Complicated Grief; Frozen in Loss
There is a the kind of grief which never eases but instead remains sharp, cutting, ever-present, and harsh - it's called complicated grief.
This is the last in a series of articles over the past month exploring loss and grief. It is our hope these posts have provided chaplains and caregivers better insight into issues concerning crisis and bereavement.
There is a degree of chaos which follows any loss, no matter how insignificant it might seem. We are pulled from our place of security all the way to the edge. From losing credit cards to the death of a loved one, the question Why always comes around.
Suddenly it becomes a matter of being judged, cosmic payback or karma.
Why is it happening to me?
Why do I deserve my fate?
Why am I left behind to survive alone?
Why is God doing this?
Of course, asking questions surrounding the Whys is a normal part of grieving, but when it persists and becomes acutely internalized along with a lack of resilience, there exists a bereavement disorder called Complicated Grief.
Just what is Complicated Grief?
It is life turned outside in. It is chaos. Several years ago, the National Institute of Health began to recognize the phenomenon of persistent and all-consuming grief. Studies show that 7% of those who suffer significant losses such as the death of a child are unable to make a transition to acceptance but rather, begin to present with symptoms of PTSD or clinical depression. CG (Complicated Grief) is particularly prevalent in older adults (about 9%) who have experienced many losses over the years (parents, siblings, friends, spouses) causing a cumulative reaction. It has also been reported that at least 20% of those with substance abuse disorders have unresolved grief or CG.
Complicated Grief Defined
Complicated Grief is a persistent form of intense grief in which maladaptive thoughts and dysfunctional behaviors are present along with continued yearning, longing and sadness and/or preoccupation with thoughts and memories of the person who died. Grief continues to dominate life and the future seems bleak and empty. Irrational thoughts that the deceased person might reappear are common and the bereaved person feels lost and alone." ~ Columbia University Center for Complicated Grief
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384440/
Katy's Story: A Grief So Deep It Won’t Die
The reason I refer to Complicated Grief (CG) as chaos is because it cycles endlessly leaving life in disarray with a seeming inability to adapt to loss. This kind of grief was not uncommon in the patients I treated for substance abuse disorders. But a good example of a life dominated by the chaos of CG is the story of my patient named Katy. She suffered deeply after the death of her young son. Her husband, a physician, and daughters were devastated by the loss as well, but only Katy found it impossible to heal. Ultimately she became dependent upon the benzodiazepines prescribed to relieve her emotional turmoil and depression.
For over three years, Katy refused to leave the house except to buy groceries. When alone, she spent hours preoccupied with thoughts of Joey. Her last words to him were cross as he went over to a friends house for an afternoon of video games and sleepover. And she failed to tell him she loved him in response to his "Love you Mom" as he left. Joey was accidentally shot while playing with a handgun that belonged to his friends' father less than an hour later. Her self blame and inability to function increased until she was finally forced into treatment by her family. Luckily, Katy came to a center familiar with CG and was able to treat her dual diagnosis effectively. She told me that "When Joey died, I died too. I stopped doing everything." Katy was finally able to engage in treatment and her condition improved dramatically. Of course, she continues to grieve Joey's death. She regularly visits and decorates his grave. Katy created a FindAGrave virtual memorial site and a Memorialized FaceBook page to preserve his memory, but has resumed her normal activities and is rediscovering pleasures in life. She no longer uses mood-altering substances to cope.
"CG is a form of grief that takes hold of a person’s mind and won’t let go." ~
Dr. Katherine Shear, MD
All grief is permanent and it is experienced differently by everybody.
For most people who face losses, the intensity begins to ebb and soften over the months. However, this is not the case for those who suffer from CG. The negative feelings become chronic and the condition becomes diagnosable. Though CG was not included as a mental illness in its' 2018 Diagnostic and Statistical Manual (DSM-V), the American Psychiatric Association did refer to it as a persistent complex bereavement-related disorder and gave it a "v" code which identifies conditions "other than a disease or injury and are also used to report significant factors that may influence present or future care." So, like most chronic disorders, professional assistance is necessary for dealing with Complicated Grief. There can be a purpose-filled, abundant life and happiness after CG is treated.
Effective CG Tool
I am including a Grief Questionnaire pdf that is very useful in determining the presence of Complicated Grief for the use of those professionals and others who are trying to help people who are overwhelmed by long term suffering.
