Grief Education

The loss of a loved one can take its toll on you both physically and mentally. You may experience a roller coaster of emotions. One moment may find you incapacitated by coping with grief, whereas in the next you may feel almost normal. Anger, fear, guilt, and panic are just a few of the emotions you may experience. This is completely normal.

The physical effects of grief can include sleeplessness, excessive fatigue, headaches, general malaise, intestinal upsets, and dizziness. During periods of extreme stress such as grief, it is crucial that you try to eat regularly and to rest, since stress can suppress your immune system, making you more prone to illness.

Your grief reaction and subsequent recovery can depend on the quality of your relationship to the deceased, your capacity to handle stress, and the type of support network that you have. If your relationship was strained or you have never experienced the loss of a loved one, your grief may be overwhelming.

Do not be afraid to seek the support of friends and family. They will want to help but might not be sure how. All too often, those who are grieving keep their feelings to themselves and feel that others will be able to anticipate their needs. As difficult as it may seem, it may be necessary for you to take the initiative and/or seek help from continuing care counselors.

• Losing a Child
  
• Losing a Spouse
  
• How Children Cope with Grief
  
• Coping Through the Holidays
  

It has been said that parents who lose a child also lose the hopes, dreams, and expectations they had for that child. They lose a part of themselves. They lose their future because their child represents their sense of ongoing life. Psychologists believe, because of these reasons, the death of a child is possibly the most difficult loss of all to accept.

People who have children often feel that parenting is life’s most important role, regardless of the child’s age. Therefore, the death of a child can be a tremendous assault on a parent’s very identity.

• What to Expect
  
• Anger and Guilt
  
• The Grief Experience
  
• Answering the Questions of Your Other Children
  
• Dealing with Grief
  

If your child has died, you will most likely experience several common reactions of bereavement. However, your grief can be more acute than normal. You may go into periods of shock and denial. You will likely become depressed. If you are normally a committed, caring person, you could find that you do not care about anything or anyone. You may find yourself preoccupied with the circumstances of your child’s death, recreating them over and over again in your mind. You may think you see or hear your child. You might have dreams and nightmares about them.

The intense grief caused by your child’s death can take a physical toll as well. You may lose weight, have difficulty sleeping, become irritable or listless, or feel short of breath. Grief has even been known to cause hair loss.

Perhaps the most acute feelings you will experience are anger and guilt. Because the death of a child does not follow the normal order of nature, there is a strong urge to place the blame on someone or something. You may be angry at the doctors or nurses who could not cure your child’s illness, or at God for "letting" your child die.

If your child died because of a traumatic accident, you may be angry at whomever you believe caused it. If your child’s actions partly caused the death, you may be angry at him or her and then feel guilty about your anger toward your child.

Parents often feel terribly guilty for simply living. If you had an argument with your child or had to discipline him or her shortly before the death, you may feel guilty for those actions. You may feel the most guilt because you believe you should have prevented your child’s death. You may find yourself consumed by thoughts of "if only."

A father tends to suffer guilt over failing to prevent a child’s death. While both parents feel responsible for their child’s safety, men have often been taught that protecting the family is their primary role.

While bereaved parents know they will experience intense grief, their child’s death can have another effect they did not anticipate. The death could alter their feelings toward each other. Almost always, the marriage will never be the same. The change could be for the better or for the worse. However, the relationship rarely stays the same.

Parents think their grief will be similar because they have lost the same child. This similar type of mourning rarely happens. The relationship the father mourns is different from the relationship the mother mourns because each parent shared a different relationship with the child.

Fathers may have a more difficult time expressing their grief, believing on some level that "big boys don’t cry," or that they need to be strong for their surviving family. Unfortunately, this may keep fathers from working through their grief and resolving it. It may become necessary to seek counseling or spiritual help.

Couples may experience difficulty in communicating after the death of their child. The intensity of grief comes at different times for each parent. One parent may use work as an escape while the other finds solace in photo albums and home videos. Dad may feel the need to box up and store the child’s personal belongings while Mom cannot bear to look at them. A physical resemblance to the dead child can also cause difficulties between the parents.

A child’s death may cause sexual problems within a marriage as well. Time, patience, and communication are key elements to resolving these problems. It is not uncommon for these effects to last up to two years or more following the child’s death.

