Coping with the Death of a Loved One

Losing someone you love can be like losing one half of yourself.  The pain and emptiness felt during the grieving process can go on for months or years, however no two people will ever respond to the same situation in the same way.  Working through grief is a day by day, week by week process.  You may have bad days when you think you will never recover from this loss.  You may also think that you will never function successfully without this person in your life.  The good news is that you will recover and you will be fully functional, if you choose to.

Each and every one of us changes in some way after the death of someone we love.   Some of us may harden after the experience; some will soften, but those who choose to learn and grow from this tragic time, will go on with their life remembering ‘what was’ and appreciating ‘what is’.  Learning about grief is helpful to the grieving process.  In this article, we will explore the common reactions of those experiencing a loss, together with looking at strategies for coping, assisting others who are grieving and facing the future.

Common Reactions

The impact of grief can cause tremendous chaos to all aspects of our life.  We all respond differently to grief but the most important thing to remember is that most reactions are normal.  Sometimes we find these responses overwhelming but knowing they are normal helps us to come to terms with the changes.  It is also important to note that there is no fixed timetable for these reactions.  Of course if general functioning is inhibited by any or some of these responses, you should seek medical advice.

Physical:

• change in appetite
• tightness in chest
• headaches
• Fatigue and lack of energy
• Nausea, diarrhea, indigestion
• General aches

Behavioural

• Sleeplessness
• Lack of motivation
• Crying (often unexpectedly)
• Social withdrawal
• Hyperactivity
• Reckless behaviour (eg drinking)

Emotional:

• Shock, numbness, disbelief
• Self blame, guilt
• Depression
• Anger
• Anxiety, panic
• Loneliness
• Relief or Indifference
• Fear

Cognitive:

• Confusion
• Poor concentration
• Pre-occupation with the loss
• Seeing or hearing the person
• Dreams of the person who died

Spiritual:

• Anger toward God
• Consolation by belief in God
• Seeking meaning of loss
• Examining meaning of life
• Strengthening in belief

Stages of Grief

As complicated as it sounds, grief is a process which can be worked through.  A famous psychiatrist, Elisabeth Kubler-Ross is recognised as one of the foremost authorities in the field of death and dying.  Her first book, “On Death and Dying” is required reading in many universities in the schools of medicine and social sciences.   Although the grieving process is very individual, Kubler-Ross found that people who are terminally ill go through similar stages before dying, and these stages are similar for those who grieve the loss of a loved one.

These five stages are not cyclical, nor is every stage common to everyone who grieves.  It might be useful for you to look at the stages of grief in order to identify where you are now and were you would like to be in the future.

Denial

Immediately after the death of your loved one, you may experience shock or denial.  This is especially noticeable if the death is sudden or unexpected or the result of a long illness where the death was not foreseen.  You may only take in small amounts of information according to what you can handle.   You will wake up in the morning wanting to push away the reality of the loss and believe only what you choose to accept.   This is a perfectly normal reaction except where the denial extends beyond a feasible time.

Anger

When the full impact of the loss hits home, many of us feel anger.  This is a result of having accepted the reality of the loss but yearnings for the loved one emerge.  This anger can be directed to the deceased person for deserting or abandoning us or displaced incorrectly to others including people who offer support, doctors and hospital staff or even God.   At this time there is a great need to speak about these feelings.

Bargaining

Bargaining is the negotiation stage and is usually when one bargains with a higher being or God.  We unconsciously or consciously say things like “if you take this pain away, I will try to get my act together”.

Depression

Eventually the full impact of the loss will catch up with you.  Whether it is a gradual or sudden realisation, you will see that things can’t be undone or changed.  You will have to come to terms with the facts and those facts can be the cause of extreme sadness and depression.  Depression should be carefully monitored and addressed by professionals if needed.

Acceptance

The final stage is that of acceptance.  Gradually, we recognise that we are becoming more interested in what is going on around us and begin to enjoy what life has to offer. True acceptance comes when functioning has returned and having acknowledged the loss in its entirety.   This is achieved when you are able to look back on yesterdays with your loved one, but are able to enjoy today and look forward to tomorrow.

Secondary Losses

Losing a loved one can bring about many unexpected changes.  When the deceased is someone extremely close like a partner or family member, the loss brings with it other or secondary losses which impact on the lives of the surviving family members.  The personal experience of loss should be looked at individually, as no two people will be impacted in the same way.   The following list looks at secondary losses a little more closely.

