His statement comes from the book of Ecclesiastes in the Bible, part of the ancient wisdom literature. This same concept has been referred to in our modern times as the “circle of life.” It illustrates a somber reality. While the beginning of life is a time of celebration, the end of life is a painful process of loss, letting go, transition, and saying goodbye.
One of the difficulties with death and saying goodbye is that it is unnatural. Most theologians would agree that humans were not designed to experience loss and death. Death is a result of man’s fallen condition, the sin that occurred at the beginning of the human race. God designed us for life, not for death. Whatever spiritual beliefs you may have, I suspect that you would agree that death does not fit into our desire for life.
The reality is that sooner or later, all of us will be touched by the loss of someone known or close to us. Most of us lose someone else before being faced with our own dying. In death, we are confronted with “loss,” simply defined as “something that once was that is no longer.” With that definition, we realize that we encounter many losses in life. And with loss, there is a process of letting go, accepting the reality that someone or something is no longer here, and adjusting to life without the lost object. In dealing with loss, it can be helpful to better understand the nature of loss and how to grieve losses in healthy ways.
There are several aspects of loss that once understood can help in the grief process:
• Some losses are concrete — the loss of a person, thing, position. Other losses are abstract (loss of identity or purpose). Still other losses are threatening — may or may not happen, or are coming in the future.
• Some losses are primary (loss of a spouse or close friend) and are usually accompanied by secondary losses (companionship, financial, and emotional support).
• Losses can occur suddenly, or they can occur gradually over a period of time.
• A person can experience a single loss or a series of accumulated losses that build up over time.
It is important to pay attention to all of these aspects of loss as they will impact, and possibly complicate, the grief process.
The “grief process” is a term we often hear, but what exactly does it mean? It is called a process because it occurs over time. Grief is intense emotional suffering caused by a loss and is a normal response. Most psychologists believe that grieving occurs in some fairly predictable states. What is not predictable is how long one takes to move through the stages. Also, some psychologists talk more about “tasks” of grieving. Let us look further at the grief process, some of its tasks, and some practical suggestions for grieving well.
Stages of the Grief Process
Denial: “This isn’t happening.” Denial is a psychological buffer, a shock absorber that helps cushion the blow, so to speak. It can last for minutes or up to hours. Having supportive people around who help you stay connected to reality is very helpful.
Bargaining: A sort of postponing the inevitable. “Maybe it isn’t so; maybe it doesn’t have to happen.” This stage can be short, or in the cases of terminal illness it can linger for months and years. The key to moving through this stage well is to deal with factual information and to talk about it with supportive others.
Anger: The emotion of anger is a typical response to feeling out of control. It is also a response to something that is happening that we do not think should be happening. Both of these thoughts are common as we are forced to let go of someone or something we are attached to.
Depression: We are not talking about clinical depression, but rather the deep sorrow and sadness that comes with losing someone. It is the sorrow of no longer having someone in our lives that we were connected to and held dear.
Acceptance: This is really a surrender to reality. “I have accepted that this loss that I did not want to happen has happened, and I can move forward in life without the lost person.” This stage is accompanied in some form by rebuilding life without the lost object.
The stages of grief are different for everyone. People move through them at different paces, and the nature of the loss impacts how long one will take in each stage. Furthermore, in loss that one knows is coming (i.e. terminal illness), much of this grieving work can occur before the actual death.
Tasks of the Grief Process
Instead of moving through a series of stages, some conceptualize the grief process as accomplishing a set of tasks after the loss. There are four basics tasks of grieving:
Accept the loss: This is really an intellectual process, accepting the reality of the death and the facts around it. Some say this is done with the head (mentally).
Experience the pain: This is the work of the heart, so to speak. It involves feeling all of the emotions associated with the loss (sadness, anger, fear, guilt, regret, loneliness). Reactions to the pain can involve disconnecting from it or being overwhelmed by it. Finding helpful strategies for processing the feelings is important in this task.
Adjust to an environment without the person: This is a process of learning to continue all aspects of life without the lost person in it. The aspects are many; the time is measured in months to years versus days to weeks.
Reinvest emotional energy in other relationships: After loss, those left behind keep living. The lost person is “relocated” so to speak to a different place in your life. You now connect to those close to you in new ways, those relationships grow, and at some point, new relationships can be started.
