few practical guidelines:

  • When describing the death of a loved one, use simple direct language.
  • Be honest. Never teach a child something they will later have to unlearn.
  • Allow children to express all their emotions
  • Listen to children, don’t just talk to them
  • Don’t expect the child to react immediately. Be patient and available
  • Understand your own adult feelings about death and grief, for until we have come to terms with it for ourselves, it will be difficult to convey a positive attitude to children.

Children do not stop grieving until they have gone through ALL their developmental levels. At each stage, there is new learning about the old experience. The child may grieve until they become young adults because it is not until we are sure that we can survive the experience that we are able to integrate the fact of our loss into our changing lives.

Dr. Bill Webster

The Loss of a Pet

PET LOSS: “ONE OF THE FAMILY!”

By Dr. Bill Webster

Marian was devastated by the loss of her husband Bob 2 years ago. She wondered if she would even survive the loss, but she persevered, worked through her grief, and was at the point where she was beginning to rediscover herself, reconcile her loss and reconstruct her life.

Then, this past summer, another family member got sick. In spite of heroic treatment with constant care and attention, they finally died.

No, it was not a child, parent, sibling, or relative. Marian lost her cat!

For those who have never had a companion animal, pet loss is often hard to understand. “After all,” many say, “it was just a cat … or a dog, bunny rabbit, hamster, budgie, or any one of many possibilities.” Pet loss is often overlooked by society, so when an animal dies, owners grieve alone because they are afraid that they will be ridiculed, or thought to be crazy or stupid, because, after all, it is “only a pet”.

But for Marian, Pebbles was “one of the family”. This loss has been just as devastating to her as the death of her husband, probably complicated by the fact that she was “their” cat, and Pebbles’ death cuts one more string that connected her to Bob. Perhaps the loss of an animal is made more difficult because there is a lack of understanding of how significant this relationship can be, leading to little sympathy from those around.

In fact, within a week of Pebbles’s death, a neighbor showed up at the door with a new kitten for Marian, which she politely refused to accept, still too hurt from her loss to be able to invest in another relationship. She managed a wry smile as she told me about it. “Too bad they didn’t bring over some younger guy to replace BOB when he died”, she retorted, and the chuckle we shared helped put it in perspective.

In case you haven’t noticed, the Pet Industry is big business these days.

Report Buyer, a UK based online destination for business intelligence, has now added a new market report titled “The Pet Industry” which predicts that last year, North Americans will spend over $43 BILLION (£25 BILLION) on pet supplies and services, and that pet owners in the UK are fast catching up with their North American friends when it comes to spending money on their pets.  Pet food is the largest segment accounting for 42% of the total market. But non-food pet supplies such as litter, toys, and over-the-counter medicines are the fastest-growing segment of the market. Stores in the UK are increasingly responding to the growing trend of the “humanization” of pets by providing accessories and products beyond leads and water bowls. A buyer for a major national chain recently stated that the response to the store’s new pet boutique has been “absolutely phenomenal”. Animal hospitals and pet cemeteries are also growing exponentially, and cremation urns and other funeral paraphernalia are becoming big business.

And so, not surprisingly, grief counselors for pet loss are emerging. The loss of any relationship can cause intense pain, and even if others may not understand, a pet is often a significant and constant part of your life. Pebbles provided Marian a source of comfort and companionship, unconditional love and acceptance, and even fun and joy after Bob’s death. Little wonder she was devastated by the loss of that relationship.

While there are many common factors in grief over any relationship, there are issues that are unique to the situation that often troubles the grieving pet lover.

A major issue is a guilt, especially in those frequent situations where the pet owner had to decide to euthanize the animal or where the cat was killed by a speeding car or a veterinarian treatment was unsuccessful. In Marian’s case, she spent an extraordinary amount on treatments hoping to give the cat a few extra years of life, and some more time with her pet.

But after 8 months, she saw the writing on the wall. Vets may be the best judge of physical condition, but Marian was the best judge of her beloved pet’s quality of daily life. Seeing the constant pain, as well as having to undergo difficult and stressful treatments that didn’t seem to be helping, as well as Pebbles’s general lack of interest in life, Marian chose to end her beloved companion’s suffering, and the vet concurred.

