Grief Recovery

Grief (noun)- Definition as defined by Merriam- Webster Dictionary:

1. Obsolete: grievance
2. A deep and poignant distress caused by or as if by bereavement
3. A cause of such suffering
4. An unfortunate outcome
5. Mishap, misadventure
6. Trouble, Annoyance
7. Annoying or playful criticism

While this definition may be concise and vague the experiences of grief are typically all encompassing, and life changing. The sad truth is we will likely all be touched by the powerful impacts of grief at one point in our life, however many of us will find ourselves greatly unprepared for the power of grief and loss.

What’s up with the stages? Are the stages of grief real?

As always it’s important to remember that everyone experiences grief and loss differently, there is no right, wrong, or one way to experience grief. You may have heard of the ‘stages of grief’ in media or from peers, let’s get into both what the stages are as well as who they apply to.

The Stages of Grieving: In 1969 Elisabeth Kubler-Ross introduced the concept of the ‘stages of grief’ in a book she published on death and dying. Kubler-Ross was a founding researcher of her time, studying a field that not many were interested in, death and dying. While Kubler-Ross’s research is still to this day used in the field and respected work, it has also been miss communicated and misunderstood through the eyes of ‘pop psychology’ and the media.

One of the most common misconceptions of Kubler-Ross’s work is that it applies to everyone experiencing a significant loss in their life. Kubler-Ross’s research and publishing actually applied to a unique population, individuals facing their own death. Following the onset/diagnosis of a terminal illness, Kubler-Ross found that individuals appeared to go through ‘stages’ of accepting and grieving their own death. It is important to note that while many individuals may be able to relate to these stages when they lose someone they love there is no research or supportive evidence that individuals will go through ‘stages of grief’ when they lose someone they love.

The Stages of Grief

As described by Kubler-Ross’s work the stages are as follows:

Denial & Isolation – The first stage is described as going numb, shock, and disbelief. This stage is our bodies natural defense to protect us in times of heightened stress and trauma. This stage is present to allow us time to make sense of this new information and changes to our daily expectations and plans. This stage will usually relieve as you are more prepared to accept the current stage and process differing emotions and thoughts related to your death.

Anger – The second stage, as denial begins to fade individuals may experience intense emotional responses related to their experiences, understanding of their illness, and potential loss of life. Individuals in this stage may find themselves angry with themselves, their choices, their doctors, their spiritual beliefs, or many other things, as they begin to process through the impacts of their illness on their life and future.

Bargaining – The third stage, as anger begins to fade it leaves room for the immense hurt and fear that may be surrounding loss. Many individuals may find themselves consumed with bargaining to get their life back to the state it was in before their diagnosis was given. Individuals may find themselves bargaining with their higher power, with doctors, or themselves, wishing and pleading for an alternative outcome or more choices. In this stage it may feel that the only way to stop the pain and fear is to change the outcome, however, bargaining is a state that lives in the past and future not in the present, so it frequently offers individuals little relief.

Depression – When all the pleading, wishing, hoping, and seeking ceases to be of comfort or relief many individuals will enter into the fourth stage, depression. Individuals may be more present focused in this stage, recognizing the prognosis and impact their illness has in their life. This stage signifies the loss of hope for changes to their outcomes, and with this may come great sadness, pain, and possibly fear. This stage offers individuals a chance to begin processing through their emotions and thoughts related to their death and begin healing from their pain, sadness, and fear.

Acceptance – The final stage,  individuals in this stage may find themselves experiencing a state of calm, while this does not mean they are “okay” with the impact of their illness it may mean that they have been able to process through related emotions/thoughts and come to an understanding that they may not be able to change their outcome but they can experience and practice presence in what they do still have left.

Stages are not always experienced in order and individuals may experience stages more than once as well as jump between stages.

Grief Descriptors

Kubler-Ross’s work was monumental for the field and heighten further research which allowed us a better understanding and support for those experiencing grief, loss, and bereavement.

So if the stages aren’t true descriptors for individuals that have lost a loved one what is?

First, it may be helpful to understand a couple of key terms used throughout this article.

Grief – As defined earlier is referred to as a distressing feeling/experience caused by a significant loss. Loss is a subjective term, meaning it will be defined differently by each individual that experiences it. Grief can be triggered by the loss of a job, relationship, house, friendship, financial state, career goal, and any other form of significant life change that an individual identifies as a loss that they find impact their life. Grief is experienced differently by everyone and while there may be commonalities among individuals experience grief everyone’s process will be unique.

Bereavement – Refers to a specific type of grief experienced when we lose a loved one.

What We Do Know

Over the years research has come a long way in understanding the impacts grief has on an individual’s relationally, psychologically, physically and emotionally. While the ‘stages of grief’ may not be the most helpful model in use today there are some common experiences individuals going through grief may relate to including the following symptoms.

