Coping with Grief

The evening sun, its once bright consciousness now markedly dimmed.

- Carl Gustav Jung

Since we were a child, our guardians have already taught us the names of various emotions that we were feeling. We were taught how to properly express those to show to other people. For instance, we grew up singing children's songs that go “If you’re happy and you know it, clap your hands” which tell us what to do when we are happy. We also sang “Twinkle twinkle little star, How I wonder what you are '' which gave us an early hint about curiosity. They also taught us how to manage our anger whenever we pick fights with our siblings or Braven up every time we got afraid of thunder or dark rooms. However, there is one emotion that was not well-introduced to us when we were young— grief.

Grief \ ?grēf \ is a five-letter word which according to Merriam-Webster (n.d.) means “deep and poignant distress caused by or as if by bereavement; deep sadness caused especially by someone's death”. In other words, it is the emotion we feel when we lose a loved one because of their death, a concept that is also difficult to explain to a young child. Due to the grave situation of the COVID-19 pandemic in the Philippines, the country recorded thousands of death tolls. Thousands of people whose death left their families to feel nothing short of grief which may result in negative impacts on our lives when prolonged. As the bereaved person undergoes a major life transition following a death of a loved one, they may experience physical symptoms of grief, such as sleep disturbances, fatigue, difficulty in concentration, and loss of appetite (Utz et al., 2012).

They may also experience chronic stress which can lead to various physical and emotional issues (Harvard Medical School, 2021). Moreover, bereaved individuals may experience an impact on their mental health. In a study by Joaqum et al. (2021), they found out that there was an increase in psychological distress experienced by people who lost loved ones due to COVID-19. More than that, those who previously presented psychiatric diagnostic characteristics who also lost a loved one because of COVID-10 have exhibited a rise in symptoms of anxiety, depression, phobia, paranoia, hostility, interpersonal subjectivity, obsessive-compulsive disorder, and psychoticism (Joaquim, 2021). Despite the sorrow they must be feeling, the bereaved must keep going. They may feel the world has fallen apart, but it does not stop spinning while they are in the process of mourning.

Five Stages of Grief

This dilemma has been more true to the students and employees who had to continue their daily routine while silently suffering from the loss of a loved one. Each of us has our own way of dealing with grief— some might express their emotions through uncontrollable crying, while some might seem to handle it pretty well. But in a book entitled “Death and Dying” published in 1969, a Swiss-American psychiatrist, Dr. Elisabeth Kubler-Ross, introduced a theory centered on five (5) stages of the psychological process or stages in one’s acceptance of death (Plotnik & Kouyoumdjian, 2014). However, she began to expand her own model and extend it to cater to other kinds of loss. It was later known to become the five (5) stages of grief (Casabianca, 2021). Based on Kubler-Ross’ model, people commonly react to loss through the following:

• Denial - This is a common defense mechanism of people after learning about a loved one’s death. This temporary response helps them to suppress pain and deal with an immediate shock after hearing devastating news (Casabianca, 2021).

Example: Waiting for a call from someone who will say that the news was a mistake and your loved one is alive and well.

• Anger - Pain can take other forms which according to Kubler-Ross, may be redirected as anger. At some point, one might feel guilty for being angry at this point in their life which could make them even angrier. Thus, it is important to remember that pain lies underneath that anger. Feeling those kinds of emotions is an important part of the healing process (Casabianca, 2021).

Example: Asking questions like “Why does it have to be me?” or “What did I do to deserve this?”

• Bargaining - It is a way of clinging to even the slightest hope we have. In this stage, people think about their willingness to sacrifice everything they have just to go back to a time prior to their loss (Casabianca, 2021).

Example: Saying things like “I will quit my vices, just bring my loved one back!”

• Depression - This stage is different from the mental health disorder. Rather, the depression stage pertains to a point when you begin to accept the reality of your loved one’s death. This realization is accompanied by extreme sadness (Casabianca, 2021).

Example: Feeling confused, fatigued, and unwilling to move on

• Acceptance - One does not necessarily need to be completely healed during this stage. Acceptance just means that you are starting to acknowledge the loss you experienced, and learning to live by them to continue moving forward with your life. It is important to remember that acceptance is not a linear process— one might experience going back and forth between grief stages. However, this is a natural part of the healing process (Casabianca, 2021).