What is clear about both the stages and tasks of grieving is that we do better in them when connected to, surrounded by, and supported by others. We were not meant to grieve alone. Healthy grieving occurs in community and connection to others. At the same time, there are things necessary to do alone following a loss, but they are easier to do when supported by others. There are many practical steps to move through the grief process well.
• Grieve at your own pace. Grief does not have a “correct” timetable. Move through the stages and tasks, and spend the time needed without getting stuck. Objective others can provide feedback on this.
• Talk to others about the grief. Call it by name (a loss, death, grief). Tell others what you need and what you do not need at this time.
• Write two letters. One is a letter from yourself to “grief.” The second is a letter from “grief” to yourself. In these letters, talk about the reality of the loss, its impact, the feelings, and how you are moving on.
• Designate a crying time. This will help you manage the tears that intrude at unwanted times. You can interrupt the tears, so to speak, and tell yourself that you can revisit them and the thoughts and feelings connected to them at the designated time.
• Create a remembrance list. The list could include short one-sentence items or experiences with the lost person, or it could be a long list, up to a thousand items if you like.
• Write in a journal. Journaling can be topical, it can be the thoughts and feelings of the day, it can include letters, lists, or it can be anything you want to get out. It can be done daily or as needed. The internet is full of creative ideas for how to journal.
We tend to think of loss as something that happens rather suddenly and that the grieving occurs after the loss. Yet, there are many losses that are in the future. Examples include a terminal illness, aging, or some form of progressive dementia (Alzheimer’s). The blessing in such losses is that it allows all involved to say goodbye in healthy, individual ways. While all of the above are helpful for impending loss, let us look at some additional suggestions for grieving such losses.
• Create final memories and experiences. Terminal illness provides the opportunity to create some final experiences that are chosen by those involved that will be lasting memories for those left behind. Celebrate the life that has been lived together. Some refer to a “bucket list,” a list of experiences one wants to have before dying. Here the opportunity is afforded for some of these. For others, the goal is to accomplish one last thing that will give the dying person’s life meaning.
• Conduct a life review. This could be a time when the dying one and family and/or
friends discuss their lives lived together. This provides an opportunity to focus on what they have had and not just on what they are losing.
• Say what needs to be said. Closely connected to this is taking the opportunity to express what each person has meant to one another. These conversations often include expressing gratitude as well as sharing the depth of feeling for each other.
• Make amends and offer forgiveness. People are not perfect, and neither are relationships. In even the best relationships, people hurt and offend each other. It is a gift to be able to take responsibility for how you have wronged the other person, to apologize, and to make it right in whatever way possible. Additionally, it is truly a gift to offer forgiveness to one who has wronged you. We never know what guilt, shame, or regrets those we are in relationship with are carrying but are hesitant to discuss.
• Talk about life after the person is gone. Again, terminal illness provides the opportunity to talk about what life will be like once the person is gone. This can involve declarative statements about life, plans, estates, other relationships, etc. It also provides the dying person an opportunity to make reasonable requests. At a minimum, it allows for a discussion about memorial services and funeral arrangements.
One of the more difficult aspects of terminal illness is the conflict between hope for a cure and acceptance of impending death. While these two concepts may seem at odds, they really can be held in a tension together. The truth is that no one knows the future. Talk about plans for treatment and hope for healing while also discussing the possibility of death. Most of us live like death is not ahead, yet deep inside we know it is.
A popular country song by Tim McGraw titled “Live Like You Were Dying” makes the point that diagnosis with an illness can make you stop and take inventory of your life. It can motivate you to do some things you have always wanted to do, to make some changes to your relationships, and to make corrections in your life so that you can live with no regrets. I believe the main point is that we do not have to wait until we are dying to live differently. Each of us has a choice to live a life of gratitude, a life of keeping short accounts, and a life with no regrets. In that sense, living with the reality that life is finite is actually a gift that can help us live life well. In the end, this will help us to grieve well.
Dr. Thomas Barbian is the executive director for the Christian Counseling Center of First Presbyterian Church in Columbia. He received his doctorate in clinical psychology from the Cambridge Graduate School of Psychology and Counseling in Los Angeles. He also holds a master’s degree in marriage, family, and child counseling and a bachelor’s degree in Biblical studies.