Coping with grief: A guide to healing
AN APPLE A DAY - AN APPLE A DAY By Tyrone M. Reyes, M.D. () - October 31, 2006 - 12:00am
Embedded in the promise of life is the certainty that everyone dies. Sooner or later, all of us will grieve the loss of loved ones, whether the agent is a sudden heart attack, a car accident, the stresses of disease or age, or a terrorist bomb. Every year, thousands of Filipino men, women, and children die, leaving behind many others who mourn them.

If you’ve experience the death of someone close to you, you know how painful and prolonged grief can be. But there are ways to channel grief and navigate its desolate waters. Be aware, however, that certain axioms about grief are backed by little or no evidence. Contrary to what you may have heard, for example, denial has a useful side. Anger isn’t always part of grieving. And no single pathway leads out of grief or ensures that you will achieve closure. No words, written or spoken, are powerful enough to erase grief. Hopefully, this article can help ease your sorrow. It may also help to know that most people are able to weather this storm and find that healing occurs in time.
What Is Grief?
People often use the terms grief, bereavement, and mourning interchangeably. Yet, they are not quite the same. At its simplest, you might describe grief as intense sadness stemming from a loss you have suffered. Experts define it as any reaction to bereavement, which is the loss or death of someone important to you. This might be sorrow you feel, but it also encompasses a welter of other feelings that may accompany bereavement, such as numbness, anger, guilt, despair, hostility, or anxiety.

Mourning is the social face of grief, the ways in which society presses you to honor the dead and to publicly deal with the emotions churned up by bereavement. That might mean, for example, keeping a stiff upper lip, or wailing inconsolably; dressing in black; or performing rituals on specific days after the death or burial. Often, men and women are subtly urged to mourn in different ways. One obvious example is a general taboo on crying for men and boys, who are expected to act strong. Of course, that may shunt painful emotions in more worrisome directions. Women and girls typically are allowed to shed tears, but encouraged to subdue angry feelings and to support others who are grieving, no matter the cost to their own needs.
Grief’s Effects On Mind And Body
The emotional maelstorm that grief stirs up affects behavior and judgment. It’s common, for example, to feel agitated or exhausted or to sob or withdraw from the world at times. Some people reach for alcohol or drugs to help assuage their pain. Grief can also fog the mind. Confusion, inability to concentrate, a sense of things being unreal, frequent thoughts of the person who died, and a stream of self-reproach about aspects of the death are normal, too.

At first, your grief may permeate everything. You may find it hard to eat or sleep. It may be difficult to muster much interest in life going on around you. Some people may develop physical complaints, such as headaches, stomachaches, dizziness, or palpitations. Often, people note a surge in ailments such as colds and more serious illnesses. Studies show that people have a higher risk of sickness and even death after losing a spouse.

Research stretching back to decades points to some reasons why this may occur. Bereavement stresses the body and can hamper the immune system. Many researchers believe that over time, stress-induced physiological changes cause or exacerbate physical ailments. Two landmark studies reported in Lancet and the Journal of the American Medical Association in 1977 and 1983 noted that the white blood cells in bereaved spouses were less able to fight off disease than they were before the death or compared with those of individuals who weren’t grieving. A 1998 study reported finding fewer natural killer cells, which help quash infections and tumors, in bereaved elderly men and women who were depressed. Because depression often accompanies grief, this is significant.
How Long Does Grief Last?
Grief is not a mountain to be climbed and then descended with map in hand. Its boundary lines differ greatly from one person to another and from one culture to the next. Popular culture also promotes the misconception that there is an orderly progression of emotions that will lead the bereaved to this end. The truth, though, is that grief doesn’t neatly conclude at the six-month or one-year mark – even if a person follows every prescription for healthy grieving. Depending on the strength of the bond that was broken, grief can be lifelong. Parents whose children die often say they never get over the loss.

The more integral someone was to your life, the more opportunities there are for happy and sad reminders that underscore the massive change in your life. Alongside warm or warring memories, you may always carry a hollow spot in your heart. Feelings of sadness, abandonment, and even anger are especially likely around birthdays, weddings, anniversaries of the death, and holidays or other occasions you might have shared. A familiar scent, song, or likeness can prompt an outburst of grief, too. All of this is entirely normal.

It’s also normal for the raw, all-consuming shock of early grief to ebb slowly within weeks or months. Gradually, at their own pace, most people do find themselves adjusting to their loss and slipping back into the stream of life. The goal is to gradually accept the changes in your life without losing sight of what has been lost.
Are There Stages Of Grief?
Slightly more than three decades ago, Elizabeth Kubler-Ross, a psychiatrist now renowned for her work with terminally ill patients, published On Death and Dying. This seminal book delved into the fear of death and described the coping mechanisms of people faced with fatal ailments. Kubler-Ross’s depiction of five distinct stages – denial, anger, bargaining, depression, and acceptance – helped legitimize the wide variety of emotions in people who are dying. But through misinterpretation, her theory entered the popular consciousness as a prescription of the emotions people commonly feel when facing the prospect of their own death.

Experts in the field of bereavement complain that not only that Kubler-Ross never intended to describe a process for resolving grief, but also that there is little hard evidence favoring the five-stages theory. Colin Murray Parkes, a psychiatrist who has written extensively on bereavement, proposed that grief follows a different course. Collaborating with British psychoanalyst John Bowlby, Parkes theorized that people experience phases of numb disbelief, yearning for the deceased, disorganization and despair, and finally reorganization, during which they carve out a "new" normal life.

J. William Worden, a psychologist who taught at Harvard Medical School suggested a more open-ended model of grieving that includes certain tasks. The first three tasks are to accept the loss, experience and work through the resulting pain, and adjust to a changed world without the person who has died. The fourth and final task is to alter ties with the deceased enough so that you’re able to invest your love and energy in others; he called this "emotionally relocating" the deceased. Despite the implicit order in these phases and tasks, people may shuttle back and forth among them. However, failing to complete all four tasks, Worden said, is like healing only partially from a wound.

What model of grief will most likely speak of your experience? It’s hard to say, because there is no single or right way to grieve. You may feel some of the emotions recorded by Kubler-Ross. You may zigzag along part of the course described by Parkes or tackle certain tasks proposed by Worden. Or you may set an entirely different course as you try to accept and adapt to the changes in your life.

Some people feel anxious if they don’t follow a particular pathway. Yet as anyone who has ever lost a loved one will tell you, grief is not a tidy, orderly process. Expect your emotions to collide and overlap. Understand that your ability to move ahead with your life will ebb and flow.

No matter where your grieving takes you, hopefully you will continue to find a measure of comfort in your life. Ask for help when you need it. Accept it when it’s offered. Take the person you loved forward with you in the things you do and say. Carve memories in your mind and memorials in the way that you choose to live. Most importantly, grieve at the pace and in the way that feels right for you.

ARE THERE STAGES OF GRIEF BEREAVEMENT CENTER COLIN MURRAY PARKES DEATH GRIEF KUBLER-ROSS LIFE PEOPLE
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