My intention in offering it for your use is that it might help identify the possibility of Complicated Grief and direct you to someone who is familiar with its specific treatment. Remember...this is not a disorder that will go away over time and requires expert intervention. The Center for Complicated Grief provides a list of therapists who can be of service by using the following link https://complicatedgrief.columbia.edu/for-the-public/find-a-therapist/
Download Grief Guides
The Center for Complicated Grief also offers these two pdf handouts for your perusal and use.
Grief Re-purposed; Reveling in Life at the Moment of Death
We continue to explore loss and grief with this third-in-a-series of four journal followup articles on Loss and Grief. This piece refers back to 'Grief and Celebration; Twins or Pairs of Opposites'.
I just returned from a week-long visit to New Orleans. The Big Easy is remarkably different from any place on earth. Celebrations of life are blown out into extreme displays found only there. Funerals (called homegoings) and weddings alike are known to have jazz band accompaniment through the city with the community of friends and family forming a Second Line parade.
Of the major attractions in NOLA, tours of its' historic and storied cemeteries are among the most popular. We were given a grand tour of three famous last-resting spots by a local haunting expert, photographer, and author, Kristen Wheeler. Our day-long adventure informed me that grief and loss are integral processes of life experience as opposed to an end story of death.
I have visited the United States Holocaust Memorial Museum and many other solemn places of remembrance. But there is no place and nothing like the open experience of life and death in New Orleans. The community, which suffered such catastrophic losses during Hurricane Katrina in August 2005, has come back like gangbusters. This is not to say that scars have been erased and pain eradicated. On the contrary, they are both quite visible. The resurrection of New Orleans is an effort in the making. But joy and hope were never blown away into The Gulf of Mexico, starved in the lower parishes, or abandoned in the Superdome. The City Under Water would not drown in a sea of sorrow.
"When the procession hits the street, the songs are played as a dirge. Mournful, slow playing. Music that suits the sad mood of a loved one’s passing. But, a song or two in, the mood changes. The brass band plays the first notes for “I’ll Fly Away,” and everybody sings. Dances. Smiles and laughs. It’s celebratory. It’s a joyful noise. It’s Gospel. Blues. Jazz. It’s music."
Ray Laskowitz, New Orleans photographer
The lessons learned from New Orleans can allow us to re-purpose grief.
What we can come to believe is that healing for loss and grief starts when we abandon dualistic thinking. Celebration and grief do, indeed, share the same space. However, it is more than that. Along with them, abundance and scarcity, joy and sorrow, fear and love, are all in a kind of circular dance. And what can be more full of fun than a dance? These things which seem to be opposites are really one and indistinguishable. This is essential to understand because when the dark hours of loss descend, it seems as if the light is no longer present. Feelings of abandonment and hopelessness can be so overwhelming that we become frozen in time. The truth that God is with us seems unreal. At these moments we must accept that the dance continues all around us. We can allow the process of grief because joy and hope are not just coming back someday, they are already present.
Here is a mindful and gentle way to allow the celebration of life to commingle with grief.
Choose a short sentence like "Love never fails" or "The Lord is my shepherd, I shall not want" and repeat it several times during the day.
The truth of it will settle into the center of your heart and darkness will begin to accept the dawn. Though this may seem simplistic or mundane, it will actually re-purpose your feelings of grief and enable you one day to dance again.
Comprehending Grief; Five Lessons for 'Passing Through'
Five Ways of Comprehending loss and grief based on the teachings of Elisabeth Kübler-Ross.
This month we are exploring loss and grief in a series of four journal articles and four follow-ups. This piece refers back to 'Grief and Loss Unbundled', digging a bit beneath the surface of Elisabeth Kübler-Ross' work.
The experience of grief is universal yet often misunderstood. Comprehending significant losses seems to be almost impossible. Why do such horrible things happen? How could a loving God allow them? These are the questions I posed to Kübler-Ross in 1991. Our mutual friend and patient, Michael, was dying slowly with his body deteriorating from a form of MS complicated by HIV and alcohol dependence. It all seemed like such a tragic waste to me.
