Grief isn’t pathological. Our society’s response to and handling of it is.
The #1 question I get from people in grief is “how long will this last?” No one wants to hear the truth: there is no predetermined end date and it's untrue that time heals all wounds (on its own).
Yet, as described in a recent New York Times article How Long Should it take to Grieve? Psychiatry Now Has Come Up with an Answer (Ellen Barry, March 18, 2022), psychiatry is attempting to give a numerical answer. “Designed to apply to a narrow slice of the population who are incapacitated, pining, and ruminating a year after loss and unable to return to previous activities.” In the article, “prolonged grief” (defined as over a year for adults, 6 months for children and adolescents) only affects about 4% of people. That’s misleading. They wouldn’t bother if it were that low.
The DSM (Diagnostic & Statistical Manual of Mental Disorders) is not the "professional Bible of mental health" as it's sometimes described. It's for categorization for billing and insurance reimbursement purposes. Therein lies the problem. The chances of over diagnosing and overmedicating are high. Particularly when you consider that grief affects nearly everyone eventually.
We’re medicalizing something that isn’t medical. Whether we want to admit it or not, there's still a great deal of stigma around mental health. There are efforts to change this, and progress is being made, though we've got a long, long way to go. Taking something like grief and labelling it "abnormal" exacerbates rather than alleviates things. Grieving people already often feel like they’re “going crazy” --and the people around them often reinforce this--because they’re comparing themselves to who and how they were before the loss(es), and they cannot be that same person anymore.
We don’t go back to being our “normal selves” after major loss, because we literally can’t, we’re forever changed by it. But that’s exactly what is so often expected of people to somehow do. Those who haven’t experienced significant loss cannot relate to that, nor can it really be told to them or truly understood.
Grief seems to be a language spoken and understood only by those who have directly experienced it. That’s a big reason why grieving people may withdraw. They’re often horribly misunderstood because it's like they start speaking in a foreign language no one around them except sometimes other grievers understand. Complicated by the fact that grief itself is so unique to each person. So even those around them who lost the same person may respond in their own grief and to each other very differently.
“Give them what they want, not what they need.”
We want a quick fix in this society, and unfortunately, that's not how mental wellness--or life--works. Only bad things happen quickly. Everything else takes time, effort, and often more of it than we'd like.
Grief is a part of life. It’s a biological, neurological response and process to the loss of someone or something important to the individual. We’ve evolved that way. Is there such a thing as complicated grief? Certainly. The course of natural grief can get tangled up with a host of other issues. With deaths come other losses. We don’t need to diagnose grief itself.
There’s been a massive amount of loss and grief (and not just from deaths) in this pandemic. Essentially, they’re creating a market. The creation of a diagnosis opens it up to pharmaceutical companies to create or repurpose medication, the “magic bullet”.” I foresee that as potentially catastrophic in the sense that it’s not solving a problem but creating a dependency.
Pills for grief—which isn’t one emotion but a response to loss—would be akin to creating a pill for anger. You may suppress it, but the underlying issues aren't being addressed, so it’s still going to be there. Even if a true addiction isn’t the result, you’d still have to keep taking the pill to keep emotions suppressed or “numbed out.”
A pill will likely be viewed as more cost effective by insurance companies than counseling. The result will be an increased medication-only addressing of grief, not a combination of medication and counseling. Even if the argument is that the prescription would be for “short term,” consider what would happen when the person is taken off the medication when the underlying issues haven’t been addressed.
Grief often has nowhere to go. If a grieving person is fortunate, they have a strong support system that rallies around them with support and acceptance for the long haul. Many people are not so fortunate. After a while, support fades, if it were there to begin with. Many people discover they’ve lost friends or other connections. Too many people avoid grievers for a multitude of reasons.
The problem isn’t that grievers “can’t handle it,” but that people around them—even professionals—can't—which makes grievers feel instead like it’s their problem. It’s a case of blaming the victims, really.
It’s almost like grief is treated as though it’s contagious. This is actually one of the fundamental problems. Grief is already treated like a pathology or disease. Officially labelling it as one isn’t solving the problem, it’s solidifying the stigma that’s already there.
When someone close to us dies, we don’t just lose the person. We lose so much beyond that. These are “secondary losses” and they can be as profound as the primary loss of the person themselves.
Secondary losses occur with any type of death of someone close to us. Is it fair, for example, to expect a parent to recover from the death of a child in a year? People say things like “they never got over it.” Of course not.
People who have experienced the death of someone close may not have lost one person: they may have lost nearly everything.
Sudden, traumatic losses, such as suicide, homicide, accident, natural disaster or heart attack typically result in even more pronounced secondary losses as well as sometimes trauma. Too many to name. The worldview of the survivors has been violently shattered.
Most of the research so far around prolonged grief disorder has been with elderly widows whose husbands have died. That’s statistically a likely scenario, though it doesn’t account for the many other variables and types of losses. Let's start there as an example.
