On Grief and Grieving

January 25, 2024 by

“This study demonstrated that pre-COVID-19 diagnoses and understandings of grief are not sufficient to picture grief during and after the COVID-19 pandemic. These grief experiences are more complex and deserve further exploration.”
– Nierop-van Baalen et al., 2023

To begin, let’s define terms.

Here are definitions of grief and grieving based on those offered by Mary Frances O’Connor, Ph.D., author of The Grieving Brain: The Surprising Science of How We Learn from Love and Loss (2021):

  • Grief. After loss, grief is the complex, anguished, yearning feeling associated with love, attachment, bonding, connection, and belonging.
  • Grieving is the process by which the heart, mind, and brain adapt and adjust to the absence.

Overviews of Mary-Frances O-Connor, Ph.D.’s research findings

In sum, the human brain has evolved to adjust to loss. The intensity of the love and bonding before the loss tend to align with the intensity of the grief after a loss. That is why “getting over grief,” “getting through grief,” and “healing from grief” may or may not be helpful directions. Is reducing or eliminating love – manifested as grief after loss of the loved being – truly the goal?

If a person can gently and kindly give the human brain time to re-navigate, love and grief may not be lessened, but the brain can adjust to the absence.

In my mind, I co-travel with grief. I am continuing on and I miss my beloved people and beings profoundly. Both are true.

Memories and rumination after loss

Memory is complex.

Distressing images may arise after loss.  Although clinically termed intrusive memories, I wonder if the brain is attempting to cue a person to be cautious, attempting to help the person to remember in order to protect.

People who have experienced loss can find themselves analyzing or replaying the end, or rehearsing what they would do in the future. Although clinically termed rumination, I wonder, again, if the human brain is attempting to practice mercy, looking for loopholes, looking for different interpretations, looking for some way to ease the ache.

Giving time to intrusive memories and to replaying losses may inadvertently deepen memories through repetition, as if one were using a flashcard deck to memorize old hurts. Practicing shifting one’s attention – rather than following the narrative with its sad, but known end – may provide balm to the mind and heart and assist with helping the brain adjust to loss.

Intrusive memories and rumination are common after loss and cause distress and fatigue. To ease this distress, one can acknowledge the thoughts, acknowledge the human brain’s attempt to be merciful (“Ah, brain, that’s you trying to help me again”), and shift one’s attention to one’s values and priorities.

Other important, grief-related terms

Ambiguous grief: Simultaneously wishing for the person or being to die and free themselves and you – and wanting to hold onto them forever.

Anticipatory grief: Feeling grief now at the slow death of the person’s selfhood or the being’s identity, all the while knowing grief will occur again when the life ends.

Cumulative grief / compound grief: The complex feelings that occur after experiencing cascading losses in rapid succession without time to adjust to each loss. Experiencing cumulative grief is inherent to aging.

“The grief is the love.”
– David Kessler

Disenfranchised grief / Unacknowledged grief: From private losses, feeling grief that others may not believe is valid or may not understand.

Existential grief: Sadness experienced over the inability to find meaning from loss and a resultant sense of futility about the future.

Traumatic grief: Occurs in response to a death or loss that is sudden,  shocking, alarming, and often involves a traumatic event.

Separation distress: Sadness, anxiety, and unease experienced from severing of bonds and the resultant neurobiological impact.

Secondary losses: Beyond a primary loss, additional tangible and intangible losses such as companionship, identity, self-concept, property or real estate, financial stability, social position, world view, and others.

“New losses bring up old losses”: Emotions, cognitions, experiences, and memories are experienced, conveyed and stored in the brain through connections and interconnections between neurons (neural pathways). New experiences may share similarities with previous experiences and activate the same neural pathways. When a loss occurs, similarities may be associated with – and be activated by – the type of loss, the feelings involved, or environmental cues. This intertwining of connections is why “a new loss brings up old losses.”

Other types of grief may include “overshadowed grief, cumulative grief, triggered grief, derailed grief, and conciliatory grief.”

