What is grief
January 30, 2019
By Lisa Brunelle, Communications Advisor, Covenant Health
Grief is something we all experience, but too few of us know how to grieve well.
Not all of us grieve in the same way after we experience the death of a loved one. We need to stop thinking there is a proper way to grieve, says psychologist Cheryl Nekolaichuk.
“The grief response is very individual,” says Cheryl. “Often we think of it as emotional, but it can manifest itself through other things like physical symptoms. Crying is one expression of grief, but it’s not the only one. There is no right or wrong way to grieve.”
And it’s important to remember that people may have different needs when experiencing a loss.
“I think in our society we have a lot of misconceptions about grief and healing—for example, the belief that you’ll wake up one day and you’ll be back to normal,” says Sandy Ayre, Occupational Therapist.
Grief is the ability of people to express their loss through emotional, physical, social and spiritual dimensions of their experience. Bereavement is the overall experience of having lost someone.
“My belief is that grief is a natural process,” says Wendell Gelderman, Chaplain. “I believe within us is the desire to release or heal after a loss. There are things we can do to help facilitate that process.”
For a long time the belief was that when a person dies, those left behind have to end that relationship before they can move on. That’s not the case, says Cheryl.
“The concept of continuing bonds, I think, is a very hopeful way of thinking about grief. It says we can’t forget about the people who were in our lives. At the same time, it asks how we can continue to have these relationships from the past but also develop new relationships for the future,” she says.
Self-care is important, say all three.
Self-care is a really important part of the grieving process. It’s important to look after yourself: get enough sleep, eat well, exercise and find people in your life who can be there for you.
“I encourage people, especially those who are busy, to identify a time when they can honour their grief,” says Wendell. “The grief will come out no matter what.”
That will also help individuals cope with what’s known as grief bursts, when something unexpectedly happens to trigger the memory of a loss.
“Grief bursts are when grief comes upon a person in a wave,” explains Cheryl. “They feel like everything is fine, then something happens that triggers a deep inner experience of loss. They may be overwhelmed by that expression.”
Over time, the frequency and intensity of the grief bursts usually lessens.
People also need to find a support system that works for their needs, such as a counsellor, social network or support group.
“I remember the woman who told me that grief takes a long time. It’s stuck with me,” says Sandy. “You think, 'After the funeral I’ll feel better, after his birthday, once I make it through Christmas.' That comment gave me permission to quit trying to be someone or something I’m not.”
And when it comes to helping someone who is grieving, people often want to be supportive but struggle with what to say or how to help. Make it safe for someone to grieve. Grief can be isolating. People need to feel safe to be able to express how they’re feeling and need to be invited to share.
“It’s important to open the door to allow the grieving person to talk about their experience. I often say something like, ‘How have you been surviving?'” says Sandy. “Then I let them talk about what they’re going through—without trying to make it better, but to just really hear them and let them express their experience.
"Show that you are open to hearing what the person has to say by finding a quiet space and sitting down to signal you have time to listen. Take cues. Don’t offer advice unless it’s asked for,” adds Sandy. “Try to reflect back what you’re hearing to give the person time to arrive at their own peace. It has to come from within them.”
There is no time limit or time frame for grief. That’s why there’s a real need to have ongoing support.
“You continue to live, and the loss continues to impact your life,” says Sandy. “I try and teach people that ongoing support doesn’t mean that you’ve failed at healing. It means that you’re trying to live well again while missing the person who died.”
Edmonton area community grief resources
The greater Edmonton area has many resources available to people who are grieving. Contact one of our chaplains to help you find a local resource or visit Inform Alberta to find the service you need.
- BriarPatch Centre for Grieving Families
- Grieving Parents Society of Edmonton
- Parent Care
- Pilgrims Hospice
- Suicide Bereavement Program Support Network
- Victims of Homicide
Online grief resources
There are many resources available online. Here are some good ones we recommend.
What is complicated grief?
Sometimes grief can become more complicated and requires additional support and professional help. It's important to find ways to help people be OK with how they're feeling and also recognize signs when they need extra supports.
- Complicated grief is specific to the experience of bereavement after the death of a person.
- When a person has been grieving for an extended period and it's interfering with the griever's normal activities.
- About 10 to 20 per cent of people who are grieving will experience complicated grief. It's important that they find the extra support and resources they need.
Potential causes of complicated grief
Many factors can contribute to complicated grief, including
- pre-existing factors, like mental health issues
- a dependent relationship with the deceased
- illness or death-related issues, such as people not being emotionally prepared for the death and the perception that the death was traumatic or unexpected
- bereavement-related factors, such as difficulty making sense of the death
- insufficient or negative social supports
Potential signs of complicated grief
If you or someone you know is experiencing these symptoms, encourage the person to visit their family physician to rule out physical causes. If there's not a physical cause, seek out a professional trained in grief counselling.
- If someone is having trouble getting out of bed and doing things they enjoy, then this may be a sign that they need some extra support.
- Other potential signs include a change in physical functioning like a weight change (gain or loss), not having energy or an inability to concentrate. They may even feel like they're paralyzed, frozen or stuck, and that they're not part of the normal world. These can be symptoms of depression as well.
Differences between complicated grief and depression
- In general, depression is associated with mood, with the two core features being sadness and loss of interest in doing pleasurable things.
- Complicated grief is often expressed as post-traumatic anxiety, including symptoms like intrusive thoughts, re-experiencing the loss, nightmares, longing to be with the deceased and difficulty moving forward in life.
When supporting someone who’s experiencing complicated grief, it’s important to make sure they’re safe. If they’re having suicidal thoughts, encourage them to call or you call the Distress Line at 780-482-HELP (4357) in the Edmonton area or 1-800-232-7288 for rural areas. The Distress Line has people trained to support those who are in crisis.
*Source: Dr. Cheryl Nekolaichuk, Counselling Psychologist on the Tertiary Palliative Care Unit at the Grey Nuns Community Hospital