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Week 1 - Introduction

The death of a loved one is an experience that many of us will face during our lifetime. Whether the loss is of a parent, spouse, child or friend, our sadness and pain may seem insurmountable. The purpose of this column is to help bereaved people to cope with the feelings and emotions that accompany loss. Also, the information shared week-by-week might serve as a guide for those who are searching for ways to help a friend or family member to deal with grief.

There are several factors which affect the way we cope with loss: the passing of time; the amount of available support; and an understanding of the phases through which we will pass on our grief journey. The adage that time heals is, in part, true. But there is much to be gained through education - verbal and written accounts of others' experience with grief. This learning is one type of support; another is that offered by a friend or professional with both willingness and expertise to listen, empathize and lighten our load.

Individuals grieving a loss will experience a combination of many different emotions (anger, sadness, jealousy, guilt) of varying intensities and duration. However, the commonalties of the grief process are basic and recognizable. It is my intent, therefore, to share each week some ideas which may help readers to navigate the new territory into which they have been thrust. The goal is to eventually emerge safe and whole, ready to face a new life - one that though undeniably changed holds great potential for growth, achievement and peace.

We will begin our examination of the grief process next week with an overview of the stages of grief.

Week 2 - Stages of Grief

As you work through the grief process, you will pass through stages - shock and denial, anger, depression and acceptance. Later we will examine each stage in detail; but for the benefit of those who have already begun their grief journeys, I offer a brief overview.

We first enter the denial stage, refusing to believe that our loved one has died. Our inability to accept the loss is normal while our minds and bodies are in shock. Our emotions run riot, and feelings of panic, anger and sadness are interspersed with periods of apparent calm due to our natural protective defences. As time passes and our defences begin to let down, we begin our search for reasons for our loss. Unable, however, to find answers, we become angry and look for something or someone on which to blame the death. Some direct anger at things or others who they feel are responsible. Or God. Or, as illogical as it may seem, on the one who has died. We might also direct anger inwards in the form of guilt.

Anger for which there is no outlet turns into depression. In this stage, we are apathetic. Nothing matters, and our main task is to find enough energy to simply get through each day. But even in sleep, we may still feel pain through dreams.

Each of these stages will repeat in random order. Even acceptance of the loss may come and go. For instance, anniversary dates and certain songs or pictures can trigger emotions with which we felt we had already dealt.
These stages as I have painted them may appear to be endless periods of discomfort and heartache. But I urge you to take courage, as there will be times, even before full acceptance of the death, when you will feel comforting, uplifting emotions. And just as we must give ourselves permission to experience sadness and anger, so we must take advantage of feelings such as hope, peace and even joy when they present themselves.

Remember... confusing, changing emotions are normal reactions to loss. Next week we will take a close look at shock and denial.

Week 3 - Shock and Denial

Whether a death is unexpected or a predictable ending to a long illness, the first reaction of those left behind is denial. In the case of accidental death or sudden physiological failure, it is easy to understand a person's inability to face reality. But in any event, the finality of death is hard to grasp.

As we work through the funeral arrangements and legal and financial matters, logically speaking, we know the truth. But the emotional part of us, which yearns for our loved one to be alive, overrides logic and keeps the truth at bay. The death may seem like a bad dream from which we would hope to soon awaken. While in this state of shock, we need time to integrate the conflicting messages of head and heart. For this reason, the bereaved person may seem to be doing quite well, and onlookers often express surprise and even relief at the seemingly calm and controlled demeanour of the mourner.

It is important for family and friends to realize that when the numbness of shock first gives way to reality, the bereaved person will need help. During the quiet days after the funeral, our body's protective defence mechanisms begin to relax. Grief attacks may occur: fits of crying, despair and loneliness often consume the griever. Others symptoms are confusion, lack of concentration and perceptions of going crazy. Sleeping and eating patterns may be disrupted. Energy and motivation are at a low ebb, and tasks such as writing thank you notes and sorting through and discarding clothes and possessions may be impossible to face alone.

The duration of this stage depends largely on the amount and type of support that is available. Therefore, it is important that we all attempt to gain a basic understanding of the grief process so that, when called upon, we might confidently and effectively take on the role of support person. Next week we will look at specific ways that a concerned family member or friend might help.

Week 4 - Role of Support Person

When the funeral is over, friends naturally return to their own families and busy schedules often with a reminder to "call if you need anything." But feeling tired and confused, the bereaved may give a message that they will be all right and just need to be alone to reorganize their lives. But the truth is that, at this time, grievers may not really know what they want or need.

