Losing a loved one feels disorienting. Feelings of anguish, disbelief, sadness, love, numbness, and anger can appear in confusing clusters. If we live long enough, we will all face the loss of many loved ones. I've lost two dear friends in the last few months. Memories of laughter, warm hugs, and meaningful conversations simultaneously produce comfort and sadness.
Some face difficult losses in childhood. My friend, author Madonna Treadway, lost both of her parents before the age of eight. In her book, Six Healing Questions: A Gentle Path to Facing Childhood Loss of a Parent, she describes her grief as a "lump in the back of my throat that has always been stuck there." It wasn't until she entered her forties that she noticed how guarded and detached she was in her relationships (Treadway, M. 2019). Psychotherapy helped her examine her early losses with a gentle curiosity. She learned how to reclaim repressed parts of herself by acknowledging the feelings she could not understand as a child.
Most people are resilient. Research shows that 60% of grieving individuals show no signs of depression or functional impairment six months after suffering the loss. During bereavement, healthy people will fluctuate between missing their loved ones, managing loss-related stresses, and the stress of adapting to new roles. We juggle those pressures while mustering energy for our day-to-day responsibilities (Stroebe, M. et al. 2010). In her memoir about grief, Joan Didion writes, "Grief comes in waves, paroxysms, sudden apprehensions that weaken the knees and blind the eyes and obliterate the dailiness of life."
Yes, often, a spasm of grief demands our attention, demolishing our sense of normal. Yet, in a large-scale study of both spousal and child bereavement, researchers found four distinct outcomes:
When we lose a loved one, we must reconcile conflicting information. Our loved one exists forever in our memories, heart, and life story. Yet we have new information that this loved one no longer exists. Here, but not here. This cognitive dissonance feels disorienting, strange, and confusing (O'Connor, M. et al., 2022).
For example, my dear friend, Suzanne Spector, passed away last month. We met in a writing group years ago. She provided valuable insights and encouragement as I wrote my book, Frazzlebrain. I was one of the first readers of her inspiring memoir, Naked at the Helm. Her influence, voice, humor, and kindness feel everlasting. Her book is on my shelf, a permanent reminder of her significant presence in my life. Yet, as I anticipate her celebration of life this month, I must face that she's gone (Spector, S. 2022).
Many feel surprised that grief leaves them exhausted and spent. The brain uses a lot of energy when it grieves. When we lose a spouse, we must learn a whole new way of being in the world. How do we manage day-to-day life and the need for affection, someone to talk to and cook with? Everyday life is shattered, and a new life must be rebuilt. Yet that loved one still exists in memory, in the objects we use in our home, in the love we share with other family members.
All losses require adaptation or new learning. When you wreck your car in an accident, you must adapt to a different vehicle, managing the stress of insurance and personal injuries. The loss of a loved one can make you feel like your life is in shambles.
Losing a spouse represents a change of identity. One goes from married to widow or widower. We need to relearn how to behave both privately and publicly. When we learn new ways to engage with life and find satisfaction, comfort, and meaning, we cope better.
Around 7 to 10 percent of bereaved individuals suffer from the diagnosis of Prolonged Grief Disorder (PGD) (Szuhany et al., 2021). If an adult still has difficulty re-engaging with life one year after the loss of a loved one, they may be experiencing PGD. Other symptoms include intense emotional pain, such as bitterness and sorrow, feelings of numbness, and avoidance of situations that remind them of their loss (APA, 2022).
Losing a loved one can feel like withdrawal from opiates. Yearning for our deceased partner can mimic the craving for a drug. It's excruciating when an absent loved one feels like one's sole source of happiness. Stomach aches, headaches, sadness, and sleep disturbances appear as disruptions of the brain's reward system. These are the same neural pathways associated with addiction (Kakarala S. et al., 2020).
In one study, a small sample of subjects suffering from PGD were given Naltrexone, a drug meant to block opiate rewards. Those subjects could no longer get the same emotional payoff from the dopamine reward system that they received from dwelling on memories of the deceased. The subjects sought out other, more rewarding behaviors that aided their recovery.
