The death of a loved one results in emotional responses such as disbelief, anger, guilt, depression and a feeling of emptiness. Physical symptoms can include sleeplessness, loss of concentration, feeling detached and numbness.

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5 Stages of Dying

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1. Denial and isolation. This isn’t happening to me!

A person in this stage talks about the future, avoids talking about the death, blames the doctor for the illness, and avoids family and friends who want to talk about these matters. (Blames God, blames everyone, and becomes isolated from contact with family and friends.)

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2. Anger. Why is this happening to me?

This stage typically occurs when the person has come to terms with the fact that they or a loved one is actually dying. This person begins to ask" why me? They may question religious beliefs. They may accuse family members or friends of uncaring attitudes. The celebrant can be on the receiving end of the grieving person’s anger. Keep your cool; keeping in mind that the anger and criticism directed at you is usually not your fault but rather their anger at the situation. (Other anger areas: suicide, tragic death)

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3. Bargaining. If I promise to do this, it won’t happen.

At this stage, a person has vented all their anger and now tries to make a deal (e.g. with God) that if they change their lives they will be allowed to live, or to live long enough to complete some particular task. (Bargaining is more relevant to a dying person than to the family after the person has died, as there is no more bargaining left to do.)

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4. Depression. I don’t care anymore.

At this stage, the person realises that death will be inevitable. The person realises that they are defeated. If the person has already died, this is when the reality of death has begun to sink in for loved ones.

Depression may be due to the change of circumstances (financial, family role, intimacy, independence) or it may be due to the loss itself. This stage is referred to as holiday blues when it occurs around the holidays. (Don’t try to counsel those showing depressive characteristics, as we are not professional counsellors. Recommend professional help, if you feel it appropriate to do so.)

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5. Acceptance. I’m ready for whatever comes.

For the person who is dying, this will be exhibited as a decrease in interest in worldly events, a desire to be left alone, a decreased desire for communication, and an increase in detachment from loved ones. For the survivors, this will be a time when healing begins. (Some families will display acceptance if the deceased battled a long illness.)

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Many people do not let themselves grieve, because the feelings associated with grief are confusing, conflicting and frightening. We live in a society that often encourages the repression of emotions. Many people grieve in isolation or attempt to hide or even run away from grief through a mixture of other things.

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Substance abuse, overwork, uncontrolled anger, or being stalwart are self-destructive ways to avoid grief. During ancient times, people expressed their sorrow through wailing, crying and yelling. Today, well intentioned, yet ill-informed people, believe that self-control and staying strong are the best responses to sorrow.

How to come to terms with your Grief

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Task 1: Accept the reality of the loss

Ways to help accept the reality:

· Speaking about the death or the deceased

· Attending functions that relate to the funeral or the death

· Helping to organise the funeral

· Collecting the ashes

· Sorting through the persons possessions in a positive, healthy way

· Balanced memories the good and the bad

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Task 2: Work through the pain of grief

Emotions are often stronger than ever felt before often described as a roller coaster ride. Emotions felt may include guilt, anger, sadness, remorse, loneliness, or anxiety.

Here are some things that may help them to work through the pain of grief:

· To feel the pain and know one day it may ease

· Acknowledge any ambivalence to deceased

· Expect that there will be difficult days, weeks etc.

· Rely on friends and family to help  don’t knock back any offers of support or help

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Task 3: Adjusting to an environment where the deceased is missing

· Look at the various roles deceased played e.g. finances, cooking, parenting. (People can often not be aware of all deceased roles until months after death.)

· Realise that you need to acquire new skills, and by doing this, you are not replacing that person’s importance/role in the family

· Redefine one’s sense of self identity  e.g. no longer one half of a couple

· Re-establish one’s sense of self-esteem  need to find this internally, not externally (i.e. from partner)

· Rediscover one’s world view  search for meaning of life

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Task 4: Emotionally relocate deceased and move on with life.

The fourth task of mourning is to find a place for the deceased that will enable the mourner to connect with the deceased but in a way, that will not preclude him or her from going on with life.

We need to find ways to remember the dead loved one keeping them with us but still going on with life. (Worden, 2002 p. 35)

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Symptoms of grief

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While loss affects people in different ways, many of us experience the following symptoms when we’re grieving. Just remember that almost anything that you experience in the early stages of grief is normal including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious or spiritual beliefs.

Emotional symptoms of grief

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Shock and disbelief - Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened, or even deny the truth. If someone you love has died, you may keep expecting them to show up, even though you know they’re gone.

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Sadness - Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning, or deep loneliness. You may also cry a lot or feel emotionally unstable.

Guilt - You may regret or feel guilty about things you did or didn’t say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.

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Anger - Even if the loss was nobody’s fault, you may feel angry and resentful. If you lost a loved one, you may be angry with yourself, God, the doctors, or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you.

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Fear -A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks. The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.