When people marry, they may say things like they’ve found their “other half” and are surrounded by messages of “two becoming one” and sharing of a life together. Is it any surprise that when someone loses a spouse that they describe it as feeling like they lost a part of themselves? Because isn’t that what they’ve been told at the beginning? Is it somehow less true at death?
When someone loses a spouse, they can lose so much more. They lose their partner, their routine, some friends, their identity as a wife/husband, sometimes financial means, loss of home or having to relocate, just to name a few.
People often expect the bereaved to bounce back within an arbitrary time frame. “Socially accepted” as a timeframe is inherently unfair as a guideline. Because social expectations are entirely out of sync with the realities of grief.
Consider that most employers give a few days to a week of bereavement time, if they provide it at all. Everyone grieves in their own timeline. The problem is that it can make other people uncomfortable and seek to hurry grievers along. The implied message is that it’s unacceptable outside of some prescribed timeline. People around grievers generally go back to their own regular lives within weeks or months after a death, and seem to expect grievers to follow suit.
Grief lasts for as long as the person remains dead. It’s our relationship to our grief, ourselves, other people, and our environment that can change. If there's a silver lining in all of this, perhaps it's that at least grief is being recognized and talked about more since the pandemic, instead of relegated to the hushed shadows.
Am I grieving? If you ask this question, the answer is probably yes. There’s an excellent chance that even if you’re NOT asking the question, the answer is probably yes, too. Grief applies to so many situations.
“While grief can result from a variety of situations, ranging from divorce and separation to traumatic injury or illness, probably the most difficult and heart-wrenching circumstance to deal with is the loss of a loved one through death.
“According to US government statistics, approximately thirty-six percent of the population is grieving at any given time. Grief associated with this type of loss is devastating for family and friends. This type of grief is a profound and all too often devastating experience for family members who are left behind. If left unchecked, grief can quickly turn into a deep depression and other serious psychological disorders.” —THERAVIVE, grief counseling
(Note that the above quote was written in 2019, BEFORE the global pandemic. The numbers are most likely much higher currently).
People generally think of grief as applying only after the death of a loved one. However, grief is a reaction to loss of something (or someone) that was meaningful to the person who lost it. That includes death, divorce, or other loss of relationship; loss of career; financial loss/issues; bankruptcy; loss of health, dementia and other ambiguous loss (the person may still be alive, but physically or psychologically absent); relocation, death or loss of pets; miscarriages; loss of routine/structure and other pandemic-related losses; retirement; death of an ex-partner; really anything perceived as loss of something/someone valued.
People also tend to think that grief looks like sadness and depression. Withdrawing, moping about, crying and sighing a lot, staying in a dark room without doing much all day long. It certainly CAN look like that, for some people, some of the time. It can also look like screaming, flailing limbs, wailing, lashing out, hitting things and looking very out of control, often in the beginning, upon discovery of the death, when grief is in an acute phase. Neither of these captures the whole picture. Each person’s grief experience is as unique as a fingerprint, with a highly individual timeline and journey.
Grief and mourning are two different things. Mourning is what is seen on the outside, the face and behavior presented to the outside world. Grief is what is felt and experienced on the inside, in private. These may be radically different. You may not see much of a reaction at all- stony-faced stoicism. Or you may see someone quick to anger at the slightest provocation—or without ANY provocation. Irritability, frustration, anger, worry, panic can all be symptoms.
There may be cognitive, behavioral, physical, emotional, spiritual symptoms. You may experience restlessness, akathesia (that feeling like you’re about to jump out of your skin), anxiety, worry, panic, physical pain that may either remain in one spot or move/travel around your body. You may feel scattered, disorganized, confused, easily frustrated, irritable, short-fused, quick to rage, overwhelmed, have no enthusiasm for anything, can’t sleep or sleeping way more than usual; increased or decreased appetite; wanting to shut everything and everyone out or retreat.
You may seek out help and support and then sometimes reject it, often angrily. Or grieving may look like throwing yourself into work or hobbies to distract yourself from how you feel. It may be that when you have quiet time, you feel a flood of emotions and it seems as though they’ll never stop—like you’ll cry forever. (You won’t). You may lose interest in things you usually enjoy. There’s a great deal of overlap between depression and grief. Grief in fact isn’t one emotion, it is many, often conflicting emotions and often all at once in a tangled ball. Often in waves, or “grief attacks” or “grief bursts.”
Grief taxes your immune system. I’ve had many people tell me “I didn’t used to get sick and now I seem to catch one thing after another!” You may feel like you’re “going crazy.” That’s actually normal. Because we’re comparing ourselves to how we were BEFORE loss(es) to how we are now, after loss. And we’re not the same person. It’s also unfair to compare how we are now to how others appear to be handling their lives and losses. This is because grief (and lives) and so highly unique to each person. It’s not a competition and there are no awards for “best at grief.”