Michael had become a spiritual guide for many people who suffered from substance abuse disorders. They were lost and broken. And despite his own death sentence, or perhaps because of it, he was a touchstone of healing. Elisabeth's response to me was short and sweet. She told me that Michael was one of the "beautiful people" and that his defeat, struggle and suffering allowed him to shine through like a stained glass window filling others with compassion and understanding. She said that "the physical body is designed to die and we have a limited time on earth...we will all be allowed to graduate and no longer be prisoners of these bodies." Somehow, I had expected more from this iconic expert, but what she gave me began to resonate as time went by. We are all on the same life journey taking different paths to arrive at the very same destination. She would call regularly to check up on how Michael was doing. When he died in 1993, I called to let her know and to share his last words to me. Michael said; "You are loved. This is the only information you need BJ." Elisabeth listened and replied after a brief silence saying: "Yes! He gets it!"
Comprehending grief and loss may not be as complicated as it seems. Dr. Kübler-Ross certainly believed that to be the case. It is our rejection and denial of the certainty which holds us back from accepting and even embracing it. Bad things do not just happen to bad people. It is almost pointless to wonder why 'bad things seem to happen to good people'. At some point bad and good occupy a similar grey area. Things happen. God is not sitting on a throne with lightning bolt consequences to punish us for sins. God is with us to comfort us as we are battered by the windstorms and droughts of life. We each are empowered to choose the way we deal with them.
Five Ways of Comprehending loss and grief based on the teachings of Elisabeth Kübler-Ross.
- We are responsible for our lives and free to choose love over fear. Fear of death and other losses can consume us or imprison us. We must learn to live while we are alive.
- Release yourself from negativity and blame. Healing will come if you allow love and keep on loving.
- Guilt is the most powerful companion of death. It can only be relieved if we are fully present when our loved ones are alive. Sit with them, listen and just be there.
- Dying is an integral part of life and our true beauty has a chance to shine unless we fail to celebrate it at the end, Remember that what we have accumulated and achieved become a zero-sum. How well we are remembered and celebrated are the hallmarks of our lives.
- Finally, in Elisabeth’s own words; Death is simply a shedding of the physical body like the butterfly shedding its cocoon. It is no different from taking off a suit of clothes one no longer needs. It is a transition to a higher state of consciousness where you continue to perceive, to understand, to laugh and to be able to grow.
The New Normal; Strength and Wholeness from Vulnerability
Learning to cope with the daily barrage of tragedy.
In May we are exploring loss and grief in a series of four journal articles and four follow-ups. This second piece refers back to 'Grief and Vulnerability'...that which we most want to see in others and least want to be seen in ourselves.
When deep wounding comes from our losses, the tendency is to build up barriers and secure what we still have. Metal detectors, armed guards, alarm systems, and iron bars greet our visitors where there was once an open door and warm hospitality. Our desire is to make ourselves invulnerable to further loss and pain. We don't ever want to go through this kind of grief again. But try as we may, modern technology makes it almost impossible to escape a daily barrage of tragedy. Everywhere you turn there seems to be another senseless act of brutality. Something screams out for us to be strong and brave. For God's sake...just restore me to wholeness.
"We can choose courage or we can choose comfort, but we cannot have both. Not at the same time. ~ Brene Brown
Here is the problem with strength and wholeness. We have a misconception of what they are and are not. Instead of coming from invulnerability, they are the underpinning of vulnerability.
Thing One: Strength is about facing a situation head on and dealing with it. This is the essence of courage and bravery. It is not about protecting yourself or walling yourself off. Though this may feel strong and tough at first, it is a strategy that only causes disconnection and isolation. The pain can only be masked and hidden in a self-constructed Fortress of Solitude. The ones who think they are invulnerable will always find a piece of green, red or gold kryptonite in unlikely places. The most extraordinary weakness comes from a sense of supposed invulnerability. Just ask Superman.
Thing Two: Wholeness is achieved by accepting the help and love of others which is done by embracing the reality of your brokenness. The New Normal which comes after loss is not about being made whole again. That just doesn't happen. We are restored to a different life over time. This rebirth of broken wholeness cannot happen in the short haul. Hope and comfort ease back in to replace the devastation as grief is integrated into our day-to-day existence. Dr. Sherry Cormier wrote a good book called "Sweet Sorrow; Finding Enduring Wholeness after Grief and Loss". It is an invaluable resource for starting over.