Marian courageously insisted on being with Pebbles to the end, needing to see the cat passing peacefully and without pain. She spent some time with her beforehand, and continued to stroke and comfort her while the procedure was administered, and remained for some time after the cat had died. Many veterinary offices have developed a very sensitive and caring process for the procedure which is sometimes done in an office, in the person’s home, or even on occasion in a person’s car.

Then there was a decision about what to do with the remains. As with a human death, there are many options. Some alternatives are to leave the pet at the vet’s for disposal; to bury the animal at home (although city regulations often prohibit this, and it can be difficult if the person moves after a while); pet cemeteries provide dignity, security, and permanence at a cost; cremation is less expensive and provides many options to handle the ashes, again at a cost, including urns, jewelry, etc. If you didn’t know it, folks, the pet funeral industry is alive and well.

Marian made all the decisions about what she wanted for Pebbles and handled the situation like the trooper she is. But then she came home to an empty house, and it hit her like a ton of bricks. She felt a myriad of emotions:

She felt sadness that this constant companion who had provided a connection to her beloved Bob was gone.  She expressed anger that the treatments the vet had promised would give Pebbles a year or two of life (and that had cost her a small fortune) had not worked and had caused 6 months of suffering. She tormented herself with guilt over the fact that even though she knows it was “the right thing to do”, that SHE had made the decision, that SHE had killed her cat. Had she been too hasty? Could she have done more? And above all, the loneliness of missing the comfort and companionship she had clung so desperately to after Bob died.

Let me make a confession. I never did “get” the significance of pet loss, minimizing its importance in my own mind because I have never owned a pet, my fear of animals going back to being bitten by a neighbor’s rampaging German Shepherd dog when I was 10 years of age.

But I get it now, thanks to hearing Marian’s story. So many people get so much love and delight from their beloved pets in life, and like any significant relationship, they grieve deeply for them when they are gone. But it is more than that. People often make pets living symbols of their inner feelings: for some, symbols of their own innocence and purest feelings and the need to care; for others symbols of aggression and dominance as I personally found out at age 10. Whether positive or negative, when that pet dies a treasured secret part of the person also dies.

I did a bit of research on the “pet loss websites” and found that much of the advice to help people through their grief is exactly the same as what is offered when a human companion dies. Regardless, grief is probably the most confusing, frustrating, and emotional thing that a person can experience. It is even more so for bereaved pet owners when society, in general, does not give them “permission” to grieve openly. Consequently, they often feel isolated and alone. It is known as disenfranchised grief. Luckily, more and more resources are becoming available to help the bereaved pet owner realize that they are NOT alone and that what they are feeling is entirely normal.

As Helen Keller once succinctly put it: “What we have once enjoyed we can never lose. All that we love deeply becomes a part of us.”

Dr. Bill Webster

The Loss of a Spouse

A 50/50 chance, to any gambler, is a pretty good bet. But did you ever stop to think that if you are in a significant relationship, there is a 50/50 chance that you will eventually grieve the loss of your partner?

Listen to some of the stories of people who experienced the loss of a spouse.

“I would go to work and it would seem that everything was the same as it had always been. But then I would come home. WOW! Just walking into that empty house. Nobody to say hello or ask me how I got on that day. No delicious aroma of supper in the oven. I had to make my own meal … when I felt like it … and most of the time I didn’t … because I was missing what I had lost … not just my wife, but also the person who used to look after me. That was when it hit me hardest.”  Michael

“The days that followed his death were both utterly full and completely empty … full of activity yet empty of life. Much of the time I sleep-walked through the things I had to do, so numb that I was often completely unaware of what was going on around me. I felt like Pinocchio must have felt inside of the whale … cut off from everything that I thought was my life. Then an event or a few spoken words would bring me out of my darkness, only to find myself standing alone and confused on some strange and unfamiliar shore, full of feelings and memories, but also feeling utterly lost.”   Robyn

“She was not only my wife. She was also the one who would tell me if my socks matched; if my tie was straight, or if my hair was combed. She was able to tell me with one look if I was talking too much or saying something stupid. She was the one who would remember all the birthdays and special occasions, and all I had to do was sign cards. She was good at all the things I am not good at. So she complemented me and made me more whole. God, I miss her so much. I feel like part of me is missing.”  Joe

A common theme among people who have lost their spouse is the debilitating effects of feeling entirely alone and incomplete. The sense of feeling like you have lost an essential part of yourself is both painful and disconcerting. The world suddenly looks like a different place, often odd and distanced. You are not sure how to cope with life in general, and sometimes you may even wonder if you even want to try.

