5 Questions and Answers for Coping with Grief

You will reach your destination in 300 yards

If you’re in a significant relationship, there’s a 50/50 chance you will eventually grieve the loss of your partner. Grief over a significant loss is a natural, human response, and neither you nor your response needs to be “fixed.”  But knowing grief is normal does not make it less debilitating and knowing that millions of souls have and will have survived the experience does not diminish the pain. The worst kind of grief is YOURS

I remember driving to the hospice center to be with my wife Mary twice each day.  I knew the way but relied on GPS to spare me the effort of concentrating.  Each time I approached the facility, I was reminded that I would reach my “destination in 300 yards.” I wondered what Mary’s thoughts were of her final destination as I considered my own.

I thought I was prepared.  It wasn’t until Mary died that I discovered how wrong I was. Her breast cancer had been diagnosed 7 years earlier, followed by multiple reoccurrences, two more primary carcinoma diagnoses, endless ER visits and a gauntlet of surgeries, radiation and chemotherapies.  In the end, on the eve of our 24th wedding anniversary, it was her wish to forgo food and water to hasten a comfortable death.  She was keep under terminal sedation for six days before the lack of fluids and the accumulation of toxins stopped her heart from beating…the longest, most agonizing week of my life.

I found myself unable to work and lost the company I founded 20 years earlier as a consequence.  I was bereft of my soul mate, my career and my identity, wanting nothing more than to escape from the suffocating pain but lacking the energy and insight to do so.

 If you’re going through hell, keep going.

When you lose someone special from your life, you are going to grieve. There is no easy way around it, no timetable, no neat package of stages to journey through to the other side. But just as life is not something that “happens” to us, like passive spectators, grieving is something we DO, not something that it done TO us.  We have choices. We may not have a choice in what has happened, but what we DO about it is optional. The key is making the right choices to work through the process and find healing.  You can’t just decide to stop grieving, nor should you. But there ARE scientifically tested tools and techniques that have been proven to ease the pain and shorten the journey. Cognitive Behavioral Therapy (CBT) and Positive Psychology offer a “cope chest” of promising examples.

 

(1)  Why Bother?

Why? Because you are not a helpless victim, although you may feel like one at the moment.  Because it is not what you’ve lost that matters now, but what you do with what remains. Because you want to lead a life well lived, not passively endured.

An optimist is said to be a person who believes this is the best of all possible worlds, while a pessimist is someone who fears the optimist may be right!  Same world, different perspectives. You have choices in creating your future, but remember not to make them based on your mood. Recognize the difference between “I don’t feel like it” and “I don’t want to.”  In the depths of despair you quite possibly won’t “feel” like doing much of anything, even things that you once enjoyed. But grappling with fatigue and hopelessness is not the way you “want” to live your life.

Half full or half empty? Our thinking styles color our viewpoint and encourage patterns of behavior that are often self-defeating.  We see the world not so much as it is but as WE are. Less like a camera recording the objective world and more like a projector creating images from an emotional script.  Our thoughts frame our picture of the world, and much of that thought is automatic, operating below our awareness, shaping our attitudes and behaviors. What stories do you tell yourself about the world and your place in it, and based on what evidence?  Do you think in extremes with no in-betweens or shades of gray?  Maybe blame yourself for what goes wrong and assume it can never go right? Or perhaps you are given to mind reading and often jump to conclusions based on what you presume others are thinking? We see what we expect and our expectations tend to be self-fulfilling prophesies, for better or for worse. Your mental filters may or may not be correct, but to start influencing the way you feel you need to uncover and challenge “unhelpful” thoughts” critically examine them, and consider the merits of alternative explanations.  One of the ways to do that is ABC analysis. Some people have a thinking style that leads them to believe problems are insurmountable. That is only a thought, not a fact.  Channel your energy into solving problems you can control, learn to identify and build upon your strengths, reach out, and through small steps and incremental, successful changes, you can achieve amazing results

(2) Are there stages to grief, how long will this last?

“How long?” The most accurate answer is probably, as long as it takes.  It’s a little bit like asking “How high is up?” except more complicated.  Was your partner’s death unexpected? Were you a caregiver or perhaps receiving care? What are your coping skills?  The professional literature attempts to offer structure to the process by describing “stage theories” or phases of grief. Parkes defines four phases of mourning as (1) numbness, (2) yearning, (3) disorganization and despair, leading to (4) reorganized behavior.(p.38) Other researchers (Sanders)  describe five phases: (1) shock, (2) awareness of loss, (3) conservation withdrawal, (4) healing and (5) renewal. The most famous is Kubler-Ross’ misinterpreted five stages (“On Death and Dying.”), denial, anger, bargaining, depression and finally acceptance.  But in her posthumously published “On Grief and Grieving” she notes these stages inform the dying not the grieving process, and further explains the stages were “never meant to help tuck messy emotions into neat packages.  Grieving is very much an individual and long term process that does not proceed in a straight line and does not result in “back to normal.”  A sentiment commonly reported by those in the process of bereavement is that grief ebbs and flows. One moment there may be laughter, and the next a casual comment may evoke unexpected waves of despair. As a widow in her mid-sixties describes it, “Mourning never ends.  Only as time goes by, it erupts less frequently.” But this is seldom an indeterminate sentence Acceptance is the universal experience, and an emotional space is reserved for the loved one, but not to the exclusion of loving others and life. More specifically and less anecdotally, Shuchter and Zisook found the period around two years is the time when a great majority of widows and widowers found a “modicum of stability…establishing a new identity and finding a direction in their lives.”