We hear quite a bit about The New Normal nowadays. There are always references to it after a horrific school shooting, a massive hurricane or wildfires, and other tragedies. But just what is this New Normal? Certainly, nothing will ever be "normal" again. That is for sure. My definition of it is the emergence of dawn as we become vulnerable. This vulnerability allows the light of New Normal to enter into the darkness of loss. With that light, there comes a transformation which exposes the inner self which is connected to something greater than our ego-driven desires. This paradigm shift brings a spiritual awakening to the truth of our oneness. There is a movement from the mind to the heart which is the foundation of vulnerability. This New Normal will shine as a beacon to others who have loss and are lost.
Welcome the New Normal, for this is the lesson of grief and loss. Life has meaning beyond our own well-being. And this is the gift. We have become wounded healers with a strength and wholeness never imagined before our deep sorrow.
Learn more about The Wounded Healer by reading Henri Nouwen's best selling book: The Wounded Healer: Ministry in Contemporary Society.
Grief and Loss; Helping Others Cope
The time comes when those who we love and care about suffer significant losses. It is important to remember that death doesn't have a corner on the market when it comes to grief and grieving. Each season of life brings change. And with every change, there is some element of loss. We are needed at these times as well as when a loved one passes on. Some of those life losses are:
- Retirement
- Birth of a Child
- Empty nest scaling down
- Losing a job
- Divorce
- Natural disasters
- Personal injury or health issue
- Financial problems
“Major life changes, even if they are for the best, can still leave a hole in your heart.” ~ Michelle Carlstrom
Of course, we want to provide comfort or give support to our family and friends. But it can be difficult to know what actions would be best when reaching out. While pondering what to do, I propose the following two things as top priorities:
Thing One: Be there. Your first and foremost responsibility is to show up when you live nearby. There is no reason for a call to announce your coming. If nobody is at home, leave a note at the front door saying you stopped by and that you'll be back later in the day. You don't have to bring anything but yourself when you do connect. Sit down with the person and listen. Touch a shoulder, pat a hand and keep your advice to yourself. For those who live far away, make the phone call and listen, listen, listen.
Thing Two: Commit. After your initial contact, construct a plan for helping. It is not necessary to ask for approval from anyone. If what you are doing is unwanted you'll find out. Keep it simple and promise yourself to do things beyond the immediate time of loss. Cook some meals and freeze some more. Clean up the kitchen. Help pack bags or boxes. Get several 'Thinking of You' cards and send them over a period of weeks. Take your loved one out to a movie. Have them over for drinks. Send little care packages if you aren't able to come in person...and keep calling on the phone.
Sometimes good intentions can cause damage. Mostly it's not so much what we do that hurts...it's what we say or what we fail to do. The effects of poorly phrased sentiments or unwanted advice can permanently affect a relationship. With that in mind, the following suggestions might be useful.
Five Don't Do's When Trying to Help
- Don't Minimize. I will never forget being at the funeral of a sixteen year old girl who died in an automobile accident. A caring neighbor told the mother that she was so fortunate to have the love of her two remaining children. Minimizing the loss of others does absolutely nothing but offend.
- Don't Offer. Obviously you should never offer something that you cannot deliver. But the best practice is not to offer at all. If you want to do something to help just do it. Never, EVER, say; "If there is anything I can do, just let me know."
- Don't Give Perspective. Telling a person who is suffering from a significant loss that life will get better is just careless and cruel. They may be sure that things can't get much worse, but seeing the light at the end of the tunnel is something that will happen for them in their own time. They hardly need your view from the mountaintop.
- Don't Use Condolence Platitudes. Nobody really wants to hear the words, "I'm so sorry for your loss". It's not about you. Greet the person, hug, tell them you love them. Avoid phrases like "You are in my thoughts and prayers." Send a prayer card or light a candle. NEVER say that God has a plan. The person is probably not very happy with God when grieving their loss. In other words...use less words altogether.
- Don't Stop Coming. Lots of people show up at the time of loss. Then, a week or so later nobody is there. This is when you step back in. There is no time limit to grief. If you think your loved one is still aching, keep coming by. A text message or phone call is never as healing as your physical presence.
There is nobody who can comfort and support better than you. Your strength is in sharing your time and love. Our uniquely individual healing hearts, hands, and ears are exactly what is needed when things get tough.
Grief and Celebration; Twins or Pairs of Opposites?
The loss of a beloved family member, friend or colleague is heartbreaking, there are many ways you can honor and celebrate their life.
