Pacific Grove Hospital is a premier 68-bed treatment center near Riverside & Corona, CA, dedicated to treating people struggling with grief & loss.
What is Loss?
Loss is an involuntary separation from something we have possessed – perhaps even treasured – or someone we love and care for. All types of loss involve a level of emotional pain – major, significant losses produce emotional upheaval. Additionally, loss necessitates change, uncertainty, and adjustment to situations that are new, unchosen, and uncertain. Loss, like grief, is universal; all people will experience some form of loss, whether it is major or minor, throughout their lifespan. It is vital to understand that loss can follow a real or perceived event.
There is no one single way a person should feel following a loss. Minor losses, such as the loss of an opportunity, may bring about feelings of disappointment, anger, or frustration, while major losses may lead to similar feelings in addition to overwhelming sadness, pain, and emotional numbness. It’s important for people experiencing loss to remember the following:
- No one has to be “the strong one” following a loss in order to protect others
- Expressing emotion is the way in which the mind and body process and relieve the pressure of intense, overwhelming emotions
- Other people may react to loss by emotional numbing
- Crying or expressing emotions doesn’t imply weakness
- No one can tell another person how he or she should be feeling or acting following a loss
What are the Types of Losses?
There are a nearly unlimited causes for losses, all of which will have a dissimilar impacts on different people, based upon type of loss, severity of loss, proximity to the loss, and effects of the loss. Obvious losses include:
- Breakup of a romantic relationship
- Loss of a friendship
- Terminal diagnosis of a loved one or friend
- Death of a loved one or friend
There are also a number of less-obvious reasons a person may experience a loss, including:
- Illness – the loss of physical or mental functioning can lead to feelings such as a loss of sense of self, loss of power, and a loss in health or abilities
- Moving away from home
- Graduation can lead to feelings of a loss of good times, feeling young, having fun, or as an end of a phase in life
- Job loss can lead to feelings of loss of self, loss of power, loss of pride, and loss of security
- Losing one’s home to a fire, flood, natural disaster, or financial woes can cause significant emotional pain
- Loss of a physical ability
- Loss of financial security
One of the reasons that loss is so difficult is that it is often permanent; loss can turn a person’s life upside down especially if life before the loss heavily relied upon the person, object, or concept that was lost. The changes following a loss can be tremendously challenging as they are often major changes that must be made during the grieving process. There are two major types of losses that have their own sets of challenges:
Sudden losses occur as a result of an accident, crime, suicide, or other sudden, major events that do not allow survivors the opportunity to prepare. These type of losses can be core-shaking, require an immense amount of time to process, and may lead to unanswerable questions about the stability of life. Sudden losses can lead to severe, agonizing, and immediate emotions; sorting through an amalgamation of emotions and responses can be tremendously difficult.
Predictable losses, such as those that come about after a diagnosis of a terminal illness, allow all affected to prepare for the loss. Predictable losses lead to two layers of grief and grieving:
- Anticipatory grief – The emotional response that occurs before the loss itself. The emotional response has many of the characteristics of grief itself with a couple exceptions. With anticipatory grief, one hopes that the loss one anticipates will not occur. The uncertainty and wishing it would happen while dreading the finality of the loss make the grieving process more unstable.
- Conventional grief – The grief and grieving of the loss itself.
What is Grief?
Grief is a normal, human response to the loss of something or someone significant to which a bond was formed. While grief is conventionally considered to be an emotional response to loss, grief also involves cognitive, physical, social, spiritual, and philosophical components. Grief is the journey toward healing and recovery from a significant loss. People may experience grief in response to physical (or quantifiable) losses, such as the death of a loved one, or in response to a symbolic, abstract, or social loss, such as unemployment. All types of grief reactions involve something being taken away. Grief is simultaneously a universal and a personal experience; each person experiences grief in a unique fashion and the grieving experience is influenced by the nature of the loss. It’s important for people who are grieving a loss to understand that no one can control their individual grieving process and nothing can be done to prepare for the different stages of grief.
What are the Five Stages of Grief?
Through interviews with over 500 terminally ill individuals, Elizabeth Kubler-Ross discovered that there were five distinct stages of grief, a model that is now used to describe the experiences of those coping with tragedy, grief, and catastrophic loss. It’s important to note that these stages of grief are not intended to be linear or chronological events, nor does every person experiencing the aftermath of an intense loss experience these stages in the same fashion. Some stages may be missed and some re-experienced, while others may get stuck in one stage.
Stage One: Denial and Isolation– Often, when a person is faced with a major loss, they experience denial, a coping mechanism that allows the pain of the loss to seep through the numbness in small increments – if the pain hit all at once, it would be debilitating. The reaction is often one of emotional shock and disbelief, “this can’t be happening.” While denying the loss, many isolate themselves from loved ones and social contact.
Stage Two: Anger- When a bereaved individual can no longer deny the loss, he or she becomes outraged, envious, bursting with anger, which, despite popular opinion, can be a healing emotion (at healthy levels). This anger may not be directed at an individual or group of individuals, but it can spill out into the relationships the bereaved has with others. The level of anger experienced is often an indication of the intensity of love toward the deceased and intensity of the loss.
Stage Three: Bargaining– After the anger abates, the bereaved often enters a stage of bargaining with a higher power. Often, the feelings during this stage are reminiscent of a child pleading with his or her parent: “Now that I’m not angry, can I please see my loved one just one last time?”
