When I was driving my mom and I to the hospital, I knew that my father, who had been on a ventilator for about two months, couldn’t breathe anymore, even with this heavy-duty machine. My mom got the call from the doctor as we were at least 40 miles away. She remained calm. Tearless.
I knew my dad was dying and they were asking her permission to take him off the ventilator. His breaths were escaping through his five chest tubes.
But she didn’t say a word to me. (This was a gift I’ll never forget.) We drove in silence, as I clutched the wheel and refused to lose my composure. We drove in silence, while I tried to keep us safe and keep myself sane at the wheel.
That day was weird. For me, it was a mix of tears and numbness. At the service, there were more tears and even laughter (when the Rabbi read a funny memory my cousin had written).
But largely, I felt empty. I wondered where the torrent of tears had gone. And I thought there was something wrong with me. That I didn’t love my father enough, that I didn’t miss him. That I was in deep denial. I waited and waited for myself to collapse. I waited for my five stages.
But that’s the big myth about grief: contrary to popular belief, there are no five stages. In fact, the foundation of Elisabeth Kübler-Ross’s famous five stages came from interviews she conducted with terminally ill patients in a seminar for doctors-in-training. She never conducted one study to test the stages or talked with people who’d actually lost someone. While grief and loss literature is lacking in general, recent research has discredited the stages.
While there are patterns of grieving, people experience a variety of reactions, said grief counselor Rob Zucker. For instance, after his talk at a seminar, one woman approached Zucker and admitted that for the first year of her husband’s passing, she felt nothing. She was so ashamed of this, and thought it reflected poorly on her. She said that she’d never told anyone, but felt comfortable after Zucker had normalized this feeling. She felt safer that she wouldn’t be judged.
We don’t come into our grief as a blank slate, Zucker said. “What you bring to the table will impact how you process your loss.” According to journalist Ruth Davis Konigsberg in her book, The Truth About Grief: The Myth of its Five Stages and the New Science of Loss, “…probably the most accurate predictors of how someone will grieve are their personality and temperament before the loss.”
Zucker describes several patterns or themes that individuals may experience. But again, there is no step-by-step ladder of loss. Just following the loss, some people may experience a deep sense of disbelief, even if the death was anticipated, he said. (He added that this might serve as a buffer in processing the harshness of reality.) High levels of anxiety also are common. Some people may experience “an absence of emotions,” and wonder, like I did, “What’s wrong with me?” said Zucker, author of The Journey Through Grief and Loss: Helping Yourself and Your Child When Grief Is Shared.
The “second storm,” as Zucker explained, is an intense period of grief that may include feelings like denial, depression and anger. After the death of his father, Zucker had been grieving for six months, and suddenly while he was driving, he felt like a “brick had been thrown [through] the windshield.” “Something about the reality of [his] death slammed into me in a way that was so difficult.”
After the acute feelings go away, some people may reflect on the loss (while others may reflect right away), Zucker said. They may wonder, “Who am I now? How has this changed me? Have I learned anything? What do I want to do with my life now?”
One of the myths about loss “is that when you’re grieving, there’s never any joy, laughter or smiling,” according to George A. Bonanno, Ph.D, professor and chair of the Department of Counseling and Clinical Psychology at Teachers College, Columbia University. He noted that in his interviews with the bereaved, people were crying one moment and laughing the next, after recalling a memory, for example. There’s been solid research that laughter connects us to other people. “It’s contagious and makes other people feel better,” he said.
We may experience loss differently as we age and go through different developmental stages and life events, Zucker pointed out.
“You can have a very satisfying and meaningful life” after a love one’s passing, said Gloria Lloyd, bereavement community program educator at Mary Washington Hospice. She likened loss to a small piece of a quilt that symbolizes your life.
Another myth about grief is that it’ll destroy us. People tend to bounce back after loss much faster than we previously thought. For instance, according to Bonanno’s research, for most people, intense grief (with symptoms such as depression, anxiety, shock and intrusive thoughts) seems to subside by six months.
As Konigsberg wrote in her book, other studies have found that these symptoms dissipate but “people still continue to think about and miss their loved ones for decades. Loss is forever, but acute grief is not…”
Resilience used to be viewed as either pathological or rare, reserved for only particularly healthy people, Bonanno writes in a 2004 article in the American Psychologist (you can access the full-text here). He wrote: “Resilience to the unsettling effects of interpersonal loss is not rare but relatively common, does not appear to indicate pathology but rather healthy adjustment, and does not lead to delayed grief reactions.”
There’s “no prescription or rulebook” for coping, Zucker said. There are lots of different ways to cope with grief, Bonanno said. And sometimes, coping is simply a matter of getting it done — what Bonanno calls “coping ugly.” He said that “anything short of harming yourself is probably OK if you’re struggling.”
For instance, in his research, he found that self-serving biases — taking credit for successes but not taking responsibility for failures — are helpful when dealing with loss. People may find benefits in the loss, such as “I am just thankful that I had the chance to at least say good-bye” or “I never knew that I could be so strong on my own,” Bonanno writes in his book, The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After Loss.
What’s effective really depends on what feels right to you. Bonanno hated the funeral ceremony for his dad. “It was making me miserable,” he said. So he went to another room and sat by himself and started rocking back and forth, humming a bluesy tune. Someone came in, he recalled, and said “I’m worried about you.” Bonanno was taken aback by the person’s reaction because this made him feel much better. After 9/11, Bonanno sought out comedy films to get his mind off of the tragedy. A German magazine that had written an article about Bonanno thought this was odd, he said.
Identifying your thoughts and feelings, expressing them in some way and perhaps sharing the process with someone you trust can be helpful, Zucker said. One way to cope, he said, is through journaling and processing what you’ve been feeling, thinking and doing. You also might talk with a loved one, or express your grief through physical activity or art. He noted that identifying, expressing and sharing can help individuals who’re experiencing the “second storm.”
People also can benefit from considering how they’ve grappled with tough times in the past, Zucker said. If you’re struggling with anxiety, what has helped you before? You may turn to new tools, such as meditation, physical activity or deep breathing.
Counseling can help, as well. However, research shows that “only people who are doing poorly [with grief] should get treatment,” Bonanno said. (Some studies have suggested that for people experiencing normal bereavement, therapy can make them feel worse.) A small percentage — about 15 percent — of people do experience complicated grief, an extreme form of grieving. Therapy is “most efficacious for people who are having serious problems,” he said. “The more effective treatments have focused on getting people back into their life and moving forward,” he added.
All experts recommend reaching out to loved ones and getting support. Some people may feel isolated and believe others don’t understand what they’re going through, Lloyd said. So support groups may also be helpful. For instance, Lloyd leads a support group a few days before Valentine’s Day.
How many times have you heard someone incredulously say something along the lines of, “Oh, her husband died just six months ago, and she’s already started dating; how could she do such a thing?” or the reverse, “It’s been six months, you should be over this already.” Accept people [and yourself] where they are,” without judgment, Lloyd said.
Again, as mentioned above, positive emotions are protective. There’s been much research to show that positive emotions and laughter are tremendously helpful when coping with loss.
Ultimately, remember that people are resilient and you have to find what works for you. Still, if you’re really struggling with grief, seek therapy.
Photo by “procrastination,” available under a Creative Commons attributive license.
Tartakovsky, M. (2011). On Grief, Loss and Coping. Psych Central. Retrieved on December 6, 2013, from http://psychcentral.com/lib/on-grief-loss-and-coping/0006128
Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
Published on PsychCentral.com. All rights reserved.