Coping with Grief and Loss: Supporting the Self in Relationship
"Loss of a loved person is one of the most intensely painful experiences any human being can suffer,” John Bowlby writes. Yet, “there is a tendency to underestimate how intensely distressing and disabling loss usually is.”[1]
Pain is a hallmark of grief. Although not all aspects of bereavement are necessarily negative or painful (the griever's sense of relief, for instance, when great and prolonged suffering is ended), the experience of the death of a loved one often consists of a majority of disturbing experiences that can be distressing and even agonizing. These may include: fear, panic, sadness, anger, helplessness, guilt and despair, a host of somatic and behavioral complaints, difficulties thinking, making decisions and relating with others, problems sleeping, eating and working, and perhaps even feeling "crazy."[2]
What seems to set grief apart most distinctly from other emotional states is described by Bowlby (1980) as yearning and by Parkes (1987) as pining, hopelessly, for the lost loved one--a unique mixture of anxiety, depression, longing and despair. Together, these descriptions correspond with Schwartz-Borden's (1992) metaphor of bereavement as a profound internal wound, leaving the griever lost "at sea," with a sense of unending, immutable pain.
Further, rather than proceeding in orderly stages or steps, “grief can be messy.”[3]
Grief often includes a paradoxical set of non-linear responses. That is, grief may not proceed according to neat, orderly steps and stages. Grief can be both an acute and ongoing response to loss, and is affected by such circumstances as:
~~ the bereaved’s relationship with the lost person
~~ the circumstances of loss, including traumatic experience
~~ the griever’s personality and coping style
~~ cultural and social background of the griever,
~~ the social and relational support system of the griever
Loss can involve multiple deprivations, such as loss of an important, personally meaningful relationship, loss of companionship, social and economic loss, and role loss. Sometimes the traumatic circumstances of a loss, and/or adverse life circumstances, can add to feelings of debilitation, increased stress, and difficulty coping.
Support can be extremely helpful, but grievers don’t always get the support that they need when they need it.
While social support is helpful if not crucial in affecting a person's responses to bereavement [2], [4], support and understanding of grief are often inadequate. As bereavement and grief occur in a variety of situations and relationships, the needs of the griever may differ, and change, over time. And sometimes the kind of support grievers receive may not feel congruent with their experience.
Psychotherapy and supportive therapy in either an individual or group setting can help people who have lost intimate loved ones by allowing them to:
~~ Share their unique experience with others in a nonjudgmental, safe setting,
~~ Express and explore feelings about the loss and the circumstances of the loss,
~~ Tell the important stories of the lost loved one and the relationship,
~~ Help integrate these feelings into their overall experience of life and self,
~~ Cope with sometimes debilitating feelings and traumatic responses related to
the death (such as nightmares, flashbacks, unresolved worries, conflicts, guilt,
ongoing sadness), as well as the project of reconstructing one’s life, life plan and
goals
My Approach
I believe the best way to approach aiding the griever is by acknowledging the uniqueness of his or her experience, not pathologizing it, but finding out together how it makes sense.
I start from the premise that people have different ways of grieving and struggle and cope with loss in unique ways. Depending on the relationship with the person we have lost, and how the person died, grief may feel more or less traumatic, and be more or less difficult to integrate into our overall lives.
I believe that it helps to tell the stories of loss and share them with others in a deep, meaningful way. We support the self in our relationships both with those who are physically lost (but psychically present) and the people we can engage with in the here-and-now.
I believe humility is necessary in the therapist to join the griever in his or her grief—treating it not as a “series of tasks to be completed,” but a sacred emotional experience, one that is both shared by others and is also unique.
For more on my approach and understanding of grief, extracts from my book may be of interest.
