Grief and Loss

Grief and Loss

Although often very painful, grief is a normal and natural response to loss (What pp). Generally, when most people think of loss and grief, they think of the death of a loved one, however, there are many other significant changes in an individual's life that can involve loss and therefore grief (What pp). Everyone experiences loss and grief at some time during their lifetime, and the more significant the loss, the more intense the grief is likely to be (What pp). Each person experiences and expresses grief differently, for example, one person may withdraw into feelings of helplessness, while another might be angry and desire to take some form of action (What pp). Yet no matter the reaction, the individual who is grieving needs support from others, thus a helper needs to anticipate the possibility of a wide range of emotions and behaviors, and accept the grieving person's reactions and respond accordingly (What pp). Therefore, it is useful for the person in grief and for the helper to have information about the grieving process (What pp).

William Worden writes in his book, "Grief Counseling and Grief Therapy: A Handbook for the Mental Health Professional," that before anyone can comprehend the impact of a loss on human behavior associated with it, it is important that an individual have some understanding of the meaning of attachment (Worden 7). British psychiatrist, John Bowlby's theory of attachment provides a way to conceptualize the tendency in human beings to make strong affectional bonds with others and a way to understand the strong emotional reaction that occurs when those bonds are threatened or broken (Worden 7). Forming attachments with significant others is considered normal behavior not only for children but for adults as well (Worden 7). Bowlby believes that attachment behavior has survival value, citing the occurrence of this behavior in the young of almost all species of mammals, however, he sees attachment behavior as separate and distinct from feeding and sexual behavior (Worden 8).

If the goal of attachment behavior is to maintain an affectional bond, situations that threatened this bond give rise to certain very specific reactions (Worden 8). Bowlby writes, that in such circumstances, "all the most powerful forms of attachment behavior become activated - clinging, crying, and perhaps angry coercion...when these actions are successful, the bond is restored, the activities cease and the states of stress and distress are alleviated" (Worden 8). Yet, if the danger is not removed, withdrawal, apathy, and despair will then ensue (Worden 8).

According to Worden, there is evidence that all human grieve a loss to one degree or another (Worden 9). In fact, anthropologists have studied other societies, their cultures and their reactions to the loss of loved ones, and report that whatever the society studied and in whatever part of the world, there is an almost universal attempt to regain the lost loved object, and/or there is the belief in an afterlife where one can rejoin the loved one (Worden 9). Interestingly however, in preliterate societies, bereavement pathology seems to be less common than in more civilized societies (Worden 9).

Grief occurs in response to the loss of someone or something, and may involve a loved one, a job, or possibly a personal phase or role, such as a student entering the workplace or an employee entering retirement (Coping pp).

Although anyone can experience grief and loss, which can be sudden or expected, however, individuals are unique in how they experience this event (Coping pp). While grief is a normal and natural response to loss, individuals respond in a variety of ways, some are healthy coping mechanisms and some may actually hinder the grieving process (Coping pp). It is important to understand that acknowledging the grief promotes the healing process, and that time and support facilitate the grieving process, thus allowing an opportunity to appropriately mourn this loss (Coping pp). Moreover, it is also important to understand that no two individuals will respond to the same loss in the same way, therefore it is important to note that phases of grief exist, however they do not depict a specific way to respond to loss (Coping pp). Stages of grief reflect a variety of reactions that may or may not surface as an individual makes sense of how this loss affects them, thus experiencing and accepting all feelings remains an important part of the healing process (Coping pp).

People suffering from loss may experience denial, numbness, and shock, all of which serves to protect the individual from the intensity of the loss (Coping pp).

Numbness is a common reaction to an immediate loss and should not be confused with indifference or not caring (Coping pp). As the individual slowly begins to acknowledge the impact of the loss and accepts his or her feelings, denial and disbelief will diminish (Coping pp). Another common reaction is guilt over what could have been done or should have been done to prevent the loss, and again if these feelings are not resolved they will hinder the healing process (Coping pp). Moreover, an individual may experience depression, which in turn can lead to sleep and appetite disturbance, as well as feelings of emptiness and self-pity (Coping pp). These feelings can easily turn into anger and resentment toward others or life in general, as an individual may begin to feel abandoned (Coping pp). All of these feelings are normal common reactions to loss, and must be accepted as part of the grieving process (Coping pp). There is no time limit to the grieving process and each person needs to define his or her own healing process (Coping pp).

However, individuals experiencing loss should avoid minimizing their emotions by self-medicating with alcohol or drugs, or spending more time at work to avoid feelings (Coping pp).

Thus, it is important for an individual to allow time to experience, acknowledge and accept all feelings, both positive and negative, and express these feelings openly, such as crying as a release (Coping pp). It is also important to try to come to a resolution, and often bereavement groups provide an opportunity to share grief with others who have experienced a similar loss, however if the healing process becomes too overwhelming, it may be necessary to seek professional help (Coping pp).

Dr. Elizabeth Kubler-Ross' first book, "On Death and Dying," published in 1969, is considered a classic and is required reading in many academic setting, including medical and nursing schools, theological seminaries, and popular psychology courses (On pp). In this book Kubler-Ross introduced the five "stages of dying" or "stages of grief" model that is still widely quoted today and has been widely adopted by other authors and applied to many other situations where someone suffers a loss or change in social identity (On pp). Although this model is often used in bereavement work, not all workers in the field agree with her model, feeling that the stages are too rigid (On pp). Others, such as John Bowlby, have developed models with different numbers of stages, however regardless of whether one feels the stages are absolute, Kubler-Ross' work is considered mandatory, a "must read," for anyone seriously interested in death and dying issues (On pp).

Elizabeth Kubler-Ross encountered problems when she began her research and interviews in 1965, because there was no real way to study the psychological aspects of dying and although patients were often willing to talk, it was difficult to convince the doctors (Stages pp). However, from her research, Kubler-Ross saw a pattern emerging that she expressed in the way stages, and while believed to be universal, there is certainly room for individual variation, as not everyone goes through each stage and the order may vary for each individual (Stages pp). Kubler-Ross' five stages of dying are:

Denial and Isolation: Used by almost all patients in some form. It is a usually temporary shock response to bad news. Isolation arises from people, even family members, avoiding the dying person. People can slip back into this stage when there are new developments or the person feels they can no longer cope.

Anger: Different ways of expression - Anger at God:

Why me?" Feeling that others are more deserving.

Envy of others: Other people don't seem to care, they are enjoying life while the dying person experiences pain. Others aren't dying. -Projected on environment: Anger towards doctors, nurses, and families.

Bargaining: A brief stage, hard to study because it is often between patient and God. -If God didn't respond to anger, maybe being "good" will work. -Attempts to postpone:

If only I could live to see..."

Depression: Mourning for losses -Reactive depression (past losses): loss of job, hobbies, mobility. -Preparatory depression losses yet to come): dependence on family, etc.

Acceptance: This is not a "happy" stage, it is usually void of feelings. It takes a while to reach this stage and a person who fights until the end will not reach it. It consists of basically giving up and realizing that death is inevitable.…