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Week 13 - Uniqueness of Relationship

While the following example may, at first glance, seem inappropriate when speaking of human life and death, it demonstrates in simple terms the link between closeness and reaction to loss.

Last spring, my daughters found a two-inch living creature, as yet hairless and pink. We named her Soupy - a shortened version of what we guessed her to be - a marsupial. For the next two weeks, she wriggled and crawled blindly around inside a box warmed with a heating pad. Each morning my girls awoke to her hungry squeaks, and in their absence it fell upon me to feed warm milk to Soupy from a medicine dropper.

One sad day she did not wake up. We presumed the problem had been a too-high heat setting. But for whatever reason, Soupy was dead, and our feelings as we buried our little friend were of sadness and anger. Why? The answer is simple: we had bonded with that tiny, vulnerable creature, looked after her and looked forward to her growing up. If she had died before we had found her in the grass, however, there would have been no relationship begun nor sadness or anger felt at her premature departure.

And so it is with people who we love and lose. The closer the attachment, the more strongly we react to loss. We miss all those parts of that relationship which made it so special. That person who we perhaps lived with, cared for and with whom we shared hopes and dreams has gone. Grief is an acknowledgement that we loved someone, and the nature of our relationship with that person is reflected in its depth. For this reason, as well as for the fact that grief  is a unique process, we must resist the temptation to urge others to follow our exact paths. For while we who have also experienced such loss might identify with other people's feelings, we must be mindful that they are mourning the loss of a relationship that was theirs and theirs alone. We must give credence to this uniqueness and refrain from insisting that they do it our way.

When we lose a loved one, absence of presence is only one of the effects. Next week we will look at the secondary losses and role changes that inevitably accompany loss.

Week 14 - Recognizing Secondary Losses

There are in infinite number of ways in which we experience loss: secondary losses follow as a natural consequence to the loss of physical presence. For those who are widowed, these losses may mean significant role changes. At first, such routine daily tasks as shopping and cooking and cleaning, previously the responsibility of the spouse who has died, may present as major obstacles. Likewise, for those whose mates took care of the family financial matters, keeping up with banking and bill payment may compound the already-strong feelings of confusion, anger and frustration that are normal reactions to grief. The problem as well is that when we assume new duties, we feel our loss all the more deeply for they are constant reminders of the many ways in which we miss our loved one. A reminder for me was a computer problem for which my son always had a solution. I now must turn to other  sources for technical help.

A diminished social life may be a substantial loss for widows and widowers. Community dances, country fairs and church functions are activities that take on a different flavour for those who always attended as a couple. Thus the bereaved person may choose to stay at home rather than face situations which serve to emphasize his or her aloneness. But being at home may not be the best solution either for it is in those quiet, familiar surroundings that painful memories are triggered. As well, if mobility is an issue and the remaining partner cannot drive, the sense of isolation may be frighteningly real.

Those who are embarking on their grief journeys may find this short list of secondary losses endless and ominous, but I bring the points to your attention because I believe that to be forewarned is to be forearmed. You will likely not experience all of these losses, and the intensity of those which you do feel will lessen over time. Remember, too, that with patience, perseverance and a healthy dose of self-compassion, you will learn new skills and incorporate them into your new lifestyle.

Being good to yourself includes asking for help from friends, family and community members. Another healthy technique involves putting on your comfort coat - the topic of next week's column.

Week 15 - Putting on our Comfort Coats

Anyone who has grieved will agree that we have good days when we feel capable of coping and bad days that hit for no apparent reason and bring us back to what feels like square one. As time passes, however, the good days begin to outnumber the bad - a change which, I believe, is in direct relation to our attainment of coping strategies.

One mother described her self-help on bad days as putting on her comfort coat. For her, this meant taking a few quiet moments early in the day to hug one of her son's favourite stuffed toys. While this practice may well have conjured up memories that brought tears, the toy actually served the useful purpose of connecting her thoughts to her lost son. This association is a necessary part of the healing process, for one of our fears is that our loved one might drift so far from our consciousness as to be forgotten. But when we purposely take time to acknowledge our loss and psychically touch the life that once was, we satisfy our need to connect and are then able to get on with the day in a more peaceful frame of mind.