 

Physical symptoms of grief

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We often think of grief as a strictly emotional process, but grief often involves physical problems, including:

Fatigue

Nausea

Lowered immunity

Weight loss or weight gain

Aches and pains

Insomnia

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Seek support for grief and loss

The pain of grief can often cause you to want to withdraw from others and retreat into your shell. But having the face-to-face support of other people is vital to healing from loss. Even if you're not comfortable talking about your feelings under normal circumstances, it’s important to express them when you’re grieving. While sharing your loss can make the burden of grief easier to carry, that doesn’t mean that every time you interact with friends and family, you need to talk about your loss. Comfort can also come from just being around others who care about you. The key is not to isolate yourself.

Finding support after a loss

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Turn to friends and family members -Now is the time to lean on the people who care about you, even if you take pride in being strong and self-sufficient. Rather than avoiding them, draw friends and loved ones close, spend time together face to face, and accept the assistance that’s offered. Often, people want to help but don’t know how, so tell them what you need whether it’s a shoulder to cry on, help with funeral arrangements, or just someone to hang out with. If you don’t feel you have anyone you can regularly connect with in person, it’s never too late to build new friendships.

Draw comfort from your faith -If you follow a religious tradition, embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you such as praying, meditating, or going to church can offer solace. If you’re questioning your faith in the wake of the loss, talk to a clergy member or others in your religious community.

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Join a support group -Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help. To find a bereavement support group in your area, contact local hospitals, hospices, funeral homes, and counselling centres, or see the Resources section below.

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Talk to a therapist or grief counsellor -If your grief feels like too much to bear, find a mental health professional with experience in grief counselling. An experienced therapist can help you work through intense emotions and overcome obstacles to your grieving.

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Take care of yourself as you grieve

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When you’re grieving, it’s more important than ever to take care of yourself. The stress of a major loss can quickly deplete your energy and emotional reserves. Looking after your physical and emotional needs will help you get through this difficult time.

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Face your feelings. You can try to suppress your grief, but you can’t avoid it forever. In order to heal, you have to acknowledge the pain. Trying to avoid feelings of sadness and loss only prolongs the grieving process. Unresolved grief can also lead to complications such as depression, anxiety, substance abuse, and health problems.

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Express your feelings in a tangible or creative way. Write about your loss in a journal. If you’ve lost a loved one, write a letter saying the things you never got to say; make a scrapbook or photo album celebrating the person’s life; or get involved in a cause or organization that was important to your loved one.

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Look after your physical health. The mind and body are connected. When you feel healthy physically, you’ll be better able to cope emotionally. Combat stress and fatigue by getting enough sleep, eating right, and exercising. Don’t use alcohol or drugs to numb the pain of grief or lift your mood artificially.

Try to maintain your hobbies and interests. There's comfort in routine and getting back to the activities that bring you joy and connect you closer to others can help you come to terms with your loss and aid the grieving process.

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Don’t let anyone tell you how to feel, and don’t tell yourself how to feel either. Your grief is your own, and no one else can tell you when it’s time to move on or get over it. Let yourself feel whatever you feel without embarrassment or judgment. It’s okay to be angry, to yell at the heavens, to cry or not to cry. It’s also okay to laugh, to find moments of joy, and to let go when you’re ready.

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Plan ahead for grief triggers. Anniversaries, holidays, and milestones can reawaken memories and feelings. Be prepared for an emotional wallop, and know that it’s completely normal. If you’re sharing a holiday or lifecycle event with other relatives, talk to them ahead of time about their expectations and agree on strategies to honour the person you loved.

When grief doesn't go away

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As time passes following a significant loss, such as the death of a loved one, it’s normal for feelings of sadness, numbness, or anger to gradually ease. These and other difficult emotions become less intense as you begin to accept the loss and start to move forward with your life. However, if you aren’t feeling better over time, or your grief is getting worse, it may be a sign that your grief has developed into a more serious problem, such as complicated grief or major depression.

 

Complicated grief

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The sadness of losing someone you love never goes away completely, but it shouldn’t remain centre stage. If the pain of the loss is so constant and severe that it keeps you from resuming your life, you may be suffering from a condition known as complicated grief. Complicated grief is like being stuck in an intense state of mourning. You may have trouble accepting the death long after it has occurred or be so preoccupied with the person who died that it disrupts your daily routine and undermines your other relationships.

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Symptoms of complicated grief include:

· Intense longing and yearning for your deceased loved one

· Intrusive thoughts or images of your loved one

· Denial of the death or sense of disbelief

· Imagining that your loved one is alive

· Searching for your deceased loved one in familiar places

· Avoiding things that remind you of your loved one

· Extreme anger or bitterness over your loss

· Feeling that life is empty or meaningless

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When to seek professional help for grief

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If you recognize any of the above symptoms of complicated grief or clinical depression, talk to a mental health professional right away. Left untreated, complicated grief and depression can lead to significant emotional damage, life-threatening health problems, and even suicide. But treatment can help you get better.

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· Contact a grief counsellor or professional therapist if you:

· Feel like life isn’t worth living

· Wish you had died with your loved one

· Blame yourself for the loss or for failing to prevent it

· Feel numb and disconnected from others for more than a few weeks

· Are having difficulty trusting others since your loss

· Are unable to perform your normal daily activities

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Always remember that your never alone and seek help to guide you through your time of need.