Grief

“Grieving is not about forgetting.  Grieving allows us to heal, to remember with love rather than pain.  It is a sorting process.  One by one you let go of the things that are  gone and you mourn for them.  One by one you take hold of the things that have become a  part of  who you are and build again.” Rachel Remen, M.D.;  My Grandfather’s Blessings

Grief is often a component of traumatic incidents, therefore it is important to understand how grief is both similar to and different from post traumatic stress disorder.  Grief is the loss of something that defines who you are.  Most people think about grief in relation to a death; however, grief can be experienced as a result of a loss of any element that defines someone.

Typically, an individual who loses a loved one who was a part of their every day life will not begin to experience a lessening of their grief for two years.  The closer the relationship, the more likely it is that intense and long-term grief will be experienced.

Siblings who are  still living at  home  will generally be much more impacted by the death of a brother or sister living with them than the death of a sibling who is no longer in the home, or who is rarely seen or talked to.  This is logical as grief is the loss of something that defines who you are and if you rarely see an individual, typically, that person does not define who you are as much as those loved ones you see on a daily basis.

This does not hold true, however, for the loss of a child.  The death of a child, no matter what the child’s age, is almost always the most devastating thing that can happen to a parent.  Parents who have lost a child say that they have never been the same.  They indicate that they have been able to move on with their lives, but they have never “gotten over it.”  It is not uncommon for grieving parents to keep their child’s room as a memorial, leaving it just as it was when their child died for many years.  Mother’s often wear their child’s clothing, because it helps them to feel close to their dead child.  Do not judge the manner in which a parent grieves the loss of their child unless you have “walked in their shoes.”

“Until you’re walking that road, you have no idea of the darkness.”

Gay Smither, mother of kidnapped and murdered child

The loss of a parent that takes place when a child is young is also quite devastating to the child.  It changes the whole direction of a child’s life and impacts his/her emotional development.  Even as an adult, the death of a parent, even one who is rarely seen, can lead their child to experience overwhelming grief and guilt.  It is not uncommon for someone who seems to be handling the experience of numerous job-related traumatic incidents to find the death of their parent to be the “last straw” or the defining event that led them to experience PTSD symptoms.

Suicide of a loved one typically leads to very intense grief, intense anger at the loved one who killed him/herself,  as well as feelings of guilt for not recognizing the loved one was suicidal and/or preventing this suicide.  Those who commit suicide have often convinced themselves that “They’ll get over it”, “They won’t really miss me”, or “They’ll be better off without me”.  The wife of a law enforcement officer who had committed suicide, commented, “If he had known his suicide would cause his kids and me this much pain, I don’t think he would ever have done it.  I will never get over it.  I can’t believe that the pain he used as an excuse to kill himself was as intense as the pain his children and I are feeling because of his suicide.”

The sudden and unexpected death of a loved one is the primary cause of 27% of PTSD in women; 39% in men.  Grief is a normal reaction to loss but a survivor must move through the stages of grief to move on with his/her life.   PTSD freezes a griever in the present, interfering with the processing of grief. Some professionals have called this “traumatic grief.”

If the survivor feels guilty about something that they said or did in the period right before the loved one died, this guilt can intensify their grief.  For example, if the last thing a fifteen year old said to his father was in anger, he may experience overwhelming guilt and shame because it’s too late to say, “I’m sorry”.   Grievers can also feel responsible for the death of their loved one if the time or place of their death had something to do with the griever.  For example, if a wife had asked her husband to delay flying on a business trip, leaving in the morning rather than the night before, and the plane he took in the morning crashed, she might blame herself for his death.  If a wife was car-jacked and murdered as she picked up her children from daycare on a day when the husband would normally have picked them up, her husband might assume responsibility for her murder.

The particular manner in which the griever learned of the death is almost always imprinted in his or her memory.   If the griever had to tell his/her children or loved ones of the death of someone they love, this can also be quite traumatizing.

The first view of the body, especially when the death was violent, can be an additional traumatizing event.  It is common for a parent to spend a great deal of time with a child’s body and to touch every wound.

Many grievers become obsessed with the circumstances of the violent or sudden death of a loved one, wondering if he/she suffered, if he/she knew they were going to die, if the loved one thought of them before dying.  These grievers often re-create the death scene in their mind, until it becomes a flashback.

When there is a death in a family, children can lose not only the loved one who has died, but the remaining parent(s), as well.  Grief pulls a parent into him/herself.  When children and adolescents lose a family member, they rarely talk about their feelings of grief to a parent.  This occurs because children become anxious at the behavior of a grieving parent.  Children of grieving parents may become the comedian of the family, feeling that it is their responsibility to keep their parent from crying.

Survivors are typically in shock before during and shortly after the funeral.  Friends and relatives may think they are doing well. Many survivors report, years later, having no memory of the viewing and funeral.  It is after they return home, and in the many days and months following, that the reality and pain of their loss becomes intense.

Holidays are particularly difficult for grievers, especially birthdays, anniversaries, Valentine’s Day, Christmas and Thanksgiving. Those who have lost a loved one through a violent death usually want the anniversary of the loss to be remembered by friends and relatives. However, if the loss was because of illness and more expected, the anniversary of the loss does not seem to carry the same importance.

Many individuals who have been violently attacked or believed that they were going to die, report that they left their body.  Understanding that nature allows people to leave their bodies when they are being critically injured, killed or believe they are going to die, can give comfort to families who become obsessed with how much their loved one suffered as he/she died.   Ask those who have been involved in life-threatening situations (where they believed death was imminent), if he/she left their bodies.

How You Can Help

Touch the griever on the arm, the shoulder, or hug them and say: “I’m sorry.” “I don’t know what to say!”

You do not have to say anything else, but you need to say something!   Nothing you say can take away or lessen his or her grief because you cannot give them back their loved one.  If you want to help, get together with his/her friends and relatives and divide up the tasks that need to be done.  If you ask the griever to call you when he or she needs help, you will rarely receive a call.  Grievers are so pulled into themselves, they rarely have the energy to call for help, but they clearly appreciate and need help.

Help with the routine activities of life

In the weeks and months following the death (if it was a spouse or child), these survivors will need help in organizing household chores, getting bills paid (even though they may have more than enough money to do so), preparing tax forms, repairs such as their car, et cetera.  Grief saps the energy and motivation to care about the routine activities that keep life going.

If you are close to the survivor and want to help, offer to take care of young kids, take prepared meals to their family, go to the grocery store for them, and mow the yard.  Grievers will need help for at least a year.

Many people do not know what to say to a grieving person, so they say nothing.  Others say something inappropriate which can make the griever feel even worse.

Grievers indicate the following comments were not appreciated and often quite upsetting although they were probably intended by the person saying them to make the griever feel better:

“God wanted your son in heaven more than you wanted him here” (This can make the griever angry at God.)

To a parent of a child who was killed:  “How many children do you have?” or “You can have another child.” or “You can get a dog.”   All of these statements imply that the child is replaceable, or having more than one child, reduces the grief of the parent.

“Now that your son is dead, and you don’t have to send him to college, you can use the money to travel.” (This was an actual comment to a parent.)

“For someone whose son was just killed, you look like you are doing pretty well.” (The griever to whom this remark was made indicated he was not doing well.)

“You should be over it by now.”

“It’s God’s will.” (Even if you believe this, don’t say it to someone who has just lost a loved one.  It can lead the griever to be angry with and/or reject God.)

“Just think happy thoughts.”  “Don’t cry.”

“He is much happier in heaven than he was here on earth. “  (“When someone said this to a woman who recently lost her husband, she whispered, “My husband could never be happy knowing how sad I am at losing him.”)

