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Week 25 - What about Guilt?

All emotions are legitimate by virtue of the fact that we do not invite them. Sadness arises out of yearning and anger out of frustration over things that happen out of our control. But in grief, guilt does not have any such legitimacy; therefore, it serves no useful purpose.

To rid ourselves of guilt, we first must acknowledge our feelings. We can do this by talking, because chances are that the words guilty or blame will come up in conversation. The next point to remember is that often guilt is a self-inflicted emotion; when we are confused, we interpret life's circumstances in a sometimes-too-personal way.

Hindsight is always twenty-twenty. How perfect life would be if we had such vision. The reality is, however, that we all make mistakes and do not have the luxury of total control of our lives and those of others. The key to dropping guilt is forgiving oneself for our humanness. But forgiving must not be confused with forgetting: it is not possible or even necessary to forget events in our past that cause self-doubt. But we can forgive ourselves, and I offer the following example as shared by grief consultant and colleague, Dr. Bill Webster.

Imagine a reversal of roles - your loved one is alive and you have passed over. Would you want him or her to suffer the torment of guilt? Or would your message be, "I understand. Don't fret. I'd rather that you remember all the wonderful things you did for me!"

If you can go through this short exercise, you may be surprised to find that you can forgive yourself just as your loved one would. It may be helpful, too, to make a list of all the special times that you shared, using photographs as graphic reminders. And if you still feel twinges of guilt, you may dispel them by realizing that you did what you could at the time, which is all that any of us can do. Keep in mind, as well, that the grief process is unique and that you need time to reach that happy state of self-forgiveness. You will know you are successful when you feel the peace that accompanies a cleared conscience.

A lot of the grief work I have talked about thus far describes what is known as our grief reaction. However, it is time now to move on to look at our grief responses, and next week we will flush out the subtle yet important differences.

Week 26 - Reaction vs. Response

Over the past weeks, I have shared information that hopefully has broadened your understanding of the grief process - and often used the word reaction in describing the many facets of each stage. A summary of the information reads as follows:

Grief is very real. It is painful, and so it hurts. We react to the pain through our emotions. And at any point during the grief process, perhaps our one comforting thought comes from knowing that our reactions are normal.

I have talked about climbing mountains, travelling along paths and getting on with the rest of our lives. To accomplish this monumental task, we need to do more than accept our reactions; for inasmuch as we must give ourselves permission to react, our individual response to loss directly affects the duration and outcome of our grief journeys. Thus, after we have allowed ourselves sufficient time to react to our new situations, we must move on to a phase in which we make an effort to take responsibility for our healing. We begin to make decisions and to choose constructive ways of dealing with grief (putting on our comfort coats is an example), bearing in mind, of course, that we are hurting and for a very good reason.

The steps to follow are personal, and there is no right or wrong way to respond. The only rule is that we do respond, always in our own way. It may be a trial-and-error approach, especially if this is our first close encounter with death, and we might follow others' examples to find ways to help ourselves. The point, though, is that we purposely pursue different avenues and activities to facilitate our healing. And it is only through trying that we will find our own best ways.

I believe that communication is the cornerstone to healing and growth (in any life situation). Human beings are social creatures and, as such, we need to trust that we may turn to one another in times of need. By talking through our feelings, we take a big first step and an active approach to grief - a response rather than a reaction.

"Give sorrow words; the grief that does not speak
 Whispers the o'er-fraught heart, and bids it break."
Shakespeare, Macbeth

Week 27 - Grief Attacks

Sooner or later we begin to put out lives back together. I have spoken with bereaved people who returned to their jobs within a week or two of their loss. Some reported having found comfort in familiar surroundings where they could focus their thoughts, during business hours, outward on their tasks rather than inward on their pain. Others, who had an option, took a leave of absence and returned to work when they felt more stable and ready to face their jobs. Either way, at home or at work, we must be prepared for grief attacks - time periods when the pain of loss suddenly overwhelms us.