Each of our comfort coats differs according to our personalities and preferences. I put on my comfort coat when I walk in the bush. As I make note of seasonal changes around me - the tiny green shoots of spring or the crisp, colourful leaves of fall - I cannot help but accept the inevitability of change and regrowth as it reveals itself in nature's life cycle.

For many, comfort is achieved through spirituality and religion, reading scripture and attending worship services. For some, it may be found within the home in such simple tasks as baking a batch of cookies, preparing a favourite meal or sewing some new drapes. A bubble bath can be a warm refuge and a place to relax and quietly gather our thoughts before we head off to bed with a cup of cocoa and a good book. Hobbies too, though often temporarily abandoned during the early stages of grief, are a good source of relaxation and comfort. Whether your comfort coat puts you in closer touch with your loved one or offers a welcome diversion, it is important that you persevere and try on several coats until you find the one or more which best suit you.

Next week we turn our attention to the fast-approaching Christmas season - a time when newly-bereaved people need all the comfort and help that they can get.

Week 16 - Planning for Christmas

The Christmas season is a time of family traditions, cards, gifts, carols and elaborate meals. But for those who have lost a loved one during the year, this season may bring mixed emotions; and because Christmas is such a family time, it is important that members of bereaved families plan the season's activities in advance so that individual needs might be met. Often this means a deviation from long-standing family traditions.

As our first Christmas without Mike loomed close, my children and I planned some small but beneficial changes. For instance, I felt that digging out the familiar ornaments and decorating a tree would evoke some painful memories with which I, personally, was not yet ready to deal. On the other hand, Mike's sisters felt that the tree was an important part of their Christmas, and it was decided that they would be responsible for setting up the tree themselves.

Shopping for gifts was another task that I knew would take more emotional and physical energy than I was willing to expend; and so together we drew up a simple gift list for which the children could easily shop. These two solutions worked well for us: they relieved me of some responsibility and yet gave my children the freedom they needed to get into the spirit of the season.

The freedom to make changes extends into all facets of the holiday season. Friends will understand if you decide against sending Christmas cards this year or taking part in the cookie exchange. You might choose to attend an earlier church service rather than the traditional later candlelight mass. It may be necessary to ask another family member to organize and cook Christmas dinner; or perhaps you may all decide to go out for the meal instead. Our Christmas dinner that first year was a home-made pizza - a necessary break from tradition and its preparation a welcome diversion and fun time.

The bottom line in getting through the Christmas season when we are grieving is accepting our limitations and communicating our needs and wishes to others. Next week we will look at other ways to cope with Christmas and more specifically, invitations.

Week 17 - Invitations and Social Gatherings

As Christmas approaches, family members and friends extend invitations to bereaved people in the hope of helping them through a particularly difficult time. Because grief emotions are so changeable, you may wonder how these visits will be and perhaps be tempted to decline invitations rather than deal with the uncertainty of the emotions that may surface. However tempting it may seem to shut yourself away until the festivities are over, it is usually best to make the effort to mingle, at least for part of the holiday. And there are ways to accept offers of hospitality that will reduce the pressure of decision-making. For instance: “Thanks for inviting me. I'd like to join you, and I know you'll understand if later on I should decide I can't come." And once you're there, hang onto the secure thought that should you find it too uncomfortable to stay, your friends will understand if you need to excuse yourself from the gathering.

Many grieving people are surprisingly strong on special occasions because of our body's natural defences that prepare and protect us during difficult times; in fact, you may find that Christmas day passes a lot easier than you had thought it would. But don't be surprised if a day or two later you find yourself in the grip of a grief attack. I felt a sense of relief at the end of the first anniversary of my son's death and even congratulated myself on how well I had got through the day. However, the next day my sadness was more intense than it had been on the actual anniversary date, and I realized then that I was having the predictable delayed grief response of which I had been warned. This delayed reaction is normal as we let down our defences, and we need to remember that sooner or later we must face our grief head on and give ourselves permission to release our emotions.