“Did he smoke?” (For example, when lung cancer or heart disease was the cause of death)  Although the person making a statement such as this is probably assessing his or her probability of death and how to avoid it, a question such as this is often experienced by the griever as placing responsibility for the death on the behavior of the deceased.  While this may have some factual validity, a griever may feel that answering this question forces him or her to defend the behavior of their loved one (when they rarely were responsible for this behavior) and may cause even greater pain.  Questions that assign blame should be avoided.

Do, however, let the griever know that you care.  Grievers become angry when no one acknowledges their loss, particularly when people where they work continue to interact with them as they had in the past, as if the death of someone they cared about never happened.  Failing to acknowledge the death of someone important to a co-worker usually takes place, not because co-workers don’t care, but because they don’t know what to say.  Co-workers who say nothing often mistakenly believe that mentioning the death will cause the griever to become even sadder, without realizing that the griever is thinking about his/her loss constantly.  Grievers say that they want and need their loss acknowledged.

Let the griever know that you are aware of their loss and pain through comments similar to these:

“I know that your son’s birthday is coming up and that will be a difficult day for you.  I will be thinking about you on that day.”

“Last year you told me that you and your husband always spent Thanksgiving in your lake home.  Is there anything I can do to help you get through this Thanksgiving?”

“I know that next week is the anniversary of your husband’s murder.  Is there anything I can do to help you get through it?”  “Would you prefer to be alone on that day or would it help for me to spend the day with you?” or  “I will be thinking about you on that day”

“Valentine’s Day is Friday.  I remember that Valentine’s Day was special to you and Sharon because you sent her flowers and took her to dinner.  Can I take you to lunch on Valentine’s Day or is there something else I can do?”

Grievers will experience intense emotions for months following their loss both in their personal life and in the workplace. Emotions and sadness can overwhelm a griever suddenly and unexpectedly.   Be patient. You might place a hand on his/her shoulder when this happens if this seems to comfort them or say, “This has to be very difficult for you” or “it’s okay.”  Most of us will lose a loved one (or many) during our lifetime.  Treat the griever in the ways you would like to be treated.

Grievers may feel forced into responding to questions of how they are doing with, “Fine” (which is generally a lie).  My friend, Roger, responded in the following way the death of his wife and my friend, Sharon:

• “I’m having a few good minutes.”
• “I’m having a few good hours.”
• “I’m having a few good days.”
• “I’m having as many good days as bad days.”
• “I’m having a few bad days.”
• “I’m having a few bad hours.”

Encourage the griever to respond to questions of how they are doing in this way so that those who care about them can determine if his/her grief is progressing, or if he/she is stuck and needs further help.  Reponding with honest answers rather that the typical “fine” also is a help to a griever, because he or she can respond to your question with an honest reflection of how they are doing.

Memorial services for peers who died in the line-of-duty can be distressing events for peers, partners, and family members because they often trigger flashbacks and intense emotions.  This is also true of other types of memorial services.  Attendance at these events should be voluntary.  If you are a survivor and memorial services are distressing rather than comforting, simply don’t attend them. Survivors indicate that they would like memorials to commemorate the positive attributes and accomplishments of their loved one or partner rather than a review of  the horrific events that caused his or her death.

“My husband was killed in the line-of-duty.  Every year, for the past ten years, his department has a memorial service to honor him.  This memorial includes a large visual display with a time-line detailing every imaginable aspect of the events before and after his murder.  It takes me weeks to recover.  His mother attended the last memorial, and it almost did her in.  Why don’t they go over the positive things from my husband’s life, rather than the ones that give me flashbacks?”

This article was created from research, from the personal experiences of Dr. Davis in treating hundreds of grievers and from the research and knowledge of Marcella Marcey, Ph.D., a friend and professional colleague. Citations for research are available on-line in the bibliography of Multi-Sensory Trauma Processing, Understanding and Treating PTSD and Job-Related Trauma.

© 2003; 2007;  Dr. Davis gives permission for this article to be duplicated and used for training and/or educational purposes provided she is acknowledged as the author.