Dr. Bill Webster, grief consultant, coined the phrase 'grief attack', an apt description of the grip of pain and the spilling over of emotions through tears. He likens the experience to standing on a beach and watching the waves roll onto the shore. In grief, waves of sadness wash over us, often when we least expect them. They may be triggered by a chance meeting with a friend, a telephone conversation, a song, or a place. And it is the element of surprise that makes us all the more vulnerable to grief attacks; for just as some waves are bigger and hit the shore with more force than others, grief attacks vary in frequency and intensity.

The way in which we handle grief attacks depends on the immediate situation and our individual response to grief. In some circumstances for some people, it feels right to express emotions on the spot. Others may feel more comfortable retreating to a private place for the length of time it takes to release their sadness and tears. The important points to remember, however, are that we need not feel embarrassed over grief attacks and that we should let them run their course. At certain times, it may be best to grit our teeth and fight back our tears momentarily, but if we continually side step our grief, sooner or later our pool of emotions will find another, perhaps more debilitating outlet. Grief attacks are healthy signs that we are working through our grief towards the day when the attacks will become all but memories.

Next week we will look at acceptance, the final stage.

Week 28 - Acceptance

There are many aspects of grieving to be covered in weeks to come, but for now it might be beneficial to look towards our goal and examine the acceptance stage of grief. Those who are moving back and forth between shock, anger and depression may wonder when and how they might ever reach that coveted point; during the early days, I refused to even read about this final phase much less imagine myself reaching it. I realize now that this refusal came from my intense desire to deny the truth. How could I look ahead to accepting the death that I still worked so hard to deny?

Progress through grief is slow but sure. During bad times, we tend to believe that our grief attacks are as intense and our depression as deep as when we began our journey. We may feel that we are hopelessly stuck, but the reality is that we have simply reached one of many plateaux of our mountain. What we need to do during these times is simply trust that around the next bend there is hope: that we'll make it; that life can be meaningful once more; that we'll laugh and feel joy again. And the strength of our hope is directly related to the effort we put into facing and dealing with our grief. We may draw on this mysterious ingredient called hope and regard each new challenge not as a stumbling block but a stepping stone - a test of our strength and faith.

Then one day we surprise ourselves. We begin to make plans, to look forward to an event or to make a major decision that might give our lives new direction. It is then that we know that we have weathered the worst. We can still expect to hit rough patches but they, too, will pass. This is the beginning of acceptance. In all likelihood, it may never feel okay that our loved one has died. It simply cannot be so. Nevertheless, our long, uphill journey is all but over, and our burden and our steps become increasingly lighter as time passes.

Time alone does not heal. Rather, we heal over time as we make choices and find new meaning for our lives. One major change may be in our philosophy of life, religious beliefs and spirituality. These topics will be addressed next week.

Week 29 - Spirituality and Religion

As mentioned in previous columns, symbolism plays an important role in the grief process. As well as picturing myself climbing a mountain and following certain paths, I envision the moods and feelings accompanying grief as a pendulum swinging back and forth between extremes. So quickly, it seems, our positive feelings can change to those of desperation especially when we are experiencing a grief attack.

This swinging pendulum image might also be useful in understanding changes in religious and spiritual thinking and behaviours following a death. As we question the fairness of life and search for answers, we may swing far left or right in our beliefs and faith. For some, church attendance, worship and prayer become an even greater part of life. Others, for many reasons one of which may be anger, tend to pull away from traditional forms of worship and seek out alternative routes to satisfy their spiritual needs. Some find comfort in attending services of different religious denominations while others may put their spiritual lives on hold until they begin to deal with their grief and sort out their beliefs and needs. Some people's behaviour may seem totally out of character, especially if they worshipped regularly before their loss. These people may simply be taking a temporary leave of absence - a time out - until they feel strong enough to deal with the emotions that are likely to surface in church so soon after the funeral.

Everyone handles grief differently; but the pain is the griever's and so, therefore, are the choices. If you are recently bereaved or are concerned with another who has lost a loved one, remember the swinging pendulum. Make allowances and go along with your choices and changes, and respect those of others. The chances are that the pendulum will swing back to a central balance and religious beliefs and practices will return to normal. But if not, we need to accept the changes as a new but valid part of ourselves, family members and friends.

