Living With Grief

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There is no one size fits all when it comes to grief. During Mental Health Awareness Month, learn the causes of grief and some resources for getting through — and living with — loss.

Loretta Wilson, NP

Loretta Wilson is a psychiatric nurse practitioner specializing in end of life and psycho-oncology at Kaiser Permanente San Francisco. She helps individuals and their families cope with the mental and emotional ramifications of illness and terminal diagnoses. A daily witness to grief in its myriad manifestations, Wilson shares what she has learned about the condition.

How do you define grief?

While we might first think of grief as the mental suffering and sorrow provoked by losing someone, a person can feel grief related to other losses as well. Divorce, losing a home, being the victim of a crime, even a career change: Each can carry its own kind of loss and grieving.

I often work with people grieving the loss of the expectation that they will be healthy or the loss of an anticipated future, which can be quite scary.

What are the symptoms?

Sadness, crying easily and often, isolating oneself, low energy, poor concentration, and eating too much or too little are all common signs of grief.  However, there is no ‘right’ way to grieve, and it can look a lot of ways.

Clinician Elizabeth Kubler Ross named the 5 stages of grief: denial, anger, bargaining, depression, and acceptance. In follow-up books she conceded there is variability in intensity, length, and order of the stages. Some people will travel through the stages over and over. Others may linger a long time in one stage or another.

How can people work through grief?

Grieving a loss is natural and appropriate, but it does take time. If we think of the loss as an injury — like a broken bone — we wouldn’t keep moving without attending to the injury, so why with grief? I would encourage someone who is grieving to stay connected with friends and family, but don’t be afraid to set limits on time and energy: balance effort and rest. Practice self-care — getting plenty of sleep, hydrating, eating healthy food. Small acts of kindness toward oneself, even turning down the bed covers and leaving yourself a cup of tea at the bedside or listening to music can help.

There is also talk therapy or groups. People sometimes think they will be bothered to be around others in pain, but often it is the opposite: We feel less alone.

Finally, maybe open just a little window of trust and identify one close person to confide in more deeply. Say that you are still hurting and could use a good meal and conversation. Then ask your friend if they are up for it. Try to be specific in asking for what you need.

What surprised you about grief?

It’s not uncommon to experience a guilt associated with the loss. I often meet with people who are berating themselves for small things they could have done better or differently, when really, they did fine and really need to hear that over and over.

New losses can reignite old ones, too. If you never had the chance to metabolize a big loss in the past, for example, another, later loss may become more complicated. The good news is that may offer a chance to work through both.

When is one ‘cured’ of grief?

With a profound loss, you may always grieve. But you will also learn to live with your loss, heal, and build around it. You can be whole again, but not necessarily the same as before. To honor your loss, you really wouldn’t want to be. Through suffering we have the opportunity to hone our compassion for others, and for some people their losses of the past will be their tools for connecting with others in the future.

 

Discussion23 Comments

  1. Great article! Reading through the different articles, it shows how many people suffer or grieve and all to often silently. This is a great avenue for us to be able to share our grief journey and be reminded while our grief and sorrow is individual, we all know the pain. It’s comforting to read/know how others have written about it more articulately than I can speak it. To be able to say “Yes me, too!”

  2. William Luhr, LCSW

    Please know that each Kaiser Permanente Hospice Program offers bereavement services. Our bereavement support groups are available to anyone grieving whether or not the deceased was served by Kaiser. The professionally led groups provide an opportunity to listen to others and share one’s own experience of loss. Kaiser Bereavement Services can also connect members with other community services and information about coping with grief.

  3. Thank you for this article. I lost my mom on 1-1-18, my husband moved out on 4-1-18 and my dog of 15 years passed away on 4-14-18. To say it’s been a very hard year for me is an understatement.

  4. Thank you so much for this article and the amazing work you do! I am a hospice nurse and my work doesn’t end with the work day as many friends and community members come to me to process their losses. I am honored to be there for people in their time of need and am always working on managing my own grief so that I may be there for others and develop a balance with my grief. Thank you for bringing up self-care and caring for each other as well. I think a lot of times people don’t know how to support those who are grieving and it can be isolating for that person. The advice of trusting one person and opening up to them more is great advice. I will be using some of your tips in my work and life. Thank you!

  5. Judith Fairchild

    Thank you for this article on grief. I just lost my brother to lung cancer April 24th. The deep feeling of loss comes in waves and the tears flow. I am very thankful that he died in his sleep and didn’t suffer. I believe he is at peace. I am deeply thankful for the love and friendship that we had. I really appreciate your words about loss and how it changes over time but the grief may always be there. I want to keep my brother close to my heart even if that means feeling the loss and grief.