Possible considerations

“[E]xperiential avoidance and rumination play a role in the persistence of complicated grief.” (Eisma et al., 2021)

“All grievers can benefit from support focused on understanding their grief, managing emotional pain, thinking about the future, strengthening their relationships…learning to live with reminders of the deceased, and connecting with memories.” (Meichsner et al., 2020)

Untitled by Trish Shelor White

“Grief will always be part of me, not as a superpower nor a thorn in my side but as a reminder that only a love so staggering in its intensity could produce an equivalent amount of sadness.”
– Rachel Daum

Here are the worst things people can say to others who are grieving (and to themselves). Here are the worst traits of people who try to help. (Please scroll to the bottom of that page to view the list.)

Image: “Untitled” by Trish Shelor White

Last updated 03/10/2024

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Filed Under: Grief

My Philosophy of Life and Death

December 30, 2022 by

Today, I am will-you-still-love-me 64.

As I anticipate facilitating a local grief support group, I have became aware that addressing grief requires a deep, existential dive, not just into the meaning of life, but into the meaning of death.

When I was in my 30s, 40s, and 50s, I wrote philosophies of life. This past year, the death of my father, the death of a dear friend, my own potential death from a fall and concussion, plus over 6 million deaths from COVID-19, all call me to break a taboo and speak of death.

This causes understandable anxiety.

100 billion humans

I am not alone. For the nearly 8 billion people alive on the planet today, anxiety – unease about things that may be ahead – may be legitimate. Indeed, global rates of anxiety have risen. According to some researchers, anxiety is considered useful and motivating, an indicator of threat, that something’s not right. In January, 2023, death may well be more likely than it was in January 2020.

I considered the deaths of my father and friend devastating losses. I felt hit, bereft, disoriented. Then, a home pull-up bar failed and I truly got hit in the head. I began to wonder. What is the ground beneath my feet? I’m already among the one-third of Americans over 60 who – if I didn’t rent rooms to international scholars – would live alone, no partner, no children, with a small extended family. What would hold me up if I were to lose everyone and everything? What holds me up when I realize that I, ultimately, will lose everyone and everything – including my own life – when I die?

Iverach et al. tell us, “Awareness of mortality and fear of death have been part of the human condition throughout recorded history. According to [Irvin] Yalom, human beings are ‘forever shadowed by the knowledge that we will grow, blossom, and inevitably, diminish and die.”

Death anxiety is considered a central cause of human distress.

What is the ground beneath my feet? What is real? What is true? How are those terms even defined? What can I count on? How do I make sense of all this? What is my philosophy of life and death?

In the 300,000 year history of Homo sapiens, in the story of the 100 billion people estimated to have ever lived, I have a paragraph.

In the photo album of the 100 billion, turn enough pages – past the photos of the famous and the infamous, your loved ones and mine – there is a glossy shot of you, then of me. Paragraphs and photos came before us and, for an unknowable amount of time in the future, will come after us.

I am human and humans die – maybe now, definitely later. I may not like it, but I accept it. People important to me have died and will die. Pets die. Death is a fact.

Right this moment, I am alive.