You may experience confusion. I’ve had folks tell me “I got lost in my own neighborhood that I’ve lived in for years/decades!” Brain fog is a big one. It’s because our brains are affected by grief. It activates the pain and stress systems. We can’t engage our executive functioning. It’s like the brain has gone offline.
We’re in survival mode in grief. Pain and social bonding are connected. We literally feel physical pain alongside loss. These systems sit on top of one another in the brain. We are essentially looking for reunification with the lost person or thing—which is often not possible. These systems can be activated even when we lose something voluntarily, like leaving a relationship or moving. Those situations still come with losses that must be grieved.
Some of the best things you can do is to seek (and accept) support from people who won’t ally with your own inner critic. Exercise is also helpful. Journaling or other means of self-expression can help with processing after loss. Do all the things you can to improve your physical and mental health and wellbeing. Engage in activities that are meaningful to you—which may be the same activities you’ve previously enjoyed or may be new ones.
It is a universal human experience to endure losses: moving, divorce, changes in friendships and other relationships, and of course, death of our beloved pets and in our inner circle, all of which usher in a host of other “secondary losses.” Time on its own will not heal. It’s what you do with the time. Finding—and perhaps learning to accept—comfort and support in your community, finding meaning, going through your own journey of grief.
What emotion do you think of when you hear the word “grief?” Did you immediately associate it with sadness or depression? That’s fair, as most people do. What’s not talked about as often is the plethora of other emotions that come with grief – and one of the big ones is anger.
Bowlby wrote about anger as a reaction to loss, and likened this to the protest displayed by children after the loss of a parental figure (especially mother) whether temporary or permanent. He concluded that this was to facilitate reunion. He also noted that a similar pattern plays out in adult relationships as well. When we lose someone- through death, temporary separation, divorce, breakup, etc. --there are “seeking” behaviors and longing that go along with that.
When some well-intentioned person attempts to help someone who has experienced loss and grief, they are often met with hostility and rejection. This happens after the grieving person may have actually sought and asked for help in the first place. Bowlby wrote that this is because what the person is actually seeking is reunion with the lost loved one, and the helper, recognizing this is not possible, may be trying to pull the griever “back to reality” (acceptance) before the griever is ready, and therefore their goals are diametrically opposed. Grief is a reaction to loss, and the anger that comes with it can be extraordinarily intense, and often seen as out of proportion to outsiders.
At the root of anger is pain. Beneath that pain are layers of other emotions. At the core is grief. And grief is literally painful. Panksepp wrote about the PANIC/GRIEF system in the brain having developed from the PAIN system of the brain.
In the past I worked in retail at a jewelry store. A couple came in one day and the man was extremely angry, visibly and audibly. After yelling at one of the other associates and reducing her to tears, it was my turn. (Great!) After talking to the couple awhile, it became apparent that the disproportionate rage was misdirected. The man’s mother was at that time under hospice care, dying. And the expensive jewelry that he’d meticulously planned for a special birthday surprise for his wife failed to meet his expectations. Fortunately, after addressing the jewelry and allowing the man to talk (vent), his anger dissipated and he apologized to everyone for the outburst. Anyone who has ever worked in retail could probably tell (horror) stories of misdirected anger/rage like this.
Often a counseling or coaching client will present as angry, which can range from general irritability to rage. Sometimes it’s more generalized, sometimes there’s a target, often someone/something that the person blames for the loss. Sometimes it’s at themselves for somehow failing to prevent the loss. Sometimes it’s a higher power or medical professional, or the person who was lost. Sometimes they just seem to be angry at everyone and everything or at someone who had nothing to do with anything but is a “safe” target rather than the actual person/things they’re really mad at. This is displaced anger.
An example occurred when I worked as a hospice bereavement counselor. I had a client who seethed with rage, stomping, yelling, intimidating others, like a giant toddler throwing an outsized tantrum. It became clear that he did not allow any other emotions to be expressed, instead they were all channeled through anger. Once he became aware of this, he calmed a bit and eventually recognized that beneath the anger were complex layers of pain, guilt, regret, sadness, and other emotions he considered too vulnerable to express.
Anger is a tricky emotion. We often deal with it in one of two ways: letting it run rampant or denying and squelching it. Both are destructive. Many times, for men, especially, anger is expressed by funneling other emotions (anxiety, guilt, sadness, shame, regret, etc) into anger and rage. It’s seen as the more socially acceptable emotion to display. Anger can feel powerful and give us a sense of confidence and feeling of certainty, which we may crave. It can spur us to action. Anger itself is neither good nor bad. Think of anger like fire: it can heat your food or furnace, or can it burn your house down if uncontrolled.
