Article #1
Grief = Love
"Grief is the other side of the coin of love." (Rabbi Earl GrolIman)
GRIEF - WHAT IS GRIEF?
- Simply stated: grief is our natural response to loss. The more acute our loss, the more acute our grief.
- Grief is a normal, natural and necessary, healing process that occurs over time. Grief affects us physically, psychologically, socially and spiritually.
- There is no definitive time-table for the process of grief.
- As we heal from our wounds of loss, we often experience unexpected personal growth and a new appreciation for life.
WHAT KINDS OF LOSSES CREATE A GRIEF RESPONSE?
Loss of a RELATIONSHIP - including loss of a loved one through separation, divorce, death, and loss due to physical and geographic distance (such as military deployment to a foreign country)
Loss of a ROLE - physical/bodily changes (illness, aging), status change (marital status, empty-nest, caring for aging parents), job change (job loss, transfer, retirement and advancement)
Loss of an OBJECT - loss of function (ie. anatomy issues), loss of meaningful possessions (damage, theft, fire, misplacement), moving to new setting, financial loss
WHAT ARE THE PHASES OF GRIEF?
While grief varies with the individual, there are characteristic phases, behaviors and feelings that occur. They are not the same for all people, nor have specific time frames. The severity of our grief is related to the severity of our loss. The following are three typical responses to significant loss:
In the early phase of grief, the SHOCK, includes responses of shock, disbelief, numbness, and denial, which are often followed by a period of "mechanical functioning" (in the early days, weeks or months of grief- depending on the loss). At this time families are preoccupied with a funeral or memorial service and attending to the issues of business, insurance, and notifications of the death. This phase is characterized by the feeling of: "I can't believe it happened!"
In the middle phase of grief, the REALIZATION, the survivors recognize the impact and the reality of the loss. Numbness and psychic insulation have eroded and reality emerges, bringing with it: anger, guilt, disorganization, depression, bargaining, fear and concern that -"I am not doing better. " Middle grief is characterized by feelings of -"Now I know it has happened and I don't know what to do."
The later phase of grief, the RESOLUTION, brings less angst, a time for reorganization, accommodation to the loss and a reinvestment of energy, renewed hope and the ability to think of the future and moving forward. Later grief is characterized by feelings of -"I think I can go on now."
WHAT HELPS US THROUGH THE PROCESS OF GRIEF?
There are three particular things that help us navigate through the confusing, discouraging process of grief. They are: information, permission, and support.
INFORMATION - knowing what to expect, guidelines, resources which give us a road-map. -"Just knowing it's normal to feel this way, makes me feel better."
PERMISSION - realizing that it is normal and necessary, permitting the feelings and behaviors to happen. -"You must feel it to heal it!"
SUPPORT - family, friends, neighbors, faith, support groups, professionals, and finding new personal interest. -"Joy shared is joy increased- grief shared is grief diminished"
GRIEF- IT IS HELPFUL TO REMEMBER:
Grief is a personal experience, unregulated by time. It has phases that overlap and sometimes we "get worse, before we get better." Grief is a necessary part of resolving personal, acute loss. Grief is an opportunity for new appreciation of life and personal growth.
@: Marilyn K. Gilbert, Ph.D. Author: Voices Left Behind - Personal Journeys Through Loss and Grief, www.drmarilyngilbert.com, drmarilyngilbert@aol.com
Article #2
I NEVER KNOW WHAT TO SAY: How to Help In Times of Loss and Grief
Many of us are uncomfortable with issues related to dying, death and funerals. For some, the discomfort is so great they avoid contacting grieving friends and relatives or attending the funeral or memorial service. Then, over time, they feel guilty and awkward about their avoidance. There are no "magic words," but there are comfortable ways we can lend comfort and support. It's helpful to express ourselves in a manner personally appropriate to the situation. If we "care," we can't go wrong!
DON'T'S
Don't make offers you can't fulfill. A completed-minimal gesture means more than an empty promise.
Don't tell them: your own grief story, to cheer-up, that you know "just how they feel," to stop crying, that their loved one is better off, that they have other children, or they are young and can remarry.