  • I will, at times, validly feel powerless and helpless about the biological fact of my inevitable death.
  • I may often have some level of anxiety and sadness about the anticipated end of my life, both for myself and those I care about who will have to do without me.
  • Significant anxiety-buffering factors – such as reliable, shared world views and social interaction – have been compromised by the pandemic.
  • I might believe things should be different, and longingly wish they were, but, given the complexity of reality, I can’t know if a difference would have made things better, worse, or had no impact.
  • I am astonished by my belief that I could accurately read and predict another person’s mind and heart, given the human brain holds an estimated 100 billion neurons and perhaps a similar number of glial cells.
  • I am astonished by my belief that, if I felt something ardently enough, or believed it fervently enough, it was a fact.
  • I am astonished by the amount of influence, power, and control I believed I had and how little I ended up having. I thought the extent to which I could control my life would determine its quality. I didn’t know that, again, given the complexity of reality, uncertainty would be natural and normal, a condition to be navigated, not fought.
  • But I long for certainty! In his poem, “Noreen,” Peter Meinke writes, “How much we need reasons! How reasons make us feel better!” Probabilities and possibilities can be estimated. Certainties cannot be determined.
  • What’s done cannot be undone. What happened cannot be made to un-happen.
  • I did my best to help things go in ways I thought would be best for everyone.
  • I did not realize how exhaustingly I tried to be all things, to all people, at all times, and secretly feared I was nothing, to anyone, at any time. Oh, my! Neither is possible.
  • I did not realize how much thinking I, they, things should be different has caused my suffering.
  • I might sometimes get frantic trying to prevent what I interpret as disaster, however much what’s happening results from facts and reality as they are.
  • I thought I was helping myself when I recoiled from inevitabilities. It brought a bit of relief in the short-term, but caused more suffering than bravely leaning forward and seeing things as they might be, are, or were.
  • I didn’t know that, paradoxically, seeking reassurance can actually escalate anxiety. For many realities of the human condition and human life, there are no reassurances.
  • I believed reprimanding myself was corrective and motivating. I didn’t mean to turn into my own predator and forsaker. Now I keep close to myself. I meticulously help myself with challenges.
  • The personnel changes. People come and people go: neighbors, co-workers, family members, partners, bosses, on and on. Beings come and go: the family dog, the beloved cat, on and on.
  • I acknowledge whom and what I’ve lost irreversibly.
  • I acknowledge whom I can’t see and what I can’t do.
  • I acknowledge with whom I will not get to continue.
  • I can fret over possessions if I wish, but, ultimately, I don’t get to keep them. When I’m gone, boxes of my things will join the boxes in my basement of my grandparents’ and parents’ things. Lovingly, my family members were trying to protect me and help me. Items, however held to be valuable, can become useless.
  • I acknowledge that I can write an advance directive, attempting to narrate how my dying must go and not go, but I am a biological organism and biology will unfold as it will.
  • I may be in such unbearable psychological, physical, mental, or existential pain that I may take action to end my own life, or take actions that might risk or hasten my death. Others cannot know what it is like to be me or to see what I see. I will not consider these acts of illness or brokenness, but of self-love, mercy, and humanity.
  • I did not realize that seeing and acknowledging reality as it is, seeing the reality of what I can and cannot do, and accepting what is mine and not mine to do, all bring me a sense of the way things are that, in turn, bring me a sense of some peace and freedom.
  • I can co-travel with loving my life and grieving it at the same time.

“Find meaning and purpose” is advice often given to those asking existential questions. However, researchers have found that “meaning in life” may not do the trick.

When I was explaining what a triathlon was to my 101-year-old grandmother, she said, “Run while you can!”

Surrounded at our school by frightened students after we learned of attacks on the World Trade Center on 9/11, I asked our head of school, Gordon MacLeod, what we should do. He answered, “Carry on!”

After all that’s happened, all that’s lost, all these feelings, all these limits, all these risks, and the certainty of my life ending, might I carry on? If so, how?

To start? Kindly. I got born into the human condition with “the wound of mortality” without being consulted and without warning. My Homo sapiens-ism, my DNA, got meaninglessly, randomly assigned to my family, in my country, in my birth year. I have made the best of things, the best I can. I scrutinize my past efforts and conclude that, if I could have done better, I would have. Altruism is as old as humaniy itself.

Logic holds that reality-based strategies are more likely to produce desired outcomes than belief-based strategies.

Given reality as it is, my feelings and thoughts, my values and priorities, my strengths and preferences – after all that’s gone down – what will be my strategies for living in the time I have left? Shall I run? Take next steps?

Such questions! Such tasks! Kindness is merited.

image: iStock

All content on this site is for informational purposes only and is not a substitute for medical, professional, and/or legal advice. Consult a qualified professional for personalized medical, professional, and legal advice.

Filed Under: Autobiography, Grief

Grief Support Group in Blacksburg, Virginia

December 14, 2022 by

UPDATE: March 29, 2023

We were delighted to facilitate this group for the first three months of 2023. We thank all the attendees for their candor and bravery. Due to low attendance, we are ending the group.

Those seeking local, in-person support may wish to consider the grief support groups offered by Good Samaritan Hospice for residents of the Montgomery County and Roanoke, Virginia areas. Please contact Good Samaritan Hospice for more information.

