Recovering from great loss: Finding help with grief

By Wendy Underhill

When it comes to grief, Elisabeth Kübler-Ross is old school. Remember her work defining the five stages of grieving: denial, anger, bargaining, depression and acceptance? These were innovative back in 1968 when she developed them, but now they're considered "foundational," which is a professional way to say "historic, but not necessarily the most current thinking." (Kübler-Ross, who died in 2004, continued to be a leader in grief work, modifying her approach as more information came to light, right to her very end.)

But the fact that she started an entire field of intellectual inquiry means that we've had 35 years to figure out this topic. So why is grief still so hard to face, so mysterious, so secretive? The old axiom, "out of sight, out of mind" seems to apply. In modern industrialized nations, we don't see death in daily life. Death has been pushed back by medical advances, and it's been pushed out of the house into hospitals and nursing homes. That leaves us without much experience when grief hits. And, as any ninny can tell you, grief will hit all of us, and probably many times.

In the past, most cultures didn't put an intellectual overlay on the experience of grief; instead, they offered a format or ritual for dealing with major losses that included returning to functionality. Americans, for lots of reasons including the patchwork of religions and ethnic backgrounds found here, don’t have a recognizable how-to-grieve plan.

That’s both good and bad. It’s good because grief comes in many forms and there’s no one right way to grieve. At the same time, it’s problematic because we’re left with no examples or guidance on what to expect, what to do, and how to accept grief. Without a framework, we may need to seek guidance or assistance to learn to live with a loss, no easy task.

Who to turn to? People who are working to change the culture of grieving. Who are bringing death and grief out of the closet. People who may call themselves grief counselors, grief educators, grief recovery specialists, and who are not offering a big turn-around from the Kübler-Ross stages, but just modifications and lots of practical applications. And, people who not only support those facing loss but educating the public before major loss occurs.

Note the “education” element. With a culture that prepares for almost everything (pre-nuptial counseling, pre-kindergarten playgroups, pre-test prep courses, pre-birthing classes), it’s a bit of a shock that most of us have no preparation whatsoever for a great loss. Grieving seems to catch us by surprise every time. Over time that can be changed; some day people may be as likely to attend a grief education workshop as a talk on tax preparation or bike maintenance.

These workshops do exist now, though they are hardly commonplace. If we were to take such a class (look for them through hospices, hospitals and faith communities) we might begin to normalize grief as part of the human experience. It shouldn’t be a surprise or a concern when someone who has suffered a loss has trouble concentrating, isn’t eating or sleeping well, and breaks out crying in the grocery store. We can recognize these effects not as signs of pathology but for what they are: reasonable signs of loss. The stiff-upper-lip approach may get you through a trying episode, but it won’t get you through the grief process.

We’d learn, too, that loss can’t be quantified: a loss is a loss is a loss. We hear (and it makes sense) that the loss of a child is the worst loss of all; and yet that’s no comfort to someone who’s lost a friend or a fiancé. And, loss can be about more than death; sometimes feelings of grief are associated with other life events, such as divorce or even moving across the country.

We’d learn that loss isn’t necessarily just in the recent past. It’s common for people to be stuck in grief for many years before beginning their “grief work,” the internal work to assimilate or adapt to the death of someone or other major loss. There is no timetable for getting over a loss. In fact, the responses to grief can circle around, cropping up in unexpected times and places. Time does not heal all wounds.

We might also learn what not to say or do when we’re with a grieving person. Don’t avoid or change the subject; don’t avoid eye contact; don’t drift away to your own to-do list or interrupt; don’t make judgments on their feelings or actions. As for words, don’t say, “I know how you feel,” “Someday you’ll see this experience as a gift,” “Don’t be sad, we’ll get a new puppy tomorrow” or “At least he had a good 75 years.” And definitely don’t say, “She’s in a better place now” unless you are absolutely certain of the bereaved’s vision of heaven. All of these things are ways to avoid acknowledging grief and loss in others and in ourselves.

Having this kind of information in our coping portfolio before we’re in the throes of loss can go a long way towards preparing us for when our time comes (as well as being more competent with friends’ losses).