(The many faces of depression following spousal bereavement. Journal of Affective Disorders, 1997, 45, 85-94). But there is no universal time table for recovery. And while there’s truth to the adage “time heals all wounds,” time combined with action is a far more effective course.  So what do you need to do to get there from here??

 (3) What do I do now?

 When someone you love dies, even if it’s expected, there is always a sense that it hasn’t happened. Joan Didion wrote of this experience in “The Year of Magical Thinking” when she explains her reluctance to post her husband’s obituary because it would give the outside world the impression her husband was dead. It is tempting to believe your partner is still away on a business trip or has gone to the hospital, but while short term denial may provide a therapeutic respite, it’s a harmful long term strategy. So the first task is to accept the reality of the loss, both intellectually and emotionally.

Next, examine your thinking style, the mental filters and internal dialogue discussed above (Why Bother). Believe that good things are within reach and are worth pursuing, while remembering the pursuit will require self-discipline, perseverance, and timely doses of positive reinforcement. The proven science of Positive Psychology emphasizes building upon personal strengths rather than attempting to cure weaknesses as the best approach (How many of your New Year Resolutions were to overcome a flaw, and how is  that working for you?  Developing the strengths you already have is naturally more rewarding, energizing and more likely to succeed. How do we identify our “strongest strengths” and how exactly do we find opportunities to employ them strengths rather than curing your weaknesses.  Well, given that change is hard, I recommend you begin flexing your muscles by…

  • Make it so easy you can’t say no. (Babuta, “The Four Habits that Form Habits” )
  • Take small steps, don’t overreach or expect overnight success TinyHabits.com
  • Design your environment.  What does the space around you prompt you to do?
  • Use already established routines to trigger new, positive habits
  • Write it down, when, where and how!  Not only does it help focus the mind, research shows it makes follow-through more likely
  • Expect to fail, it’s the only way to succeed.  Recognize that failure is part of the process but must not be allowed to become part of the pattern.
  • Work with a trusted partner/coach LifeWellLived.life

(4) Are there coping strategies?

Like grief itself, coping styles vary from person to person, and even between genders. For instance, grieving women are more likely to express their feeling to others, known as Active Emotional Coping (Derlega. 1993. Self-Disclosure.Thousand Oaks, CA: Sage) whereas men often tend toward Avoidance Coping strategies. Avoidance include blame (both of self and others), social withdrawal, and distraction (drugs and alcohol would be a negative example). Active coping involves finding something positive and establishing new roles and identities. At the top of the active list are redefinition, reframing and/or restorative strategies, recognized more commonly as “growth through grief. Coping research identifies multiple models, but experts find Problem Solving skills to be the most useful. Those with the poorest skills overuse ineffective strategies, or they try one thing to solve the problem and then give up when that doesn’t work. Humor is another therapeutic skill.  Just as it’s okay and even recommended to cry, it’s also okay to laugh.  Venting emotions rather than bottling up feelings is usually a good idea, except when the display blows people out of the door, contributing to isolation. The ability to accept support is a related dimension of active emotional coping.  Passive strategies (there is nothing I can do about it) are among the least effective, as is rumination, a persistent and repetitive focus on painful emotions without taking action to relieve them.

Practical coping tips include:

  • Postpone major decisions. Grief makes it difficult to see beyond the pain, and impulsive decisions, selling the house for example, may make a bad situation worse.
  • Express yourself creatively. Try keeping a journal or write letters, whether you send them or not. Painting, sculpting, dancing, scrapbooking, all can be creative outlets for grief.
  • Get fresh air. When even the slightest activity is too burdensome, just stepping outside on the patio or front steps can help relax body and mind.
  • Nutrition, exercise and sleep. Motivation to exercise may be in short supply, but a brief walk or bike ride every now and then can lift your spirits and help you to sleep at night. Counteract a poor appetite by eating small amounts of healthy foods rather than large meals.
  • Personally, meditation and sleep were my primary respites.  You’ll find a variety of easily accessible teachers and styles on the internet
  • Be prepared for grief triggers. Anniversaries, birthdays and holidays are among the special situations that can trigger strong memories. Plan ahead, talk with family members, and create a commemorative ritual to acknowledge the loss.
  • Share your knowledge and experiences to help others and yourself. “The best way to find yourself is to lose yourself in the service of others.”  Mahatma Gandhi

 (5) Where can I get help?

Grieving has historically been facilitated through the family, religious organizations, funeral rituals, and other social customs. But these traditional resources are now complemented by a host of programs and services, support groups and grief counselors.

  • All hospice and palliative care organizations provide bereavement support for up to 13 months following the death of a loved, regardless of prior enrollment in their program.
  • Associations such as the American Association for Retired Persons (AARP) and the Alzheimer’s Association provide a wealth of information on aging and grief recovery. Most hospital also facilitate support groups for family caregivers and the recently widowed, many of them disease specific.
  • Learn from fellow travelers. If support groups aren’t right for you, you can still reach out, learn, and hopefully find inspiration by hearing the stories of others. Insights and inspiration can be found in DVD/films such as “The Gifts of Grief” by Nancee Sobonya, and absorbing books of personal challenge and growth like Barbara Wheeler’s “When a Spouse Dies: What I Didn’t know” or “The Year of Magical Thinking by Joan Didion.  For a more inclusive list, check out the Resources tab of my website, LifeWellLived.Life.

Not everyone needs the help or support of others to overcome their grief.  I didn’t. Nor did I want it. But I could have used it. I’m now convinced the most effective grief work is not done alone. But friends and family may have unrealistic expectations about morning and not everyone will be ready, willing or able to understand and respond.. I believe in the power of shared experiences, and feel that others who have traveled the same journey can make for comforting travel companions.

 

 

.