Those seeking online support may wish to consider David Kessler’s Tender Hearts Grief Support Community, which includes an online course and support group participation. Attendees pay $34 per month. Kessler’s Grief Educator Certification program may also be of interest.

Many people need professional support after experiencing a loss.

What seemed to offer most comfort to most people was the definitions of grief and grieving offered by Mary Frances O’Connor, author of The Grieving Brain. Here are insights from her book. We used these paraphrases:

  • Grief is the complex, anguished, yearning feeling associated with love, attachment, bonding, connection, and belonging.
  • Grieving is the process by which the heart, mind, and brain adjust and adapt to the absence.

The group’s description is left intact below if of interest.

I am very open to offering phone support to people who have experienced a loss. Please contact me if I can be of assistance.

Pax.

. . . . .

After the loss of a person important to you, you may have found yourself asking questions such as these:

  • How can I possibly do without this person?
  • How do I endure this painful, heavy grief?
  • If I have ambivalent feelings about the person, what does their absence mean to me? What am I feeling and why?
  • Why am I experiencing such extremes in feeling?
  • How do I make sense of what happened? Does the world even work the way I thought it did?!
  • Who am I without this person? Am I still me?
  • What is the meaning of my life – of life itself – without this person?
  • How and why do I go on? With whom?
  • The World Health Organization reported a 25% global increase in anxiety and depression since the pandemic began. How am I to navigate grief in such times and in the wake of such hardship and uncertainty?

If you are an adult living in the Blacksburg, Virginia area and wish to address these and related questions in the supportive company of others, you are invited to attend our in-person, weekly, grief support group.

What? Grief Support Group
Where? Lobby of 102 Hubbard Street, Blacksburg, Virginia
When? Sorry, this group is no longer meeting. 
Cost? None. Attending the group is free.
For whom? Adults who have experienced the loss of a person important to them, of any age, in any way, whether they are newly bereaved, are continuing to have concerns after a year, or after many years.
How do I sign up? Filling out this contact form is preferred. Walk-ins, however, are welcome.

Please note:

Meeting format

  • We start and end promptly.
  • We use a group sharing protocol designed to offer people the opportunity to speak and listen in a safe way.
  • We’ll do our best not to say the worst things people can say to people in grief and not to exhibit the worst traits of people who try to help. (Please scroll to the bottom of that page to view the list.) Most importantly, we will not give unsolicited advice, nor “bright side” each other, i.e. say, “Look on the bright side. At least the person _____,” nor imply, “You should be over this by now.”
  • Our goals are to learn about grief, to become aware of our individual experiences with grief, and to explore ways to co-travel with what has happened.

Prior to attending, participants are encouraged to do two things.

1. Take a well-being assessment.

  • The “Flourish” measure is described as “a measurement approach to human flourishing, based around five central domains: happiness and life satisfaction, mental and physical health, meaning and purpose, character and virtue, and close social relationships. Each of these is nearly universally desired, and each constitutes an end in and of itself.” Here’s a link to a printable .pdf.
  • The Well-being Assessment is described as “a concise, freely available tool for communities to measure the many aspects of health and well-being.”
  • Take either or both of these assessments, or a well-being assessment of your choice. You are encouraged to return to these assessments, take them again at any time you wish, and compare scores over time. Your score is private and you will not be asked to share it.

2. Prepare what David Kessler terms “a loss inventory.”

  • In chronological order, make a list of approximately 10 losses you have experienced in your life.
  • Losses are not limited to deaths of loved ones, friends, or pets, and may include relationships ending, job losses, moves, loss of physical health or abilities, and others. The losses may have been sudden or expected.
  • Your list is private and you will not be asked to share it.
  • The purpose of the exercise is to become aware of the context of personal loss in which a recent or profound loss occurred.

Recommended reading

The Grieving Brain: The Surprising Science of How We Learn from Love and Loss, Mary-Frances O’Connor, 2022

The Grieving Brain: 5 Key Insights

“Grief will always be part of me, not as a superpower nor a thorn in my side but as a reminder that only a love so staggering in its intensity could produce an equivalent amount of sadness.”
– Rachel Daum

Important: Although attending the group may be therapeutic, attending cannot be construed as receiving therapy and cannot take the place of therapy. Many people need professional support after experiencing a loss.

