Written by Melanie Taussig
Grief can be all-consuming, complicated, and difficult. Yet, it is a universal experience that touches everyone at some point. There is no manual or guidebook for the grieving process. Grief can present as an array of emotions, which are often misunderstood. A discussion about how grief shows up and how to navigate the hardship
You could say that therapist Ann Price is well acquainted with grief. It is, after all, an area of specialty at her therapy practice in Loveland, Colo. Ms. Price has been providing grief counseling to clients for 25 years. “I think grief is perhaps the deepest emotion that we may experience as human beings,” she says sitting in her office on a brisk January day. Ms. Price’s concentration in grief counseling was a serendipitous happenstance. “Grief work really found me,” she says. “I was drawn to the connecting thread that grief is, the universal experience. We are all going to grieve at some point.” This was reinforced when Ms. Price grappled with her own grief during her father’s dying process more than twenty years ago. Today Ms. Price is zealous as she discusses grief, not because it is a joyful topic but, because she stresses, it is a necessary one.
In order to address a very complicated issue, let’s start with the basics:
What is grief?
The Five Stages of Grief is a longstanding research model developed by Elizabeth Kubler-Ross. Over the years this model has served as a roadmap for many navigating the grieving process. The five stages include denial, anger, depression, bargaining, and acceptance. These stages have often been referenced when it comes to understanding grief but, what does it mean to grieve?
According to Ms. Price, “traditional grief,” commonly referred to as bereavement, results from death, however, grief can occur following circumstances that are not necessarily connected to dying. Grief can be connected to any type of loss, whether that is the loss of a significant relationship such as a breakup or divorce, the loss of one’s independence such as no longer living in one’s own home or, or the loss of good health (for example, being diagnosed with a chronic illness).
Here are some examples of circumstances that can lead to feelings of grief:
• Death of a family member, friend, colleague, or acquaintance
• Death of a pet
• Loss of a revered public figure
• Loss of an unborn child, miscarriage
• Loss of a relationship (break up or divorce)
• Loss of a job
• Transitional loss (Becoming an empty nester, moving out of a home you lived in for several years, loss of a driver’s license)
• Loss of health
• Loss of hopes/dreams
• Loss of independence
No matter how grief shows up, when an individual experiences a significant loss, Ms. Price explains there is a ‘grief journey.’ She uses this term as a metaphor to describe a process that individuals frequently experience when mourning a loss. “Everyone’s grief journey is different,” says Ms. Price. “Think of it as a person who is on a pathway following their loss, reflecting and seeing things that they didn’t expect to see, detouring as necessary, and not always knowing which direction to go in.”
“We have small bits of grief that occur and we don’t always acknowledge those,” explains Ms. Price. What is a “small bit of grief?” It might be the feeling associated after being passed up for a promotion at work or feeling the loss of youthfulness. In our western culture that reveres youth many individuals, especially women, lament the loss of what it is to be young. “We live in a society that often denies the reality of aging and idealizes youth,” says Ms. Price. Such attitudes can devalue aging and dismiss the inevitable reality of death.
The Impact of Grief
For some, grief strikes in a way that is all-encompassing; for others the effects may not feel as massive. It is not unusual for people who are grieving to experience the following:
• Cognitive disturbances such as forgetfulness, lack of concentration, trouble focusing, decreased attention span
• Intense and fluctuating emotions including sadness, anxiety, worry, anger, frustration, confusion, and panic attacks
• Religious or spiritual conflicts such as feelings of anger toward god, losing trust in a higher power or one’s faith, questioning longstanding beliefs and values
• Physical afflictions such as pain, decreased energy, tightness in chest, inflammation, headaches, and stomachaches
• Behavioral issues including frequent crying, change in appetite, sleep disturbances, dreams about the person whom you are mourning, and social withdrawal
“Everyone has their own grief experience and I often remind clients that there is no timeline [for grief],” says Ms. Price. It is not unusual for some to spend a lifetime mourning the loss of a loved one. A precarious timeframe can be difficult to reconcile in a culture in which we have become accustom to wanting quick answers. “The grieving process,” says Ms. Price, “is going to take as long as it needs to take.”
Grief: Sadness & Depression
The grieving process can be painful and often includes feelings of intense sadness. Symptoms of grief and depression may appear similar and even overlap, allowing the two to sometimes become conflated.
There are clear criteria that distinguish bereavement from depression. Because people who are grieving often feel an abundance of sadness, it can be difficult to discern grief from depression, particularly when it is common to use “depressed” as a way to describe how an individual is feeling. It is important to remember that depression is a clinical diagnosis while grief is an expected response following a loss.
If grief persists and starts to impact everyday functioning, Ms. Price recommends an individual consider consulting with a Mental Health professional, who can provide a clinical diagnosis and treatment. Chronic grief can lead a person to develop clinical depression but, this is more the exception than the rule. While people who are grieving will often (and understandably) feel sad, they are still able to find moments of happiness. An individual who is clinically depressed will struggle to experience pleasure and the depression can impair the ability to function optimally.