Don't forget extended grievers: siblings, grandparents, step-parents, step-children and significant others.
Don't forget holidays and personal anniversaries (often the weeks preceding the event are the most difficult).
Don't put a timetable on grief, telling survivors: "It has been......months now, it's time to move on."
Don't hide your own tears. If you show your own feelings, the bereaved know you really care.
DO'S
Do something! There many ways to acknowledge loss: a phone call, a personal visit to the home or funeral home, a written letter or card, email, text, preparation of food, helpful tasks, sending memorials, flowers or donations.
Do write - if that's your style. Families appreciate written notes, cards, or texts and emails which they can save to re-read as time goes on, and they don't feel obliged to answer them. It's always comforting to receive a written note months after the funeral - there is always time for kindness.
Do give "permission to grieve." You are not expected to have answers, just be available to listen and care.
Do refer to the person who died by name. Often we avoid talking about the deceased to protect families. It's just the opposite; families want and need to discuss their loved one, even if it evokes tears.
Do remember survivors in the days, weeks and months following the funeral (remember, grief is generally "worse" six to eight months after the funeral).
Do know that you can't remove hurt and pain, but you can lighten the load by caring.
Do give yourself credit - any gesture, small or large, overt or quiet, means a great deal.
Do allow the loss and grief of others, help you enjoy and appreciate your own life even more.
Cr: Marilyn K. Gilbert, Ph.D. Author: Voices Left Behind - Personal Journeys Through Loss and Grief, www.drmarilyngilbert.com, drmarilyngilbert@aol.com
Article #3
Children and Death
The child asked: "Why do people have to die?"
The adult responded: "To make life important." -(HBO Series: Six Feet Under)
Timmy ran into his kitchen exclaiming: "Mommy, the workmen are cutting down the big tree next door? Won't they kill the tree?"
His Mother wisely used that opportunity to explain to five-year-old Timmy that there are seasons of life. In the spring, our trees have new leaves bursting open and in the fall, the leaves turn pretty colors, die and fall to the ground. Also, some trees get older, they die, and workmen must cut them down. Then new trees grow. The same is true of people and the cycles of life.
Should children know about death? Yes! Learning to understand and accept death is a normal, natural life experience. Excluding children, "protecting them" from difficult times, robs them of the opportunity to develop adequate life coping skills. Including them in family events, such as weddings and funerals, helps them feel like part of the family unit and builds confidence.
Children and teens, who are not provided with information and clarity, will create their own answers to questions. In their "magical thinking" they may come to the wrong conclusions. Based on their own frame of reference, they may conclude that somehow the death was "their fault."
Including children in family events, gives them an opportunity to vent their feelings and ask questions. Honesty is the best policy. Try to avoid euphemisms. Instead of saying, "Bobby, we lost your Grandpa," it is healthier to say; "Bobby, your Grandpa was very sick and he died yesterday. We will put on our dress up clothes and go to the funeral home to say goodbye together."
The following may be helpful tips with children and teens:
• Honesty is the best policy. Tell the truth, carefully selecting the words you choose.
• Keep it simple. Younger children don't understand unseen truths. Their major concerns are their own personal needs, so assure them they are safe and secure.
• Include them in the family plans and rituals. Young children, for example, can draw pictures to place in a casket or pin on a memory board. Teens may be suitable for assisting with the funeral service, helping during the visitation, even as "junior pallbearers," when appropriate.
• Follow through. In the days and weeks that follow a death in the family, check in with children and teens to be assured they are not harboring personal guilt or unrealistic expectations.
• Share happy, positive family experiences, tell stories and enjoy scrapbooks and family movies This keeps the memories vital and memory is the cradle of love.
Participating with the family in times of joy and sorrow, enriches family ties and ensures future growth. Dealing with death, helps us deal with life.
