Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Grief is a process. Although we would wish otherwise, grief cannot be
bypassed, hurried, or rushed; it must be allowed to happen. We do not go through
grief and come out the other side the same as we were before the loss. Grief
Four stages of grief have been identified. Nothing is absolute, because each person's grief is unique, but listed here are characteristics of the stages that many people experience.
Shock and disbelief: This initial phase, which may last from a mere few seconds up to
six weeks, is marked by numbness, disbelief, and, often, alienation from others. The loss may be intellectualized and dealt with on a "rational" level, as opposed to a "feeling" level. This is the stage many people are in at the time of the funeral.
Awareness: This next stage is an emotional and suffering phase that resides in the heart. At the same time that the chemicals (for
example, adrenaline) released in response to the stress
of our loved one's death are beginning to decrease, and the support of friends
is lessening, the impact of the person's loss is beginning to be truly realized:
the lonely bed, the lack of someone with whom to talk. The onset of this stage
occurs two to four weeks after death, and the pain we experience continues to increase until it peaks about
three to four months after the death. Typically, this is the longest phase. Strong emotions, such as anger, fear, and guilt, may be experienced.
Individuals may experience uncontrolled bouts of weeping, as reflected in the words of someone identified only as Colette, who said: "It's so curious:
One can resist tears and 'behave' very well in the hardest hours of grief. But then someone makes you a friendly sign behind a window...or one notices a flower in bud only yesterday has suddenly blossomed...or a letter slips from a drawer...and everything collapses."
The full recognition of the implications of our loss can take years. Speaking metaphorically, Mark Twain wrote: "A man's house burns down. The smoking wreckage represents only a ruined home that was dear through years of use and pleasant associations. By and by, as the days and weeks go on, first he misses this, then that, then the other thing. And when he casts about for it he finds that it was in that house. Always it is essential -- there was but one of its kind. It cannot be replaced. It was in that house."
Depression: We desperately want everything to be the same as it was before the loss. This unachievable desire, simultaneously so natural and so understandable, may elicit depression at around
Reconciliation and recovery: The final stage resides in the gut. For most of us, it is several months before we overcome the most severe emotional stress, and it takes at least a year to work through the grieving process. We must weather the "first" everything (for
example, birthdays, holidays, date of the loved one's death) without the person who has died.
As time passes, and as we allow ourselves to work through our grief, we begin to reconcile the loss and to engage in rebuilding our lives. The swings of emotion slow, and a scar is formed, lessening the pain. Our focus shifts from the death, and life begins anew. Reaching this stage does not mean we will never grieve again but that the grieving feelings no longer disrupt our lives or block our capacity for growth, discovery, and joy.
A caution, however: After a significant loss, we are changed forever; thus, the "new normal" is not like the "old normal." It has been suggested that we should attempt to reach an accommodation with our loss, rather than an "acceptance" or an effort to "recover."
What about children and grief? We should be open, honest, and gentle when children lose someone they love. Do not force them to attend a funeral if they do not want to, but give each child a chance to devise meaningful family rituals to observe the death, and have the child participate in some service or observance (for
example, lighting a candle). Allow each child a chance to talk at family meetings, which should be held perhaps once a week. Ask the child about guilt, which is common after a death ("I said I wanted my brother to die after he took my crayons, and he did!"). Do not be afraid to cry in front of your children. When a child dies, parents commonly are so mired in their grief that they do not or cannot reach out to their other children to support and comfort them. As tough as it is, parents must be there for surviving children.
Some factors can interfere with the resolution of grief. Try to avoid these
if at all possible: