Dealing with grief for the bereaved and their associates

Grief affects different people in different ways. Some are able to work through it fairly quickly while for others it takes a great deal of time.

Dr. Elisabeth Kubler-Ross, one of the premier researchers on death and dying, identified five primary stages of grief:

1. Denial ("This isn't happening to me")
2. Anger ("Why is this happening to me?")
3. Bargaining ("I swear I'll be a better person if....")
4. Depression ("I don't care anymore")
5. Acceptance ("I'm ready for whatever comes")

It is important for those going through this process and for those who know them to understand that you can not get to number five without going through at least parts of 1-4. The human mind needs those stages to fully cope with what is happening. If you miss every stage, you'll end up going back to it later and slowing down your progress. Depending on who you are, you may go through more than one at once, but you can not come to acceptance automatically.

Some of us have a hard time expressing ourselves. Some think they will be considered weak if they show pain and others don't want to be a bother. The simple fact is that every person on this planet that lives for a reasonable amount of time is going to experience the loss of a loved one, whether it's a parent, friend or pet. The very small percentage of people who do not understand someday will. So don't feel afraid to feel. It's natural.

Dealing with someone with an illness can be especially hard because you actually go through the stages of grief twice. First you have to come to accept the disease in the first place and later you have to come to accept death. Even if you feel prepared however, you can't predict how you will react when death finally comes to someone you love.

There is one part of the grieving process not immediately acknowledged in Kubler-Ross's five part list: guilt. Especially during the Anger stage, guilt can play a big role. You may feel guilty because you feel you could have been more helpful, said more kind words, been around more, or just for feeling angry at all. Guilt has no positive impact that I can think of in this situation. The reason these stages are so acknowledged is because they are human nature. You should not feel guilty about feeling something that is entirely natural.

Once you accept that you will go through many or all these stages, you can start to work through them. It is possible no matter how difficult it may seem, as long as you don't try to stop yourself. Coming to accept the situation is the only way to move on. The pain will always remain to an extent but the first order of business after losing someone is to figure out how to keep living. That may take time but it's a necessary journey.

Here's an example of how not going through these stages will hurt you in the end: A friend of mine died tragically before her time, but I was so busy for the first several months after her death that I didn't allow myself to grieve in any capacity. A year later it all came crashing back and even though the breakdown was hard, it was also a breakthrough. I was finally able to start getting past it. Once you lose someone you love, it's my opinion that the best thing you can do in their honor is to live the best life you can. To do that you have to allow yourself the time to truly grieve.

Losing someone is one of the most painful things you can go through but it can be made better by others. If you know someone who has just experienced this, here are some helpful tips:

• Their moods may change dramatically. One minute, they might laugh hysterically and the next they may break down in tears. This isn't your fault, and they just need some silent support. If the mood changes make you angry, just remember that they can't help it. They are working through something that may take time to overcome.
  
  
• Anger is common. If they suddenly snap at you, don't feel bad or get angry yourself. You are most likely not what they are mad at, but they needed the release. If you're hurt by it and they don't seem to notice, let them know kindly. They will most likely apologize but understand it isn't personal.
  
  
• A lot of times, just being there is enough. Don't worry if you don't know what to say. A hug can say it all.

Because one must go through all five stages of grief, "stealing" it can be a problem, if not at all intended. When I say "stealing grief," I'm referring to some sometimes well-intentioned habits that stop a person from going through the stages for a period of time. Here are a few ways you can steal grief, even if you have the best of intentions:

• Telling a bereaved person not to cry. Letting out the pain is a necessary function of progression. A person needs to expend that energy because if it isn't let out, it doesn't fade - it builds. "Bottling up" feelings leads to future break downs and bouts of depression. One of the best stories my Death and Dying teacher told us to illustrate this is about a woman who had just lost her husband. An acquaintance was there when she got the news. The women broke into hysterical sobs, screaming and railing against the world. The man simply sat there and stayed quiet, keeping his hand nearby for touch if it was needed. When the woman exhausted her tears, she hugged him and thanked him for his support. His presence was the strength she needed to allow herself to let go. She could free herself and know that someone was there to help her when she was ready. If the man had instead told her not to cry, the same pain would have come out later when she may have been alone and especially vulnerable. Sometimes just being there is the best thing you can do.
  
  
• Countering someone's pain with your own. Everyone has either done this or experienced it. You just lost your mother and your friend tells the worst possible story about how hard it was for him to lose his father. This is a tough one because some people do want to hear those stories, while for others it only causes more pain. In my experience dealing with people who are grieving, I've decided that not telling those stories does far more good. Instead you can be there for them and when they're ready to hear about how you got through it, they can ask. Most of the people I've dealt with only feel an increase in their pain as well as a renewed worry for their friend's situation, no matter how far in that past that situation is. And some feel like you are telling them that their pain isn't bad enough to worry over, which can lead to very bruised feelings.
  
  
• Telling someone it will be all right. This is a very well-intentioned idea. You want your distraught friend to know life will go on, but in my experience that person may not be ready to hear that. I can't tell you how many times a bereaved person has exclaimed to me, "I wish they'd just stop telling me it will be all right! It's not all right! How would they know?" Someone who just lost a loved one isn't going to feel like the world is spinning properly until they decide that it will. Some also take this phrase as an admonishment that they shouldn't be upset because things will get better. Someone experiencing loss can not be told that they are not allowed to be upset, because there is no way to stop those feelings. I know that when people told me things would be all right after my mother's ALS diagnosis, all I could think in my mind was, "Yeah right. Your mom doesn't have an incurable disease, what do you know?" Even though I knew those people were only trying to help, it was natural to buck off their advice.

There are a lot of opinions about whether or not children should be told when a parent, friend or other loved one is seriously ill but the medical community by and large agrees that honesty is the best policy. Children are extremely aware and can tell when something is wrong. If you lie to them, they will come up with a reason for mommy's tiredness on their own and it will most likely be worse than the truth. If children aren't told what is going on, they may feel extremely betrayed later on, or at least resentful because they know something is being hidden from them.

Kids will have a lot of questions. The answers will help them deal with the situation. They need to know that mom or dad's illness is not their fault - they are very likely to believe something they did caused it and they need reassurance. They are also moment-by-moment sort of people so they may ask the same questions more than once.

There's a very succinct article on talking to kids about illness at Growing Kids.

Grief can be exceedingly difficult for the bereaved and the people they know. It can be dealt with and you will survive. After all, what happens to us doesn't define us - how we deal with it does. Make the most out of your life and you will do a great honor to those you miss.