One 68-year-old widow said, “There is no use trying because you can’t get anywhere anyway. I’m so tired all the time. Everything is too much effort.”

Some of the most common feelings and concerns after the loss of a spouse are reflected in the following statements:

I felt like I had lost my best friend

I am angry.

I feel guilty that I didn’t do enough for him/her.

I am afraid.

I worry about lots of things, especially money.

Suddenly I feel very old.

I feel sick all the time.

I think about my own death more frequently.

I seem to be going through an identity crisis.

I feel relieved that his suffering is over, then immediately guilty for feeling that way.

Behind each of these statements is a feeling. To fully understand the effects that the loss of that spouse has on that survivor, we need to understand the dynamics behind each of these reactions. The feeling communicates what the person is missing and offers an opportunity to examine the deficiency and find ways to cope with these responses in a way that will ultimately facilitate healing.

First, it is essential to recognize that healing cannot take place unless you EXPRESS what you are feeling and thinking as a result of your loss. That which cannot be put into words, cannot be put to rest. This is where a support group can play such a vital role for grieving people. The opportunity to talk about the person, their life as well as their death, what you miss about them, your feelings of loneliness, anger, and many others, and to review the final days of their life and your relationship.

Even when there is some ambivalence about certain aspects of the life shared, it is important to verbalize your anger or your regret about what you lost and never had, or about what could or should have been.

There are some very real consequences of not expressing feelings. Studies clearly show that mortality rates are higher among those who do not articulate their grief, and this may also account for the much higher rate of males who die within a year of their spouse, due to the societal norms that make it more difficult for men to express emotions.

Some survivors ask, “How long should I talk about this? What is normal?” This concern is often motivated by the fact that within a few weeks or months of the death, others seem reluctant to talk about it. After all, their life has returned to normal. But the widow or widower needs to talk about it because it just feels unbelievable. Life will never be “normal” again (even though a new definition of normality will be established eventually). So some grieving people need to talk for six months, but for others, it can be two years or longer. Everyone needs and deserves to follow their own timeline.

Over the years, I have noted FOUR situations particularly affecting grieving spouses that require an inordinate amount of personal courage:

1. Coping with persistent unpleasant memories

2. Avoiding certain rooms or situations in the house

3. Experiencing hallucinations where the dead spouse is seen or heard

4. Dealing with their spouse’s personal effects (clothes, tools, etc.)

Unpleasant memories most often relate to the painful images surrounding the death, and the frustration of not being able to “do” anything to change the outcome. Often through a life-threatening illness, a relationship will peak in one direction or another … a good relationship will tend to get better, a poor relationship will tend to get worse … although there are glorious exceptions. This intensity of the relationship prior to the death magnifies the loss, either by the person missing all the things done and shared through the illness or by feelings of regret that they did not do enough. Often the inability of the survivor to “let go” of the image of the person in the present is connected to one or other of these factors.

If the person is avoiding sleeping in their own bed or steering clear of certain areas of the house, this behavior should not be considered unusual or pathological. They are merely protecting themselves from stress. There is a reason for every behavior and perhaps that location is a too painful reminder of the death, or expresses a concern as to “how will I manage”.

Hallucinations (or however we choose to define these experiences) have a wide range of “explanations”. Is it a “visitation of the person’s spirit”, or is it a “product of sensory recall”. I try not to attempt to explain what it may or may not be, but rather to ask how the survivor felt after the experience. And almost always, the person feels reassured, relieved, comforted. If that is the effect, it hardly matters whether it is a dream, a hallucination, or a visitation, and to argue that seems to me to miss the point.

Dealing with a spouse’s personal effects is something many survivors procrastinate over. Sometimes this has to do with an understandably low physical energy and emotional stamina. Because these are “special things” you may not know who to give them to or what to do with them. That is OK.