While grieving people need a certain amount of quiet time to themselves, prolonged periods of silence and aloneness may compound their feelings of desperation and loss. They may not phone the friend out of fear of becoming a nuisance or perhaps because they think they must somehow be strong enough to face their grief alone.

What bereaved people need most, however, is the chance to talk when they are ready - to vent their constantly changing emotions. Therefore it is the task of the support person to take the initiative to call or to drop by for a coffee, thereby giving the griever an opportunity to once again go over the details of the death, if he or she so wishes, and to share precious memories of the deceased. At this time, the support persons' words are far less important than their presence; just by being there, they show a willingness to listen and a desire to lighten the load. Nor do some people always need to talk. One bereaved person told me of a friend's visit shortly after his wife's death. No words were spoken; the two simply sat, held hands and cried together. The grieving man reported feeling much better after the visit.

The key word in the grief process is permission - an unspoken message that the griever is allowed to set the tone and pace of his healing, whether it is to talk, to cry, to reminisce or just to touch in silence. And when a friend leaves with a promise to call later, he need not worry about what he said or should have said; rather he has the satisfaction of knowing that he was there when his friend needed help. His time and show of concern are, indeed, the ultimate gift of true friendship. Next week - approaches towards visitation.

Week 5 - Early Response to Friends in Grief

Visitation at a funeral parlour gives us an opportunity to offer our condolences to the family shortly after the death of their loved one. As we search for the right words to give solace and convey our concern and sadness, we may resort to using clichés: "It must be a relief after all that he's suffered." "What a blessing that you have other children." "One day you'll be together again." "He wouldn't have wanted to live in that condition."

While these well-intended phrases may contain words of wisdom, the bereaved in the numbing grip of this early stage of grief may not be ready to accept such basic truths as they struggle to grasp what has happened and to begin to deal with the loss. One minister approached a mother with a serene smile on his face hours after her daughter had died, expounding how lucky the girl was to be in heaven and no longer plagued by worldly worries. The mother did not share in his joy and reacted angrily. Only much later when she had herself found some semblance of peace over her daughter's untimely death, did the mother take the meaning of the words as they were intended.

Two words - simplicity and sincerity - are the keys to ensuring that meetings during these first harrowing days or weeks will be comforting to the griever and rewarding to the visitor. As such, it is probably best to put philosophical thoughts aside and address more immediate facts and feelings. "I was so sorry to hear that she's died." "What an awful shock that must have been for you." "It's so hard to believe that he has gone." "I wish I knew how I can help you." Or how about a heartfelt, "How are you doing?" while holding hands or giving a hug?

Any of these responses, verbal and physical, tend to normalize the bereaved persons feelings of shock, sadness and disbelief; as well, the knowledge of these shared feelings opens up channels of communication and allows for further expression of feelings. There will be ample opportunity to philosophize over the issues of life and death later on.
Next week's topic is the benefits of reliving our memories.

Week 6 - Reliving Precious Memories

It's Christmas day, and all the family is there except for one. The same thing happens at Easter and Thanksgiving. As you think about the way these family gatherings used to be, your mind wanders. Sadness and loneliness, even in the company of family and friends, washes over you like a wave.

The strange thing is, though, that the name of your lost loved one may not be mentioned, and you wonder if anyone else remembers or feels the emptiness of the chair that the person used to fill. It is quite likely that others are also thinking of that missing person but refrain from voicing their thoughts for fear of upsetting you. Paradoxically, the opposite is true; more than anything you need to have your loved one remembered and the lack of his physical presence acknowledged.

The way in which we deal with grief is changing for the better. The feeling used to be that to bring up the past was to get stuck in it. While it is still true that, in certain cases, dwelling on memories may be counter-productive to healing, we now know that speaking of departed loved ones and looking at pictures helps us to come to terms with our grief. One thing of which we are fearful is that our loved one might be forgotten: in remembering, we celebrate the life that once was and keep memories alive.

I have found that one way to handle my feelings on special occasions is to put a candle close to my place at the table. As I light the candle, I simply say something like "this is for Mike." For me this is a comforting ritual and one that opens the door for others to join in and remember the good times. As we share memories and humorous anecdotes, we may laugh or shed a tear. But no matter what emotions are expressed, remembering takes us one step further along our grief path.

Next week we will look at the way in which crying helps to release emotions and begin the healing process.

Week 7 - Crying as a Response to Grief

We often hear the expression "don't cry... it will be all right." When a child falls and scrapes his knee, we console him and urge him to stop crying, assuring him that a band-aid and a candy will take the pain away. Soon he is off playing again, the tears and pain forgotten.