Losing someone close to you can mean also losing one’s hopes and dreams.  The survivor and the deceased had planned futures together which may include dreams such as owning their home, or travelling together in their twilight years.    Losing hopes and dreams can be devastating until such hopes and dreams can be replaced with others.

Quite often people lose their faith either temporarily or permanently after the death of a loved one.  Statements like “why would God do this to me?” or “life just isn’t worth living” are indicative of someone who has lost either their spiritual faith or their faith in life.

Losing a spouse or partner can feel like losing part of self.  The individual does not feel whole as their “other half” has gone forever.  The survivor feels lost as he/she learns the new roles expected and adapts to life without their partner.  Wholeness can be restored over a period of time.

In cases where a family member dies, the loss of family structure requires painful readjustment.  Not only does the family grieve the personality lost, but the role that person played within the family.  Loss of a father may place financial stain on the family which could result in the mother having to undertake a working role.  The loss of a mother can mean childcare becomes a challenge, and possibly additional roles for the father.

Losing a loved one can result in social losses including those of friendships and family relationships.  Some people find relating to someone who is grieving quite difficult and therefore step back or avoid the survivor leaving the survivor to feel isolated and alone.  In-laws and family members may be reminded too much of the deceased and therefore emotionally withdraw from the survivor.

Prior Losses

Some of us may feel we have encountered more than our fair share of losses in life.  The emotion of grief is not restricted to the reaction to the death of a relative or close friend.  It can be experienced in many situations including divorce, miscarriage, severe injury, loss of a job or pet, or even when our youngest child leaves home.  These experiences can compound our grieving and it is important to acknowledge them in order to understand our particular reaction to the circumstances we are faced with today.

A good way to do this is to draw a timeline of our life and the respective losses we have endured.  This not only serves as a reminder of various events and people in our lives, but helps identify our various coping mechanisms.

Tips to Cope: On a large sheet of paper, draw a time line of your life.   Take the time to record major events which caused you to feel pain and sorrow, or other feelings similar to those you are feeling now.  Write down your age at the time of the loss, together with any details you remember about how you survived that time.  This exercise will not only remind you of other events and people in your life, but you may begin to understand and remember how you got yourself through those intense periods.

Coping With a Loss

Whether the loss of your loved one was sudden or expected, the grief associated with the loss hurts.  Sometimes we put ourselves through unnecessary pain by wishing for things like a better relationship or more time with the deceased, or the opportunity to say things we didn’t say when we were with the person.   This is particularly common where sudden and unexpected deaths occur.   The important thing to remember is that our loved one loved us for who we are and the person we were in the relationship.

Journal writing

Many people enjoy journal writing as a therapeutic and healing tool when grieving.   Writing our feelings does not always come easy; however, once you start you will soon learn the benefits of getting words down and completely out of your system.   Your journal can be a way of letting out your feelings throughout this sad time, or it can be used to communicate things you wished you had said to the deceased.  Every time you identify feelings such as anger, fear or sadness, go to your journal and write.  After each entry, your feelings will have a lesser impact on your daily life.  For example, if you are feeling angry and are able to write about that anger and what made you angry in the first place, you are less likely to behave angrily toward those who do not deserve that anger.

Keeping a journal can also be suggested to children in order to help them grieve.  Keep in mind that losing a loved one does not end the relationship, but changes it.  For this reason, children can use their journal for all the same reasons above, but also to remember their loved one and relay messages they feel are important.
Below are examples of headings which are designed to help get you started with your journal writing.

GREAT TIMES TOGETHER
OUR PRIVATE JOKES
YOUR FUNNY WAYS
THINGS I ADMIRE ABOUT YOU
THINGS I LEARNT FROM YOU
WHAT I LOVE ABOUT YOU
THINGS YOU ANNOYED ME WITH
OUR PRIVATE SECRETS
THINGS I NEVER TOLD YOU
THINGS I’D LIKE TO TELL YOU

Thought stopping

Thought stopping is a process of interrupting obsessive thoughts as a means of blocking them from one’s consciousness.  It works much like when a child puts their hands over their ears and sings loudly to block out what they do not want to hear.  It can also act as a way of deliberately turning negative cues into positive ones.   Below are three thought stopping techniques for you to practice.