Cr: Marilyn K. Gilbert, Ph.D. Author: Voices Left Behind - Personal Journeys Through Loss and Grief, www.drmarilyngilbert.com, drmarilyngilbert@aol.com
Article #4
Funerals are for the Living
"The funeral or memorial service can be considered a personal gift to our loved one." -Dr. Marilyn K. Gilbert
My Father died on Halloween, one of his favorite days of the year. His was a "good death." He died in a hospital bed at home in his living room, with his family close by. Dad died in peace. Less than three months later, my Mother died on a frigid January afternoon, in a sterile hospital room in ICU, with impersonal (but necessary) machines and life support surrounding her. Hers was a difficult death. I grieved for both of them, but it was a different grief. The way our loved one dies affects our grief.
The funerals I planned for each parent were really for me and for all who knew my parents. The memorial services for each parent gave us a chance to honor their lives and, also to come together to share and grieve. It was in planning my parents' funerals that I realized that funerals are for the living.
Funerals have two key purposes: (1) to honor the person who has died, and (2) to address the needs of the living. As enlightened as our culture has become, we continue to struggle with death and funerals. It's easier to divert our grief than address it. Often we become so involved in the details and planning and the "business of the death," that we lose track of the meaning of the funeral. Funerals and memorial services are important life passages, and the more personal they are for us, the more meaningful they become as time goes on.
Marge, a recent widow, said: "Here I am at the funeral home, meeting people who knew my husband, and there he is in the casket over there. Yet I feel like a hostess planning a reception of some sort. I introduce relatives to neighbors and attend to details of his funeral. Yet, my husband is dead and I feel nothing. Is this normal?" I assured Marge it was normal and not at all unusual. In early grief, at the time of the funeral, we find ourselves feeling numb and distracted, almost "doing better than we think we should."
The more personally involved the family is in the funeral, the more meaningful the funeral. Know what is best for you and your family. Talk about these issues as freely as possible. Resolving conflicting ideas and making critical decisions before the need arises, helps circumvent conflict and confusion. It also creates a healthier resolution of the loss.
It's also helpful to speak with a clergy person or a funeral director, getting information and assistance about these major end-of-life-decisions. If you are in a position of arranging a funeral for a loved one, make an appointment with a local funeral director. Ask questions and clarify your needs and wishes. The funeral is a significant, life-altering event in the history of a family. It deserves forethought, concern, honesty and even, when appropriate, levity. It is an opportunity for a family to love and grow together.
Cr: Marilyn K. Gilbert, Ph.D. Author: Voices Left Behind - Personal Journeys Through Loss and Grief, www.drmarilyngilbert.com, drmarilyngilbert@aol.com
Article #5
Suicide: Why? What?
"Why," we wonder, "would anyone willingly choose to die?"
When someone dies of suicide, the grief is extreme. Among the feelings are: shock, disbelief, shame, guilt, anger, and total confusion. The adjustment to this critical loss is slow, confusing, painful, and lonely.
WHY DID THIS HAPPEN?
It is believed by professionals, that people who die of suicide, are in incredible personal pain, and most likely they are not choosing death as much as seeking an end to unbearable (physical or psychological) pain.
It's difficult to understand the hopelessness of the victim, and we continue to seek answers to the question "WHY?" I suggest that survivors try to replace the question "WHY?" with the question "WHAT?" It may be more helpful to ask: "What can I do about this, now that it has happened?" We can't change the outcome of the suicide. We can, however, change the impact of the event on ourselves and others affected by the loss.
WHAT CAN BE DONE?
To heal the pain, we must feel the pain.
We find ourselves overwhelmed with feelings. These may include:
Initial shock - "I can't believe this has happened."
Bargaining - "If only I had___________, then he/she would not have done this."
Guilt, remorse -"I should have seen the clues. I didn't try hard enough."
Anger - "How could he/she do this (to me)?" or "Why couldn't I stop it?"
Depression- "I feel so sad. I have an empty, hopeless feeling about life now."
Disorganization/confusion - "Things aren't the same anymore; my life is all out of sync."
Stigma/shame - "What can I tell people? This is so embarrassing."
Impotency - "I have no energy, no zest for life. I don't even know who I am any more."
To heal the wounds of grief there are three steps to take that can help:
l) INFORMATION: understand normal grief reactions to loss, especially as it relates to loss by suicide, and know that grief is a natural, normal and necessary response to loss.
