G1803

Understanding Grief and Death

This NebGuide defines loss, offers suggestions for dealing with grief and loss, presents psychological and emotional responses to loss, and describes ways to help people who are mourning the death of a loved one.

Gail L. Brand, Extension Educator, Marilyn S. Fox, Extension Educator,
and Kathy R. Bosch, Extension Family Life Specialist

Understanding Loss and Grief

Loss is defined as a “separation from, a detachment from something or someone of value.” The degree of the loss and its meaning and value to the individual affect the intensity of a person’s response. Therefore, it is virtually impossible to predict how any one person will respond to a particular loss. But it always causes some change in perception of one’s self or lifestyle, and some type of adaptation or adjustment is required.

Following a loss of great significance (e.g., the death of a spouse or child), a person normally moves from a period of acute emotional pain and sadness to a more comfortable emotional state. This movement through a series of adaptive stages is known as the grief process. Elisabeth Kübler-Ross, in her work on death and dying, identified the stages of grief as (1) shock and denial, (2) anger, (3) depression and detachment, (4) dialogue and bargaining, and (5) acceptance. There is no definite order or time line in which these stages may occur. It may take from several weeks to several years to adequately complete the process. No one can keep a person from suffering, but the person grieving does not have to suffer for the wrong reasons. Those who are grieving must choose what to remember of the past, cherish the joys of the present, and plan a future to which they can look forward.

The Fear of Death

No matter who you are, your ethnicity, your spiritual beliefs, your educational background, or your status in life, you, like everyone else, face death as an unknown certainty. In understanding your feelings about a terminated relationship, perhaps you can learn more about what you want from life. Death is the most critical loss and has the greatest fears associated with it. Some of these fears are:

  1. Fear of interruption of life goals — death may keep you or your family from achieving all you hope to achieve.
  2. Fear of impact on survivors — a fear of what happens financially and emotionally to the people left behind.
  3. Fear of physical suffering — the thought of a lingering, painful death is upsetting, especially to very active people.
  4. Fear of “not being” — worrying about the finality of death; not being around to enjoy people; not seeing children grow up; the loss of the meaning of life.
  5. Fear of punishment — worrying about not having one’s spiritual life in order and having to “pay” for unacceptable behavior.
  6. Fear of death of others — young people particularly fear the death of others and living without the care and comfort of the one who died.

Psychological Responses to Loss

Whether an individual copes with a significant loss or death in a positive and constructive — rather than a negative or destructive — manner depends on the types of coping mechanisms used and the quality of support being given. Two major psychological responses are used by individuals when adjusting to loss: (1) the use of coping mechanisms; and (2) emotional reactions. Those who want to help friends and loved ones in a time of sorrow need to understand how these are expressed by them.

Coping Mechanisms

Coping mechanisms psychologically protect individuals and reduce the level of anxiety they feel at a given moment. This allows them to better adjust to the loss and begin the grieving and healing process:

  1. Disbelief or denial: This response reduces anxiety by allowing individuals to limit their awareness about the reality of what has happened until the pain can be let in more slowly. Everything inside shouts “NO!” and the mind struggles to escape. Unable to tolerate the pain that would emerge if reality were faced, individuals experience emotional anesthesia. Numbness and confusion are often predominant responses. Sighing and crying can be readily observed. Others cannot cry and may withdraw. This stage is handled more easily if people will listen to the bereaved and help them express their whole range of feelings. Listening to feelings without giving advice is the best helping strategy.
  2. Disorganization and dependence: This period is characterized by a time of confusion in which those grieving may feel out of touch with the ordinary proceedings of life. They may exhibit very dependent behavior and a time orientation that focuses solely on the present. They may become quite demanding, asking others to do things they normally can do themselves. Some of the talk and actions may seem foolish and out-of-character to others. It is wise not to make major decisions, such as selling one’s house or moving, during this period.
  3. Rationalization: This is a coping mechanism in which those grieving gather a great deal of knowledge and information and analyze in detail the situations leading to the loss. They may find out the most intricate medical data of a fatal disease, for example. Surviving individuals may rationalize the loss by saying, “He’s better off in the long run,” or “She suffered so much.” This allows the individual to remain emotionally detached and to become an observer of the situation. If it remains within reasonable bounds, rationalization can give the individual and family members a greater sense of control.

Emotional Reactions

Emotional responses are a way for those grieving to express emotions and feelings associated with the loss.