Symptoms of Grief and Bereavement:

While no grief is alike it is common that individuals may experience some or a combination of the following:

• Intense sadness
• Depression
• Uncontrollable emotional responses
• Anger
• Irritability
• Memory impairment
• Impaired concentration
• Difficulty sleeping
• Excessive sleeping
• Change in appetite
• Loss of interest in activities/social isolation
• Fear of future losses
• Anxiety
• Emotional numbness

The intensity and frequency of these symptoms may ebb and flow as individuals process their grief, at times feeling overwhelming and at other moments feeling distant and easy to distract from. It is also important to remember that there is no specific timeline for grief, some individuals may experience symptoms immediately following a loss while other may experience no observed symptoms for several months or years after the loss. Grief symptoms can be experienced briefly or experienced over months and years. Each individuals process is unique and genuine to them.

Common Experiences Related to Grief and Bereavement

Another founding researcher in the field of grief, Sidney Zisook, has found four common and significant experiences observed during grief, described as:

Separation Distress – Which may be experienced as many different and changing emotional experiences including, sadness, anger, fear, pain, and shame. This experience may be present as individuals begin to notice the absence of their loss in their daily life, are reminded of past experiences or memories of that include their loss.

Traumatic Distress – Which is commonly felt as a state of disbelief, denial, shock, as well as active efforts to avoid intrusive thoughts and intrusive emotional experiences related to the loss. This may be experienced as individuals become overwhelmed and exhausted by the many emotional, physical and cognitive experiences of grieving and their body/minds way of gaining a reprieve from the pain of grief.

Guilt, remorse, and regrets – As we experience loss it is likely that we also look both to the past as well as into the future identifying experiences we wished could be different, hoped for, or feel like we should have changed. While this processing is common it is important to remember that when we find ourselves “shoulding, woulding, coulding” we are placing significant blame and judgment on ourselves which does not help or change our experiences, rather adds an additional layer of pain to work through on top of our grieving.

Social Withdrawal – Sadly our culture does a poor job of preparing, honoring, and supporting individuals through grief. We very rarely talk about death and dying and its impacts on us in till we ourselves are faced with a personal experience of loss. Family and friends may not know what to say or do to support someone through the grief process, they may also say and do (unknowingly) things that make it difficult for the griever to open up or be present with the grief. At times this lack of supportive resources, as well as intensified emotional responses, may lead a griever to seek isolation as its difficult to describe or ask others to understand their process and needs.

STERBS – Short Term Energy Relieving Behaviors

What are they? And do I do them?

The Grief Recovery Handbook By John W. James and Russell Friedman, a book exploring the symptoms of grief as well as tools to recover from grief introduced a term to the field to describe behaviors that temporarily allow a griever to feel relief however frequently impeded the individuals processing of grief and recovery.

As coined and described by the Grief Recovery Institute, STERBs are defined as Short Term Energy Relieving Behaviors. STERBs are behaviors that individuals engage in to distract from thoughts/experiences/emotions related to grieving. Many times these behaviors can cause more difficulty and distress to the griever as they do not allow for grief processing but rather continue to push feeling and thoughts related to grief aside, hoping the will go away.

STERBs can include the following:

• Drug and alcohol use
• Shopping
• Gambling
• Excessive exercise
• Overeating
•  Sex

Distractions from grief can be appealing and relieving at times however they frequently only work for the short term, leaving individuals with overwhelming and surprising symptoms when the effects of our distractions wear off.

So if distracting myself isn’t helpful what can I do to help with symptoms of grief?

Just as everyone experiences grief differently what individuals find helpful may differ as well, here a couple of suggestions to keep in mind when attempting to relieve symptoms of grief and support further healing and recovery:

• Physical Health:  During experiences of grief of and loss it is easy to engage in comforting behaviors such as oversleeping, overeating, and lack of physical activities. It’s important to try and keep your body healthy to allow your minds recovery. Be mindful of your eating and sleeping habits, while its okay to engage in comforting activities make sure you are balancing that ice-cream and chocolate with some healthy foods as well. Try to get outside, take a walk, go to the gym, take a yoga class, ask a friend or family member to help remind you of keeping your body healthy and a state of healing.
• Taking time to remember and honor your loss: Find ways to connect to and remember your lost loved one, engage in activities that hold found memories related to your loved one (cooking, a favorite park, etc). During grief recovery, it is common for individuals to find ways to feel connected to the person they lost in a new way.
• Set aside time for grief recovery: This can be very hard to do, but so impacting if you are consistent about it. Set aside a few minutes or hours (whatever feels right for you) each day for your grief. This time can be structured with activities (reading, art, writing, listening to music, videos etc.) or it can be organic with whatever feel needed in the moment. Use this time to check in with yourself, your thoughts, feelings, and physical experiences of the grief. Make sure that you take time for self-care and healing following this time, take a hot shower, call a friend, listen to uplifting music, etc. practice things that bring you back to the here and now.
• Let go of Judgments: It is easy to judge and compare how we “should” be feeling/experiencing grief, but remember, this is hard, it is different for everyone, there is no ‘right’ way to grieve, you will get through this, and there is support if needed. Allow yourself to feel what you need to feel during this process, the one thing that is true about emotions is they are constantly changing and at times may even feel conflicting, however, they are not capable of remaining fixed, so practice active awareness and acceptance of your emotions in place of judgment and shaming them. If you are finding themes or feeling stuck in certain unhelpful emotional responses it may be helpful to reach out for support from family/friends or a professional to further process and make sense of complex emotional responses.

