Let me start with this: I am no expert on grief.
Yes, I am a mental health professional. And yes, I’ve helped clients navigate loss. And, of course, I’ve experienced my own losses. But I do not have the expertise demanded by true tragedy. Three of my four grandparents are still living, as are my own parents and siblings. I’ve been close to people who are close to tragedy, but I myself have not crossed paths with it. I have not had to grapple with the all-consuming, life-changing experience of loss. Yet.
I say yet because, well – it will happen. I don’t know when and I don’t know how, but grief will come for me as it does for everyone. It’s the price you pay for love, and a price we all pay willingly. For now, I don’t know what grief is really like. What I can offer, what I offer now, is some general clinical information about grief alongside some words from true experts, because, from what I understand, sometimes what helps the most is knowing someone else does know what it’s like.
Clinically, The American Psychiatric Association (APA) has done its best to balance the appropriateness of grief (of course people act and feel differently in the face of loss) with its sometimes need for diagnosis and mental healthcare (offering the option to diagnose after a loss often gives clients access to insured services such as therapy and medication – without diagnosis, these services might be difficult to access and would be paid for out of pocket). There is plenty of criticism for how the APA changed its view of grief when it developed and introduced the Fifth Edition of the Diagnositic and Statistical Manual (DSM-5) in 2013, with some interpreting the changes as insulting, reading the new criteria as the ability to diagnosis Major Depressive Disorder if a client grieves for more than two weeks after the loss of a loved one.
Another clinical factor is Elisabeth Kubler-Ross’s work, best known as the five stages of grief: denial, anger, bargaining, depression, acceptance. Kubler-Ross herself never intended for these stages to be viewed as linear or separate from each other, and yet mass media has largely presented her work as suggesting a step-by-step process through healing from loss. You’ve probably already heard this but just in case: grief does not involve a checklist. You do not move on from one reaction to the next, leaving the first forever behind. Grief is multi-layered, complex, deeply subjective, and impossible to predict. It certainly doesn’t fall into a nifty model.
What I’ve learned from clients about grief:
- Support groups really help. When a client’s husband died from suicide, her survivors’ support group was immensely healing for her.
- Honoring the life of your lost loved one is extremely important. Whether with a traditional funeral, party, or memorial service soon after their death, or a piece of art, special vacation, or ongoing service project, paying attention to the person’s values and respecting their life, not just their death, makes a big difference for long-term grieving.
- Grief ebbs and flows. I’ve heard clients say somedays they don’t even think about their loss while others they do little else.
Suffice to say, grief is a bit of mystery from the clinical perspective. All mental health is, in many ways, mysterious, but grief seems to be very misunderstood and yet there’s also a pervasive, macro-level delusion that we’ve figured it out.
There are some people who seem to have figured grief out, though, at least for themselves, and only because they have been faced with loss. Some of their words:
“On January 1st, 2017, in Room 44 of the NICU at Children’s Hospital, I held my first and only son Afton as he died in my arms. He was just one day old. It was every bit as painful as it sounds. For those first few days after his completely unexpected premature birth and death, I was sinking, slowly sinking, and eventually, I crash-landed right there on the bottom of the ocean. No light, no air – just hard, jagged rocks and one thousand pounds keeping me pinned to the bottom. As time has gone on, I have vacillated back and forth from the top of the water where I find myself for just a minute, feeling the sun and breathing in the air and noticing the color of the water and sky, to finding the weight of loss pulling me back down to the lifeless bottom again.”
“When someone you love dies, and you’re not expecting it, you don’t lose her all at once; you lose her in pieces over a long time—the way the mail stops coming, and her scent fades from the pillows and even from the clothes in her closet and drawers. Gradually, you accumulate the parts of her that are gone. Just when the day comes—when there’s a particular missing part that overwhelms you with the feeling that she’s gone, forever—there comes another day, and another specifically missing part.”
“You lose yourself, your identity, meaning, purpose, values, your trust”.
“A few years after the stillbirth of my son, I had a very vivid dream. In it, I was being followed everywhere by a dark-haired woman. She would hide under my bed, in my closet, in corners and shadows, always lurking near me. I was terrified of her. I tried running from her, but I couldn’t get away. Finally, I mustered up enough courage to confront her. I told her to go away and leave me alone. She looked at me and said, ‘I will never leave you alone.’ At that moment, I knew she was telling the truth. She wasn’t going away. My mind searched for a solution. I decided that if she wasn’t going away, I needed to become friends with her. I reached out and embraced her. The fear instantly evaporated and both of us started crying. I woke up, still feeling the dark-haired girl’s tears on my shoulder. And right away, I knew she was grief.”
And, the last of my offerings: a resource list. [updated May 22, 2019]
- The Year of Magical Thinking by Joan Didion
- Tara Brach’s free lectures and meditations on grief and loss
- A Grief Observed by C.S. Lewis
- H is for Hawk by Helen Macdonald
- Abraham Lincoln’s letter to the daughter of a close, recently departed, friend
- A Heartbreaking Work of Staggering Genius by Dave Eggers
- A list of support groups for the bereaved
- Ambiguous Loss by Pauline Boss (who also gave a spectacular interview here)
- To find a great therapist, start here or here
- This article from Tuck (a mattress company of all things) about sleep and grief, with an excellent list of resources at the bottom
Lastly, and with love, a brief poem by Mary Oliver, who many of us are grieving after her death Thursday:
“When Death Comes”
When it’s over, I want to say all my life
I was a bride married to amazement.
I was the bridegroom, taking the world into my arms.