  1. Anger and resentment are common emotions of grieving individuals. These emotions often are expressed as a protest against what seems to be a cruel, unfair, and incomprehensible fate. It is a reaction to frustration — the source of which cannot be removed, creating feelings of being trapped and helpless. When this happens, grieving individuals may project this anger onto more accessible targets (e.g., spouse, family members, the hospital, physician, government) or others involved in the loss chain. Overt expressions of anger, such as verbal outbursts, sarcasm, and unreasonable or persistent demands, should be recognized as an understandable response to a traumatic situation and not necessarily a personal attack. For most people, talking openly about their feelings helps reduce anger. Other ways to help reduce anger might include physical activity or just listening to calm music. Each person needs to find her or his own way to release anger.

    Friends can help by listening empathetically and resisting the temptation to return anger with anger or becoming defensive if accusations are made. Unexpressed anger may be turned inward and replaced by silent bitterness, indifference, apathy, aggression, and, ultimately, depression.

  2. Guilt feelings are frequently a part of the grief process. These feelings become focused as grieving individuals search for the cause of the loss, thinking thoughts such as these:

    • “What did I do wrong?”
    • “Could _____ have done anything differently?”
    • “If only I hadn’t _____.”
    • “If only I would have _____.”

    When you live with someone for any length of time, you will say things you regret. When that person dies, you suddenly realize all the things you wanted to say and didn’t. You remember words you wish you had not said or actions you wish you had not taken. It is human to feel guilty and to want another chance to erase neglect or failure. If the individual openly expresses guilt, it is better to encourage talking about it rather than clamming up. Saying, “No, you’re not to blame” doesn’t really help either. A caring person will encourage the full expression of feelings rather than blocking them, which could make the person grieving feel even guiltier.

  3. Fear and anxiety is another emotional component of grieving. The grieving person may exhibit feelings of helplessness, hopelessness, hurt, and anxiety. Loss means change and demands great adjustment. Starting over with a new job, new career, or a new relationship can be a frightening experience. The loss may create great anxiety about an unknown future. Joining a support group in which people can freely express their worries in a supportive environment can help reduce needless anxiety.

  4. Shame occurs when people think they are not living up to the expectations of others or themselves. Shame, guilt, anger, and regret often intertwine and are overlapping. Accepting the individual as an OK person and being there when needed is being a compassionate friend.

  5. Loneliness and depression are considered the most painful processes. People often are overcome by feelings of utter sadness and isolation when a loved one is removed from their lives. Gradually, the finality of the loss sinks in — an empty chair near the TV, an unused pillow, a family photo, a missing phone call. Depression may follow and self-pity is frequent.

    Problems that are manageable when shared with a partner become magnified when faced alone. Sometimes those grieving may search for a quick replacement. However, healing and recovery are more likely achieved if they complete the grieving process before seeking a new partner or making any new lasting commitments. Delaying major decisions allows people to see new perspectives and make better decisions.

  6. Relief and recovery: Feelings of relief are difficult to admit and acknowledge openly. Relief is so intermingled with a sense of loss that those grieving may not be able to see it for what it is — a normal, human response. It is OK to mourn the lost relationship. There is an overlap between relief and recovery — in fact, feelings of relief may signal recovery. As the mourners bring closure to grieving and as hope softens the intense feelings of loss, a new life begins. There is no specific timetable as each individual’s grieving process is unique. Often, people reach out and make constructive efforts to rebuild by responding more readily to phone calls, attending meetings, and seeing social gatherings as opportunities.

Ten Helpful Guidelines

These guidelines are presented to help grieving individuals in their journey through grief.

