Debbie Caine a Limited Licensed Professional Counselor (LLPC) in private practice at Trinity Family Counseling Center. She completed her Master’s degrees in Clinical Mental Health Counseling from Oakland University, and works with individuals, couples, families, and groups across a range of presenting issues.
When someone we love dies that person is usually memorialized, celebrated, and remembered. During this time, words are spoken, pictures are displayed, videos are compiled, flowers are sprawled, and music is played. But what happens when there is advance notice of a death? When we are aware that a loved one is dying? When that individual’s life and the impact it had can be contemplated and perhaps people begin to mourn before it is over? The normal mourning that begins to occur when a person and family is expecting a death is defined as Anticipatory Grief.
One of the hardest parts of caregiving is watching your loved one slip away. It is the knowledge that you can’t stop the decline and grieving the loss of the person you once knew, long before they are gone. This process is very common among caregivers and family members of those suffering from dementia, cancer, and any other terminal illnesses.
There are healthy ways of coping and working through the feelings associated with anticipatory grief:
Allow feelings of grief to help you prepare – Give yourself permission to grieve for the future that you will not have with your loved one, for the loss of your hopes and dreams. No emotion is “wrong”.
Educate yourself about what to expect – Learn about your family member’s condition and know the symptoms, side effects, and prognosis.
Talk to a professional – Find a professional counselor that will provide the opportunity to share your feelings of loss and frustration. Finding a support group with individuals that are sharing a similar experience can provide emotional support and insight.
Enlist help and continue to live your life – Reach out to family and friends or hire someone to help with the care of your loved one. Don’t put your life completely on hold. In the long run, it will help the patient and yourself. It will provide strength for the journey so that you can care for your loved one in a positive and intentional way.
Plan to spend meaningful time together – Try and plan time with your loved one that is meaningful to you both. Talk about special times you have shared, things that you are sorry about, and about how much he or she will be missed.
Help your loved one adjust – Look for ways to add new activities to your loved one’s life or think about how you might incorporate elements of a favorite pastime. Give them the opportunity to express what they need to.
Anticipatory grief gives family and friends more time to slowly get used to the reality of the loss. People are provided with the opportunity to complete unfinished business with the dying person. Anticipatory grief may not always occur. This type of grief does not mean that before the death, a person feels the same kind of grief as the grief felt after a death. There is not a set amount of grief that a person will feel. The grief experienced before a death does not make the grief after the death last a shorter amount of time. The grief experience is as unique as each individual. Remember the love you shared will last a lifetime and beyond.
Everyone is grieving when a family loses a loved one. However, not everyone is grieving in the same way. Once each person moves beyond the initial stage of shock in response to the death, there can be significant differences in each individual’s experience of the loss. These unanticipated differences often present an added layer of confusion and despair for the individual mourners, and can result in discord within the family unit as a whole.
When we anticipate a loss, we often assume that our closest family members will be the ones to support us through our grief. However, each family member’s experience will be unique to them; influenced by a wide range of features specific to the individual’s age and stage of life at the time of their loss and to their relationship to the deceased.
Other factors influencing our experience include:
the stability and intensity of our relationship with the deceased at the time of their death
the age of the deceased at the time of their death
whether the death was sudden or anticipated
whether the death occurred as a result of natural causes or from an accident or tragedy
The task for family members is to recognize these factors and not assume that their spouse, parent, sibling, or child is feeling as they are at any given moment in time. Support offered by others outside the family, or in a griefsupport group can provide the understanding we need to process our grief on our own terms.
Deb Toering is a Board Certified Professional Christian Counselor (BCPCC) in private practice at Trinity Family Counseling Center. In addition to working with a wide range of client populations and presenting issues, Deb is also an engaging public speaker. She has spoken in front of various groups across a range of topics including marriage, bullying, ADHD/ADD, and teen leadership.
Life is full of heartache and disappointments. A spouse has a debilitating disease. Children travel down self-destructive paths. Jobs are lost. Financial difficulties come upon us. Storms destroy our homes and our marriages. Test results show cancer. Family relationships are strained. We feel alone, afraid, helpless, vulnerable and sometimes, full of shame. How are we to respond to these things? Who can we talk to who will understand? Some things are so personal that we decide to travel alone. And the journey can be painful and lonely.
