Grief is a normal response to loss. It can be the loss of a home, job, marriage or a love one. Often the most painful loss is the death of a person you love, whether from a long illness or from an accident or an act of violence.

This guide will help you understand the grief you and others may feel after a death, whether sudden or anticipated. We hope this guide will help you realize that these feelings are not unusual and things can get better. You are not alone.

The Grieving Process
Grief is painful and at times the pain seems unbearable. It is a combination of many emotions that come and go, sometimes without warning. Grieving is the period during which we actively experience these emotions. How long and how difficult the grieving period is depends on the relationship with the person who dies, the circumstances of the death, and the situation of the survivors. The length of time people grieve can be weeks, months, and even years. One thing is certain: grief does not follow a timetable, but it does ease over time.

Because grief is so painful, some people try to “get over” a loss by denying the pain. Studies show that when people don’t deal with the emotions of grief, the pain does not go away. It remains with them, and can turn up in unrecognizable and sometimes destructive ways. Understanding the emotions of grief and its feeling and symptoms are important steps in healing and in helping others who may be grieving.

The Feelings and Symptoms of Grief
Experts describe the process of grieving and the emotions of grief in various ways The most commonly described reactions are: Shock, Denial, Anger, Guilt, Depression, Acceptance, and Growth. Some people experience the grieving process in this order. Most often, a person feels several of these emotions at the same time, perhaps in different degrees.

Shock
If the death comes suddenly, as in an accident or murder, shock is often the first response people feel. Even if the death is anticipated, there may be disbelief at its finality. A person may be numb, or, like a robot, be able to go through the motions of life while actually feeling little. At the same time, physical symptoms such as confusion and loss of appetite are common.

Denial
Shock and denial are nature’s way of softening the immediate blow of death. Denial can follow soon after the initial shock. People may know their loved one has died, but some part of them can’t yet accept the reality of the death. It is not uncommon to fantasize that the deceased will walk through the door, as if nothing has happened. Some people leave bedrooms unchanged or make future plans as if the loved one will participate, just as in the past.

Anger
Anger is normal. It may be directed at the deceased for leaving and causing a sense of abandonment, or at the doctors and nurses who did not do enough, or at a murderer who killed without remorse. People of faith may feel anger at God, for allowing so much pain and anguish. Anger may also be directed at oneself for not saving the life of the loved one. It can be a mild feeling or a raging irrational emotion. It can test one’s faith in religion or even in the goodness of life.

Guilt
Few survivors escape some feeling of guilt and regret. “I should have done more” are words that haunt many people. Were angry words exchanged? Most people are very creative in finding reasons for guilt. So many things could have been done differently “if only I had known.”

Sadness
Sadness is the most inevitable emotion of grief. It is normal to feel abandoned, alone and afraid. After the shock and denial have passed and the anger has been exhausted, sadness and even hopelessness may set in. A person may have little energy to do even the simplest daily chores. Crying episodes may seem endless.

Acceptance
Time alone will not heal grief. Acknowledging the loss and experiencing the pain may free the survivor from a yearning to return to the past. Accepting life without the lost loved one may give way to a new perspective about the future. Acceptance does not mean forgetting, but rather using the memories to create a new life without the loved one. Hoping for things to be as they were may be replaced by a search for new relationships and new activities.

Growth
Grief is a chance for personal growth. For many people, it may eventually lead to renewed energy to invest in new activities and new relationships. Some people seek meaning in their loss and get involved in causes or projects that help others.

Some people find a new compassion in themselves as a result of the pain they have suffered. They may become more sensitive to others, thus enabling richer relationships. Others find new strength and independence they never knew they had. After the loss, they find new emotional resources that had not been apparent before.

The Experience of Grief
Grieving people have two choices: they can avoid the pain and all the other emotions associated with their loss and continue on, hoping to forget. This is a risky choice, since experience shows that grief, when ignored, continues to cause pain.

The other choice is to recognize grieving and seek healing and growth. Getting over a loss is slow, hard work. In order for growth to be possible, it is essential to allow oneself to feel all the emotions that arise, as painful as they may be, and to treat oneself with patience and kindness.

Feel the Pain.
Give into it - even give it precedence over other emotions and activities, because grief is a pain that will get in the way later if it is ignored. Realize that grief has no timetable; it is cyclical, so expect the emotions to come and go for weeks, months or even years. While a show of strength is admirable, it does not serve the need to express sadness, even when it comes out at unexpected times and places.