Next week's topic is philosophy of life - another area of thinking that may change drastically after a death.

Week 30 - Philosophy of Life/New Paths

When one whom we love dies, it is as if a line has been drawn through our lives. I found that ever after I speak in terms of before and after the death. Perhaps outwardly we seem to be the same as we were before, and our friends breathe a sigh of relief when we appear to have returned to 'normal'. However, I believe that a close death affects us to the core - so much so that we are profoundly changed. Therefore, many bereaved people develop a different way of looking at the world - a new philosophy of life.

This cognitive switch is a subtle process born of our search for answers and an intense need to find new meaning. One obvious sign of my change was my reaction to trivial concerns that before the loss were of major consequence. However, thoughts involving trivialities seemed grossly unimportant when viewed in the larger context of life and death. Although everyday trivialities must be dealt with, other aspects of life take on new meaning. For me, my relationship with my remaining children took precedence over a squeaky-clean house. In fact, a large part of my whole family's change process was a re-evaluation of our lifestyle and a focusing on dreams - hence our move from a big city to a small community, a country home, open fields and quiet wooded trails.

While it may be unwise to make major changes too soon after a loss, our changing thought patterns and beliefs invariably lead us in new directions. The certain knowledge of our mortality gives us the impetus to differentiate between what is important and what is not - to list and priorize goals and invest energy into realizing them.

Change is part of life and brings with it losses and gains. We do not choose to have death touch our lives, but as we approach the point of acceptance, we often find that the experience is an opportunity for personal growth. I urge you, therefore, to give your revelations about life credibility as they have the potential to take you along a new life path - one filled with meaning, promise and peace.

Parting with our loved one's clothing and possessions is the topic of next week's column.

Week 31 - Parting with Possessions

Just as many factors influence our reactions to loss, so it is when we address the question of when and how to part with clothing, furniture and possessions of one we have lost. I have spoken with people who immediately set about accomplishing the task and others who felt more comfortable tackling the job after some time had passed.

As with other issues of grief, there is no right or wrong way to deal with possessions. However, if you feel that it is time to begin the sorting but lack motivation, it may be that you simply need some help. One type of help may be found through an understanding friend who might work along with you to help make decisions on what to keep, to move furniture and pack up and dispose of the things that you decide must go. As you work together, you will find yourself reliving precious memories and expressing emotions. And when the job is completed, you may feel a huge sense of relief and a feeling of moving on.

If, however, you are procrastinating over the sort-out and are upset about feeling unable to face it, the help you need may be of a more therapeutic nature. A trained professional can help you to see that the reasons for your reluctance to face the job may be rooted in a desire to continue to deny the reality and finality of the death. This type of support will allow for discussion and help you to move through a difficult stage of your grief process. Once you have done this, you may feel ready to call upon a friend and get the sorting done.
Some people set aside a special place in their home for the most precious items. It could be a shelf in a china cabinet - a place to visit when we feel the need to connect with our loved one. We may decide to keep and use a favourite chair or footstool or to wear certain items of clothing. And as painful as it may seem to live with the reminders, eventually these items become sources of comfort that trigger memories of happy times past.

The topic of this column came through a written request by a reader. I invite others' comments and suggestions.

Next week we begin a series of columns on a child's grief process from infancy through adolescence.

Week 32 - Children in Mourning

As parents, we strive to protect our children - to do all we possibly can to ensure their health and happiness. And so it is when a close family member dies: our first impulse is to spare our children the pain that accompanies loss. Studies have shown, however, that we need to assist the bereaved child in actively confronting the death. The logic behind these findings is that, no matter what age, we must all deal with grief lest we carry the residual emotions far into our futures.

My sister died when my nephew was four. His father seemingly dealt with the loss of his young wife by burying the past; there was little talk of the suddenly absent mother and wife, and any reminders - her belongings and pictures - were packed away out of sight and apparently out of mind. That boy, now a man of thirty-three recently wrote so eloquently: "It was as if someone had ripped the first five years from my photo album. It feels like my life began at five when dad remarried. I wish I could get those years back."