1. Thought replacement: When an unwanted thought enters, immediately replace the thought with a healthy, rational one.
2. Yelling “stop”: When the unwanted thought enters, immediately yell “STOP”.  The yell can either be out loud or in the mind.  Continue yelling STOP until the unwanted thought goes away.
3. Visual image: If you tend to visualise negative images, replace that image with something positive and healthy. Now let’s see if this technique works for you.  Allow yourself to think or see a negative thought or vision.  This could be imagining your loved one in pain or emotionally depressed on hearing about their illness.  Depending on whether this thought occurs visually or cognitively (thinking only), consciously replace it with an image or thought that automatically brings a smile to your face.  For example, if you were to think repeatedly about this event or vision, learn to automatically replace it with a “snap-shot” of your loved one when they were in perfect health.

Relaxation

Some of us find getting to sleep or relaxing extremely challenging after the loss of a loved one.  However it is vitally important to take care of yourself during the grieving process.   There are numerous relaxation techniques readily available from bookstores and internet sites but we will go through an easy to remember technique useful for people finding it hard to get to sleep.

1. Make sure your clothing is comfortable and lie in a straight position.
2. Tighten the muscles in your toes, and hold for a count of 10.
3. Relax your toes and enjoy the sensation of releasing the tension from them.
4. Flex the muscles in your feet, and hold for a count of 10.
5. Relax your feet.
6. Continue to flex and relax each muscle group as you move slowly up through your entire body, eg your legs, abdomen, back, arms, neck and face.
7. Breathe slowly and deeply, and sleep will come.

Helpful Tips

So far we have identified some specific reactions to your loss, secondary and prior losses and looked at various feelings which are individual to you at this time.  Don’t expect these feelings to disappear overnight.   Below are some helpful tips that you might like to consider:

1. Look after yourself.  You may be experiencing some physical reactions as a result of your loss such as sleep problems, losing weight or lack of concentration.  Pay attention to these reactions and visit your GP if they persist.
2. Recognise that each day will be different and so will your moods.  Enjoy laughter when it comes and surround yourself with people you enjoy and who make you laugh.  It’s OK to cry too.  Sometimes people hold their emotions inside, thinking it wrong to show them outwardly.  If tears don’t come naturally, try encouraging them with photo albums and favourite songs.
3. Start writing a journal of your feelings and emotions.  Writing is one of the most common therapeutic tools used because it helps to get rid of unwanted feelings.
4. Don’t try to get through this time alone.  Surround yourself with positive people and seek the support of a counsellor if required.  Join support groups with others who are experiencing similar losses.
5. Do something physically active every day, even if it’s just taking a short walk.
6. Don’t make major life changes.  Hold off making any major decisions such as moving, remarrying, changing jobs or having another child.  You should give yourself time to adjust to your loss.
7. Write to your doctor, nurse or support person and tell them how helpful they were.
8. Spend time with yourself and take time to relax.  Take care of your health.  Maintain regular contact with your doctor and be sure to eat well.
9. Be aware of the danger of developing a dependence on alcohol or medication to deal with your grief.
10. Be patient.  It can take months or even years to deal with your loss and accept the changes associated with losing your loved one.
11. Seek outside assistance when necessary.  If your grief seems like it is too much to bear, seek professional assistance to help work it through.  It is a sign of strength not weakness, to seek help.

Rituals

Rituals provide us with opportunities to engage in behaviours that connect us with people we love, despite their absence.   They are specifically designed actions, either physical or mental, which are used individually and provide inner peace from what was causing us pain. Certain days can be particularly painful after the death of a loved one.  These include birthdays, anniversaries, Christmas, Valentine’s Day and the anniversary of the death itself.  Confronting these days, rather than avoiding them, is the best way to handle them.

The use of a ritual can not only acknowledge the day, but reconnect us with our loved one with fond memories and symbolic connections.  When planning rituals, pay attention to particularly significant places, events and things which meant a great deal to the deceased and yourself.    Below is a list of ideas for rituals which you may like to use.