In 1974, Kubler-Ross explained that some people might not go through all stages or they may experience a different grieving stages sequence. By doing so, she stressed that there is no “best” or “specific” way of dealing with the loss of loved ones. Sometimes, people do something they think is helpful in dealing with grief, only to find themselves in situations that hamper their healing process. According to Bruce (2020), these unhelpful practices include avoiding emotions, engaging in compulsive behaviors, minimizing one’s feelings, overworking in their job, and misusing drugs, alcohol, and other substances. While these activities temporarily suspend people from confronting their grief, these could be harmful in the long run. As previously mentioned, there is no right or wrong way to cope with grief. However, people may want to engage in healthier ways to get through such tough situations in their lives.

Overcoming Grief

The process of grief resembles a wave-like pattern (Morris, 2008). There were times when the bereaved reported to have moved on from the death of their loved ones, only to encounter a surge of emotions each time confronted by various triggers such as hearing the favorite song of the deceased played by local radio or remembering events from a significant death. These ‘trigger waves' are perfectly normal and part of the healing process. Aside from this, the waves also help to create a framework that helps the bereaved understand their experience of grief and improve their sense of control during a challenging time in their lives (Morris, 2011).

A CBT-trained clinical psychologist, Sue Morris, published a book in 2008 entitled “Overcoming grief: A self-help guide using cognitive behavioral techniques. In the book, she mentioned simple strategies that bereaved individuals could follow and expedite their process of healing. These are as follows:

• Doing simple routines - It can be as simple as following a regular schedule for meals and bedtimes.
• Engaging in self-care activities - This may include regular medical check-ups, daily exercise, and eating right.
• Categorize worries - Create a list of things that worries you, and act towards resolving those. You may tick off the items that you already completed.
• Brace one’s self to new or challenging situations - Always plan ahead of time, and adopt a "trial and error" approach to various situations
• Oppose unhelpful thinking - Identify intrusive thoughts that lead to guilt and anger. Reflect on things that possibly motivated those thoughts.
• Create a decision-making framework - It is helpful to avoid arriving at a certain decision that may affect the rest of your life. It is important to remember that decisions should be based on evidence and not emotions.

Aside from these, Morris (2008 as cited in Morris, 2011) also stated that it is important for the bereaved to have information about grief which may help them learn what to expect along the process. Grief is an emotion not often talked about. Hence, bereaved individuals must know that grief patterns have a wave-like nature and they cannot expect a straight path in their process of overcoming grief. They must expect ‘trigger waves’ and acknowledge that it is a part of the process. Younger children who also experience grief must also be included and educated that the sad feeling they experience is a natural response to loss.

When left unattended, prolonged grief can make negative impacts on our lives— especially in our mental health. The pain that comes with the loss of a loved one must seem unbearable for now. But just like how there is always a rainbow after the rain, we can hope that things will get better. For now, introduce yourself to the feeling of grief that for you was once a stranger. Get to know it better and find your own way of understanding and dealing with it. You got this.

Author: Christine Joy M. Infiesto

References:

Bruce, D. F. (2020, September 20), Grief and Depression. Web MD. https://www.webmd.com/depression/guide/depression-grief

Casabianca, S. S. (2021, February 11). Mourning and the 5 stages of grief. Psych Central. https://psychcentral.com/lib/the-5-stages-of-loss-and-grief

Grief. (n.d.). Merriam-Webster. https://www.merriam-webster.com/dictionary/grief

Joaquim, R., Pinto, A., Guatimosim, R., de Paula, J., Costa, D., Diaz, A., da Silva, A.,

Pinheiro, M., Serpam A., Miranda D., & Malloy-Diniz, L. (2021, November). Elsevier, 2. https://doi.org/https://doi.org/10.1016/j.crbeha.2021.100019

Morris, S. (2011, December). The psychology of grief - applying cognitive and behavior therapy principles. Australian Psychological Society, 33(6). https://www.psychology.org.au/for-members/publications/inpsych/2011/dec/The-psychology-of-grief-%E2%80%93-applying-cognitive-and-b

Utz, R., Caserta, M., & Lund. D. (2012, August). Grief, depressive symptoms, and physical health among recently bereaved spouses. The Gerontologist, 52(4), 460-471. https://doi.org/10.1093/geront/gnr110