So if grief is so “normal” why are we talking about it? And why do so many people struggle with?

The inevitable and sad truth that we all learn throughout life is that every living thing must one day die. While this is a recognized fact of life, it is not a necessary an accepted fact for many people. The truth is that we will likely face many losses within our lives, some small some significant. So when we experience this what do we do next? What’s normal? How do we get through something that feels unbearable and unending?

Most grief research acknowledges that grief is a normal and natural response to the loss of something significant. Most research also agrees that while some grief is “normal” some grief becomes more difficult to manage and becomes impeding in multiple areas of functioning not allowing the griever to heal or return to full functioning following the loss.

“Normal (for lack of a better word)” grief is typically referred to as:

Acute grief:  Acute grief can come in many shapes and sizes and is unique to individuals. It may include symptoms from the list above as well may ebb and flow coming in waves of intensity following by periods of relief. As individuals continue through their grief they typically begin to experience other emotional/cognitive/physical symptoms along with their grief including positive emotions (happiness, joy, found memories, relief), as well as acceptance of the loss (again not that the loss is ‘okay’ or preferred’ but understanding that it can not be changed). Individuals experience acute grief will also create meaning surrounding this loss, at times this translates into turning their pain into power, advocating for support or action toward topics associated with their loss, researching to better their own knowledge of the loss they experienced, or joining advocacy or support groups to help others through their own loss experiences, whatever the way in acute grieving individuals typically find a way to create meaning surrounding their loss.

When experiencing acute grief individuals will always be impacted by their loss, however, they may find that they hold a ‘bitter sweet’ view of their loss, being able to remember the good without becoming overwhelmed or consumed by the grief symptoms.

Prolonged or Complex Grief: While prolonged grief may begin the same as acute grief, the griever becomes overwhelmed and consumed by the grief symptoms. Individuals experiencing prolonged or complex grief may find their symptoms impacting their ability to engage in relationships, work, home-life, and daily tasks (showering, eating, bathing, cleaning, etc). Individuals experience complex/prolonged grief may find themselves stuck in pain, regret, fear, guilt, anger, sadness, disbelief, as well as experience intense fear of the future and future losses. Individuals may feel like recovery from grief is dishonoring, forgetting, or betraying their lost loved one. Individuals experiencing prolonged/complex grief may experience all or some of the same symptoms experienced by individuals experiencing acute grief however they do not experience the positive emotions and thoughts related to recovery from grief experiences.

It may be helpful to reach out for support or professional grief counseling anytime you are experiencing grief that is impacting your life, however, if you are worried that you may be impacted by prolonged/complex grief it is strongly recommended that you seek our professional supports as this rarely alleviates on its own.

What to do if I experience a loss or think I am grieving?

Not everyone that experiences loss will need counseling in order to process and manage grief in a healthy way. It is important to remember that grief and loss is a normal and natural process of life. When you experience a loss it’s important to remember:

• Give yourself grace and patience, change won’t happen overnight
• Take care of yourself, taking extra time for you, and engaging in self-care can be helpful and healing
• Reach out: Contact friends or family, talk about your experiences, people may not know exactly the right thing to say, but sometimes just asking them to listen without attempting to fix, change, or understand can be incredibly powerful in the grief process
• Share: Share how you’re feeling, share memories, share stories
• Try to avoid engaging in the myths of grieving (replacing, avoiding, time will heal, grieving alone), these will only prolong and further complicate the grief process.

In reviewing these recent models and explanations of grief it is important to remember that each experience of grief may be different, individuals may experience, some, all or none of what is discussed in this article. It is important to honor your own experience with grief and be present to allow yourself grace and growth through your grief.

Remember, grief is hard, if you need help or feel stuck, please reach out, there is support, there is recovery.

The Take-Away

Grief can come in many forms and impact anyone at any time in life. It’s important to remember that it’s not your fault if you are experiencing grief and bereavement, this is a NATURAL and NORMAL part of life. If you are having a hard time managing your experiences of grief or you want to learn more about your grief there is help and support available! Reaching out and getting information is the first step toward feeling relief from symptoms and working toward grief recovery.