Researchers found disruptions in oxytocin processing and reward system processing in those who suffered from PGD. This suggests that some may remain stuck in grief to avoid fully facing the loss of a loved one. Sometimes the pain of grief can make us feel emotionally connected to those we’ve lost. Letting go of painful grief can feel like letting go of love. (Kakarala, S. et al. 2020).
Grief can be complicated. Death often arrives at inconvenient times. Financial, emotional, and physical stresses can combine to shake our foundations of security. Worries can lead to rumination, sleep issues, and obsessive yearning for the deceased. It helps to find a supportive therapist, a grief and loss support group, and support for reintegration into a new life routine. Cognitive-behavioral therapy focusing on goal setting, coping skill rehearsals, and positive reinforcement can help.
In a study of mind-body interventions, researchers found that mindfulness training and progressive muscle relaxation helped reduce rumination and the severity of grief symptoms. Mindfulness Training involves paying attention to the present moment, on purpose, without judging that moment as good or bad.
Progressive muscle relaxation requires paying attention to various muscle groups in your body. You first tense the muscles and then release them, with deep breathing included to reduce tension. You can start with your face and move down the body, tensing and relaxing each muscle group (Knowles, L. M. et al., 2021).
The task of grief is to learn how to let go of a loved one while retaining the love you feel for that person (Worden, J. W. 2008). As composer Irving Berlin said, "The song is ended, but the melody lingers on." If we remain open to the music of life, it will always offer up new songs to learn and love.
References
American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). American Psychiatric Association Publishing. https://www.psychiatry.org/psychiatrists/practice/dsm
Knowles, L. M., Jovel, K. S., Mayer, C. M., Bottrill, K. C., Kaszniak, A. W., Sbarra, D. A., Lawrence, E. E., & O'Connor, M.-F. (2021). A controlled trial of two mind–body interventions for grief in widows and widowers. Journal of Consulting and Clinical Psychology, 89(7), 640–654. https://doi.org/10.1037/ccp0000653
Kakarala, S., Roberts, K., Rogers, M., Coats, T., Falzarano, F., Gang, J., Chilov, M., Avery, J., Maciejewski, P., Lichtenthal, W., & Prigerson, H. (2020). The Neurobiological Reward System in Prolonged Grief Disorder (PGD): A Systematic Review. Psychiatry Research. Neuroimaging, 303, 111135. https://doi.org/10.1016/j.pscychresns.2020.111135
Maccallum F, Galatzer-Levy IR, Bonanno GA. Trajectories of depression following spousal and child bereavement: A comparison of the heterogeneity in outcomes. J Psychiatr Res. 2015 Oct;69:72-9. doi: 10.1016/j.jpsychires.2015.07.017. Epub 2015 Jul 17. PMID: 26343597.
O'Connor, M., & Seeley, S. H. (2022). Grieving as a form of learning: Insights from neuroscience applied to grief and loss. Current Opinion in Psychology, 43, 317-322. https://doi.org/10.1016/j.copsyc.2021.08.019
Stroebe MS, Schut H. The dual process model of coping with bereavement: a decade on. Omega. 2010;61:273–89.
Szuhany, K. L., Malgaroli, M., Miron, C. D., & Simon, N. M. (2021). Prolonged Grief Disorder: Course, Diagnosis, Assessment, and Treatment. Focus (American Psychiatric Publishing), 19(2), 161–172. https://doi.org/10.1176/appi.focus.20200052
Worden JW (2008). Grief counseling and grief therapy: a handbook for the mental health practitioner (4th ed.). New York: Springer.
Spector, S. (2022) Naked at the Helm: Independence and Intimacy in the second half of life. She Writes Press, Berkeley, CA.
Treadway, M. (2020) Six Healing Questions: A gentle path to facing childhood loss of a parent. MCM Publishing, San Diego, CA.
login
who are we?
contact us
qosheapp
Toi Staff
Gideon Levy
Belen Fernandez
Mort Laitner
Rami G Khouri
Ali Fathollah-Nejad
Nikkei Editorial
visit website