Crying is a normal part of the grief process and thus needs to be encouraged; it is one of nature's ways of releasing the pain of losing one we love. Often after we cry, we feel better because along with our tears, our bodies release chemicals that have a soothing effect on our entire system. Sometimes then, we are able to relax and perhaps sleep. I picture the source of our tears as an internal pool that fills with emotions as we strive to deal with our loss. These emotions bubble beneath the surface of our pool and cause it to spill over. If we fight back our tears, our pool of sadness gets deeper, and the emotions bubbling throughout our bodies manifest themselves in other ways. For this reason, people in grief often experience psychosomatic illness: difficulty swallowing or breathing; heart palpitations; digestive upsets; and muscle tension and pain (to mention only a few).

Therefore, we must give ourselves and others permission to cry, and those taking a supportive role can help by reacting to tears in a positive way. When we notice tears welling up in a friend's eyes, we must try to be aware of our own body language. If we react with discomfort or embarrassment by lowering our eyes, glancing away or changing the subject, we send the subtle message that tears are not acceptable. Thus, the grieving person is left to deal not only with the physical symptoms but also with the equally damaging thought that crying is an inappropriate behaviour that must be avoided.
In your role as a support person, keep the Kleenex box handy and be prepared to sit by patiently until the tears subside. For when we cry, we usually talk, and the more opportunities we have to speak about our loss, the sooner we will come to peaceful acceptance of the death.

Next week we begin to explore the second stage of grief.

Week 8 - The Second Stage of Grief

This stage of the grief process is probably the toughest one; it comes at a time when we can no longer deny the fact that our loved one has died but are as yet unable to come to terms with the awful truth. This stage has been called the anger phase, perhaps for lack of a better term. But during this painful period of grief, we will experience so many strong and changing emotions that I have dubbed it the roller-coaster stage.

Undoubtedly, anger is at the top of our list of emotions during this stage and one that can flair up without warning. The source of this anger is our inability to justify the death. We can think of many reasons why our loved one should have lived but none for why she died. The if-onlys dominate our thoughts as we think about the people and events that we feel played a role in the outcome. "If only she hadn't taken that ride... had been diagnosed earlier... had stayed home that night... had been more careful... had talked to me about it." This type of thinking is normal and predictable - a temporary outlet and first step towards recognizing and venting anger over the loss of life.

Contrary to common belief, anger is a positive emotion but one which becomes negative when misdirected or uncontrolled. For this reason, I caution against getting stuck in or compulsively acting upon the if-only's. I believe that our anger in grief is rooted in an overwhelming sense of powerlessness to turn back the clock and to have things turn out differently - mostly, to have our loved one with us still. And when we have exhausted all of our sources of blame, we often turn our anger towards life itself as we question its fairness and worth. In order to begin to heal, we need to express our anger, and in later columns I will share some ideas on how we might do this. Once again, I emphasize the importance of finding someone with whom we can freely share our feelings of frustration and anger. This person might be a friend or a professional.

Discussion groups offer opportunities to learn from those whose experiences closely parallel our own. Next week we will look at the advantages of attending a bereavement group.

Week 9 - Bereavement Groups

Four months after my loss, I attended my first meeting of a group established for bereaved parents. There were fifteen present all at varying stages of the grief process. Under the guidance of a leader/counsellor, we began with a check-in; we introduced ourselves and briefly described our losses and feelings. As the leader continually stressed that participation was absolutely voluntary, the atmosphere was relaxed and non-threatening. Some parents gave detailed accounts of their experiences; others simply stated their names and passed the group's attention on to the next person. Once everyone had had an opportunity to speak, the leader introduced the evening's topic as agreed upon at a prior meeting.

This particular group discussion centred around the Easter holiday. Each person was invited to share their experiences and feelings during those days and their thoughts and plans on how they might approach future family-focused gatherings. Towards the end of the meeting during check-out time, the leader encouraged members to make further comment to ascertain whether or not any individual needed extra support before leaving the meeting.

As I drove home that night, I felt more calm and hopeful than I had been since my son's death. In my mind, I recalled the discussion and realized that, for me, the group would serve three main purposes. First, the people in the group understood and helped me to feel less alone. Secondly, it offered a safe environment in which I could freely express emotions without fear of shocking others or of being judged by them. Thirdly, I knew that by listening to others' experiences I, too, could learn to cope with my grief.

Groups are an excellent place to start the healing but not the only one. Some people, for personal reasons or because of geography and transportation, may be able unable to attend a group. There are many other options to choose and combine to suit individual needs and preferences, and next week we will look at the therapeutic value of reading and writing.

Week 10 - Help through Reading and Writing

Everybody has his or her own concept of the grief journey. Mine is that of climbing a high mountain, and my goal is to work my way up along its rocky paths to its peak. I envision that from that vantage point, I will have a clear view of the horizon and the knowledge that I am ready to descend the other side of my mountain and rejoin the world. But first I need to discover the most direct paths to facilitate my ascent towards my goal. One of my tools is reading.