Talk About Your Sorrow.
Take the time to seek comfort from friends who will listen. Let them know you need to talk about your loss. People will understand, although they may not know how to respond. If they change the subject, explain that you need to share your memories and express your sorrow.

Forgive Yourself.
Forgive yourself for all the things you believe you should have said or done. Also forgive yourself for the anger and guilt and embarrassment you may have felt while grieving.

Eat Well and Exercise.
Grief is exhausting. To sustain your energy, be sure to maintain a balanced diet. Exercise is also important in sustaining energy. Find a routine that suits you - perhaps walks or bike rides with friends, or in solitude. Clear your mind and refresh your body.

Indulge Yourself.
Take naps, read a good book, listen to your favorite music, get a manicure, go to a ball game, rent a movie. Do something that is frivolous, distracting and that you personally find comforting.

Prepare for Holidays and Anniversaries.
Many people feel especially “blue” during these periods, and the anniversary date of the death can be especially painful. Even if you think you’ve progressed, these dates may bring back some of your painful emotions. Make arrangements to be with friends and family members with whom you are comfortable. Plan activities that give you an opportunity to mark the anniversary.

Get Help.
Bereavement groups can help you recognize your feelings and put them in perspective. They can also help alleviate the feeling that you are alone. The experience of sharing with others who are in a similar situation can he comforting and reassuring. Sometimes, new friendships grow through these groups - even a whole new social network that you did not have before.

There are specialized groups for widowed persons, for parents who have lost a child, for victims of drunken drivers, etc. There are also groups that do not specialize. Check with your local hospice or other bereavement support groups for more information.

If you find that you are in great distress or in long-term depression, individual or group therapy from a counselor who specializes in grief may be advisable. You can ask your doctor for a referral.

Take Active Steps to Create a New Life for Yourself.
Give yourself as much time to grieve as you need. Once you find new energy, begin to look for interesting things to do. Take courses, donate time to a cause you support, meet new people, or even find a new job.

It is often tempting to try to replace the person who has been lost. Whether through adoption, remarriage, or other means; this form of reconciliation often does not work.

Many people discover that there is hope after death. Death takes away, but grief can give back. It is possible to recover from grief with new strengths and a new direction. By acting on our grief, we may eventually find peace and purpose.

Helping Those in Grief
You may know someone who has experienced a loss. Many of us feel awkward when someone dies, and don’t know what to do or say. The suggestions below are designed to help you help friends, family and coworkers who are grieving.

Reach Out to the Grieving Person.
Show your interest and share your caring feelings. Saying the wrong thing is better than saying nothing at all. At the same time, avoid clichés like “It was God’s will,” or “God never gives us more than we can bear”, or “At least she isn’t suffering.” Do not say you know how it feels. Do say you are sorry and that you are available to listen. Be prepared for emotional feelings yourself. A death generates questions and fears about our own mortality.

Listen
Your greatest gift to a grieving person can be your willingness to listen. Ask about the deceased. Allowing the person to talk freely without fear of disapproval helps to create healthy memories. It is an important part of healing. While you can’t resolve the grief, listening can help.

Ask How You Can Help.
Taking over a simple task at home or at work is not only helpful, it also offers reassurance that you care. Be specific in your offer to do something and then follow up with action.

Remember Holidays and Anniversaries.
These can be a very difficult time for those who are in grief. Do not allow the person to be isolated. Remember to share your home, yourself, or anything that may be of comfort.

Suggest Activities That You Can Do Together.
Walking, biking or other exercises can be an opportunity to talk, and a good source of energy for a tired body and mind.

Help the Grieving Person Find New Activities and Friends.
Include grieving persons in your life. Grieving people may require some encouragement to get back into social situations. Be persistent, but try not to press them to participate before they are ready.

Pay Attention to Danger Signs.
Signs that the grieving person is in distress might include weight loss, substance abuse, depression, prolonged sleep disorders, physical problems, talk about suicide, and lack of personal hygiene.

Observing these signs may mean the grieving person needs professional help. If you feel this is the case, a suggestion from you (if you feel close enough to the person), or from a trusted friend or family member may be appropriate. You might also want to point out community resources that may be helpful.

Death can be a painful and permanent loss experience, and one of the hardest from which to recover. Death takes away, but facing it and grieving can result in peace, new strengths and purpose.