1. Plant a flower or tree in memory of your loved one
2. Look through photo albums regularly
3. Light a particular candle in memory of your loved one
4. Wear an item of clothing / jewellery that your loved one bought for you
5. Enjoy a meal which was your loved one’s favourite
6. Have lunch or dinner with friends at your loved one’s favourite restaurant
7. Read and re-read cards given to you by your loved one
8. Read poetry which reminds you of your loved one
9. Travel to places you have been to together
10. Watch movies that you enjoyed together
11. Toast your loved one on anniversaries and birthdays
12. Play music that your loved one enjoyed
13. Wear perfume that your loved one liked you to wear
14. Keep a journal
15. Volunteer for an organisation in memory of your loved one
16. Donate money to research illness that caused the death of your loved one
17. Visit the burial place
18. Send balloons into the sky on the anniversary of the death of your loved one

Helping Others Grieve

You may be reading this article wondering how to help someone close to you, grieve the loss of their loved one.  Some people have firm beliefs about the grieving process and what should and should not be done when assisting others.  Generally speaking, there are some myths about grieving which should be considered when assisting the bereaved.

Myth: People who are grieving don’t want to talk about their loss, and bringing up the name of the deceased should be avoided.

Don’t be afraid to talk about the deceased or mention his/her name as it is probable that the bereaved person will want to talk about it.

Myth: Keep the bereaved person busy in order to avoid them thinking about the deceased.

If the bereaved person is kept too busy, the grieving process could be delayed.  They need to have a healthy balance of alone time and time with people who can support them.

Myth: The grieving period is lasting too long and the person should be  over it by now.

The grieving process is individual to each person and dependent on many things. These may include the type of  relationship with the deceased together with the level of support available to the bereaved.  Other stressors in the person’s life may also hinder the grieving process.

Myth: The bereaved person appears to be OK, so I will avoid any mention of their loss when I see them.

Some people feel very uncomfortable mentioning death or even being around people who are grieving.  It is not only important to keep in contact with the bereaved, but to acknowledge the loss.

Myth:A person who is not showing signs of grieving is probably coping well.

Sometimes people avoid grieving publicly because they believe they have to be brave for the sake of others.  By holding back their emotions, they are more than likely delaying the grieving process which can be unhealthy for their eventual recovery.

Many of us find talking to someone who is grieving, extremely difficult.  It may be so difficult we decide to avoid the bereaved person for a period of time.  Here is a list of helpful tips to remember:

• DO use the deceased person’s name
• DO talk about the deceased person.  Keep memories alive by looking at photos, recognizing anniversaries and commemorating the person.
• DO share you feelings with the bereaved.  Be honest about your fears of saying the wrong thing, but be there anyway.
• DO provide opportunities for the bereaved to express their feelings.
• DO be patient with the bereaved.
• DON’T use euphemisms like ‘passed away’.
• DON’T say things like “you must be brave” – people don’t have to be brave, they should be allowed to express their emotions.
• DON’T say “you should be better by now”.  There is no timetable for grief.

Helping Children Grieve

You may not be grieving for your loved one alone.  You may have a small child or children who are grieving, and along with your own grief, you need to be supportive and understanding of their reactions to the death of their special someone.  The following section is for parents of children who are grieving.

Children, like adults, experience grief in many different ways and each child has his or her own pace of recovery.  It is impossible to predict how a child will respond to losing a loved one; however there are certain reactions that are common to children as well as adults.  For example, whilst an adult may express anger verbally, a child may do so through drawing pictures.  Children also grieve irregularly – one minute they are crying loudly and the next they are happy outside playing with friends.  Understanding the concept of loss depends on the age of the child and below is a table of how children grieve at different ages.  Keep in mind that other factors play a part in a child’s grieving, for example, intelligence, family environment and previous experience with death.

The Young Infant (Age 0-3)

• Thoughts: Children at this age have little or no understanding of death and tend to think that it is temporary and that the person who has died will eventually return.
• Feelings: Young infants can sense that something is wrong as they experience the grief of their primary caretaker.  Responses may include feelings of being left behind, fear and insecurity.
• Reactions: Anger, crying, searching, lack of appetite and finally quiet resignation is the way in which a child will grieve.
• Ways to help cope: What we do is far more important that what we say to a child this age.  Generally, a grieving infant needs large does of tender, loving care … holding, cuddling and stroking.

