“There is a time to mourn and a time to dance.” –Ecclesiastes 3: 4
“I will turn their mourning into gladness; I will give them comfort and joy instead of sorrow.” –Jeremiah 31: 13
“Blessed are those who mourn, for they shall be comforted.” –Matthew 5: 4
“Rejoice with those who rejoice; mourn with those who mourn.” –Romans 12: 15
Appalled by the treatment of dying patients in the 1950’s and 1960’s, a Swiss psychiatrist named Elisabeth Kubler-Ross made it her goal to “break through the layer of professional denial that prohibited patients from airing their innermost concerns.” She described five stages people often experience when coming to terms with their imminent death. These stages—denial, anger, depression, bargaining, and acceptance—came widely to be known as the grief cycle. Over time Kubler-Ross’s phases were applied to any significant loss in life, not just an individual’s own terminal illness and approaching death.
In 1967, psychological researchers Holmes and Rahe developed the Life Event Rating ScaleThis chart evaluates major changes on a scale of 1-100, according to likely stress caused by the event. Any indicator on the scale can be defined as a loss and may need to be grieved.
An awareness of grief processing steps has given many people the validation they need to express personal pain at life’s losses. Even so, mourning seems to have a life of its own; it refuses to bow to anyone’s expectations and must be accepted as it comes because it is woven tightly into all life’s joys.
Some people may stay many months in a single stage; others cycle from anger to acceptance to depression again and again. Grieving is the way we let go; all deep healing comes through letting go. Coming to terms with loss is unique to every individual and does not move along in an orderly fashion, according to sequence or timeline.
Those passing through grief may be influenced positively or adversely by events going on around them, and by where they are in their own life cycle. For example, new losses can trigger old grief. Or a smile, seasonal event, light on a lake, indeed any sense memory may remind one of someone gone, and bring about unforeseen waves of sorrow. Releasing pain is messy and characterized by unexpected changes.
When in grief a person often feels alternately lonely, sad, abandoned, angry, lost, and overwhelmed. For the sufferer, it can seem like a ubiquitous dark cloud is ever around her. As time passes, though, most people gradually start adjusting to their loss, making tentative steps toward reinvestment in life. Survival has fresh meaning.
Many who come for heart-healing counseling have sorrows hidden away that have never been adequately grieved. Because of this, they can’t let go of the pain. We encourage them to confront the losses and take time to mourn. Sometimes it is not just a person that is gone. Sometimes they must grieve a lost fantasy, a lost childhood, or all the lost expectations around a future. Grief is universal and inevitable.
As with many other presenting problems in counseling, grief can start to be resolved when the person faces her pain and begins expressing it in the safe environment of the session. For all of us, it is very important to be sensitive to our own reactions when the wrenching agony of loss is shared. Nearly everyone struggles with the desire to avoid facing death; consequently, we may tend to shut down in the presence of another’s anguish. We might try to rush the sufferer through their time of letting go, or show the suffering person our discomfort and impatience with their misery. For the afflicted one, our encouragement to take time for mourning can of itself be healing.
Here is summary of Kubler-Ross’s grief cycle with typicalsymptoms at the different stages:
THE GRIEF CYCLE
(Not necessarily experienced in order)
Protecting against issues too immense to deal with. Minimizing the loss by avoiding feelings and thoughts related to it.
~Obsessive thinking and compulsive behavior
~Need for constant activity
~Numbness from shock
~General refusal to accept or acknowledge reality
~Trying to make things the way they were
~Pretending the situation is not happening
~Constant anxiety and fear
~Repressing the truth
Moving out of denial.
~Raging over the loss (hopefully in an acceptable manner)
~Projecting anger irrationally onto anything or everyone, through outbursts, demands, arguments, etc.
Offering to trade something in order to stop the loss.
~Creating another focus for behavior to affect the loss, “rebounding”
~Trying to do something differently to change the inevitable
~Attempting to make a deal with God
~Looking for alternatives and options brought about by the loss
Feeling hopeless and helpless to stop or change the loss.
~Constant crying, sadness, and lamenting
~Diminished energy and fatigue (physical, emotional, and mental)
~Lack of affect, lack of interest in anything
Coming to terms with the changed condition.
~Ability to acknowledge and articulate the loss
~Ability to see new opportunities
~Ability to feel like “normal self” sometimes
TASKS OF MOURNING
Mourning a death can be approached as a series of tasks to be completed. Sometimes this may assist people who need a structured set of goals to help them move through the process.
Task I: can be defined as accepting the reality of the loss. The denial, which is natural at first, must be broken through before the individual can move to the next level. Refusing to acknowledge the facts of the loss can vary from slight distortion to full-blown delusion.
Sometimes survivors will keep possessions of the deceased intact for extended periods or will minimize the meaning of the loss. Others will block the memory of the person completely from their mind.
Intellectual acceptance of loss is not enough. Emotional acceptance takes time but is of greater importance in bereavement. Traditional rituals such as the funeral are very beneficial in this process. Other events shared by strong ethnic communities that acknowledge anniversaries of death are also helpful in progressively letting go.
Task 2: is the need to work through the pain of grief. The newly bereaved is often unprepared for the sheer power and intensity of emotions in mourning, and people around the sufferer may subtly communicate that the grief should be hurried or stuffed altogether. Platitudes commonly dispensed by well-meaning friends can communicate ideas such as the following: the mourner is really just feeling sorry for himself, or the lost person would not want the grieving one to act like that.