I recently spent some time with a woman whose son had died two years earlier. She was experiencing physical symptoms resulting from repression of her feelings but had yet to give herself the freedom to deal with her grief. Her healing began by first acknowledging her loss and then by identifying symbols which she could use as tools to get through difficult times such as holidays and anniversaries. Next week we will look at the healing power of symbolism.

Week 18 - Coping and Healing through Symbolism

The research on the grieving process reveals that communication with others in similar circumstances is of immeasurable value. After our loss, my girls and I linked up with Bereaved Families of Ontario, a group established to help in the event of the death of a child. One month before Christmas, we attended an information evening. It was a learning experience - an opportunity to glean ideas and gather strength from others further down the grief path. One focus of the discussion was the use of symbolism in grief.

We can use symbols as coping tools. For example, my family makes a donation to Bereaved Families by buying an angel for their Christmas tree. The emotional return is two-fold; we support a worthy cause and most importantly give a gift in the name and memory of our lost son and brother.

One mother in the group spoke of the hour or two she spends on Christmas Eve, alone except for one candle she lights as a symbol of her daughter's presence. This yearly ritual is not a morbid experience; rather it is a very real way to get in touch with feelings that inevitably surface at special family times. Some people donate a gift to a local agency to be distributed to needy children. The symbolism here is that although we cannot give gifts to the ones who are no longer with us, we have the satisfaction that comes from giving to another in their memory.

Visiting the grave or attending a church service and saying special prayers are other ways to symbolically connect with lost loved ones. And although we cannot deny the fact that these rituals fall far short of what we really wish we could do at Christmas, over time they can become an accepted and meaningful part of our holiday activities.

If you are facing a first or second Christmas without a family member, take heart and summon courage. Talk with others if you have the chance. Share your feelings and misgivings and think of symbols that you might use within your family circle.
Next week we will resume our examination of the factors that affect our grief response.

Week 19 - Multiple and Prior Losses

Other factors to be considered in grief work are the number of former losses we have faced and the way in which we dealt with them. This is not to imply that our grief journey through subsequent losses is any easier - quite the contrary in fact, for residual emotions from past losses have a way of resurfacing and complicating the issues of a more recent loss. And often the time that has elapsed between losses has little bearing on the kind of grief reaction that we might experience. For example, one thirty-year-old man reacted very strongly to the death of his cousin with whom he'd had little contact over the years - so strongly, in fact, that his wife was surprised and alarmed at the depth of his grief. This man's reaction was quite normal. His mother had died when he was a young boy, at a time when the effects of grief were not understood and little help was available to bereaved people. As he mourned his cousin, this man was also dealing with repressed emotions and memories of his mother and of her death. Only after he sought professional help was he able to deal with his emotions of the past and separate them from those of the present. How much better it would have been if he'd had the opportunity to properly mourn his mother soon after she had died.

When we experience multiple losses or more than one death over a short period of time, we may suffer from grief overload. When this happens, we must be even more patient with ourselves than in the case of a single loss; our grief process will likely be more complicated, our emotions even more changeable and recovery time longer.

Yet another factor apart from experience is personality and temperament. Some people seem, and indeed are more able to cope with loss than others There is no explanation for this wide range of reactions other than an acknowledgement of one's individuality. It bears repeating that because of our uniqueness, we must consider all aspects of our ourselves and our circumstances as we travel our grief paths and assess our progress. Next week we will look at age and life fulfilment issues of the deceased as they affect our grief reactions.

Week 20 - Age and Life Fulfilment Factors of Loss

Reactions vary according to the age at which our loved one died and our perception of their fulfilment of life. It has been said that to lose a parent is to lose one's past; to lose a mate is to lose one's present; and to lose a child is to lose one's future. When a child or a person in the prime of life is taken from us, we not only mourn the relationship that we have lost; we also focus our thoughts and feelings on the wasted potential of life. This loss of future is double-edged. We who survive, particularly parents, must deal with a multitude of broken dreams. This reaction may seem to be a selfish one, but it is perfectly natural considering the fact that when our children are born, we plan our lives around a future with them. The other edge of the sword is that we feel sad and angry on behalf of our young loved one who was deprived of his or her own future.