    • Loretta Wilson

      Thank you for your kind words, Judith. And between those waves of tears and loss, I hope you get breaks in the storm. ~Loretta

  6. David Harding

    Thank you for the article. I appreciate the sharing of this information. I lost my mom to cancer in April 2011 and my brother to suicide in October 2011. This was a difficult time. I learned about the 7 stages of grief on my own through research performed on the Internet. Due to circumstances I had to handle my brother’s affairs on my own, which was difficult. I am finally at the stage of acceptance, and peace. I will always miss my family…

    • Loretta Wilson

      Hi David – Dealing with the particulars of an estate is certainly daunting, and even more so when suicide and previous layers of grief are pulling at us. Good to hear that you are feeling fresh air at last after scrambling through so much rubble. ~Loretta

  7. Claudia Wooley

    You said what I have said to many people related to grief and especially death. I lost my mother in 2004 and even now in 2018, I can talk about her and as I am typing this, my eyes are welling up with tears. But I tell people who have lost loved ones that there is NO TIME LIMIT for grief. We learn to live differently without our loved ones. I never want to hear someone tell me to “get over it” because I NEVER WILL. This was a great article for someone just going through a loss. And yes, a loss doesn’t have to be just a relationship, it could be anything, i.e. job, surgery. So live life one day at a time and EXPECT the sadness to creep upon you at any time a trigger comes. Accept it and move on. If the grief becomes debilitating, seek counseling.

    • Thank you for this great article. I think anyone who’s going through grief can relate to your article. You are so right. I just lost my father and I cannot even talk about him without crying. I do believe that’s the natural way of healing. Every time I walk through the hospital, it’s a reminder for his last days. He spent his last 23 days in the hospital. Strangest thing about the mind is the more we run from our thoughts, the more they follow us. Sometimes our mind and heart teach us how to heal and accept. I believe talking about him, sharing thoughts and, as you said, treating it like an injury is the way to heal faster. Let the injury heal and you can run again. Positive thoughts, memories, and the great way they lived is the reminder to us to live every moment and make it memorable.

      • Loretta Wilson

        Hi Gagan – thank you. And I hope your “recovery” returns to full health soon. ~Loretta

    • Loretta Wilson

      Hello Claudia – my own eyes well up with tears as I read your post, reminding me of how alive grief can remain years later. Fortunately, I smile when I get misty over my dad’s passing – like a little visit from someone I miss so dearly. Thanks, Loretta

      • Claudia Wooley

        Loretta Wilson, thank you and I feel you. I always say when I see a butterfly, “Hi Mom,” and when I look up in the sky and see the brightest star … “That’s MY momma!!” (insert smile here) Me and my dad helped take care of my mom when she was first diagnosed with brain cancer and would not change anything. One thing I asked God was to let me be there when she took her last breath and I got that wish. I am a social worker in health care and this has helped me deal with death and look at things differently, but I was no means immune to it. I believe I have a more realistic way of thinking, which in turn has helped me and the way I have dealt with grief. I know what to expect, but when it is personal, it still hits you…

  8. Thank you for this article. It seems as though you knew I needed this. I lost both of my parents in a year’s time. My mother March 7, 2017 (my daughter’s birthday) and my father a year later, March 25, 2018. I had just started getting to a state of acceptance from my mother’s passing. My father went into cardiac arrest March 17th. Medical professionals administered CPR for more the 45 minutes. They got his heart back but within a week we got the results that his brain had suffered too much damage. Every time they would lower the sedation he would start seizing instantly. I was left with the decision-making. I was the one to decide to take him off of life support. It was the hardest thing I have ever had to do. My heart aches. My children are 4 years and 14 years old. My youngest asks for him all of the time. I can cry at the drop of a dime. My grieving for each parent has been completely different from each other.

    • Loretta Wilson

      Ah Cheri,
      What a long, complex, jarring time this has been for you. And just when you were feeling so alone, to hold the responsibility for speaking for your father when he couldn’t. Of course your heart aches, and if this article helped even a bit, I’m so glad. ~Loretta

  9. I really appreciate this article. I lost my mom Nov. 2017 – on my birthday. I am learning how to allow the waves of grief to roll in and out as needed and not feel weird about those feelings. While I expect to never “get over” losing my mom, I am learning to live with the wonderful lessons and treasured memories I will have forever.

    • Loretta Wilson

      Hello Brigget – I want to acknowledge how bittersweet this timing can be when the anniversary of a loss coincides with what is expected to be a time of celebration. Yet, I hear you finding a richness in the complexity, and I hope that between the waves of grief, you get the chance to kick up your heals or clink a toast and know that you’re doing it right. ~ Loretta

  10. Thank you for opening the discussion on a topic often ignored in our fast-paced society. Let’s continue to speak honestly about grief so that we can honor our losses & preserve our humanity.

    • Loretta Wilson

      Yes to opening more to each other – thanks for being part of the conversation. ~Loretta

  11. cynthia reeves

    This email came at the perfect time for me. Losing my brother has been the hardest thing I have ever had to deal with. It is important to have a solid support system. Its hard to open up to people because if they have never experienced the same pain, they may not understand. One day, one minute, one second at a time is how I get through.

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