Do nothing until you are SURE that you feel comfortable with what will happen, even if that takes several months or longer. But when you do decide, ask a friend or family member to assist, or even just to be there and talk to you while you do it. Maybe there will be things that you simply do not want to discard or give away so keep them. Remember, it doesn’t hurt anyone or anything to leave your spouse’s things right where they are. Don’t allow anyone to force you into dealing with things until you are ready, sure, and comfortable.

So far we have looked at some of the unique challenges surrounding the loss of a spouse.

Now we turn to examine how the surviving individual must convert the mourning process into a nurturing process as they seek to rebuild and reorganize a life where they feel like half of them is missing.

I believe that an often overlooked aspect of losing a spouse is the change in identity the survivor experiences. We tend to define ourselves by our relationships, our work, our activities, and our involvements. Many couples define themselves as just that … a couple. It is not ME, it is WE. Admittedly the degree of change will be determined by the complexity of the relationship. But we really cannot understand what any person has lost until we understand the relationship that was shared and is now lost. What is missing from that relationship is really what the person is grieving. And, obviously, every single relationship is unique, with different dynamics and interactions.

So it is reasonable to say that the more dependency the person had on their spouse and the role as husband or wife, the greater the void now that the role is no longer there.

In other words, the surviving spouse not only grieves the person who has died, they also grieve the role that is lost. They suddenly find themselves cast into the role of being a “widow” or a “widower”, a role they neither relish nor desire. The question becomes, “Who am I now?” I still feel like the same person, but my roles in the family, community have changed. This, by the way, is often why a grieving spouse will find comfort in getting back to work because at least THERE, their role remains somewhat “constant” in that familiar context.

Listen to the comments of one widow:

“For almost a year after Jim’s death, I thought of myself as only his husband. I had invested my whole self in him.

I had to think, NO, I didn’t give him all I had, I LOANED it to him. Now I needed to reclaim it, take it back, because I needed it for myself.”

Of course, reclaiming one’s self is only possible when you know who your “self” IS. Before you are able to reclaim, you have to identify and redefine, “Who am I NOW” in the light of my loss. The W of WE has to become the M of ME … but turning a W to an M means turning everything upside down, and that is exactly what the widowed person may feel.

So how can a grieving widow or widower redefine themselves? I think it is inextricably linked to interests and experiences. People who get involved, whether in necessary tasks like looking after children, family or work, or by involvements in the community, groups, activities, find that these things increase self-esteem and energy as they enhance the person’s identity.

But let’s take a walk on the wild side. Although it is grossly unfair, the widower is often viewed as more “socially acceptable” than the widow. Because the percentage of widows greatly exceeds that of widowers, males are regarded as “eligible” whereas females are regarded as a “threat”. Accordingly, hostesses more frequently extend social invitations to males than to females, so a widow’s social life may not be as jam-packed.

On the other hand, because many men rely on their wives to arrange social activities, after her death it may be difficult to go out without her, to develop social skills, or to put forth the effort that he will need to enjoy the pleasure of other people’s company. Again, social clubs or support groups can provide a good bridge to help the person develop skills, or at least feel more comfortable in such situations. Michael, almost a year after his wife died, said:

“I think the difference between a male’s grief and that of a female is a cultural thing. Men are not as social as women. I mean I have friends, but when we sit down for a drink or something we talk about business or sports or activities. Men aren’t really taught to relate their feelings or emotions, and certainly not their vulnerabilities. So when my wife died, my friends didn’t know what to say, as if they were afraid to ask me how I was feeling.”

Physical health is another area that concerns many people. Suppressed emotions can contribute to physiological symptoms, which can have serious consequences. Health doesn’t just happen! It involves exercise, good nutrition, avoiding excessive intake of caffeine, alcohol, or drugs. Some survivors live on coffee or snack foods and rarely eat a balanced meal.

“The last thing in the world I wanted to do was eat. Everyone kept urging me to “eat something” so if someone was there or watching me, I would eat something to please them. But when I was alone, I ate nothing. In the first month after my husband’s death, I lost 20 pounds. It wasn’t till I started walking daily with my neighbor that my normal appetite returned.”

