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Good Grief

Some people may be familiar with the concept of stages of grief based on the model of Kubler-Ross (1969). It has been widely adopted and accepted. It is important to note that a person who is grieving does not simply go from one stage to the next – it is a much more fluctuating process where a person can go back and forth between the stages. The following illustrates each stage and its characteristics:

1. Denial: Denial is a coping mechanism when the death first occurs. It is a state of shock, where feelings are suppressed, and the death is denied or unacknowledged. The person may feel numb and is continuing to live in a ‘preferable’ reality.
2. Anger: Anger following a loss can result in thinking such as, ‘Why me?’ and ‘It’s not fair.’ This anger may be directed at the person’s spiritual higher power, family, friends, community members, or the deceased loved one. Directing anger at something or someone can feel like a way of staying connected to reality.
3. Bargaining: Bargaining is the stage of false hope. It involves negotiating, often with a spiritual higher power. The person falsely believes they can avoid grief. These negotiations are often framed as, “If you change this, I’ll change that.” This stage is the result of the person being so desperate to get their life back to what it was before the loss, that they are willing to make any major life change to regain normality.
4. Depression: Depression describes the emptiness a person feels following the loss when they realize the loss is forever. In this stage, they might withdraw from connecting with others and activities, feel numb, or feel a profound sense of sadness. They often isolate, not wanting to be around others and may express feelings of hopelessness.
5. Acceptance: Acceptance is not about recognizing the loss as okay, but rather the person will be okay despite the loss. Emotions begin to stabilize and the person recognizes their loss is not coming back. Acceptance does not mean the person will not experience any more negative days, but it is understood that there are more good days than negative days in this stage. Further development of this stage brings a new identity and sense of being able to manage and cope with the loss.

What is the difference between grief and depression? It is common for natural helpers to become concerned with the grief and the level of sadness they are observing. There are some similarities and clear differences between grief and depression:

• Both infuse lives with sadness, and both cause disruption in their lives.
• Depression is considered a mental illness (persistent feeling of sadness and loss of interest). – Grief is not a mental illness (grief is a process to manage and deal with a loss).
• Depression is a perception that the person and/or world is flawed, inadequate, or worthless. – Grief is sadness about a loss.
• Depression inhibits the capacity of the person to experience positive emotions. – In grief, the emotions are intense with positive emotions.

What are the needs of mourning? It is a ‘to-do-list’ for people who are grieving as they process their loss. You provide support to the person by helping them manage their energy and assisting them to adapt and to integrate the significant loss into their life.

• Acknowledge the loss: It is common for people to replay the events of the loss and confront memories that are both positive and emotionally charging.
• Embrace the pain of the loss: Create a space to manage and deal with the pain and loss. People need to honour their experiences.
• Remember the loss: As a new relationship to the memory of the loved one, remembering and sharing the past makes hope for the future possible.
• Develop a new identity: Part of the new identity is the relationships one has with others as well as a new self-perception. The person discovers new roles and some positive aspects of a changed identity.
• Search for meaning: Part of the new identity and discovery is one’s philosophy of life and one’s new journey.
• Receive ongoing support from others: The quality and quantity of compassionate support the person receives has a major influence on their grief journey. You have an important role in providing this compassionate support.

Your support is to acknowledge the impact the loss has had on the person. In order for the person to heal, you must create a safe environment that shows understanding for the person to be allowed and even encouraged to mourn (even long after the loss). Overall, grieving is experienced as a result of a loss and a necessity to be expressed.

What are some of the factors that complicate grief and mourning? Depending on events surrounding the loss, grief and mourning are complicated by factors such as:

• Questioning why this happened: Searching for an explanation for the profound loss and engaging in “shoulda”, “woulda”, “coulda”, statements that would have changed the outcome are common responses. The person may feel intense guilt or shame.
• Feelings of re-victimization: Sudden death and loss such as homicide entail involvement with the criminal justice system (CJS). The person is generally thrown into this system that they neither are prepared for or understand. In addition, the person has to give up control to allow the CJS to manage the most vulnerable and worst time of their life. Navigating the media leads to further distress. People often feel uninformed, mistreated, or ignored and tend to focus all of their energy on the accused. There is no legal representation for the victim or their loved ones in the court process which can result in intense feelings of re-victimization, anger, or even vengeful expressions by people. These feelings can be so intense that people can be scared of their own grief response. These emotions of rage and anger are common.
• Grieving as a family: Families that lose a member experience unique challenges. Individual family members may have different grief styles and trauma responses. They may need different kinds of support at different times, which they may not find from each other. They may have “unfinished business” with the family member they lost. This can result in unhelpful comparisons with each other, unmet expectations, and feeling disconnected from one another.
• Coping with stigma: Some traumatic deaths, particularly suicide and drug-related deaths, have a significant stigma attached to them. The public, in general, is judgemental and overcritical in regard to addictions and mental health. People may act uneasy around people hurt by the loss or avoid them. There may be stereotyping and victim or survivor-blaming. People may feel misunderstood and unheard or rejected and abandoned as a result of the stigma.