We are not in the habit of welcoming or celebrating death and loss. It seems counter-intuitive or just plain wrong on so many levels. We aren't ready to grieve and mourn regardless of how well we've been prepared. Planning and anticipation might set the stage for loss, but when it comes there is little which has been done that truly relieves the suffering. I remember when my paternal grandfather died at age 97. He had lived an active, happy and virtuous life to its fullest. But it was the only time I saw my father cry.
Western culture tends to divide things into either-or's as opposed to both-and's. This two-ends-of-a-spectrum, dualistic thinking leaves little space in the middle and narrows wiggle room for processing death, loss, and suffering leaving only simple opposing choices. Either you are happy or sad, angry or forgiving, beginning or ending, grieving or celebrating.
The dualistic mind wants everything to be black or white. And, in reality, isn't it interesting that black and white are so much alike? On the color wheel, black is the presence of all color and white is the absence of all color. But on the light spectrum white is the presence of all color and black is the absence. Maybe God is trying to tell us something. Eastern cultures and religions such as Buddhism and Hinduism practice non-dualism. And Christian mystics have long understood the value of oneness.
When it comes to grief and celebration, the two are never far apart at all. Many traditional funerals with somber open casket viewings and formal services are often set aside for Celebration of Life memorials. Stories of good times and bad are offered by family and friends who might gather over a banquet table with cocktails and luscious desserts. Laughter and tears share the same space. Such gatherings create an atmosphere conducive to healing. The dark specter of loss and finality gives way to the possibility of new beginnings.
There is a beautiful, hopeful and certainly non-dualistic verse attributed to Henry Van Dyke or Luther F. Beecher that was presented to me when I was volunteering at an AIDS hospice in 1992. It sums up for me what loss, grief, and death are all about.
Gone From My Sight
I am standing upon the seashore. A ship at my side spreads her white sails to the moving breeze and starts for the blue ocean. She is an object of beauty and strength. I stand and watch her until, at length, she hangs like a speck of white cloud just where the sea and sky come to mingle with each other. Then, someone at my side says, "There, she is gone."Gone where? Gone from my sight. That is all. She is just as large in mast, hull and spar as she was when she left my side. And, she is just as able to bear her load of living freight to her destined port. Her diminished size is in me -- not in her. And, just at the moment when someone says, "There, she is gone, "there are other eyes watching her coming, and other voices ready to take up the glad shout, "Here she comes!"
New Perspectives on Grief and Loss
David Kessler, a co-author with Elisabeth Kubler-Ross of the classic book, On Grief and Grieving, has written a new book called Finding Meaning to be published in November 2019. Kessler identifies a Sixth Stage of grief which takes us beyond denial, anger, bargaining, depression, and acceptance to one in which loved ones are celebrated and honored. He also provides specific tools that will help those who are suffering loss.
Grief and Vulnerability; So Hard to Go There
Someone once told me that vulnerability is what we most want to see in others and least want to be seen in ourselves. Becoming vulnerable can be one of the most difficult and uncomfortable experiences. Exposure of secrets, mistakes, flaws, and sins leave a person open to scrutiny which is hard to bear. We seem to be set up for all kinds of personal loss. Reputations painstakingly built up over long periods of time are rendered precarious or come crashing down in unmendable pieces. The grief which follows is almost impossible to bear.
We live in an age where it is increasingly difficult or even impossible to escape from who we are. Rabbi Moshe Scheiner recently taught that suicide rates are increasing in adults partly due to the dynamic of transparency created by instant background checks on the internet. Good names are destroyed every day. Children who suffer the loss of character due to perceptions of peers, bullying and cyber victimization can feel so trapped and hopeless that they consider or commit suicide. Becoming vulnerable can create the deepest feelings of shame when those whom we trust wound us.
When we are grieving we become vulnerable. In fact, it has been said that grief and vulnerability go together hand-in-hand. Either can come first but neither walk alone. The word vulnerable comes from the Latin word vulnera which means to wound. In our most wounded times, we are laid bare. Lost is our stature and resolve. No longer can we appear strong and self-reliant. Our pain is visible to everyone. This begs a rather obvious solution. Just never allow yourself to become vulnerable and then the grief would remain private. manageable, and controlled. Voilà. Unfortunately, there is a horrible downside to that. If we don't allow vulnerability, we will never experience authentic friendships, belonging, trust, or love. What we all have in common is our brokenness and when the risk of vulnerability is rejected true connections are impossible. If all of this is true then how could vulnerability and grief be so discouraged in our society? I guess because it is just so hard to go there.