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Frequently Asked Questions About Grief

How long will this go on?
The journey through grief is a highly individual experience. Rather than focus on a timeline it is perhaps more helpful to focus on its intensity and duration. Initially grief is overwhelming and people can feel out of control. With time people find they have more ability to choose when they access memories and emotions. The intensity of grief is related to the degree of attachment to the person, the type of relationship and other factors such as understanding and social support, personality and specific details of the bereavement.

Am I going mad?
It will certainly feel like it at times! Particularly if the individuals need to grieve is out of step with social and cultural expectations. Grief affects people physically, emotionally, psychologically and spiritually. People may be required to make adjustments to their lives eg, learning new skills, at a time when they feel least able to do so. Validation and permission to grieve are powerful comfort to a bereaved person's experience.

Do I have the right to inflict this on others? What can I expect of them and they of me?
Others will feel intensely uncomfortable with the emotion and the pain of the bereaved to the point of feeling helpless. The anxiety this causes may mean that the bereaved person will be avoided &endash; further increasing the possibility of them feeling isolated or being avoided or they may wish to take over details to protect the person from further pain. It is important that the grieving person is assertive about their needs and wishes, and it is helpful if they communicate with family, friends, and colleagues rather than leave them guessing about what would be useful and comforting. Never underestimate the power of listening and being a warm presence. There are no magic words or actions. Trust your ability to care taking into account your relationship with the person you are trying to help.

Is there a right way and a wrong way of coping with grief?
People are individuals with personalities and life experiences, which influence the way in which they deal with grief. People's style of grieving must be respected and in this sense there is no right or wrong way of coping. However it is generally believed that the amount of support people receive can ameliorate some of the impact of grief and facilitate recovery. People often have an awareness about what they need to do to feel better but feel inhibited or judged and don't act on their inclinations. Talking about what is happening, what they are going through, expressing emotion and existing in a supportive and accepting climate is generally helpful. Cultural factors may impact on a persons feelings of a "right" or "wrong way".

How do I know I need help?
Reassurance from others who have also experienced grief and an understanding of what people have commonly undergone when grieving can be a helpful yardstick. Any continued fears or anxieties about your well being or thoughts of self-harm should be addressed by seeking help. Prolonged intense emotion or obsessional thought or behaviour that make functioning difficult may also require help.

Stages of grief
Grief does not follow a linear pattern. It is more like a roller coaster, two steps forward and one step back. Ultimately people manage to integrate the experience to the point of having a new life arising from the old. The loss remains and is always remembered but the intensity is no longer disabling or disorganising.

Much of grieving is about expressing emotion- some may be unfamiliar, and unacceptable to self or others, eg, rage, guilt, remorse. Finding a safe place and an accepting person for support to work through all the effects of bereavement is important. The amount of support available from family and friends may be limited if they too are grieving. Misunderstandings can arise when people are at different points within the grief experience. External supports may then become a vital factor in surviving and continuing on. It is important to know that you can survive the experience and that the new life that eventually comes about may have very positive effects despite the difficulty of arriving at this point.

Does counselling help?
It is important to say that grief is a normal response to loss and that people frequently get through with the loving support of family and friends. However for a variety of reasons it may be necessary to seek professional help in the form of counselling. Counselling may initially intensify painful feelings as the external distractions are removed and the client is able to focus on their experiences and explore them fully. People who are grieving may need to talk about their story over and over again and are often concerned about the 'wear out' factor on family and friends, especially if details are very distressing. Equally they may find that others have unrealistic expectations of their recovery or experiences. . Where people have to continue on in roles as parents or carers it may provide valuable time-out for their own need to grieve and receive support. A supportive, safe and accepting environment and time set aside regularly can make a great difference. It may provide comfort and hope at a time of great confusion and crisis.

Twelve Ways to Help the Bereaved

• By being there
• By tolerating silences
• By listening in an accepting and non-judgemental way
• Avoid the use of cliches such as "Think of all the good times", "You can always have another child" etc
• By encouraging them to talk about the deceased
• Be practical in your offer of support by minding children or cooking
• By mentioning the dead persons name
• Accept that tears are normal and healthy
• Don't try to fill in conversations with a lot of outside news.
• Remember that grief may take many years to work through
• Acknowledge birthdays, death dates, anniversaries etc
• By accepting that you cannot make them feel better

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