Many of our emotions arise from our perception of unfinished business that may be viewed in different but equally significant ways. We may dwell on the plans that our loved one had made - graduation from university, a business venture, marriage and a family to name but a few. Also, any unfinished business between ourselves and our loved ones may present us with additional stress and heightened emotions: we may second-guess many aspects of our relationships and harbour feelings of regret and guilt over things that we feel were said or left unsaid, done or left undone. Each of these thoughts and issues need to be addressed as we work our way towards a sense of peaceful closure with our loved ones.

Over the past weeks, I have offered a brief overview of the main factors that affect grief reactions. My purpose for so doing is to assist readers in assessing their response to grief. Using this information, you might make a mental check list of the factors as they apply to your situation and thereby gain a better understanding of yourself and your journey. This list can be used not only as a measure of the work necessary for completion of your grief journey but also as a gauge to pace yourself along the way.

Next week we will look at the physiological factors which are important to the outcome of our grief process.

Week 21 - Physiological Concerns

When we are physically ill, we often notice a change in our state of mind and feel anxious or depressed. The opposite holds true: our physical health usually suffers when we are going through emotional upheaval. Bereaved people need to acknowledge this link between our psychological and physical selves and take steps to maintain a reasonable level of physical health.

A change in sleep patterns is a common complaint. Difficulty falling asleep and waking early or during the night is indicative of a troubled mind. The problem with sleep deprivation is that neither our minds nor our bodies get enough rest, without which we lack the bodily and spiritual strength to face the tasks associated with grieving and healing.

To counteract fatigue and lower our body's susceptibility to viruses, infections and disease, we must make a conscious effort to rest. Catnaps during the day are one solution to catching up on much-needed sleep, or we may resort to traditional methods to induce drowsiness - a warm bath, soft music, television or a good book.

Drugs bring temporary relief and, if prescribed by a doctor, serve a useful purpose in the short term. Alcohol may have the same effect, but prolonged use of either of these may be harmful to health and counter-productive to emotional healing: with dulled minds and artificially controlled emotions, we may indefinitely postpone our grief work. But later, when we begin to work through our feelings after friends have gone back to their routines, the loneliness we feel could lead to substance dependency.

When we grieve our appetites change and we may skip meals or choose foods that deprive our bodies of the nutrition necessary to get through this tiring time. Weight loss is common but usually short-lived if we make an effort to balance our diet once we begin to feel more stable.

Exercise has obvious physical benefits: it helps to overcome sleep problems and is an excellent outlet for anger and depression. Next week we will look at exercising and other methods of releasing emotion.

Week 22 - Staying Healthy and Venting Anger

How strange it would be to lose one of the most important people in our lives and bounce right back, apparently the same as we were before. To do so would be to deny the drastic change that our lives have undergone. It is equally absurd to deny the emotions that surface through grief, one of which is anger. We often find it difficult to express anger; we may be unaware that we are feeling angry or reluctant to admit to having what is commonly but mistakenly felt to be a negative emotion.

Exercise is therapy for body and soul and an excellent outlet for anger. The physical benefits are obvious: after a brisk walk, a home workout, a fitness class, a game of tennis or bowling - any activity in which we use muscles, raise our heart rate and increase blood flow - we feel more relaxed, and the psychological benefits are three-fold. While we concentrate on physical activity, we temporarily defocus from ourselves and our grief. Secondly, we feel good about ourselves simply by knowing that we are making the effort to exercise our bodies. Thirdly, as we expend physical energy, we also release nervous energy. I once played a game of tennis when I was feeling angry. Having first warned my opponent of my feelings, I hit the ball as hard as I could, using the ball (and my willing opponent) as the target of my anger. When the game was over, I felt tired but relaxed and relieved.

