GRIEF AND LOSS

Grief is the normal, natural and expected reaction to loss. When we think of loss, the first thought is usually the death of a loved one. This is a severe loss. But we all experience loss throughout our lives.

Think of your transition from high school to college. You probably went through or are going through several losses, some more extensive or difficult than others. They might include specific people -- the friends you spent time with, or your family members or specific objects such as your room at home, your favorite chair in the family room, the family pet. Losses can also be physical, emotional, or spiritual aspects of yourself. They can also involve the loss of a cherished value -- such as faith, loyalty to an institution, or belief in certain people.

Grief is the hardest part of the healing process following a loss. For most of us, it's easier to be angry than sad. When we are angry, there is release of adrenalin. We feel powerful and strong, that we can vent the rage and get what we want. But in grieving, we feel more like a collapsed balloon -- we feel vulnerable, defenseless and weak, it feels like the pain might engulf us -- it hurts.

There is little support in our culture for weakness. We do not focus on it and do not accept it. We are more likely to hear a message that implies or even overtly says "chin up". But we must grieve to heal from loss.

Unresolved grief can be dangerous. It can lead to outbursts of anger and rage, restlessness, depression, addiction, compulsion, anxiety, and panic disorders. Physical symptoms may include the development or worsening of diabetes, heart disease, hypertension, cancer, asthma, allergies, and gastrointestinal disorders such as constipation, diarrhea, and ulcers.

When we grieve, we are mourning the loss but also the fact of our powerlessness. No matter what we do, we cannot replace what has been lost. We are also grieving our own mortality -- the fact that we are going to die -- the ultimate expression of our powerlessness.

We cannot resolve grief until we know what we are grieving, what the losses are. Not only is there a cultural tendency but also a human tendency to deny loss, to not think about it. But it is important that we do this.

Grieving is the process by which we separate ourselves from the past (that which was lost) and replace it with the present -- new relationships, new ways of being, and so on. There are several stages in this process. First, we experience denial and isolation. We are shocked. The loss is not acknowledged. This holds back the pain and works for a time. This permits us to function and to take it in slowly.

Second, when we can no longer deny the reality of the loss, we are angry -- at the unfairness, at life, maybe even at God. This is also a time of sadness and fear.

Third, we bargain -- there are fantasies of "what if". There may be excessive self-blame and guilt. There may be attempts to change one's own behavior or that of others -- to have it turn out different this time. Getting stuck in this stage is wearing, draining.

We next experience a bottoming-out -- depression is evident. This is a normal response to a stressful situation. There is acute awareness of the reality of the loss and its meaning, the disruption in everyday life, the loss of feelings that the world is safe and fair. This stage is temporary but very painful. There may be symptoms of clinical depression, such as changes in sleeping and eating habits, feelings of profound sadness and hopelessness, low self-esteem and physical illness. It is at this stage that the risk of suicide is greatest.

Finally, there is acceptance. The feelings of depression and rage are less intense. There is acceptance of the loss and the toll it takes on one, and one beings to make compensations. The losses and scars are accepted. There is remembering of comforting memories.

This is a process -- it is important to remember it takes time. We can get stuck at the various stages and move back and forth between stages -- triggered, for instance, by anniversaries. It is important to remember that grieving is work -- it requires psychic energy and a time and place to grieve.

Coping with grief means taking steps to deal with the loss directly and constructively -- it does not mean overcoming the loss. Things will never be the same, but life can be happy and meaningful again -- the present and future need not be destroyed.

There are several things that can help facilitate the grieving process. Create a time and place to grieve. It is important to allow ourselves to feel the grief and to accept that the time and energy spent grieving are important and valuable. Express the grief -- cry, scream, talk about it -- it may also be helpful to write or draw. We need to give dignity to the grief -- rituals can be helpful in this regard. It is helpful to talk to ourselves positively, saying things such as, "There's nothing wrong with me being I'm upset" and "I am grieving. and it is painful" -- this acknowledges one's life and attachment -- that there was time and energy spent building something meaningful and its loss is significant. It is also important to develop a support system -- grieving is a time for sharing and being with others, not for isolation.