Only recently has this man delved into his past, talked to family members who knew his mother well, begun to retrieve memories of her and fill in his lost years. Since accomplishing this difficult task and gaining the satisfaction of having put his past to rights, his relationship with his wife and children is stronger.

Thankfully we are beginning to understand the long-term effects of early loss and now know that by using an educated, active approach to helping children to deal with their feelings as they arise, we are actually protecting them in the long-run. For often it is unresolved grief that leads to adult psychosomatic and conduct disorders, depression and neuroses.

In making what may seem to be a dark prognosis, by no means do I mean to be an alarmist. There are many ways in which we, as adults, can guide our children safely through the grief process so that they might emerge from childhood emotionally sound and equipped to face tomorrow.

In the next few weeks, we will learn more about our intervention tasks in response to a child's grief according to the age and stage of development at which the loss occurs.

Week 33 - When Baby Loses Mom

Much of the grief research on babies and young children is based on the death of the mother, as she is the person most likely to be the infant's main caregiver. However, the wisdom that applies to a mother's death can be generalized to others.

Infants in the first three months of life react to the loss by crying and showing distress, but once their basic needs (food, warmth, comfort, touch and love) are met by a surrogate mother, they are soothed and their initial response diminishes. However, the infant of four or five months expresses a high level of ongoing distress as a response to the absence of his mother as a specific person.

For a child of six months to two-and-a-half years, the separation triggers the beginnings of grief and mourning. Shock is followed by protest - a child's way of trying to get his mother back. As time passes and mommy doesn't return, the child becomes frustrated, realizing at last that his protests are to no avail. His despair rises and yearning and pain ensue. He then goes into periods of withdrawal during which he engages in distracting activities and attempts to lose himself in play because of his inability to tolerate the feelings of longing for extended times. Eventually he gives up looking for his mother, abandons hope of her return and becomes sad.

The signs of this stage are a lack of interest in objects and activities that would ordinarily bring pleasure. This natural separation response will continue until a constant and caring person steps in to fill the painful void. At first, the infant may seem inconsolable, no matter how much comfort and consolation is offered: he simply wants his mom. But it is through a persistent pattern of nurturing and comforting that his pain will eventually ease. The key here is ongoing support despite the child's signals that it is unwelcome at times.

This process of letting go and working towards acceptance of loss applies to bereavement at any time of life but never so poignantly as at this early stage. Children do not have the advantage of maturity and knowledge from which we, as adults, may draw throughout the grief process. And so we must assume the responsibility of being informed, recognizing the signs of distress and intervening on behalf of our children. Such intervention may involve a professional.

Next week we will look at loss from a three-to-five year old's point of view.

Week 34 - A Three-to-Five-Year Old Child's Grief

By the age of three, a child's grief process is much the same as an adult's but with one major difference - a little person's inability to verbalize his or her thoughts and feelings. This point is important to note lest we perceive a lack of communication as a sign that children are relatively unaffected by the death. They simply do not understand what is happening and eventually start to ask seemingly inappropriate questions. They are bewildered and often exhibit regressive behaviour, become demanding and clinging as they were earlier in their lives. Bed-wetting is one example of such regression. The child continues to question his mother's whereabouts and protests angrily when she does not return. In this confused state, he or she may become attached to transitional objects, such as blankets and soft toys, and react angrily when they are taken away for laundering. We need not worry about this object dependence, however: as time passes and adjustment begins, these objects will lose their importance and appeal.

Preoccupation with the deceased is normal, and the child will benefit from frequent reviews of his relationship with the lost loved one. In the movie Sleepless in Seattle there is a scene where dad and son speak of the absent mom. Together they recall the bedtime song she used to sing. Together, too, they remember other things and cry.