Your other children will look to you to explain the death to them. A child’s questions will depend on their age, but your answers should always be honest. Guard against telling children that their brother or sister is "sleeping," or that "God wanted their brother or sister." These may simply cause other fears in your children that may be more difficult to resolve than a more direct answer. Be direct, without offering more information than necessary.

Young children sometimes fantasize that they caused the death by being mean to the deceased sibling or by fighting with them. In this case, it is important to assure your child that he/she had nothing to do with their brother’s or sister’s death.

Remember, your other children need to resolve their grief. They will take their cues from you, so support them in their grief by being open in showing yours. You will not do them any favors by protecting them from the grieving process; in fact, there is no way you can while coping with loss.

It may not be possible to work through your grief alone. We can recommend different bereavement services: support groups, counselors, books, and videos that deal specifically with child bereavement. Ask us to recommend a specific book, or visit your local library.

It is important for parents to realize that severe grief can make them feel like they’re going crazy. If you are afraid your grief is out of control, you might consider asking your clergy, doctor, or funeral director to suggest a counselor. You may be relieved to find that your problems, in this situation, are normal.

Finally, remember that other people will likely feel very awkward around you because they will not know what to say. You can help bridge the gap by simply telling them what you need and letting them know if it is all right to mention your deceased child.

How can one possibly absorb the shock of the death of a mate? No matter how many years you have shared, memories of courtship, lifelong plans, and your marriage are most difficult to bear. Not to mention what has been left behind: children and grandchildren; dreams yet to be fulfilled. These memories are part of your past and the death of your spouse is something you must deal with today. The thought of which is painful at the very least.

• Reactions to Death
  
• As the shock wears off
  
• Coping
  

If your spouse has died, you will probably experience some of the common symptoms of grief. You will very likely go into shock and denial. You may experience feelings similar to what an amputee goes through, where they actually "feel" pain in the missing limb. In the case of a lost loved one, you’ll “see” them sitting in their favorite chair or coming through the front door. This "phantom" pain may manifest itself in hearing their voice calling from another room. Their cologne or perfume lingers in closets and throughout the home you shared, evoking powerful feelings.

You may feel "numb," like a spectator watching events unfold. This is nature’s way of protecting you from what is happening while your life is in transition.

You may also find yourself filled with anger. You may feel angry at the doctors or nurses who couldn’t save your spouse, or maybe even with God. You may feel anger toward your spouse for leaving you, and then feel guilty for this anger.

In fact, guilt can be one of the toughest feelings to overcome in your grief recovery. It is common, in transition, to feel guilty simply for being alive when someone else has died. You may believe you somehow could have prevented the death, or should have been present to say good-bye.

Because relationships are never perfect, you undoubtedly had unresolved issues at the time of death. These can be very difficult to overcome, and many choose to seek counseling to help bring about closure.

Powerful reactions to grief are most often unexpected by the bereaved. The effects are physical as well as mental. The feeling of being alone causes your mind to race. You cannot sleep. You cannot think clearly. Your muscles are tense and your body aches.

It is not unusual to experience nausea, dizziness, rashes, weight loss, in addition to difficulty in sleeping. You may become irritable or listless, feel fatigued, or short of breath.

The acceptance of your spouse’s death will slowly become a reality. You may think, "My life will never be the same again." "I cannot change what has happened to me." "Oh God, what am I going to do now?" A course of grief recovery depends partly on your age and mostly on your individual situation.

A surviving spouse from a younger, two-income family may end up in a tight financial situation; not to mention any children to consider, as the transition to a single parent household is made.

Profound loneliness occurs when future plans include having children and the opportunity is lost by the death of a spouse. This is especially true if the bereaved feels a child would have been a living part of the mate who died.

"Empty-nesters" feel the effects of a spouse’s death in other ways. The fact that the house is completely empty now precipitates an entirely different level of loneliness. This is especially true in marriages that have lasted many years, where plans for a long and enjoyable retirement were disrupted by a spouse’s death.

Losing your life companion can leave you feeling confused and panicky at any age. For this reason, you should delay making any major decisions. Try to postpone them until you can think more clearly and have a better idea of how your life is going to change. Antoine de Saint-Exup’ery wrote, "... you cannot plant an acorn in the morning and expect that afternoon to sit in the shade of the oak."

