With the holidays approaching, it may seem an odd time to read about loss and grief. Yet those who have experienced the death of a loved one, understand that holidays bring poignant and even painful reminders of their losses. So it seems an appropriate time of year to consider what author Judith Viorst calls normal and necessary—the journey of grief.

Unfortunately, our culture seems to promote a “get over it” attitude; the bereaved are told to be brave, or even that they are young and can have another child. Employers may allow THREE days off of work. Outward displays of grief are pathologized. In fact, the death of a loved one is not something we “get over”; it is something we learn how to live with, a readjustment to a world in which our loved one is missing. Grieving is necessary: we all have or will experience loss, and must find the path to wholeness. Normal reactions to a significant loss include: painful sadness; anger, even at the deceased; guilt, especially felt by parents, since a child’s death can feel like a failure; fear, such as a fear of being alone, or a fear of “going crazy”; a sense of unreality, thinking you see or hear the deceased; and physical symptoms such as loss of appetite, disrupted sleep, and headaches.

Most are familiar with Elisabeth Kubler-Ross’s stages of grief—Denial, Anger, Bargaining, Depression and Acceptance. She formulated these stages as descriptive of the dying, but many have applied them to the bereaved as well. Further studies show that if a bereaved individual did experience these stages, it was rarely in a step-by-step fashion. In addition, this stage model seems to suggest passivity, steps to be endured. More recent models of the grief experience are based on “tasks” or “grief work”, suggesting action and empowerment. In Grief Counseling and Grief Therapy, J.W. Worden describes four tasks of mourning:

Accept the reality of the loss – participate in the funeral or memorial service; tell and re-tell the story of what happened; use the word “death” rather than euphemisms; ask questions of the doctors and nurses if appropriate.
Experience the pain of grief—recognize and talk about your feelings; give yourself permission to be angry; journal; write a letter to the deceased; avoid self-medicating with drugs and alcohol.
Adjust to an environment from which the deceased is missing—restructure roles and relationships; reassess finances; decide what to do with the deceased’s belongings; anticipate upcoming events such as anniversaries, the deceased’s birthday, holidays, and prepare yourself.
Let go emotionally and reinvest in the future – you will never forget your loved one, but you can alter your relationship with him to make room to embrace life. Be open to possibilities; remember that moving forward is not being disloyal to the deceased. Find meaningful ways to memorialize your loved one, perhaps creating a memory book, lighting a candle on his birthday, or creating a ritual or tradition that fits for you and your family.

There are notable differences in the way of males and females grieve. Do not think that one way is healthier that the other. The differences in styles are worth recognizing and understanding. Men are more likely to be reserved in the direct expression of feeling (the exception is anger regarding the loss) and instead deal with loss through goal-directed, problem-solving activities. It is not necessarily helpful to push a man to talk about his feelings. Men can benefit from companionship whether or not their companions discuss the loss. Men may seek solitude to “think through” how to make sense of their loss. Bereaved women tend to be more direct in expressing painful feelings, seeking understanding and support, perhaps joining a support group. They may limit activities in order to have time to be with and express their feelings, with others to perhaps through journaling. In marriage, these differences in grieving styles can be misinterpreted, leading to serious misunderstandings. This helps account for the fact that 75% of bereaved parents face serious marital problems after the death of a child.

Above, I have listed normal grief reactions and the majority of us will navigate these with the support of loves ones. When is it appropriate to seek professional help? Complicated bereavement is a matter of degree. If the intensity and duration of the grief reaction interfere with daily functioning, if the feelings of hopelessness are overwhelming and more than transient, then it is time to seek counseling. A counselor will first assess for depression and take into account the individual’s typical coping strategies and current support system. Therapy can assist the bereaved to recognize and manage feelings such as anger and guilt, learn new ways of coping, redefine roles as necessary, recognize “old grief” triggered by the more recent loss, recreate meaning, and invest in life.

Suggested Reading:

Living/When a Loved One Has Died
Talking about Death: A Dialogue Between Parent and Child both by Rabbi Earl Grollman
Necessary Losses by Judith Viorst

Local Organizations:

Highmark Caring Place (services for grieving families are available to the general public) 717-302-8404
Hospice of Central PA 717-732-1000
Compassionate Friends ( a self-help group for anyone grieving the loss of a child) 717-761-8048

Lori Hogg, MS, was a licensed Psychologist with Franco Psychological Associates, PC.