  1. Accept your emotions. Any significant loss, such as death of a loved one, hurts. It is difficult to say goodbye — to realize that in your lifetime you will never physically see or touch your loved one again. Why pretend that you are not experiencing turmoil by not letting others see your emotions? Your emotions are a natural response to the death of a loved one.
  2. Express your feelings. Deal with your conflicting feelings openly. A feeling that is denied expression is not destroyed; it remains with you and often erupts at inappropriate times. It hurts to use words like dead and widow or widower, but you must confront reality and put your feelings into words. Cry if you want to. It is a natural expression of grief for both men and women. Crying is the emptying of emotions so healing can occur.
  3. Don’t expect miracles overnight. Allow sufficient time for the grieving period to proceed through the steps. Don’t compare yourself to others in similar positions. Their smiles might not reveal the depth of their sorrow. Be yourself. Don’t pretend grief beyond the time you need to grieve or pretend recovery before you have recovered.
  4. If you have children, include them in the grieving process. Death is a crisis that should be shared by all family members. Too often children are forgotten by grieving adults. Silence and secrecy deprive them of an important opportunity to share grief. In your own grief, you may overlook your children’s feelings and heighten their sense of isolation.
  5. Don’t escape into loneliness. If you isolate yourself or stay alone too much, your home will become a protective shell that keeps you from facing the challenges of life. Look at what is important and necessary now and prioritize. As you look to the future, take one step at a time.
  6. Keep in touch with your friends and family. Let the right people know that you need their support and feedback. They cannot bring you comfort unless you talk with them and share your feelings. They cannot bring you comfort unless you allow them to enter your sorrow. Holidays, birthdays, and anniversaries are especially difficult times to be alone. Plan ahead to spend these days with caring and understanding friends and family. It is OK to bring up the deceased person in conversation, just not all the time.
  7. Join a support group. At some point you may be disappointed by the reactions of your friends or family. Perhaps you don’t hear from them as often as in the past. They may seem to feel awkward or uneasy in your presence or even avoid your company. That is why self-help groups have been successful in providing necessary emotional intervention through the crisis of a great loss. People in these groups understand your fears and frustrations; they have experienced a similar loss.
  8. Counseling may be very beneficial. Sorrow leaves its imprint on the healthiest of personalities. You may need more than the warmth of a close friend or understanding of a fellow sufferer. A professional counselor who is not emotionally attached may be more effective to assist you in dealing with your intense feelings or maintaining a clear perspective.
  9. Be nice to yourself. By treating yourself well, you could become your own best friend. While you need caring and supportive people, you also need moments of solitude to find yourself. A little withdrawal and reflection will allow you to become more relaxed and energized. By taking care of yourself, you will recognize your strengths as well as your weaknesses. You will become more confident that you can manage the challenging days ahead. After all, if you’re not nice to yourself, who will be?
  10. Turn pain into growth. Through grief, you can become a more understanding, compassionate, and sympathetic person. Resolve to live, love, and serve others to turn the pain into a growing experience. This is your new challenge.

Helping People Cope with Loss

It is important to be a caring and understanding person as you guide a friend or family member through the grieving process. Here are just a few tips to help you with this process. You may not feel comfortable in these situations, so it is important to approach and interact even if you say the wrong things.

  1. Listen attentively. As you listen, reflect back to the mourner what you hear them saying and not assume you know what the person meant. Listen to feelings without giving advice is the best helping strategy.
  2. Take the initiative to call or visit.
  3. Continue to invite or include the individual in your circle of friends.
  4. Since grief is a long process, caring and attention beyond the first week or month is needed and appreciated.
  5. Avoid such statements as “You need to move on,” “Pick yourself up,” “I know how you feel,” “It’s just like when my mom died,” “Your loved one is better off because there’s no suffering anymore.”
  6. Do say things such as “I am so sorry about your loss,” “Is there anything I can do to help you?” and “I am thinking so much about you.”
  7. Acknowledge the person who is deceased through stories, kind words, and memories.
  8. It is never too late to send a condolence.
  9. Make the conversation relate to them and their experience and not your experiences.
  10. Use spiritual condolences appropriately. Some people appreciate them. Some do not.

Summary

Grief is a basic part of life, and you cannot totally separate yourself from it. You can prepare for it by understanding the emotions of grief and the process of mourning. The stages of grief and mourning are in no way separate; they intertwine and overlap. Some may last only a few minutes, and flashbacks are common in the grieving process. Months or years later certain phases of grief can recur. The causes may be obvious — Christmas, birthdays, a sudden meeting of mutual friends, anniversaries. Less obvious causes are hidden in the complexity of grief — it may mean that one phase of grieving has not been completed.

As one widow said, “Acceptance finally comes, and with it peace. Today I am more independent, more understanding, and have more sympathy. I have a quiet love for Martin. I have passionate, poignant memories. He will always be a part of me, but Martin is dead. I am a different woman, and the next time I love, if ever I do, it will be a different man, a different love.”

When grief occurs, remember these guidelines:

Not everyone who grieves will experience all stages of grief. And, not all people work through their grief the same way. Working through grief takes time.

Resource

Kübler-Ross, Elisabeth, (1997). On death and dying. Simon & Schuster.

Acknowledgment

The authors would like to acknowledge the contributions of Herbert Lingren, the author of the original edition of this publication.


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Index: Families
Adulthood and Aging
Issued January 2008