By contrast, I once met a woman who had been adopted whose birth mother was never seen or even spoken of. While only three, the girl discovered a model in a Sears catalogue who reminded her of her mother. The adoptive parents, interpreting the girl's habit of looking at the book as obsessive and unhealthy, tore out and threw away the page. Afterwards, that little girl spent hours leafing through the catalogue in search of that one picture until one day, even the catalogue had disappeared. Sadly, along with the book, the child's last hope of dealing with her loss vanished. At that point, this child withdrew into her own little world of which neither questions nor answers about her birth mother were a part.

The questions that grieving children ask are normal and predictable. Next week we will look at the answers that are commonly given and their interpretation by children.

Week 35 - Answering a Child's Questions

"Where has mummy gone?" - a simple, direct question. Here are some typical answers and children's reactions to them.

"Mummy has gone on a long trip." A child may feel abandoned and resent the fact that her mother left without telling her or better yet, taking her along. She may feel guilty and wonder if she might have been the cause of the abrupt leave-taking. This response also conveys a false sense of hope that mummy will return some day.

"Daddy was so good that God wanted him." The child, who also needed his dad, may feel angry. He will also feel confused while he sees others sad and crying. As well, he may develop a fear of being good in case the God the adults talk about decides to whisk him away too.

"Auntie died because she was sick." This explanation sounds reasonable and harmless enough but it, too, has drawbacks. The child may afterwards associate all sickness with death, fearing for himself and other loved ones.

"Grandma has gone to sleep forever." Such an answer may give rise to an association between sleep and death, causing obvious problems at bedtime and the development of sleep disturbances.

While these answers and their effects may seem far-fetched, they have been documented and verified. And while we may be tempted to protect children and resort to fairy tales and myths, our explanations must be gentle yet honest. Relay the news as soon as possible lest the child hear the facts, right or wrong, from someone else. Use a normal tone of voice: whispered messages may give death a spooky, unreal connotation. Approach the child in a familiar and secure environment. It is important, too, that we offer an honest explanation that conveys the irreversibility of the death. As permanence is a difficult concept for children to grasp, we might use an analogy of a broken toy - one that we wish we could fix but know will never work again.

Most important of all, the child needs to know that he's loved and will continue to be cared for. Warn him that he will feel sad and strange for a while, and that it's okay to cry and to talk about his feelings and the lost person. Reassure him that these different feelings will not last forever.

The funeral can be an opportunity for both children (of a certain age and cognitive level) and adults to begin their grief journeys. Next week we will look at the healing benefits of funerals and other rituals of mourning.

Week 36 - Emotional Benefits of the Funeral

Many bereaved people report having difficulty remembering the details of a loved one's funeral. This limited memory recall is largely a result of the state of shock in which we find ourselves directly following he death. But no matter how much we can or cannot remember, a funeral or memorial service serves several important emotional purposes.

Visitation at the funeral home, and the service itself, are the beginnings of acceptance of the death. At the time, while in the denial stage, we may not experience psychological acceptance, but still there is no denying the setting - the casket, the grave and friends who have gathered to pay their respects and offer support. Later, even scant memories will help confirm the reality of the loss. In the case of a closed casket, it is not unusual for some family members to request a private viewing of their loved one simply to convince themselves of the presence of the body of their loved one.

Funerals offer the survivors an opportunity to express their feelings and to recall memories of the deceased. Each time a story is told or an incident recounted, we move one step forward, no matter how tiny, towards resolving the loss.

A major component of the grief process is accepting the changed relationship with our loved one; that is, the physical presence and interaction that once was exists no more, and a new relationship, based on memory and recollection, begins to form. Without the ritual of the funeral, we might spend a lot more time and energy trying to move along our grief path.
We all need to know that our loved one was thought well of in the community, and tributes given at the funeral attest to this. As well, as we hear the kind words, expressions of how much the person will be missed, we give ourselves permission to grieve: our loss has been validated and our grief legitimized.

All of these emotional benefits of funerals apply to children, and they should be given the chance to decide whether or not to attend. A decision to decline needs to be respected and, perhaps later on, a visit to the gravesite might be useful in helping the child begin to come to grips with his loss.

Next week's topic: grief reactions of older children.