Stage Four: Depression- Once the individual realizes that he or she cannot bargain his or her way out of the loss, reality hits and the full weight of what has been lost begins to sink in. The bereaved becomes depressed as he or she feels the weight of the grief, sadness, and loss heavy on his or her shoulders. Talking to a therapist and seeking treatment can be tremendously helpful during this stage of grief which, like the others, can ebb and flow over weeks, months, and years.
Stage Five: Acceptance– Acceptance is the most confusing stage of grieving; while the bereaved accepts that he or she has gone through a tremendous loss, he or she will never become truly over it. During this stage, many outsiders will believe that the bereaved has moved on with his or her life, and in some senses, it’s true. The individual is simply learning to build a new life and create a new normal – life will never be the same as it was, but it can be lived again.
What are the Patterns of Grief?
While grief is universally unique, there are several documented patterns of grief:
Early phase of grief is marked by emotional shock, dismay, and disbelief. This stage of grief leaves a person unproductive, dazed, and mechanical as they attempt to go about their life. The early phase of grief may last hours, minutes, days, or weeks, and due to emotional numbing, a person may not recall what has occurred during this time period.
Middle phase of grief is characterized by much emotional pain and more intense reactions and can often last many months. Even after life appears to be back to normal, a chance remark, reminder, or experience may cause these intense emotions to resurface.
Late phase of grief is manifested by experiencing glimmers of hope about the future, a renewed sense of coping, a returning sense of overall well-being, and a renewed belief in life.
What are the Symptoms of Grieving?
Loss affects everyone in different ways, however, there are many commonalities among the emotions during grief. There is no timetable for grief, and the ways in which a person grieves will vary depending upon personality, coping style, life experiences, faith, and the nature of the loss. Some of the most common symptoms of grief and grieving include:
Anger – Anger is common even if the loss was no one’s fault, and may be directed at oneself, a higher power, physicians, and even the person who died. Often, people need to blame someone for the injustice of the loss.
Fear – A major loss can lead to a number of worries and fears, causing anxiety, helplessness, panic attacks, and insecurity. A tremendous loss can trigger feelings about mortality, facing life after loss, or of the new responsibilities caused by the loss.
Guilt – Many people feel guilt after a loss about the things left unsaid or things that were done. Bereaved individuals often feel guilt about certain emotions they experience or not doing more to prevent the loss.
Physical symptoms – While grief is often thought to be an emotional process, there are a number of physical symptoms a person can experience following a loss, including fatigue, nausea and vomiting, weight gain or loss, physical aches and pains, insomnia, and a lowered immune response.
Profound sadness – Extreme sadness is one of the most universal symptoms of grief and grieving and may be accompanied by feelings of despair, yearning, longing, emptiness, or intense loneliness.
Shock and disbelief – It can be extremely difficult to accept a loss, which is why many report they feel numbness, disbelief that the loss occurred, or deny the truth of the loss.
What is the Difference between Grief and Depression?
It’s not always easy to distinguish between the grieving process and depressive disorders as they share a good number of symptoms. One of the most important distinctions is that grief is a mixture of complicated emotions, with good days and bad, and its symptoms change throughout the days, weeks, and months. Depression, on the other hand, leads to static feelings of sorrow and despair. Other symptoms that signify depression – not normal grief – include:
- Seeing or hearing things that are not there
- Slowed speech and body movements
- Inability to function well at school, home, or work
- Feelings of hopelessness and worthlessness
- Pervasive, all-encompassing sense of guilt
- Thoughts of death by suicide
What is Complicated Grief?
Complicated grief is a type of incapacitating sorrow that often occurs for a long period of time that involves disorganized, depressed behavior. Complicated grief can lead to trouble accepting the loss and resuming one’s own life – professional help is needed to come to terms with the loss and reclaim a sense of acceptance and peace. Symptoms of complicated grief, which is much like existing in a chronic, heightened state of mourning, may include:
- Excessive focus upon the loss and reminders of the loved one
- Difficulties accepting the loss
- Emotional numbing and detachment
- Extreme longing for the deceased
- Obsession with personal sorrow
- Resentment about the loss
- Decreased ability to enjoy life
- Profound depression
- Difficulties performing normal activities of daily life
- Withdrawal from social activities, friends, and loved ones
- Belief that life is meaningless and purposeless
- Agitation or irritability
- Inability to form bonds or trust other people
Effects of Complicated Grief
Without proper intervention, support, and treatment, complicated grief can lead to a number of dire consequences. These complications may include:
Depression is the most common effect of complicated grieving and most noted when a person experiences a divorce or death of a partner.
Anxiety is very common throughout the grieving process and can lead to feelings of emotional instability, overwhelming fears, extreme guilt, and panic attacks.
Post-traumatic stress disorder is an intense emotional and psychological response to a disturbing event such as the death of a loved one.
Physical illness can occur as grieving stresses the body, weakens the immune system, and leads to aches and pains. Those who have chronic medical conditions may experience an exacerbation of symptoms. People experiencing complicated grief are at greater risks for heart disease, hypertension, and cancer.
Substance use and abuse is a way that some people coping with complicated grief try to self-medicate the overwhelming feelings that occurred as a result of the loss.
Suicidal thoughts and behaviors may occur for some experiencing complicated grief and should always be taken as a serious medical emergency. The threat of suicide increases if a person is contemplating suicide and has the means available to harm him or herself or another, has a time and place set to complete the act, and believes that there is no other way to end his or her emotional pain.