Insomnia is one of the major symptoms resulting from conjugal bereavement. This can be aided by what we do and what we consume in the hours before going to bed. But many males experience other physical symptoms. Again Michael brings an important insight:

“I’ve noticed some changes in my health. Particularly in my stomach … pains, indigestion, and other symptoms, I won’t mention in polite company. My doctor put me through tests, which I think was a good thing to do, but he indicated that often men experience physiological reactions to the emotional stress of grief. That doesn’t minimize their importance. Maybe it’s easier for us to say “I have a pain in my stomach” than it is to say, “I have an ache in my heart.” But whatever it is, it is important to pay attention to the message.”

It may seem strange, but several people have reported to me how changing their physical environment has helped their emotional state. We should all from time to time look around our environment … at home, at work. Many times that can reflect our emotional state. A cluttered, untidy, or dismal environment can often reflect a state of mind. But the opposite is also true.

Change usually happens from the inside out rather than the other way. The more you do to enhance your environment, making it cheerful and pleasant, the more your emotional health will be positively influenced.

While everyone is different, I found after my own wife died, and I was left to raise my two young sons, that I had to carefully arrange the surroundings in my home in order to better cope. I put lots of colorful and happy things in the kitchen because that was where I had my biggest struggles after her death. I put positive, inspiring posters and items in the bedroom because that was where I felt most lonely. I had ONE room where I had pictures and artifacts of our life together, and when I wanted to think about her, that is where I would go. When I left that room, I closed the door and focused on all the tasks I had to get on with.

Add color, brighten the place, tidy up a space for yourself, buy a new chair … the ways to make your daily living more pleasant are innumerable and the positive impact on your emotional well-being will be tangible.

There is of course no definite point at which the grieving process is complete. Can we ever say, “I have completely healed from the loss of my spouse”? Who knows!

But as we redefine ourselves; as we relinquish old roles and establish new ones; as we develop increasing confidence in our social outlets that satisfy personal needs and coincide with our interests; as we become more able to

talk about our loss with relative ease; as we become able to be involved in an activity without being plagued by painful memories and images, as we find ourselves more able to reach out to others, and not be afraid to have fun and even to laugh again; you will be reassured that healing is being reaffirmed.

But it does take time. As one lady put it:

“A year was a big event for me. But once I got through that, I felt like I didn’t have to look back. Now I could look forward to seeing what I could do with what I had left. So I asked myself “What am I going to do with the rest of my life?” I want to do something significant but I’m not exactly sure what just yet. For the first time in my life, I can do whatever I want and I plan to make the most of it.”

And why not?

Dr. Bill Webster

Understanding Beravement

How are we to understand bereavement?

Over the years, there have been numerous attempts to explain it. Perhaps the most influential and well-known theory has been that of Dr Elisabeth Kübler-Ross, who in her 1969 book “On Death and Dying” focused on an emotional transition through five stages, beginning with denial and progressing through anger, bargaining and depression before arriving at acceptance. The “stage theory,” as it came to be known, quickly created a paradigm for how people die in our western culture, and eventually a prototype of how we should grieve.

The trouble is that the stage theory of grief that make loss sound so controllable turns out largely to be fiction. Though Kübler-Ross captured the range of emotions that mourners experience, more recent research suggests that grief and mourning rarely if ever follow such a checklist; the process of grief is often complicated, untidy and unpredictable, more of a process than a progression, and one that sometimes never fully ends.

Even Dr Kübler-Ross herself, towards the end of her life, recognized how far astray our understanding of grief had gone. In her book “On Grief and Grieving” (1995) she insisted that the stages were “never meant to help tuck messy emotions into neat packages.” If her injunction went unheeded, perhaps it is because that very messiness of grief is what makes us all so uncomfortable.

The implied suggestion of many traditional grief models seems to be that the person suffering a loss simply has to go through the inevitable process, wait it out, “see it through,” on the assumption that “time heals all wounds,” and that eventually “in time,” they will “get over it.” This would seem to suggest that in the emotional aftermath of a loss, bereaved individuals are essentially passive, having to simply submit to suffering through a series of stages or a certain structured grief system over a defined period of time and incidentally over which they have little or no control and in which there is not much choice.

But this is not what people actually experience after bereavement. We cannot understand the grief process ONLY by some “timeline” system or “set formula” whereby a person goes passively through certain emotions, stages, phases or reactions in order to somehow eventually arrive at this destination we erroneously call acceptance.

