WHAT IS GRIEF?
The first step towards better interaction with a grieving person is a better understanding of grief. In this context, a grieving person refers to someone who has lost a loved one in a shocking or devastating manner. Suicide, homicide, or loss of a child or spouse at a young age are cases where the bereaved person is likely to need a lot of support in their grief. Interacting with a person who has lost a loved one in this manner may be difficult for others: the enormity of their grief may make you feel helpless. For practical information on how a professional should interact a grieving person, see Meeting a bereaved person.
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Grief following a sudden death of a loved one
Grief is more than sadness. The grief resulting from the loss of a loved one comes with a wide spectrum of emotions: it’s common to miss the person, to feel anger, bitterness, fury, guilt, anxiety, despair, loneliness, depression, hopelessness, isolation, agony, pain, helplessness, exhaustion, fear, terror, unsafety and shame. The loss may also come with emotions that are regarded as positive, such as relief and joy. Besides emotions, the loss affects a person’s behaviour and attitudes – and manifests itself as physical reactions in your body.
Life changes permanently with loss. Grief is more than a disturbance to get over with – it’s a normal reaction to a heavy loss. The goal of a grieving person is not to ‘let go’ of their dead loved one, it’s to adapt to a life without their loved one. Time will bring new things into your life without breaking up your relationship with the deceased.
The most acute pain will ease with time, but you will never have to stop missing your loved one. Grief can bring about positive changes: the bereaved person may feel that their values have changed for the better. They may value life and people dearest to them more. On the other hand, if you lose your loved one to violence, you may feel permanently disappointed with humanity and life.
Not all bereaved people need medical assistance, but they all need compassionate interaction that treats their loss respectfully. Even the most devastating of losses does not always lead to clinical disorders.
The greatest risk factor in grief is not receiving help and support. Research indicates that support by a professional has a major impact on the wellbeing of the grieving person, both in the short and long term.
It is the professional’s job to encourage the social network of the grieving person to help them. The grieving person should also be encouraged to seek peer support and other professional help if needed. For many, the support of their loved ones and peers is most important.
“I spent half my life with my wife, and it was clear to me that the past was just as important as the future. Living with grief and loss is not a project that you get over in a year or five, or in any time. Loss has become a part of me, and I’m getting better at living with it. It doesn’t stop you from keeping on living or accepting new things into your life.”
Myths about grief
“All the talk about phases creates unrealistic expectations and threats. If somebody is doing well, others may say, ‘just wait, the crash is right around the corner.’ The person will start fearing it and waiting for it, even though not everybody goes through a crash.”
Different cultures, discourses and professional practices are influenced by conceptions of grief that are unhelpful to the bereaved. These conceptions are the result of a long legacy of research that sees grief as a temporary disorder and a process. In this view, grief goes through stages before reaching its destination. The task of a professional has been to help the grieving person move onto the next stage, or ‘onward’ in their grief. The idea is that the reactions will come sooner or later, and that they should pass by a certain time after the death.
Current research into grief does not support this stage model. Grief is very personal and the way it manifests itself depends on several factors: the individual resources of the bereaved, social support, the bereaved person’s relationship with the deceased, and the circumstances of the death. Although we can see many similarities in the experiences of the bereaved, it’s impossible to set limits or time frames to grief. When helping a bereaved person, the help should be based on the person’s needs and on respectful, humane interactions.
Common reactions after the death of a loved one
Many bereaved people are concerned about their reactions and may even be afraid that they’re a sign of ‘going crazy’. Because of this, it’s comforting for them to hear that many other people have gone through the same things, and that the way they’re reacting is completely normal, considering the situation. However, it’s important to acknowledge that everybody’s reactions are unique, and the lack of ‘normal’ reactions is not worrisome or uncommon.
Common long-term reactions
Strong sense of loss and longing, emotional pain
Feelings of guilt
Clear recurring memories of events related to the death
Trouble concentrating, memory issues
Irritation, feelings of anger
Physical symptoms, illnesses
Deeper appreciation for close and good relationships
Change in life values
Desire to change the society and/or help others who have gone through the same thing
No matter how strong or distressing, emotions related to the death of a loved one are normal. If the grief feels unbearable or the bereaved person is self-destructive, they should be directed to a trained professional immediately.
Grief is not a sickness, but it can make you sick
Trauma, depression, complicated grief, prolonged grief…?
Strong and distressing physical and emotional sensations are normal after the sudden death of a loved one. The bereaved person will need crisis support and extensive social support following the death. Medical assistance, however, is rarely needed.
The loss may lead to inability to work, and a medical diagnosis is needed for sick leave. Because of this, reactions stemming from grief are sometimes misdiagnosed as depression. This problem is well known within health care, and Finland is about to adopt a diagnosis of prolonged grief or complicated grief. According to some estimations, 10% of the bereaved require a medical diagnosis.
Although grief can manifest itself very strongly, you should never dismiss the feelings of a grieving person. A heavy loss can lead to physical and mental illnesses, such as depression and post-traumatic stress disorder. If the bereaved person appears to need professional help, they should be forwarded to a competent professional. This evaluation can be done by a psychologist, while a doctor can make the diagnosis and prescribe psychotherapy. The most important thing is to consider the person’s feelings: offer help to those who need it. Don’t pressure the bereaved person into getting better more quickly.
Signs that the bereaved person may need professional help
Their grief feels constantly unbearable
The person is preoccupied by painful memories of the death and can’t think of anything else
They have strong, recurring fears of new disasters
Painful and constant self-blame, feeling of worthlessness
Strong and constant thoughts of anger and revenge
Prolonged lack of functional ability that disrupts the person’s life or prevents them from getting help
Inability to take care of one’s children
Total inability to talk about the deceased or the death
The most important thing I want the professionals to understand about grief is that you should not try to heal grief. A professional can support a bereaved person with their grief, but they must not carry a burden of whether the bereaved person will be “healed” of their grief or not. Grief is not a sickness.