Perhaps we could find some answers from Dr. Brené Brown, a research professor at the University of Houston Graduate College of Social Work, author, and popular TED Talk personality. Dr. Brown has made it her mission to explore the power of vulnerability. She emphases how important it is to dare greatly in order to live life fully and to achieve success. And more can be discovered in the spiritual wisdom of Richard Rohr, founder of the Center for Action and Contemplation who tells us that vulnerability is the path to wholeness and holiness.
In the final analysis, we have to come to the realization that it is not only okay to grieve and to become vulnerable, but it is also necessary. If we are to heal we must be touched. The work can never be accomplished alone. There are big risks associated with all of this to be certain. But from our perceived weakness will come a new kind of strength. Not the strength of the invulnerable but the strength of love. For, as scripture tells us, the one who stumbles "shall mount up with wings as eagles; they shall run and not be weary," (See Isaiah 40:31).
Grief and Loss Unbundled; Revisiting the Five Stages
Bob Jones reflects on the Five Stages of Grief and his own time studying with Elisabeth Kubler-Ross in 1969.
I was at the bedside of a dear friend who tried to commit suicide. Under the influence of sedation, he kept repeating the phrase "Lose, Lose, Lose". I understood what he meant.
My own losses were significant, and I had been in his place not so many years before. The weight of sadness from family suicides, divorce, estrangement from my children and financial ruin had crushed me. Denial, alcohol and drugs could no longer relieve the pain I suffered. Ultimately, I found my way to Talbott Recovery Campus where the grief work really began. My friend trudged on with help from professionals and family support. He and I are the fortunate ones. Current rates of substance abuse, major depressive disorder and suicide on the rise tell a tale of grief and loss in epidemic proportions.No one among us will escape the dark anguish of grief. You just can't get out of life without painful loss.
Some of us will endure more and some will have a lesser share. But grief is certain and impossible to measure or compare with that experienced by another. With that in mind, and with the nationwide crisis which we face, it is important that we develop a good understanding of grief and loss. After finding that basic understanding, the next thing is discovering an effective way of dealing with them and living with them.
Over the next four weeks, we are going to explore loss and grief together. What better way to start it off than by revisiting the five stages developed by Elisabeth Kubler-Ross in 1969.
I had the privilege of working with Elisabeth Kübler-Ross during the early 1990s. Her life work with terminally ill patients, death, dying, and loss helped her to uncover five stages of grief which are denial, anger, bargaining, depression, and acceptance.
Though sometimes misunderstood, these stages have provided a road map for hospice as well as for most grief counseling and grief work done for fifty years.
Elisabeth was delightful She was also plucky, impatient, grouchy, playful, funny, controversial and unsinkable. Beyond her scientific research, Kubler-Ross had her fair share of loss as well.
In 1994, her farm retreat and training center at Headwaters, Virginia was burned down. All of her work was destroyed by arsonists who had lobbied to get her out of the community for years. They were frightened that children and adults with AIDS who came there would start a spread of the disease. They mistrusted the outsiders and "new age loonies" who studied and visited there. She suffered strokes and subsequent disability which sidelined her for several years. But she carried on. What I learned from her guided my work with survivors of childhood sexual abuse and with people who suffer with substance abuse disorders.
- Denial: When we are first faced with a terrible loss, a kind of shock and numbness set in. These are protective survival responses to an overwhelming situation. There is no way to fully grasp what has just happened. As a result, the brain and psyche work together so that things can be processed. Denial fades as we can handle things, a little at a time. It is the beginning of the healing process.
- Anger: The rage against loss is experienced when the unfairness of it all becomes apparent. It can manifest in what feels like a judgment from God who seems to have allowed this tragedy to occur. It can show up as resentment at people who failed to be by your side. Anger is just another coping device. What had seemed to be weakness and vulnerability now comes as a kind of strength. Anger will allow us to find the will carry on. An important thing to remember is that, like denial, it will diminish and disappear.