You have grown accustomed to living a certain life-style and engaging in favorite activities with your spouse. You are used to being the object of your spouse’s love. For example, a woman who becomes a widow didn’t just lose her husband. She lost her best friend, her confidant, her "knight in shining armor." The death of your spouse can also change the relationship you had with mutual friends. Those same friends you socialized with as a couple may have a difficult time interacting with you as an individual. You may begin to feel like the "fifth wheel." Life without your spouse may steer you in the direction of a new circle of friends. Many times, lasting friendships develop between people who met in grief support groups. Your loss is a common bond.

How can you overcome the problems you face after your spouse has died? First, you must recognize that grief is necessary; it is something you must work through. There are no shortcuts to coping with grief.

It is important to express your feelings. Take time to cry. Don’t be afraid to share your tears with others. Express your anger when you feel the need. Talk openly with family members and friends; this is a time to lean on them. Some of your friends may feel awkward for awhile because they don’t know how to talk to you about your loss. You can help them by simply telling them what your needs are. Don’t try to protect your children or other family members by hiding your sadness.

If you normally have a pressing schedule, try to lighten it. Remember, grief is mentally taxing; you do not need the added strain of too much to do. Set aside some quiet time for yourself, time when you can think about your spouse’s death and put things into perspective.

If you are worried that you are not coping well with your grief, consider talking to a counselor. You may be relieved to discover that you are reacting normally. If you believe you need help, ask your clergy, doctor, or funeral director to suggest a counselor who will help you through your transition.

Many bereaved spouses find adjusting to life without a partner becomes easier if they talk to others in the same situation. You might want to consider joining a local support group. Ask us for information regarding local groups specifically for those who have lost a spouse.

After some time and effort, you will adjust to your new life and your grief will diminish. This does not mean you must forget your loved one; it means you have accepted the death and can begin to live each day in the present, savoring the memories as part of your new life. In fact, many agree the best way to honor a loved one who died, is to live a life full of friendship and even new love.

Dealing properly with your grief can make it all possible.

The cognitive and emotional levels of development from infant through adolescent cover a wide span of grief. The age of a child/adolescent and a child's/adolescent's perception of death must be understood before the caregiver or facilitator starts interacting with the child.

A grieving child at each different level of development will need assistance in building coping skills and finding a sense of closure to his/her loss. Children at all developmental stages experience grief on different chronological and emotional levels.

• Infants and Toddlers
  
• Four to Six Year Olds
  
• Seven to Eleven Year Olds
  
• Adolescents 12-17
  

Children younger than four can sense that something is wrong as they experience the grief of their primary caretaker. The absence of the mother may cause a clear biological reaction. Anger, crying, searching, lack of appetite, and finally quiet resignation are the ways in which a child will grieve for the loss of the mother/primary caretaker.

The child should not be passed from caretaker to caretaker.

What one does is far more important to the child this young than what one says. Generally, a grieving infant or toddler needs large doses of tender, loving care--holding, cuddling, and stroking.

Bereaved children between four and six have a limited and literal understanding of death. For a child in this age range, death may be explained in physical terms. Because thinking is very literal and bodily oriented, death may be best explained as follows: His/her heart stopped beating and no one can make it start again. Therefore, we won't be seeing him/her move or talk anymore. We will bury the body in the ground, because (identify the person, using their name) is not able to do or say anything anymore.

Children will often note the discrepancy between burial of the body and the description of "going away" or "going to Heaven."

While the young child probably can't grasp the concept, one might address the distinction as the part that we love--the part that smiled and laughed and loves us-is the part that has gone to heaven. The old, broken body is now what is in the ground.

Caretakers can facilitate therapeutic role-play by sitting with the child as he or she plays with dolls, stuffed animals, puppets, toy cars, and doll houses. Look for aggression in play and explore where the anger is focused.

Children ages seven to eleven are still primarily oriented to the family, and although they've begun to relate to and gain self-identity through their peers, play is still a mode of self-expression. Children this age also express themselves quite well orally, especially the primary feelings of mad, glad, and sad.

They have begun to grasp more abstract concepts such as truth, time, space, and death, although magical thinking still plays a role. Most commonly, seven or eight-year-olds become fearful of death because they realize for the first time it's real.

No matter who dies, they may feel devastated at the thought of losing a parent. Obviously, the death of a parent is extremely traumatic at this age. Some of their questions may indicate fears of their own death. Death is seen as an attacker who takes life.