So, consider this foundational fact:

We cannot understand bereavement and every individual response to it unless we appreciate how each bereaved person’s world has been forever changed by the loss.

I am suggesting a different paradigm, another way of thinking about our topic. The main focus should not primarily be (as it so often is) on a person’s emotional reactions, or on their behaviours or manifestations of grief, and more specifically how we can “control” these in order to get things “back to normal.” Those who focus on these considerations are trying to “fix” a situation that simply cannot be fixed; trying to get “back to normal” something that has changed forever.

Losing someone we love is often likened to an amputation. But even this analogy tends to be too clinical. The word bereavement comes from the root word “reave” which literally means being torn apart. Losing a loved one has been described as being like a branch that is torn off a limb, not in some nice sanitized surgical way, but literally being ripped away. The emotional and behavioural reactions of the grieving person should be seen as symptoms of this unwelcome change.

I am suggesting that we serve people better if we focus on the significance of this bereavement to the individual rather than on the substance of their specific reaction to the bereavement. Rather than concentrating on the reactions of grieving people and then quantifying their responses, we need to ask the “why” of these reactions. We must understand the meaning of the loss to this individual, which I suggest is being “expressed” through their specific emotions and uniquely individual behaviours.

In other words, the emotions and reactions of grief should be seen symptomatically as behaviours in response to and in protest of the need to search for meaning in what has become a new and unwelcome world. This is the crucial point in understanding bereavement, one which many people do not recognize, understand or perceive. The task is to help the bereaved and grieving person locate themselves in a world that they know nothing about, and that they, and indeed WE, cannot fully understand.

Put simply, instead of trying to get people back to normal by seeking to resolve and rectify their emotions and behaviours, we should rather regard these reactions as a symptom of the much deeper issue, namely, “My world has changed … and I don’t like it.” Grief is a protest against something I didn’t want, don’t like, but can’t change. And the challenge for the helper is in enabling them to come to terms with this new albeit unwelcome reality by beginning to form appropriate new patterns of emotion and behaviour.

We would probably all agree that, in one way, bereavement is a “choiceless event.” Few if any would choose to lose those they love or suffer through the other life losses that inevitably affect us. Even when the death is “by choice” such as a suicide, the incident is usually “choiceless” for survivors who wish they could have “done something” to change the outcome and feel guilt and regret because that option was not made available to them. Thus, bereavement is an unwelcome intruder in our lives, one which refuses to retreat despite our impassioned protests.

But, from another perspective, while the loss may be a reality we are powerless to avert, the experience of grieving itself involves hundreds of concrete choices that the bereaved person is invited or forced to make, or indeed avoid. It is in another way a call for us to change. To go with it, or to resist the process. We have a choice of whether to attend to the distress occasioned by the loss or to avoid the pain by “keeping busy” or “trying not to think about it,” which is an impossible task, by the way. We have a choice as to whether to feel and explore the grief of our loved one’s absence or to suppress our private pain and focus instead on simply trying to adjust to a changed external reality. Loss may be inevitable, but what we DO about it is optional. We may not have a choice in what has happened, but we do have a choice in what we do about it.

Foundational Fact

Grieving is something we do, not something that is done to us.

We need to gain a better understanding of not only “what” people experience after a loss, but also “why” grief affects people so uniquely and individually. We have come to realize that people do not passively and inevitably go through a series of stages or tasks. Rather the grief process involves many choices, with numerous possible options to approach or avoid the situation at hand.

In other words, any good paradigm of grief will not simply propose some futile attempt to re-establish pre-loss patterns of emotion or behaviour, expressed in comments like “getting back to normal.” Life has changed and will never be the same again! But that does not mean it cannot be good. The challenge is how we can support the person in integrating these changes into their life as it now is.

Perhaps we can illustrate it this way. We all write a script for our lives. I remember writing the screenplay for my life when I was a teenager. As the main character in the production, my draft scenario included going to school and university, having a career, meeting and marrying the most beautiful woman in the world. As the plot progressed, we would work hard, have children, do things as a family and when the kids were grown we would travel, then retire, and ride off into the sunset together. Think about YOUR script … most of us have one.