About the facilitator

Anne Giles, M.A., M.S., L.P.C., is a Licensed Professional Counselor in the Commonwealth of Virginia, U.S.A., and a student of Mandarin Chinese. She comes to the work of trauma, loss, and grief through what is clinically termed Adverse Childhood Experiences (ACE), infertility, student-on-teacher violence, university shootings, the death of her mother, the death of her father – who suffered profoundly from symptoms of dementia – and the unexpected death of a beloved friend. Anne has done extensive reviews of the current research literature on grief, trauma, caregiving, and end-of-life concerns, is trained in Cognitive Processing Therapy for PTSD (CPT), and  completed the Grief Educator Certificate Program with David Kessler in January, 2023. She participates in the Tender Hearts Grief Support Community.

To have your pain witnessed
To express your feelings
To release the burden of guilt
To be free of old wounds
To integrate the pain and the loss
To find meaning in life after loss
– “Six Needs of the Grieving” from work by David Kessler

For more information, please contact Anne Giles.

Good Samaritan Hospice offers grief support groups for residents of the Montgomery County and Roanoke, Virginia areas. Please contact Good Samaritan Hospice for more information.

Update on 12/30/22: I have become aware that addressing grief may require a deep existential dive, not just into the meaning of life, but into the meaning of death as well. I explore those subjects here.

Image: iStock

All content on this site is for informational purposes only and is not a substitute for medical, professional, and/or legal advice. Consult a qualified professional for personalized medical, professional, and legal advice.

Filed Under: Grief

About Grief

October 8, 2021 by

What’s to be done about grief?

Untitled by Trish Shelor White

It’s real.

It’s painful. The end in mind would be to feel less pain. Turning away is instinct. Forcing it to change is instinct. However, grief handled really, as it is, eases. What optimizes the easing of grief?

This is what I’ve become aware of about grief, from personal experience and training:

  • Neither stalling nor hustling help. Neither distracting nor avoiding help. Tough love hurts.
  • Turning towards the reality of grief, as it is, begins with self-kindness and compassion.
  • Grief without judgment, without beliefs, and without rules eases. “I should be feeling/thinking/doing ____,” and “I shouldn’t be feeling/thinking/doing _____,” exacerbate grief.
  • Seeing grief as it is offers up this question: “Can I help myself do something about this? Or is this something to help myself accept? Help do? Help accept?”
  • In the context of grief, acceptance can be having the bravery and compassion to rearrange one’s heart to make space for a new fact about being human, however unwelcome.
  • Replaying scenes to see if they truly happened the way they did or to see if different clues can be found to change the ending or its meaning works like flashcards to deepen painful memories, escalating grief. Becoming aware of replaying scenes is the time to say, “I have given that due time. I accept that it was the way it was.”
  • Being with people who aren’t grief-savvy exacerbates grief. The unconscious subtext under well-intentioned intoning of rules about grieving, e.g. “Time heals all wounds,” “You should travel,” or “_____ helps,” is usually judgment and criticism: “You should be over this by now. Why aren’t you farther along in ‘the grief process’? Follow my rules and you’ll get through it faster.” The deeper subtext can be that the person feels frightened and lonely without the person in grief.
  • Grief has to be felt and life has to be lived. Both are true at the same time. Opting out of either exacerbates grief. Grief is felt and relationships are tended. Both are true.
  • Guilt, a feeling born from the thought, “I should be/have been/do/have done more or something else,” often accompanies grief. Standard feeling and thinking skills can help:

“What am I feeling? Which of my feelings are natural human emotions and which are caused by thoughts? Which of my thoughts are facts and which are beliefs? Okay, let me challenge the beliefs and ease those thought-created feelings. And now let me help myself with whatever feelings are left and follow the facts!”

The vast complexity of each person’s brain and body, each person’s history, each person’s temperament, all suggest each person’s experience of grief, moment-to-moment, is individual and may fluctuate. Awareness, though, can help people decide moment-to-moment what is real and what can help.

Image: Untitled by Trish Shelor White

The content of this post is informed by the work of David Kessler and therapies derived from cognitive theory.

This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Filed Under: Grief, Trauma