Free expression of grief must be encouraged, and children must be told over and over that they didn't cause the death and that the dead person did not choose to die. A child of this age may also fear that death is a punishment for improper behavior. They may fear that their naughty behavior has brought about the death of a loved one, and they are being punished for it. They may also believe that they or another loved one will be the next to die.

A more adult concept of life and death develops roughly between the ages of nine and eleven. At this developmental level, the children have learned that only people, plants, and animals live and die. Children of this age are not only sensitive to their own feelings, but can now enter into the feelings of others. As a result, they are more understanding of what the loss may mean to others, and they are able to show empathy. Children in the upper end of this range not only need support and comfort, but also can be a source of support and comfort for others. Opportunities to be helpful to others during the crisis can actually help children deal with their own feelings.

To the emotionally healthy adolescent, death is foreign; it's something they simply do not want to think about. Sometimes their self-destructive behavior, such as alcohol or drug abuse or playing chicken in an automobile are means of saying "I'm not afraid of death; it's a game--I'm making a plaything of it."

However, the real meaning beneath the behavior is that they're trying to control their fear and insecurity by making it a game. Moving fast and keeping the music loud can be an escape from having to face their fears.

When met with the loss of an important relationship, the adolescent's self-centered values may cause them great fear, guilt, anxiety, and anger. Adolescents have the capacity for empathy with other grieving family members or friends, so their pain is doubled.

Because an adolescent forms more intimate relationships with peers than with parents, it's advisable that networks or groups be made available for adolescents who have experienced the death of a loved one. The adolescent may respond well to another adult who is willing to listen and assume a surrogate parent role with them. While reluctant to participate in their own family grief or support groups, they may respond well to a pastor, school counselor, or another adolescent who "understands."

Caretakers of a grieving adolescent should not be discouraged if their teen reaches to someone other than family. That's normal at this stage of development.

Authored by Yvonne Butler Clark, author, It's Okay to Cry.

Halloween barely passes before stores stock their shelves with holiday decorations. Christmas carols echo through shopping malls, and the first of the holiday commercials hits the airwaves. If you've lost a loved one, these can be stark reminders that the holidays won't be the same.

Whether your loved one died recently or decades ago, the holidays bring forth powerful memories that may trigger your grief. If the person died on or near a holiday, the two events are forever linked and may be particularly painful, especially if you have unresolved feelings about the lost relationship.

While coping with grief, it's important to understand that grief is cumulative. We don't experience a loss, move through predetermined emotional stages, and then emerge on the other side. This holiday season, if the first Christmas card you open or the first "Happy Hanukkah!" you hear starts to bring on sadness, use that opportunity to work through your feelings. Don't just ignore those feelings. Here are some tips to help you cope.

• Expect to have some pain. When the feelings come, let them.
• Accept a few invitations to be with close family or friends. Choose the ones that sound most appealing at the time and avoid the ones that feel more like obligation.
• Talk about your feelings. Let people know if you're having a tough day.
• Incorporate your loved one into the holidays
• Share your favorite stories over dinner.
• Make a toast or light a candle in remembrance.
• Make a donation in his or her name.
• Help others:
  • Take a meal to a homebound couple.
  • Volunteer in a shelter or soup kitchen.
  • "Adopt" a family to buy presents or food for.
• Modify or make new traditions if it feels right. Just remember to include others who are grieving, especially children, in the decision.
• If the idea of holiday shopping overwhelms you, buy gifts online or through catalogs.
• Replace negative thoughts with positive ones.
• Prepare yourself for January. Sometimes the aftermath of the holidays can bring more sadness than the holidays themselves.

• Don't hide your feelings from children in an effort to be strong for them or protect them. You'll only be teaching them to deny their own feelings.
  
• Don't isolate yourself. Although you may not feel much like celebrating, accept a few invitations.
  
• Don't accept every invitation or throw yourself into work in an effort to keep busy. It may only add more stress.
  
• Don't expect to go through defined stages of grief. Every person is different and every relationship is unique.
  
• Don't act as if your loved one never lived.
  
• Don't be afraid to cry. Crying is like the valve on a pressure cooker. It lets the steam out.
  

• Encourage him or her to talk about their feelings. Listen to them. 98 percent of people who have recently lost someone want to talk about the person who died.
  
• Let them cry.
  
• Don't pretend their loved one didn't die - it's okay to say the deceased's name.
  
• Don't say things like: "At least he's not suffering anymore", "She's in a better place.", "I know you'll miss him.", "I know how you feel."