Every human being constructs a unique world of meaning. We all make assumptions about “how life is going to be” in the course of daily living. We are sustained by the network of explanations, expectations and enactments that shape our lives with ourselves and others. These assumptions provide us with a basic sense of order regarding our past, awareness regarding our current relationships and predictability regarding our future.

And most of us, at the end of the script, whatever the final details, add the words … “and they lived happily ever after.” Because that is what most of us would like to think is going to happen. While the particulars may change from time to time, we all want to think that life will be orderly, predictable, and go “according to the script.”

But sometimes life does not go according to the script. Not everything works out the way we planned. And then we find ourselves struggling to come to terms with “the grief of unmet expectations.” Any loss can be interpreted as disrupting the continuity of this assumed narrative. When this occurs, we have one of two choices: either we revise the plot by rewriting the script and assimilating the loss into pre-existing frameworks of meaning, ultimately reasserting or justifying the viability of our pre-existing belief system, or we accommodate our life narrative to correspond more closely to what we perceive as a changed reality in the violation of our assumptive world.

It is vitally important to realize that “who we are” is determined not just by genetic makeup, but also by our experiences and how we allow them to affect us. In this statement, we find an important key for life and living. We do not have a choice in how we are born and our genetic or cultural influence. We may have a choice over some difficult events and negative experiences that affect us. Stuff happens! But while we may not have a choice over certain circumstances, we do have a choice about how we are going to allow them to affect us. The key is in enabling people to make good choices about what they are going to “do” about what has happened.

So, we need to place the loss in a context of meaning. We can do this in one of two ways. First, we can reaffirm what we formerly believed about life; or secondly, we can establish a new belief system about the meaning of life. In other words, does this experience make sense according to what I believed about life before or do I have to adapt my way of interpreting how life can be meaningful? The challenge is to find ways to integrate the experience into life as it now is and to adopt new assumptions about our world which has been shaken and even violated by the loss.

The implication of this idea for caregivers, families and those seeking to support grieving people is that we need to recognize the unique and personal meanings of loss which will take us beyond clichéd expressions of support or preconceived ideas of what a particular loss “feels like” to any given griever. The particularity of any loss should prompt us to listen intently for clues as to the unique significance of the bereavement experience for each individual.

Thus I contend that helping people through the grief of bereavement is not simply a matter of understanding the emotions that they may be expressing. Rather it involves supporting them through a reinterpretation of “how life can be meaningful even in the light of loss,” and empowering them to define life as it now is and to find ways to make the most of what they have left.

Dr. Bill Webster

10 Facts About Greif and Grieving

10 FACTS ABOUT GRIEF AND GRIEVING

By Dr. Bill Webster

One reason that we often find grief such a difficult challenge is that we have never learned what to expect. The following facts will help you understand some crucial truths about grief and grieving and how we can work through the process to find healing.

    1.  Grief is normal.

Grief is not a disease. It is the normal, human response to a significant loss. People may encourage you to “be strong” or “not to cry”. But how sad it would be if someone we cared about died and we didn’t cry or we carried on as if nothing had happened. I’d like to think that someone will miss me enough to shed a tear after I’m gone. Wouldn’t you? When you lose someone special from your life you are going to grieve. Our grief is saying that we miss the person and that we’re struggling to adjust to a life without that special relationship. Admittedly, saying that grief is NORMAL does not minimize its DIFFICULTY. It may be one of the most challenging experiences of your life.  But you are not crazy, or weak, or “not handling things”. You are experiencing grief and after a significant loss that is a normal response.

     2.  The worst kind of grief is YOURS

A loss is a very personal matter. Your loss seems like the worst possible thing that could have happened to you. Sometimes people ask if it is more difficult to lose a spouse than to lose a child. Others question if it is worse to lose someone after a long lingering illness or if they die suddenly and unexpectedly from a heart attack or in an accident. While these circumstances make each loss different, they are not important to you right now. The worst kind of loss is yours. When you lose a significant person from your life, whatever the relationship, it hurts and nothing takes away from your right to feel the loss and grief of the absence of that person from your life.

    3.  The way out of grief is through it.

Grief is painful. Loss is one of the most difficult human experiences. There is no easy way around it. We may try to avoid the pain. We may attempt to get over it as quickly as possible.  But most often it simply does not work that way.  Helen Keller said, “The only way to get to the other side is to go through the door”. We need to find the courage to go through this experience of grief. Learning this is a major key to recovery.

