Understanding the grief process can help when a loved one is hurting 

Karen Collins, M.S.W., L.I.S.W.-S.
Licensed Independent Social Worker

Grief is a normal and healthy emotional reaction to a significant loss. Grieving is the emotional life adjustment people experience after a loss. There are categories of loss, including loss of a significant person, loss of part of self, loss of external objects and developmental loss. Common losses include death of a loved one, diagnosis of a chronic illness, health issues, loss of a home, loss of job, divorce, the end of a relationship, loss of pregnancy/infertility, loss of independence because of marriage or having children, natural disasters, loss of a pet, retirement, aging and relocation.

In the case of the loss of a loved one, there are a number of factors that influence a person's grief reaction. It is important to consider who the person was to the griever, the nature of the attachment, the strength of the attachment, the way the person died, the griever's history of losses, the social environment and other stressors.

Grief involves cognitive, emotional and physical processes. The griever needs to detach from the deceased or loss. The griever will eventually have to withdraw the emotional energy by working through feelings, thoughts, memories and expectations surrounding the loss. In essence, the person will form a new relationship with the loss. As the griever's life is reorganized, he or she will decide what the new relationship with the deceased or loss will be like. The griever must acknowledge that the loss has changed her personally and is now a part of her life history.

There are many normal emotional grief reactions, including anxiety and fear, sadness, guilt, anger, inadequacy, hurt, relief and loneliness. There are many normal physical grief reactions, including hollowness in the stomach, tightness in the chest, oversensitivity to noise, a sense of depersonalization, breathlessness, muscle weakness, a lack of energy and a dry mouth. There are many normal cognitive grief reactions including, disbelief, confusion, preoccupation and a sense of presence of the deceased.

A griever needs acceptance and non-judgmental listening to facilitate the expression of emotions and the necessary review of the loss. There is no timetable for grieving. Everyone grieves in his or her own way and needs to be free to do that. It is okay to withdraw from the world for a while to regroup and reenergize. It is okay to avoid talking about the loss and to be in control of what others know regarding the loss. Grievers do not have to tell others the details of their experience even if they are asked to. Grievers should have a generic response ready for people who ask and be prepared with a response that is comfortable.

Loss is not experienced only once. Memories and emotions can return and affect the griever. This is not necessarily a setback in the grieving process and should be expected. Common triggers of reactions include weddings, wedding anniversaries, family gatherings, birthdays, childhood milestones, special days, holidays, seeing others who have what was lost, sights, sounds and smells. It is important to develop coping skills to process the loss in a healthy way. Grievers should be reassured that anniversary reactions are normal and the intensity will lessen over time. Grievers should focus on the positive parts of the relationship. Grievers can plan a distraction like a weekend getaway when needed. A new tradition can be started in loved one's memory. Exposure can be limited to events or things that create anxiety, sadness and distress. Grievers should embrace their family and friends to create a support system as needed. Grievers should allow themselves to feel sad and feel the sense of loss. Grievers should allow themselves to feel joy again without feeling guilty for smiling again without the deceased.

Those who are grieving can talk to a licensed social worker or licensed independent social worker to get help with the grief process. It is a sign of strength in a time of adjustment to ask for help from a trained professional. A social worker can help with the adjustment process, encourage and teach positive coping skills to the griever.

Last updated September 22, 2008