“Loss of a loved person is one of the most intensely painful experiences any human being can suffer. And not only is it painful to experience but it is also painful to witness, if only because we are so impotent to help. To the bereaved nothing but the return of the lost person can bring true comfort; should what we provide fall short of that it is felt almost as an insult. That, perhaps, explains a bias that runs through so much of the older literature on how human beings respond to loss. Whether an author is discussing the effects of loss on an adult or child, there is a tendency to underestimate how intensely distressing and disabling loss usually is and for how long the distress, and often disablement, commonly lasts. Conversely, there is a tendency to suppose that a normal, healthy person can and should get over a bereavement not only fairly rapidly but also completely.” (From John Bowlby's Attachment & Loss Trilogy, Vol. 3 pg 8).
He who binds to himself a joy
Does a winged life destroy
He who kisses the joy as it flies
Lives in eternity's sunrise
A reminder of the ephemeral, flowing nature of life, and not to cling too tightly to anything or anyone--a recipe for suffering--but rather enjoy them while we have them, and realizing nothing lasts forever.
How can I get rid of this anxiety?!?
You may have heard—or asked yourself—some version of the above question. Spoiler alert: you can’t! Sorry to break the bad news to you. Don’t worry though (a form of anxiety!). There’s also good news.
Human beings have anxiety, first and foremost, as a survival mechanism. The stress response, “fight, flight or freeze.” That’s how your ancestors, you, and everyone else kept alive. It alerts us to danger, or potential threats that could lead to danger. The trouble is, in the modern-day world, it’s unlikely that we’re being chased by tigers, but there are a multitude of other everyday events and situations that can trigger those same survival mechanisms. Constantly. And that’s when it becomes problematic.
Uncertainty is a big trigger. Enter this current pandemic, and we collectively have massive doses of unknowns in every direction. There is unquestionably a wide spectrum individually, though no one is entirely unaffected. Even if we think we’re handling things well, there is a pervasive undercurrent of anxiety and stress, always on in the background, sapping our energy, unseen.
That’s our current reality.
But I promised good news, so here it is!
What if, instead of seeing anxiety as an enemy that must be beaten back and conquered, caged, or otherwise controlled, we chose to befriend it? Yeah, I said it. What in the world does that mean??
As I said earlier, we can’t get rid of anxiety, and it serves an important purpose. Recognizing this is the first step.
The next is to become curious. Notice when anxiety, worry, or panic come up for you. Ask it, as if it were a person “what are you trying to tell me or warn me about right now?” See what response you get from yourself. Then ask “is there anything I can do about this now?”
If yes, do that! If not, well, then it’s time to focus on things that ARE within your control. Perhaps that means stepping away from the situation for now, or taking care of yourself by checking in with yourself and addressing your needs, such as hydrating, eating nutritious food if you’re hungry, taking a break, meditating or simply focusing on your breath, journaling, connecting with another person, exercising, taking a walk (preferably outside in nature if possible) or an impromptu dance break (two of my favorites!). Or any number of other actions that work for you.
The point is to change how you relate to anxiety itself. You can do this by noticing when it comes up for you, any patterns you may have (also called “being present” or “mindful), focusing on the things you can actually change, allowing the anxiety emotions to move through and release, and taking care of yourself. Do this often enough, it can become a healthy habit, and you will eventually be able to catch anxiety early and prevent it from getting to such a high degree (or become panic).
Take good care.
Today I looked at the weather app on my phone, to see how long this rain was expected to last. A while later, I realized that I had looked at the app, but had no idea what the temperature was, because that wasn't what I was looking for in that moment. And it occurred to me, wow, that's how people are generally. We see what we look for, and what we believe. All else will be invisible to us.
This is how the human mind works, in fact. If we took in all sensory information available, we would be overwhelmed immediately. So our minds primarily delete anything outside where we habitually, or consciously focus, what it considers potentially important.
Our brains scan our environment based on our thoughts, feelings, experiences, and beliefs--our filters. Much of this is unconscious and habitual. We can also consciously ask a question, then our minds (and nowadays, fingers and Google) will search for answers to that question.
The questions themselves direct the answers we get. For instance, if our focus is negative, we'll get more negative back. The same happens if our focus is positive. So, we can use this system to our advantage, by paying attention to what questions we ask, and also HOW we frame them. In that way we can open up a world of possibilities, by making more of the invisible, visible.
It is unfair for you to ask of anyone something they are unable (or unwilling) to give, and that you are unable (or unwilling) to receive.
I sent this recently to a friend who is struggling with a breakup & depression during this pandemic, but I think it applies to most of us:
On this day, no matter how boring or difficult you may find it, know that you can choose to find ways to make it better. There's always a light in the darkness, though you must choose to see it, or may even need to seek it out. You are not alone, there are people who care about you. Know also that you MATTER...not just for what you can do, but for who you are. Remember that, especially on the grey days. 🤗