Just as exercise is an emotional release, so are certain causes we may choose to take up. For instance, one parent working through her grief derived great satisfaction through establishing MADD (Mothers Against Drunk Drivers). The British Columbia dad whose daughter was murdered travelled across Canada to raise support for a change in parole laws. These people re-channelled the energy they once invested in the relationship with their loved one, and we each need to search for the channels just right for us. Two of mine are writing and counselling. Volunteering is another constructive way to spend time and energy.

By turning anger into action, we begin to take charge of our lives and move along our grief paths. By contrast, repressed anger can turn into depression, the topic of next week's column.

Week 23 - Reactive Depression

No matter how hard we try to work through our anger, this phase of the grief process is usually followed by or intermingled with periods of reactive depression. Some symptoms are sadness, apathy, helplessness, loneliness, difficulty concentrating and making decisions, crying, irritability, low self-esteem and fatigue. Many of these symptoms are the same as those of clinical depression, but there is a difference. By recognizing the source of reactive depression (such as a death), we may take heart in the knowledge that, as we work through our grief, our symptoms will decrease in number and intensity.

We do not always recognize our symptoms or adequately describe our feelings to a friend or professional in words that will alert them to our depressive state. All we may know is that we feel differently now, and it is often through changes in our behaviour that depression is diagnosed. For example, a change in dress or appearance from neat to unkempt is a clue. Another sign is irritability when once we were agreeable. Depression has been described as anger turned inward, and our irritability may stem from anger at ourselves for the part we think we played in the loss or our inability to ‘get over it' sooner.

Bereaved people need time alone to adjust to changes, but prolonged social withdrawal is a warning to seek help. Depression is unique in that it is cyclical. Lethargy leads to a lack of motivation to engage in activities that might lift our spirits, and lowered activity feeds into feelings of helplessness and loneliness. A simple example of this cycle is a reluctance to get out of bed. But if we manage to muster the energy to get dressed, take a walk or pick up the mail, we give ourselves a chance, albeit brief, to think of something other than our loss. Along the way, we may find someone to talk to and once we have made contact with the outside world, we have made a small break in the cycle of depression.

Depression is a normal consequence of grief, and the keys are patience and perseverance. By recognizing the symptoms, asking for and accepting help when offered and taking small steps, we can work our way up and out of depression.
Next week's column will deal with another misunderstood emotion: guilt.

Week 24 - The Burden of Guilt

As we question the why and wherefore of loss, the if-only's have potential to add to the weight of guilt. Two obvious sources that come to mind are l) a feeling that we may have contributed to the death or at the very least, that we failed to prevent it, and 2) regrets over our absence at the time of death or for neglecting to leave a contact number in case of emergency. And to make matters worse, our mixed, changeable emotions fuel the fire of guilt. One woman shared with me her desire to put her husband on a pedestal but was feeling remorse over relief that some of the more difficult aspects of her marriage had ended. By accepting the reality that no relationship, or human being, is perfect, she dropped her guilt and focused on more positive memories.

Feelings of guilt often arise when we remember times with our loved one that we would change if given the chance. As we work to resolve this unfinished business, we let ourselves off the hook by accepting the inevitable; the past is unchangeable, but it can be reframed into a more positive picture.

The sense of relief we feel following death after a lengthy illness may cause ambivalence and trigger guilt. The long days and weeks are over, and we are thankful that the suffering has finally ended. In this case, the integration of conflicting emotions of relief and guilt is often a hard task.
Anger goes hand in hand with guilt when we displace anger onto an innocent party (a common occurrence in grief). We may question our reactions and turn our regrets into guilt.

The anger/guilt connection may become an issue even when we keep our anger in check. Other emotions such as sadness and yearning seem more acceptable, but anger, somehow, seems inappropriate, and so we feel guilty.

Another source of guilt is our inability to justify our continuing earthly existence after a partner or a child dies. This survivor guilt is often a factor in a parent's grief.

Guilt crops up in so many situations that it may become a serious obstacle to our progression along our grief paths. I have briefly described some of the circumstances in which we formalize guilt feelings. Next week we will look at healthy ways of dealing with and ridding ourselves of guilt.