Grief is a universal experience. Though it’s said that everyone deals with grief in their own way, all of us know the pain of losing someone for whom we care deeply. Death is a natural part of life, and experiencing significant loss is the way of the world. It even appears that grief is not limited to humans, for some animals display behaviors which provide evidence that they are capable of grieving.
But, as we all know, the loss of a loved one is among the most challenging and emotionally intense experiences of our lives. Indeed, it changes our lives. Not only does it create great emotional disturbance that can seem to go on forever, but it can leave us with a host of other problems – and during a time when we feel least able to deal with them. So how do we handle death, loss, and grieving?
There are different theories on working through grief, and most people are familiar with the Stages of Grief developed by Elisabeth Kubler-Ross: Denial, Anger, Depression, Bargaining, and Acceptance. Not everyone experiences each of these phases, though, nor necessarily in that order. But it provides a helpful understanding of what we can likely expect when this happens to us or someone we know. But what do we do when experiencing this? What decisions do we make, and what actions will help us move through this period of grief so we can continue with our lives?
There are no cookbooks for this, but an approach I find helpful is the Four Tasks of Mourning developed by J. William Worden, a psychologist with academic appointments at Harvard Medical School and the Rosemead Graduate School of Psychology in California. If you are interested, you can find his books on Amazon, including Grief Counseling and Grief Therapy and Children and Grief. These tasks outline the major goals that Worden believes need to be achieved in order to resolve the mourning process to a point where the loss no longer disturbs our functioning, and we resume a “normal” life, though it is forever changed. The term for this point that my clients seem to relate well to is “peaceful acceptance.” It is respectful, easy to understand and recognizes that people never really “get over” the death of a loved one.
Below we’ll summarize these tasks, problem indicators, and include some suggestions for actions that may help achieve them. Not all these actions work for everyone, and individuals must determine for themselves what they are comfortable with, but these are some considerations. Also, bear in mind that if you read any of Worden’s work you may find the precise wording of the tasks slightly different. He even has changed some wording over time as updated versions of his books were published. But this will provide the gist of them.
Task I – Accept the reality of the loss
Death, and other significant losses, such as the loss of a lifelong career, can be sudden and unexpected. When this happens we may be unwilling or unable to recognize that the loss is real. In the event of a death, we may deny it and pretend that the person is going to return. A parent who keeps their deceased child’s room exactly the way it was when the child died for an extended period of time, such as for several years, is an example of this.
Some other behaviors which may indicate we are having difficulty resolving this task are:
– Searching for the lost loved one
– Misidentifying someone else for them
– Ignoring facts about the death
– Avoiding discussing the death, or avoiding words such as “death” or “dead”
Some actions that may be helpful when stuck on this task:
– Admit the person has died and will not return
– Speak about the person in the past tense
– Visit their grave or keep their urn in an appropriate and respectful place
– Decide which belongings to keep and let go
Task II – Process the pain of grief
This is about finding ways to express one’s feelings about the loss. The amount of pain can feel enormous, and it may never completely go away. We’ll still have moments of sadness because we miss them, and perhaps even a tearful episode from time to time, but grief does have its limits. Sometimes with clients, I use the analogy of emptying a swimming pool. After putting the hose in and beginning the draining process, if you just sit and watch the water level it won’t seem to be diminishing. But leave and come back after a while, and even though there is a lot of water in there, you’ll notice it’s a little less. Eventually, you’ll get the water level down to a small amount, and that’s good enough. You’re done.
Behaviors that indicate we’re stuck in this task may be:
– Avoiding expression of feelings or talking about the deceased
– Avoiding places we went with the deceased
– Avoiding people we associate with the deceased
– Avoiding situations or events that remind us of the deceased
– Erasing reminders of the deceased, such as getting rid of all of their belongings, pictures, and any mementos – essentially trying to delete them from our life and memory
Actions that may be helpful:
– Talk to support people. Tell them what you’re feeling, how your life is changing, and the difficulties you are experiencing. Don’t be afraid to ask for help.
– Express your feelings through art, such as drawing, painting or music
– Write your feelings out. You can even write to the person you lost.
– Create a memory book with pictures, papers, and artwork
– Join a grief support group or individual counseling
– Get involved with a related cause or charity
Task III – Adjust to an environment without the deceased
Essentially, this means learning how our life has changed and what we will do differently now that this person is no longer physically present. This involves not just an emotional adjustment but often involves practical concerns. For example, if the deceased was the primary caregiver of the children then the surviving partner must learn a new role, which likely means learning tasks and taking up responsibilities they may feel they aren’t good at.
Some indicators of problems with this task may be:
– Increased financial problems
– Difficulty socializing
– Chores or responsibilities not being taken care of
– Learning new roles
– Secondary relationship losses related to the deceased (friends you lose contact with)
– Hopeless thinking (“I’m never going to learn how to do this.”)
Actions that might be helpful:
– Prepare for a new situation with role-play practice, such as a job interview
– Reality test negative thinking: “Is this really true? Do I have any real evidence that I should believe this?”
– Spend time with others, which helps maintain normal social interaction
– Make a plan for chores that is realistic
– Get help with responsibilities as you adjust
Task IV – Find an enduring connection with the deceased while embarking on a new life
Sometimes I shorten this with clients to, “find a healthy connection,” after I’ve talked about what this means. Obviously, we can’t have the same connection with the deceased, but there are healthy ways to keep them a part of our life. If we spend time reflecting on how their presence influenced us, we can identify the parts of our identity that they helped mold. What did we learn from them? What interests did they spark in us? What beliefs do we hold that we got from them? We may even have mannerisms or idiosyncrasies that we adopted from them. When we get a clear idea of how our identity has been shaped by them, it becomes easier to feel their presence remaining with us – but in a way that’s healthy and not disruptive.
Some indicators of problems with this task may be:
– Excessive amounts of reminders of the deceased, such as filling every room with pictures, instead of just a few in expected places
– Repeatedly refusing social invitations
– Avoiding new relationships
– Guilt for when we don’t think of the deceased or for when we aren’t feeling sad
– Making decisions for us based on what we think the deceased would want instead of what we want, or what is best for us
Actions that might be helpful:
– Limit pictures or items of remembrance to a select favorite few
– Attend an event with a friend that you previously attended with the deceased if you still have an interest in it
– If you are religious, ask for a service dedication
– Talk with new people
– Be open to new relationships with whom you are comfortable
In general, when working through grief be patient with yourself, allow yourself to express your feelings in healthy ways, and use available support. If you bottle up your feelings because you want to avoid the pain, or shut people out who want to help, you increase the odds of doing yourself long-term harm. You may miss out on worthwhile experiences, create impairments to social functioning, and may even develop habits that contribute to poor mental and physical health. It can take a year or two to work through the mourning process, and possibly more. This is especially likely if there are unusual circumstances surrounding the death, such as for those who have lost a loved one to a plane crash over the ocean and never recover the body, or one who went missing in action during a war.
Finally, when you’re talking with someone who is going through grief, avoid saying things that are dismissive of their experience, such as, “You’ll get over it,” or, “It’s not so bad. At least you’re not going through what I went through.” Don’t treat grief like it’s a competition. There’s no trophy for suffering the most. Instead, if you’re sad for them, tell them that. If you can set aside time to help them, you can offer to do so. It’s also okay to ask them for permission to run some errands for them, help them with a few home chores, or even bring them food so they don’t have to bother cooking. Saying things is easy, but giving our time can be more helpful and will probably mean even more to them.
Tom Sutherland, LPC
Oakland Psychological Clinic