- Bargaining: The guilt, self-blaming, and emptiness of loss result in lots of 'What ifs" and 'If onlys'. "If only I had been a better boy/girl/family member/friend they might not have died". "What if I spend every day living the way my loved one had wanted then life will take on a meaning that will be a memorial to them". Bargaining is about trying to make a deal with God or the Universe so that the loss and grief will loosen its grip. We want so desperately for life to go back to normal that we might promise anything to end the pain.
- Depression: This stage is the most enduring of the previous ones. The depth of loss sinks in. Bargaining seems ridiculous. Life will not be the same as it was. Everything is forever altered. This is a normal feeling and should not be confused with clinical major depression. These feelings will lighten. People will want for us to move through the sadness and try to pull us out of our feelings. But there is no time limit to how we process grief and loss. Being gentle with ourselves as it progresses is the best medicine.
- Acceptance: This stage is about 'finding a new normal'. It is not about getting over the tragedy we have experienced. Because getting over it would be as if the loss never happened or that our loved one never existed. Acceptance is about re-aligning, re-awakening, and re-establishing. It is embracing the present while honoring the past. Acceptance comes gradually in gentle waves. Life will be worth living fully once again.
These five stages are not linear. One doesn't necessarily follow the other in order. Some stages may be experienced simultaneously. Nothing about them is absolute and every person will feel them differently. They are as unique as the individual. What they teach us is that moving through loss and grief is a process that can be comprehended and even tolerated.
Lincoln and Embracing Grief
Lincoln still has much to teach us about grief.
"Men of power sat around him. . . all struggling with their tears — great hearts sorrowing with the president as a stricken man and a brother.” Nathan Parker Willis on the Death of Lincoln
On February 20, 1862, William Wallace Lincoln, the 11-year-old son of President and Mrs. Lincoln, died of typhoid fever. The openly mourning president would become a symbol of our nation’s grief as the Civil War began to take the lives of 620,000 soldiers over what remains the bloodiest four years in U.S. history.
Upon first seeing his dead son, President Lincoln murmured, “My poor boy. He was too good for this earth. God has called him home. I know that he is much better off in heaven, but then we loved him so. It is hard, hard to have him die!” Willie was interred in a borrowed crypt at Oak Hill Cemetery in Georgetown.
His coffin would accompany the president’s on a funeral train to Springfield, Illinois in 1865. This is a story of such profound grief that we can still feel the pain and suffering upon hearing it. Lincoln continues to teach us how to cope with tragic loss…not with a stiff upper lip, but with an unashamed embrace.
According to the United Nations World Population Prospects report, approximately 7,452 people die every day in the United States. Annually, some 37,000 people are killed in automobile accidents, another 45,000 commit suicide and 17,250 more are victims of homicide. There is no doubt that each of us will encounter, and deal with death on a fairly regular basis.
Chaplains & Grief
For Chaplains and First Responders, the chance of frequently facing such tragedy is imminent. It is so important for all of us to open ourselves to the reality that we will be called upon as intimate comforters for family, friends and others.
And it all starts with notifying loved ones. In order to be of any help to those who grieve we must be able to be with them without offering advice. In his book Compassion; A Reflection on the Christian Life, Henri Nouwen called for us to be first and foremost, people of compassion saying;
“Compassion asks us to go where it hurts, to enter into the places of pain, to share in brokenness, fear, confusion, and anguish. Compassion challenges us to cry out with those in misery, to mourn with those who are lonely, to weep with those in tears. Compassion requires us to be weak with the weak, vulnerable with the vulnerable, and powerless with the powerless. Compassion means full immersion in the condition of being human.”
If we are to abandon the stages of denial and impatience in the process of grieving, we must also be able to embrace the darkness of loss. This is not supposed to be easy. It requires a listening ear open to suffering with those in pain. It also requires sharing and experiencing personal sadness when grief comes to our own door.
Resource For Chaplains Continuing Education:
The Association for Death Education and Counseling is an organization dedicated to the study of death and dying. They provide a place for professionals from diverse backgrounds to advance knowledge and promote practical applications to research and theory. Their 41st annual conference will be held in Atlanta this April. Continuing Education Credits are available. This would be a great opportunity for Chaplains and others. Here is a pdf link to the conference overview. An online webinar, Working with Continuing Bonds in Grief Therapy and Counselling is coming up on Wednesday, March 13, 2019 (12:00-1: 30 pm EDT).