Giving permission to indulge the pain is crucial. Some people try to run away from heartbreak by changing locations, looking for a geographic cure. The hurt must be experienced; at the same time we can assure the person that it will one day lessen in intensity.
Individuals need to be reminded that more than sadness and depression can characterize grief. Other emotions such as anger, guilt, anxiety, and loneliness are also common in mourning.
Task 3: is to adjust to the environment that no longer includes the lost person. This takes place in three realms: 1) the external environment–how one’s everyday functioning is affected, 2) the internal world–how the loss affects one’s sense of self, and 3) the spiritual life—how the loss has altered one’s beliefs, values, and assumptions.
Most people make it through this stage by filling new roles, developing new skills, and moving forward with a reassessed sense of their own identity and purpose. If a mourner fails to progress at this time, he may withdraw from the world and hide from life’s challenges.
Task 4: is to find a place for the lost person that will enable the mourner to honor his connection to the past but will allow him to move on to new relationships. This is often the most difficult part of grieving, but it is critical to accomplish. If an individual fails to move beyond this, years may relentlessly go by while he continues to have no investment in the present. In fact, some people are so devastated by loss that they vow never to love again.
FACTORS THAT INFLUENCE GRIEVING
Many variables influence the individual’s grieving experience. For example, the depth of the continuing bond with a departed person is determined by the intensity and duration of the love relationship they have known. And if the survivor relied heavily on the lost one for positive self-image and security, this makes grieving all the more difficult, as when a wife who has needed the reassurance of her husband for many years also loses that comfort when he dies. Physical, practical, and monetary dependence on the deceased all affect adjustment to the loss.
Grieving is more complicated when there was great ambivalence in the relationship, i.e. if positive and negative feelings were equally strong. Guilt and anger predominate if the relationship was mostly negative. And a great deal of historical conflict in the lost relationship can cause grieving to be permeated with all the unfinished business that now will never be fully resolved.
How the person died also affects grieving. Deaths at a significant geographical distance away can make the loss feel more unreal than if the person was close by. Suddenness of death tends to be more difficult to grieve than when there was warning. Violent deaths such as murder and suicide can be extremely difficult to resolve, because the survivor must cope with psychological trauma as well as the death itself. If the loss was preventable, the whole idea of culpability must be explored, often with prolonged ongoing litigation, interviews, and court appearances.
Inability to see the body of the deceased makes it hard to let go, as does ambiguity in the circumstances of death, such as when there is a missing-in-action report or an airplane crash without remains. And if shame can be associated with the loss, like in AIDS or suicide, this may prevent needed social support because friends are unsure how to relate to those left behind.
It is also important when helping a person who has lost a loved one to know whether he has experienced other losses and if earlier grief in his life has been resolved. A present trauma will often bring to light issues from the past that until now have not been addressed. Physical and mental predispositions and illnesses can be triggered as well.
With advancing age grief multiplies: friends and family members pass on, physical health diminishes, and vocation is relinquished. This accumulation of sorrows coupled with decreased strength to cope and the awareness of encroaching debility and death can make mourning feel like an ever-descending spiral.
Of course temperament variations also account for individuation in reaction to loss. Early environmental factors play a part too. Childhood modeling of a healthy attachment style learned from balanced loving parents helps a person process inevitable grief effectively. The ability to adapt when loss occurs is influenced both by learning and inherited traits.
Men and women tend to grieve differently, as do children and adults. Also, certain personality and mood disorders by their very nature cause an exacerbation of the grief process. (A detailed analysis of how this can manifest is beyond the scope of this article.)
Other features like thinking habits (positive or negative), feelings of self-worth, and strength in beliefs, values, and faith influence success in moving through mourning. In addition, the course of bereavement is affected by changes and crises arising after the death. If different events are precipitated by the loss or are concurrent with it, the mourning period can be much more stressful.
Good availability of social sustenance is important because some of grieving needs to be experienced in the presence of others. The time spent with supportive friends must be adequate to be effective, even when months have passed since the loss. It also helps for the survivor to interact in several different venues with others. Studies have repeatedly shown that people who have a strong community of religious faith around them fare far better than those who are left to process their pain alone, without hope of reunion with the loved one.
GRIEF AND STRESS
The stress of grief can manifest in many ways. When a person is exhibiting significant physical or behavioral symptoms such as those enumerated below, unresolved grief might be the cause. Here are some stress reactions that may occur when one is actively processing the anguish of a deep loss:
Chest pain, heightened heart rate
Increased blood pressure
Muscle tension and tightness
Nausea or dizziness
Headaches, backaches, muscle pains
Fear, shame, depression, or hopelessness
Anger, doubt, or generalized anxiety
Sense of being overwhelmed
Compulsive overeating, increased smoking, or escapist drinking
Overuse of prescription drugs
Emotional outbursts or withdrawal
Changes in sleep habits, absenteeism from work
Suicidal ideation or attempts
Memory loss or calculation difficulties
Inability to concentrate or stay focused
Decreased decision making or problem solving
In summary, we need to give close attention to the universal yet exquisitely individual experience of grief in those who come to us, remembering how critical it is to our own humanity that we help fellow travelers though times like these. God designed us to comfort those who mourn, so they can heal (2 Corinthians 1: 3-11).
Loving relationships enable sufferers honestly to experience their profound losses. Our hope is that when given permission to grieve in a sensitive and supportive environment, with guidance in facing and resolving difficult aspects of the loss, the individual in sorrow will feel empowered to move forward.