And when our time of loss does come, what are we do do? Find support. Grief support groups are available through many hospices and hospitals; attend one, or many. Depending on where you are, you may find groups dealing with the loss of a child, or the loss of someone to suicide, or other kinds of bereavement. Such groups can be a huge resource and relief, especially if you don’t have a personal community around you that can warmly and nonjudgmentally listen to you.

In such a group, you’ll share your experiences, learn to be forgiving of yourself when things get off track, and perhaps find concrete ways to honor your loss. For instance, you may find yourself creating memory books or sharing photos.
Or, try working directly on your grief through the program set forth by the Grief Recovery Institute. This isn’t counseling; it’s an action-oriented, step-by-step program with specific tools you can use to work with the pain and unfinished emotions that death or loss is sure to provoke. The thinking at GRI is that grief continues unabated when the relationship with the lost one is unfinished. So, the exercises at a GRI workshop or in The Grief Recovery Handbook involve remembering the person in detail, writing a letter to that person that sums up your feelings and desires and what you wish you could say to him or her, and other direct exercises to address the object of your loss. Find a grief recovery specialist by going to www.grief-recovery.com.

Some people might prefer seeing an individual counselor with a broader focus, who might refer to the Diagnostic and Statistical Manual, the catalog of conditions used by the psychological community. The book includes both “Bereavement, Uncomplicated” and “Bereavement, Complicated.” All of us experience the first, but not all of us experience the second. The complications come in when the grieving person gets stuck in the pain of initial loss and does not begin to return to good function. Psychologists can help with this—but be aware that not all psychologists and counselors have specific experience dealing with grief.

To find out what social worker, psychologist, or other counselor will work well for you, try this question: “What is your understanding of grief?” If the answer begins with Kübler-Ross’s stages of grief, the counselor may not have studied up on the topic in the last generation. If he or she speaks of grieving as a normal and holistic experience in the sense that every part of us—mind, body, emotions, spirit—is involved, you may be on the right track. To find someone who specializes in grief, look at the Association for Death Education and Counseling, www.adec.org.

Since grief is felt by every fiber of the body, you may find that physical experience is a part of the grieving process. Being in nature seems to be an intuitive and appropriate response to loss. Some find that physical exercise or the continuation of a meditation or other spiritual practice can be soothing. Even keeping to the quotidian demands of the day—teeth brushing, bathing, fixing food—can help regularize life for the bereaved. (Kübler-Ross’s website, www.ElisabethKublerRoss.com, includes some of these suggestions for the bereaved, plus journaling, reading up on the topic, seeking comforting rituals, and avoiding other major upheavals in life if possible.)

One last thought gleaned from grief educators: when bereavement means we are focused on the dead, rather than the living people whom we love and who love us, it’s time to do our grief work so that we can return to living fully. Paradoxical, perhaps, but true.

Resources, local and beyond

For more information on grief recovery, try the following resources:

• www.centerforloss.org: This website of the Center for Loss and Life Transition in Fort Collins offers practical advice and resources.
• www.ElisabethKublerRoss.com: Includes much theoretical and professional information, but the page “About Grief” is intended for helping with bereavement.
• www.grief-recovery.org: The website for the Grief Recovery Institute offers information, books, contacts, and training courses.
• The Grief Recovery Handbook by John W. James and Russell Friedman (Harper Perennial, 1998)
• On Grief and Grieving, by Elisabeth Kübler-Ross (Scribner, 2005)
• Understanding Your Grief: Ten Essential Touchstones for Finding Hope and Healing Your Heart by Alan D. Wolfelt, Ph.D. (Companion Press, 2005)

The following are Nexus advertisers who offer grief work. Turn to the page number after their names to learn more about what they do.

• Vicki Barbour, grief recovery specialist, 720-841-3529
• Linda Backman, PhD, The Ravenheart Center, 303-938-0292
• Chuck Barr, MA, LPC, 303-449-5667
• Lynne Foote, MA, LPC, 303-447-2987
• Melanie Guilbault, RN, 303-548-3211
• Graceann Harrington, MA, 303-877-4103
• Bonnie Heidbrak, RPh, MBA, RTM, CHom, 720-200-4403
• Pilar Johnson-Dae, MS, NCC, 303-437-7825
• Jo Ann Morris, MA, LPC, CHT, 303-665-9505
• Jennifer Rudin, MA, 303-786-7228
• Edie Stone, MA, LPC, 303-415-3755, www.ediestone.com
  

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