The Older Infant (Age 3-5)

• Thoughts: The older infant has a limited understanding of death depending on the information that is provided.
• Feelings: Because the preschooler has not yet developed a clear understanding of the permanence of death, their feelings may include confusion, anger and aggression.
• Reactions: Regression in behaviours such as sleeping and toilet training may occur together with reverting to baby behaviour and clinging.
• Ways to help cope: When talking about death to the preschooler, it should be explained simply to avoid confusion.  Role playing with animals, toys and puppets can help the child gain an understanding of the loss.

Age 5 – 8

• Thoughts: Slightly older children have a greater understanding of death, recognising that it is irreversible.
• Feelings: They can find it difficult to understand their emotional reactions such as feelings of guilt or fear.  If the child has lost a parent, he/she can feel anger towards the surviving parent or even the parent who deserted them.
• Reactions: Behavioural problems such as underperformance at school and disruptions in friendships may occur as a result of the loss.
• Ways to help cope: Children’s artwork can speak louder than words and free expression can be encouraged by taking this approach.

Age 8 – 12

• Thoughts: Children aged from around 8 years and older have a more realistic understanding about death and the implications of permanent separation.
• Feelings: They tend to react with similar emotions to adults such as extreme sadness and anger.
• Reactions: The death of a loved one at this age is quite traumatic.  Some of their questions may indicate fears of their own death.
• Ways to help cope: Children of this age not only need support and comfort but can also be a source of comfort for others.  Opportunities to be helpful to others during the crisis can actually help children deal with their own feelings.

Adolescents

• Thoughts: To the emotionally healthy teenager, death is foreign and is something they do not want to think about.
• Feelings: When losing an important relationship, the adolescent’s self centred values may cause them great distress, anxiety and fear.  Adolescents have the capacity for empathy with other family members, so their pain is doubled.
• Reactions: Sometimes self destructive behaviour such as alcohol or drug abuse is experimented with as a means of deferring the pain attached to the loss.
• Ways to help cope: Caretakers of a grieving adolescent should not be discouraged if their teenager reaches out to someone other than family.  It is also not uncommon for him/her to take on the role of parent to younger siblings.

Moving Forward

Together we have looked at your individual reactions and feelings after the death of your loved one.  We have then explored ways of coping which range from relaxation techniques to journal writing and rituals.  After that we have learnt how to assist those who are grieving including the different developmental ages of children.   And lastly, we have identified abnormal grief reactions in order to identify when our grief goes beyond what is considered normal.

Many people find that after recovering from the loss of a loved one, they have a desire to help others.  This can be achieved by doing volunteer work or assisting charities in the area of illness that affected your loved one.  Others find that they move forward by setting small goals such as going for a walk and taking up a craft or hobby.

There are no short cuts to working through grief.  It is a difficult process which is individual to each of us.  We need to work through grief in our own time, and deal with the loss of our loved one in healthy and not destructive ways.  If you or someone in your family needs support, get it.  Grief can be a very lonely journey if travelling it alone.

One thing to remember after losing a loved one is that death does not end the relationship.  It is important to recognise the ways that he or she is still with you and honour these connections as you move forward to full recovery.

As you look to the future, decide on new goals, hopes and dreams.  Choose to embark on your journey of life with renewed passion as a result of having known your special person.  Your life may never be the same now that he or she is gone, but you are an infinitely better person for having know them and richer for having been loved by them.

Further Readings

• Adams, J. (2005).  A dragonfly door:  a new book to explain death to a child.   Minnesota, USA: Feather Rock Books.
• Brown, L.K. & Brown, M. (1996).  When dinosaurs die:  A guide to understanding death.  USA:  Little Brown Publishing.
• Kubler-Ross, E. (1969).  On death and dying.  New York:  MacMillan.
• Kubler-Ross, E. (1975).  Death, the final stage of growth.  Englewood Cliffs, NJ: Prentice Hall.
• Kushner, H.S. (1981).  When bad things happen to good people.  New York: Schocken Books.
• McKissock, M. & McKissock, D. (2006). Coping with Grief.  Sydney: ABC Books & Audio/BBC Audio.
• Wunnenberg, K. (2000). Grieving the loss of a loved one.   Michigan USA: Zondervan Publishing House.

Support Agencies (in Australia)

Lifeline (24 hours): 13 11 14  www.lifeline.org.au
Centacare:  3252 4371  www.centacare.org.au
Relationships Australia: 1300 364 277 www.relationships.com.au