These unexpected events are losses we did not anticipate: the loss of health and a happy retirement. The loss of financial security. The loss of a physical home or marriage. The loss of the hope of a happy family or happy and successful children. A healthy way of coping with these losses is to do the actual work of grief: working through the anger, bargaining, perhaps depression and finally acceptance. These emotions are normal. Talking about them is helpful. Sometimes a professional counselor can be just the one who can hear your pain and disappointment and help you work through the grief.
For the Christian, we know that this life is not all there is. Jesus told us that we would have trouble in this life (John 16:33). The comfort that we have is that God will wipe away every tear. In Heaven there will be no mourning or crying or pain or death (Revelation 21:3-4).
During a time of loss the people who care about us are often quick to offer unsolicited advice and counsel in an effort to comfort us. However, the language they use—although unintentional—often exacerbates our sense of isolation and confusion. While intended to comfort or encourage, their words often leave us feeling even more alone in our grief.
In my work as a grief counselor, I have become acutely aware of the power of words to influence our perspective and experience of personal loss. I devote an evening of my ongoing grief support group to a discussion of this topic, and I offer alternative language to use when discussing one’s grief journey with others. This discussion—perhaps more than any other during the course of my group—is often transformative for the attendees who have been hurt by the words and well-intentioned advice of others.
“You really should be moving on by now…”
My suggestions include challenging the use of the word should in any discussion of one’s grief work. There simply are no “shoulds.” Certainly, there are universal features of the grief experience. However, there are many more features which contribute to the uniqueness of one’s journey, and often amplify those intense feelings of being alone in our grief. These features include the individual’s age and stage of life at the time of their loss, their relationship to the deceased, and the stability and intensity of that relationship at the time of the death. The circumstances of the death itself can often complicate the grieving process as well. This includes the age of the deceased at the time of death, whether the death was sudden or anticipated, and whether the death occurred as a result of natural causes or from an accident or tragedy. It becomes quite clear when all of these factors are considered, that any idea of how someone should be enduring the process of grief is entirely unreasonable. Grief work is an arduous and uniquely individual experience, with no rules and no “shoulds.”
“Isn’t it time for you to just let go?”
“Why haven’t you gotten past this yet?”
I suggest that the griever consider the task to be that of moving forward. Suggestions of moving on, letting go and getting past imply the need to somehow leave our loved one behind. When in fact, the real challenge is to figure out how to move forward,with one’s loss now being a part of what informs who they are now.
“When are you going to get back to normal?”
The loss of a loved one changes us forever. With this understanding, it becomes evident that getting back to normal is not a goal at all! We will never be the same person we were before our loss. We absolutely can feel joy, love, and happiness in our lives again, but it will be a new normal; nothing like before our loss.
“You should be reaching a place of acceptance soon…”
I also take issue with the concept of acceptance. Here, I am referring to the painstakingly long ordeal of learning how to live our own life with our loved one no longer a part of it. If we consider the dictionary’s definitions of acceptance, we learn that it can mean:
the act of taking something that is offered
a favorable reception
to receive willingly
to give admittance or approvalto
to endure without protest or reaction
to regard as normal or inevitable
the act of assentingto or agreeing
A common theme of choice or a sense of willingness is implied with each of these variations of the definition of acceptance. However, our loss has certainly not been our choice. Nor would many admit to any sense of willingness to confront life without their person. With this perspective of the idea of acceptance in mind, is it any wonder why so many people who are grieving report feeling offended when asked by others if they have “accepted” their loss yet?? Quite the contrary, their feelings are often ones of resistance and protest.
I suggest we replace the word acceptance with the words adapt and accommodate. Through many conversations with people struggling in their loss, there is a strong consensus that these words more accurately reflect how they are attempting to manage their day-to-day struggle. They readily acknowledge that they are trying to adapt to the changes that their loss has imposed on them. They further recognize that it is possible to accommodate—or make room for—the changes to their own lives that have occurred—through no fault of their own. Informing a well-intentioned observer that they are hard at work attempting to adapt and accommodate to their loss feels more congruent with their actual experience, than an effort to reach some undefined (and often unimaginable) place of acceptance of their loss.
Finally, as a person makes their way through their grief journey, finding ways to cope with the emotional overload, and meeting the challenges of simply getting through each day, there eventually comes a time when the load begins to lighten. Moments of quiet reflection replace anguishing sorrow. There are more sweet memories and fewer feelings of emptiness. It is during this transition that I often suggest we shift our language from words focused on the loss to those that highlight all that our loved one has meant to us. I suggest we leave behind the language of loss and step into our future speaking in terms of honoring—rather than grieving. This final shift in the use of our language of loss supports our renewed sense of our own life as it begins to take shape again.