There is much to be learned from personal accounts of those who, in the enviable position of looking back on their journeys, have written of their experiences with a view to helping others. Libraries are an excellent resource, and most have a good selection from which to choose. Some books I read cover to cover; others I quickly scanned, reading only the chapters that seemed relevant to my feelings at the time. In any case, my reading time was well spent, and the information that I gleaned increased my understanding of grief as a normal human process. Too, I learned many coping strategies along the way.

Writing is another helpful tool: my journal became my silent friend to whom I turn when I feel the need to identify and sort out my feelings. Just about anyone can keep a journal: simply disregard the rules of grammar and spelling and let your instincts be your guide. Start with one or two words and you will be amazed at the way they flow into sentences, paragraphs and then full pages. Sometimes journal writing turns into poetry - not necessarily the kind with rhythm and rhyme but of a style all your own. And it is helpful to not only write but occasionally reread your journal as it offers valuable insights into how you are feeling and why. As well, your journal may become a log by which you can measure your progress up your mountain.

As I flip through the pages of my journal, I note that many of the entries are written as if I was speaking directly to my son. I have discovered that directing thoughts and words to loved ones is a common practice and can be a healthy expression of the yearning that accompanies loss. Next week we will explore other ways in which this yearning may surface.

Week 11 - Yearning and Preoccupation

During the roller-coaster stage of grief, there will be times of yearning - so strong that we actually search for our lost loved one, half-hoping or expecting to see them. Often this is the case in first-time visits to familiar places when, in our mind's eye, vivid memories of scenes in the not-too-distant past leap into the present. Or the situation may be as simple as sitting in your living room, glancing at the empty chair, seeing the person there, looking again and realizing that the vision was merely a product of your imagination. Occurrences such as these are more than simple wishful thinking: they are a temporary buffer and our mind's way of slowly coming to grips with reality.

I truly believe, too, that silent conversations with loved ones are also normal expressions of yearning and need not be taken as signs of "oh, no, I'm losing it." On the contrary, when we communicate this way, we are actually advancing along our grief path by expressing feelings and perhaps even resolving unfinished business.

Preoccupation with those who have died goes hand-in-hand with yearning as we resume our daily routines. For instance, a trip to the grocery store can be a challenge. As I walked down the aisles and filled my basket, I could not help but think of my son's culinary likes and dislikes and his delight at coming home to the delicious aroma of his favourite meal. It was the same at McDonalds, the bus station and football games - so many sad thoughts in places I had formerly frequented with a light heart and relaxed step.

There is no magic formula for getting through this time and no time line to follow. The key to handling yearning and preoccupation lies in the knowledge that such feelings lessen in intensity and frequency as time passes. And because each of us is unique, we must resist the temptation to compare our progress with that of others.

There are many factors that affect individual reactions to loss. Next week we will begin an examination of the grief journey with respect to these factors.

Week 12 - Factors affecting our Grief Response

There are many factors that affect our reactions to loss through death and cause us to take varying paths on our grief journeys. Two major factors are the actual circumstances of the death and our perception of its preventability.

Generally speaking, the circumstances of the death, including its suddenness and nature, have a direct bearing on the amount of time we may expect to spend in a state of shock and disbelief. In the case of accidental death when our only warning may be a call from the hospital or police, we have precious little lead time to emotionally prepare for our loss as we might have when death follows a prolonged illness. Often after an unexpected visit from the grim reaper, our shock and disbelief may be magnified through a lack of knowledge of the events that led to the death. If this is the case, one goal of grief work is to accept the fact that we may never make sense of the details or find all the answers. Some grievers dwell on the question of the pain that they imagine their loved ones may have suffered. As our questions arise, however, it is important that they are aired, discussed and even if not answered fully, put to rest.

Our reaction to loss (accidental or expected) also depends on our perceptions as to whether or not the death could have been prevented. As with the question around pain and suffering, we could drive ourselves to distraction by playing and replaying our mental tapes, each time changing one minute detail to alter the outcome. While this type of thinking may seem magical and non-productive to an onlooker, it does serve one important purpose: over time, we come to the conclusion that a number of factors, many or all out of our control, came together to precipitate the death. At the same time, as we allow our thoughts to wander and recreate scenes in our minds, we begin to recognize and to release our anger over the loss.

Both of these factors must be taken into consideration as they apply to our own grief scenarios. Next week we will look at what is felt to be the number-one factor in our grief reaction - the uniqueness/closeness of our relationship with the deceased.