2) PERMISSION: give yourself --"permission" to feel whatever emotion is occurring and don't compare your grief to others' as grief is a very individual process.
3) SUPPORT: try to glean support and understanding from a relative, friend, colleague, clergy, a professional, a support group (look on the internet), or a neighbor. Know that sharing and support diminish the hurt and pain of such loss
"Grief is a testimony to our love. Grief shows that we have compassion for others. It takes time, sometimes a long time. Often we get worse before we get better. This is all normal. Try to let the grief experience help you grow - not diminish you."
-Dr. Marilyn K. Gilbert
Cr: Marilyn K. Gilbert, Ph.D. Author: Voices Left Behind - Personal Journeys Through Loss and Grief, www.drmarilyngilbert.com, drmarilyngilbert@aol.com
Article #6
Depression: Walking in Glue
The young woman curled up into a small ball on the "therapy" couch, lowering her eyes to stare at an invisible spot on the carpet below her. For her 30 years, she looked young, vulnerable, frightened. Finally, she spoke:
"It's like this, Dr. Gilbert - it's like walking in glue. For me, it's so hard to move through the day, through my life. Some days I stay crouched in the warm water of my bathtub. It feels safe there, and I never want to leave that place. Does this make sense to you?"
For those who have never known the debilitation and fear of acute depression, my patient's experience may be difficult to comprehend. For those who suffer from acute depression, it may be all too familiar,
DEPRESSION: WHAT IS IT?
I tend to think of depression as a continuum, ranging from, at one end, "a mild case of the blues," to the opposite end of "severe blackness, immobility, and hopelessness." It is an experience common to many, and it is often misunderstood.
There are two forms of depression: exogenous and endogenous-
Reactive depression (exogenous depression) results from external stimuli and events. Onset occurs as a reaction to a significant life event such as: illness, loss, trauma, divorce, job loss, death in the family, life change, world event and anticipation of an event. It causes feelings of sadness, lethargy, loneliness, loss, disorganization, fear, appetite and sleep disturbances, impotence and behavior problems. The intensity of this form of depression is milder and more short-lived than clinical depression.
Clinical depression (endogenous depression) refers to internal, chemical processes and is not brought on by external events, but attributed more to biochemical chemical imbalances. It is more severe, and of greater duration and intensity than reactive depression. One who suffers from this depression experiences: debilitation, fright, impotency, acute sadness, appetite and sleep disorders, loss of interest in life and activity, overwhelming fatigue and suicidal idealization. Professional help is critical.
DEPRESSION: WHAT CAN BE DONE?
The first step is to acknowledge or recognize it. Depression is nothing to be ashamed of and help is available. Assessment can be done in many ways: medical and psychological professionals, depression screening, counselors (school, workplace, private, and community social services).
Accurate evaluation of the nature and severity of depression is critical. It provides a guide and course of treatment, offering a solution. Generally, it's believed that a combination of psychiatric and pharmacological assistance, combined with psychotherapy, is an effective treatment plan.
Depending on the severity of the depression these are some of the tools available:
- Personal commitment to understand depression and to feel better via:
Nutrition including healthy diet with protein, vegetables, fruit, lots of water
Exercise on a daily basis, including even minimal (ie. walking 10 minutes/day)
Adequate rest, sleep, relaxation time
Assistance and support via family, friends, support groups, medical and mental health professionals
-Medical intervention via:
Consult a medical professional for a complete physical
Consult a psychiatrist, who can effectively address pharmacology
Hospitalization when needed: outpatient or inpatient
-Psychological intervention via:
Consult a psychologist, counselor or mental health care provider
Group therapy
Support groups (consult internet)
Involvement in activity (find something you enjoy, regain a sense of purpose)
The bottom line: Whether you have a mild case of the blues or are suffering from long-term debilitating depression, it's important to address these issues and regain control of your life.
Help is available!
Cr: Marilyn K. Gilbert, Ph.D. Author: Voices Left Behind - Personal Journeys Through Loss and Grief, www.drmarilyngilbert.com, drmarilyngilbert@aol.com