    4.  Your grief is intimately connected to the relationship

Every relationship holds a special and unique significance to us. To fully interpret our grief response we need to understand what the relationship brought to my life and therefore what has been lost from my life. We may grieve the loss of a parent differently from the loss of a friend.  Each made a different contribution to our lives. What we have lost is not the same and so we grieve differently. Two individuals, both experiencing the loss of a spouse, may grieve quite differently because of the differing circumstances (the duration, level of happiness, etc) of the relationship.

    5.  Grief is hard work

A grief response is often referred to as “Grief-work”. It requires more energy to work through than most people expect.  It takes a toll on us physically and emotionally. This is why we often feel so fatigued after a loss or why we may feel very apathetic towards people and events. The problem is often compounded by people’s expectations of us to be strong or pull ourselves together or get on with life.

    6.  Your grief will take longer than most people think

How long will grief last? It is finished when it is finished. The first few months may be particularly intense. The first year is difficult: especially the first Christmas or Hanukkah, the first birthday, anniversary, Mother’s Day, Valentine’s Day, “a year ago today day” and many other times that remind us of our loss.  All are difficult days and we need to anticipate them, know they are normal, and be compassionate with ourselves. Some writers describe the second year of grief as the lonely year when the realization of the life without the deceased becomes even more of a reality. Take your time. As John Donne says “He who has no time to mourn, has no time to mend.” Grief always takes longer than people expect.

     7.  Grief is unpredictable

You may experience a wide variety of feelings and reactions, not just those generally associated with grief, like sadness, crying, depression, etc.  Some of your responses may seem quite uncharacteristic.   “This isn’t like me”, you may think. Grief is unpredictable. We cannot present it in a neat predictable package.  Just when you think you have it figured out something comes along to surprise us. In an unexpected moment, suddenly, without warning you find yourself missing the person again. In fact, the one predictable thing about grief is that it is unpredictable.

     8.  There may be “Secondary losses” to deal with.

The death of any individual, difficult as that may be by itself, may also precipitate many other changes in your life. For some, it may mean the loss of financial security, a home, or even their independence. For some, it may mean the loss of a role: eg the role of being a parent to a child who dies. For others, it may be the loss of our hopes and dreams of “living happily ever after” or enjoying retirement together, or having dad walk me down the aisle. There may be many losses – environment, status, alteration of relationships – because of the death. Each one has its own impact and each loss needs to be mourned.

    9.  Grief comes and goes

We have said that grief is not a disease. If you have a sore throat, it is painful for a few days, then the pain eases off and gradually disappears. Grief does not work that way, however. Our healing process is different from a sickness model. Sometimes, at first, we do not feel the pain of grief because we are in shock and numb. Often the pain is more intense some months after the event. Even then grief is not unlike a roller coaster. One day we feel pretty good, the next we find ourselves in the depths of despair.  Just when we think we are getting over it we may experience another devastating setback. This can be discouraging to those who do not know what is happening. Most have not learned that grief comes and goes and takes much longer than most people expect. We need to realize that this is the way grief works itself out and trust that the process, difficult as it is, is helping us work towards reconciliation.

    10.  Effective grief work is not done alone

Society has unrealistic expectations about mourning and often responds inappropriately. Most people do not understand what is normal in grief, expecting us to get over it quickly and expressing these expectations in a way that seems less than sensitive. Many people mistakenly believe that grief is so personal we want to keep it to ourselves. People mean well, but they are not being helpful.  Sometimes when people are using cliches or expressing unrealistic expectations we feel like shutting ourselves away. Often they feel uncomfortable with our grief and so, shortly after the funeral is over, the person or the loss is not mentioned. There sometimes seems to be a conspiracy of silence. People are afraid to say or do the wrong thing so they say and do nothing which is possibly the worst thing. Grieving people need to talk.  Not everyone will be willing or even able to respond to you. In fairness, not everyone can.  Accept that and try to find a support group or a counselor who can help. Or talk to someone who has been through a similar experience. I believe in the power of shared experiences, and often others who have been through the deep places can be a real help. Grief is about coping with the loss of a relationship and often in a helping relationship, relief can be found.

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