Grief: A truly universal experience
While grief is a universal, human experience, it also affects other species throughout the animal kingdom, making it an experience that connects all living beings. There is well-documented evidence that animals grieve, among the most notable are elephants, who have been shown to mourn the loss of their relatives. Another remarkable example of an animal grieving was on display when a whale in the Pacific Northwest mourned the loss of her calf by carrying the deceased young for seventeen days.
Why is an experience that is so widespread so difficult to seemingly understand? It must be acknowledged that grief is uncomfortable, and people are often conditioned to avoid discomfort. While we may not always know exactly what to say during moments of discomfort, personal experience can sometimes be a good place to start. While no one can fully understand another person’s experience, we all will face some level of adversity in our lives. Referencing personal hardship can be a way to convey compassion for others. People often want to “say the right thing” [to the person who is grieving] but don’t know what to say; taking a compassionate approach signifies sensitivity and that empathetic virtue has the ability to transcend words.
Providing Support to Someone who is Grieving
People generally have good intentions when attempting to console another person. However, a well-meaning act can easily be misconstrued or misinterpreted. Oftentimes, there is a great deal of ambiguity around grief. Because it is a topic that elicits discomfort, people are frequently maladroit in finding the right words or knowing what to say. This is a theme that was examined in the PBS documentary, Speaking Grief.
“When we grieve, it is a deep experience,” says Ms. Price. “I believe that words don’t matter as much as presence and actions.” Therefore, it is sometimes the small nods that may carry more weight than words. For example, sitting with someone or giving a hug may have a greater impact than words, particularly if you don’t know what to say. There is nothing wrong with admitting that you don’t know what to say in the moment. Acknowledging uncertainty conveys authenticity and honesty, comforting qualities to extend to a person in the midst of grief. If you are unsure what to say to someone who is grieving, Ms. Price recommends something along the lines of: “I don’t know what to say but please know that I care about you” or “I am here for you.”
For additional suggestions of what to say to a person who is grieving as well as things to avoid saying, click here.
Complicated & Disenfranchised Grief
Grief is not one-size fits all and each individual’s experience is unique. When there are additional issues surrounding the situation, the grieving process can become compounded, something that is referred to as complicated grief.
Complicated grief consists of multifaceted circumstances regarding the relationship and/or the loss. Additional challenging factors can intensify the grieving process and complicated grief can show up in a variety of ways. The following are examples of situations that illustrate complicated grief:
• A dysfunctional or ambivalent relationship with the person who passed away
• A death with unknown circumstances
• The person grieving is disenfranchised, and others may pass judgment or disagree with that individual’s life choices
• The person who is grieving has underlying mental health or substance abuse issues
• Anger or feelings of judgment toward the person who passed away
• The person who is grieving witnessed the actual death
• An unexpected or sudden death
• A death due to catastrophic circumstances such as war, a natural disaster, or an event where there are massive casualties
Looking the other way: The dangers of ignoring grief and coping through the process
According to Ms. Price, in Western culture, there is a “hurry up” mentality when it comes to grief. This type of thinking consists of pervasive messages to “get over it” or “move on.” Ms. Price stresses the importance of acknowledging feelings connected to the loss. It is not uncommon for individuals to avoid uncomfortable feelings. It can be easier to suppress feelings associated with sadness and distress rather than to embrace those emotions. Ms. Price warns against ignoring important emotions, explaining that can be a perilous way to cope. “What we resist will persist,” she says. Avoiding emotions in the short-term, may cause those feelings to become more pronounced and disruptive in the long-term.
When it comes to grief, all emotions, difficult, positive, negative, hopeful, and hopeless, are part of that grief journey. Seeking support and engaging in self-care are important factors as an individual works through the process. “These are not black and white issues, it’s very grey,” says Ms. Price. “Grief is messy. Anytime there is loss of any kind, it might be long, it might be short, it might be deep, and it may not be any of these things. Whatever the loss is, processing grief and being in touch with your feelings is one of the most important things that you can do for yourself. You will experience both healing and an increased ability to meet future challenges with grace and resiliency.”
*To learn strategies for coping with grief provided by Ms. Price click here. If you have concerns about your mental health or well-being, seek professional consultation and support. For assistance with resources, visit the Help & Resources page.
*This interview was conducted before the pandemic began. It is important to acknowledge the colossal and pervasive grief connected to Covid-19. There is traditional grief of death and fear of dying that has been very poignant over these past several months. The pandemic has also created unique circumstances; many have experienced the loss of what has been referred to as “normal.” In this “new normal,” there has been a collective loss of routine as well as many activities including travel, sports, going to the gym, watching live performances, dining out, or partaking in momentous celebrations. For additional information specific to grief and the coronavirus, Shape Magazine published an article that explores these losses more in depth. More recently, The New York Times featured an article about losses experienced during the pandemic.
Ann Price is a Licensed Clinical Social Worker in Loveland, Colo. Photo courtesy of Ms. Price.