Patient Presence

     There are many misconceptions about grief: grief is for people who are weak or not strong enough to push through it or that there is a magic day when it is over. However, these ideas are simply not true. While there are many misconceptions about grief, let’s review these: everyone goes through the five stages of grief in order, the same way and then it’s over; children are too young to understand and should not be involved in grieving or mourning rituals; and grief and mourning are the same thing.

 

Everyone goes through the five stages of grief in order, the same way and then it is over.

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     In preparing to write On Death and Dying, Elizabeth Kubler-Ross interviewed people who were facing imminent death. The stages of denial, anger, bargaining, depression, and acceptance were following by death. Over the years, many have applied these stages to the grieving process and somehow there is a connotation that everyone goes through each stage, in a linear fashion, and then it is over. Nothing could be further from the truth. Firstly, grief can occur after other circumstances in addition to death of a loved one, like separation, a move, divorce, a pet’s death, or a change of circumstance. Secondly, the stages do not happen sequentially, and some people do not experience all of them. Thirdly, even for people who have lost the same person, like siblings losing a parent, grief can be quite a unique experience because of the relationship each had with the deceased and their own personal process of grieving. It is not a matter of one loving the parent more than the other; each person’s grief process is unique. As David Kessler says, “If you’ve seen one person grieving, you’ve seen one person grieving.”  Finally, grief is something we learn to live with; it is never finished. The expression, “time heals all wounds,” is a falsehood. Once experienced, grief changes you and you learn to live within a new reality. The process can change how you see the world, how others treat you, your relationships, and your perception of your own identity.

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Children are too young to understand and should not be involved in grieving or mourning rituals.

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     In Alan D. Wolfelt’s book, Companioning the Grieving Child - A Soulful Guide for Caregivers, he repeatedly states that if a child is old enough to be attached to others and to love, he or she is old enough to grieve. Because of their developmental stage, it is true that children may not understand and may not have the words to explain their feelings, and yet, they are grieving. It is also true that it is hard to see a child sad or struggle with emotions and we tend to want it to be over for them. It is important to understand that a grieving child may take 3-4 four years to fully process a loss. As children mature through different developmental phases, they start to comprehend the death with alternate perspectives, and the rush of feelings can return. We need to ensure they are given the space to feel, not to just push them to feel better.

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The question of whether to allow children to be present for funerals or other mourning rituals is common. Mourning rituals allow the child to experience the loss, honor the life of the deceased and witness others openly mourning, which is a powerful message that mourning is acceptable and important. There is a mistaken belief that letting the child cry and be sad will harm them. However, crying is a natural response to loss and is cleansing. It helps children release internal tensions and allows them to communicate their need for comfort. Being strong and not mourning publicly prolongs the healing process. Being present and curious about a child’s emotions is more valuable than shutting them down, substituting food for connection or not allowing them to express themselves. Healthy mourning takes time. The days after a death of someone emotionally close to them will be the hardest they have experienced. Life will be different, and they can and will move forward in a natural way if allowed to be part of the process.

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Grief and mourning are the same thing.

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     Grief and mourning are not the same experience. In Atlas of the Heart, Brene Brown defines grief “as a process that includes many emotions, rather than a single emotion. Three foundational elements of grief emerged from the data:  loss, longing and feeling lost.”  People commonly confuse grief with depression and think there is something wrong with them. It is entirely normal and natural to feel bad, sad, hurt, angry, lost, relieved, etc. after a death. It is also thought that grief is a private matter that should not be expressed or discussed with others. This is where the activities of mourning come in.

Mourning is the outward expression of the internal experience of grief. Typical mourning rituals include funerals and wakes; wearing black; elaborate death ceremonies in some cultures; tolling of bells; 21-gun salute; washing the corpse; and sitting shiva. Small rituals of mourning include enjoying a meal or restaurant that the deceased liked; carrying a remembrance like a piece a jewelry or handkerchief; creating art, song or dance in honor of the deceased; attending to an altar in a special place in the home; planting a tree; writing a letter to the person who died; and or making a charitable donation in his or her name.  I carry the buttons from the shirt of my Uncle Louie. The paramedics ripped his shirt open to administer drugs and perform CPR. I found the buttons on the floor amongst discarded syringe caps and the pie crust he dropped when his aneurysm burst.

In closing, grief is a unique experience for each individual and each loss. If you do not feel it, you cannot heal it.