The holidays are an extraordinarily difficult time for those who are grieving the loss of someone they loved. We attach tremendous significance to special days and holidays, and our psyches preserve moments of joy and feelings of closeness that occur on these distinctive days. Who among us hasn’t reminisced about birthdays, family Christmas celebrations of years gone by, or our favorite Valentine’s Day memory? Or anniversary? All, of course, when our missing loved one was still with us.
A resurgence of grief during the holidays is a natural and normal part of the grieving process, and an experience that one must find a way to endure. In his book, Handling the Holidays, author Bruce Conley offers some suggestions for coping which he titles:
The Griever’s Holiday Bill of Rights
You have the right to say, “time out” anytime you need.
You have the right to “tell it like it is”.
You have the right to some “bah hum bug” days.
You have the right to do things differently.
You have the right to be where you want to be.
You have the right to some fun.
You have the right to change direction in mid-stream; grief is unpredictable.
You have the right to do things at different times.
You have the right to rest, peace, and solitude; you don’t need to be busy all the time.
You have the right to do it all different again next year.
My journey to the field of professional counseling–more specifically grief counseling – began with this profound realization. My own mother died when I was a young mother myself, and as a result of her death, I suddenly realized how little control I had over anything at all. A few years later, as I began my graduate studies in the counseling field, I was immediately drawn to grief work.
Those who are grieving the loss of someone they love are truly suffering through no fault of their own. The emotional, spiritual, psychological, and physical assault of loss is profoundly overwhelming and life-changing.
The ability to successfully navigate your grief work involves tolerating [rather than avoiding] the emotional pain, and recognizing that your unique and very personal grief experience will be a very lonely place for an undetermined period of time. These insights, forced upon us in our darkest moments, can help us reconcile the fact that life has indeed, changed forever, without our permission.
Our task, when working through our grief, becomes figuring out how to take this experience–as part of what now defines us–and move forward in our own life.
Grief turns out to be a place none of us know until we reach it. We anticipate that someone close to us could die, but we do not look beyond the few days or weeks that immediately follow such an imagined death… No one can know ahead of the fact [and here lies the heart of the difference between grief as we imagine it and grief as it is] the unending absence that follows, the void, the very opposite of meaning, the relentless succession of moments during which we will confront the experience of meaninglessness itself. Joan Didion The Year of Magical Thinking, pp.188-9
This passage reflects the overwhelming initial reaction of many to the loss of someone they love. The goal of a grief support group is to assist grieving individuals through the process of coping with this sense of meaninglessness. Engaging in this painful process within a group dynamic offers several unique opportunities for the grieving individual.
First and foremost, the company of others who are also grieving is enormously comforting. When we have lost someone, we are usually “allowed” a reasonable period of time to feel sad, after which a simmering impatience emerges, as others deem it is time for us to “get on with living.” The beauty of the support group is that there is no impatience with the grieving process, which often continues well beyond society’s acceptable “timeline” for grieving.
Second, grieving individuals need opportunities to tell their stories again and again. They need to feel safe to explore the painstaking details of their loss experience in order to begin to make sense of it. Group members understand and support this need. They often ask questions of one another, and are able to empathize in ways that only another grieving individual could.
While each individual’s grief journey is uniquely their own—based on their relationship with the one who died and the circumstances of the death—there are many features of the grieving process that are universally experienced. The opportunity to sit with and share with others the sorrow and confusion that comes from grieving can serve as reassurance and comfort that the individual is not alone.
Additionally, recognizing one’s own feelings in another who is also grieving offers comfort and confirmation that “I am (in fact) not going crazy,” which is how many grieving people describe their early grief experience. Reports of confusion, distractibility, poor concentration, difficulty making decisions and emotional instability are common reactions to loss. In isolation, many are unaware that these experiences are a natural part of the grieving process.
Few people have the luxury of taking the time they truly need for their grief work. Families, jobs and other daily responsibilities are not able to be put “on hold” while we grieve. Being able to sit with others on a regular basis—as is offered through a group experience—often is the only time many find in which to actively allow themselves to process all that they are experiencing.
Because the group is composed of individuals with varying lengths of time passed since their loss, members are able to see others who may be a few steps ahead of them on their grief journey. This experience allows them hope that it can be done; that someone can traverse the incredible pain they are feeling—and survive. Likewise, there is tremendous reward in serving the needs of another grieving individual, and in recognizing how far we may have come ourselves.
Group work provides this perspective on our own journey as well as, offering hope for others.