GRIEF IS ALL-ENCOMPASSING

Grief affects all aspects of our human experience. Sadness is, of course, the hallmark symptom of grief. It is so pervasive and encompassing that much of the time I think we tend to equate grief with sadness. Acknowledging and expressing sadness are essential functions of the griever, but equating grief with sadness can be problematic on many accounts. Perhaps the most important one is this: when we do not look or feel sad, others may think that we are no longer grieving. In fact, we sometimes deceive ourselves into the sense that we are not — or should not be — grieving, because our sadness is no longer observable.

Researchers who have dedicated their professional lives to the study of grief can tell us that loss not only triggers common psychological responses, but also physical and relational ones. Psychologically, we easily think of grief as emotional, but it can have cognitive, perceptual, and spiritual implications as well. Even limiting our consideration to the emotional aspects of grief, sadness is what we think of most, but anxiety, panic, anger, hostility, irritability, impatience, guilt, regret, frustration, loneliness, yearning, helplessness, apathy, and relief are other common emotions experienced.

Grief can alter our cognitive functioning as well. Perhaps you have seen distractibility, disorganization, impaired decision making, diminished concentration, and pessimism or lack of interest, motivation, or initiative in others who have experienced a monumental loss. In all likelihood, it was not surprising to you to witness those struggles. However, you may have been unprepared for them yourself. Many times, I have heard grieving people describe episodes of "not thinking straight" and then, with a puzzled look, comment, "I don't know what's the matter with me." Of course, the matter was grief.

Perhaps most unsettling are the perceptual disturbances that can accompany grief. The sense that things are not real, that one is not oneself or is absent from one's body, or a sense of dread, the continuous feeling that something bad is about to happen, can be frightening. So can auditory or visual extrasensory experiences. But hearing or seeing the one you have lost, or feeling a sense of his or her presence, can be comforting as well. Depending on a person's background and culture, all of these experiences may fall within the range of a normal grief response.

Life-changing loss can also bring about a spiritual crisis. Hopelessness, despair, a sense of meaninglessness, spiritual confusion, and feelings of spiritual alienation are common. But so are increased spirituality and a renewed search for meaning. Faith can help us cope with loss, or it can be deeply shaken, and these are not mutually exclusive experiences, either. Either or both are normal.

As you can see, uncomplicated grief can take many forms, and even vastly contrasting responses can still be considered typical. This becomes especially important to keep in mind when you are evaluating the grief of others who shared the same, or a similar, relationship with the one you have lost.

Sleep and appetite disturbance may be the physical symptoms most readily associated with grief, but a myriad of other physical responses can be observed. Sleep disturbance can include sleeping too much, sleeping too little, having trouble falling asleep, or waking frequently. Appetite disturbance could mean loss of appetite with weight loss or increased eating with weight gain. Deep sighing, fatigue, low energy, feeling easily exhausted, and trouble remembering or concentrating fall loosely within the category of symptoms professionals identify under the label "psychomotor retardation." Trembling, shaking, twitching, restlessness, searching, pacing, and feeling as if your mind won't be still or turn off fall loosely within the category we label as "psychomotor agitation." Headaches, heart palpitations, shortness of breath, dizziness, nausea, trouble swallowing, numbness and tingling, all of these are commonly reported by people experiencing grief! In fact, almost any physical ailment can be found in the list of physical responses, including vague, diffuse physical complaints which come in waves and can last minutes to hours. Grieving parents, in particular (myself included), have described muscle pain, aches, and soreness. In other words, sometimes, our arms literally ache for the ones we love. It is always a good idea to talk to your doctor about any new physical symptoms you are experiencing, but if you have had a thorough physical exam and received a clean bill of health from your provider, your unusual aches and pains may be a sign of grief.

For many of us, the social or relational experience of grief is one of the most difficult aspects of the grieving process, and surprisingly so. We can be caught off guard by the way grief alters our relationships with others. There are at least two reasons for this that I can identify. One is that when we are grieving we tend to pull away from others. The second is that when we are grieving others tend to pull away from us.

Why do we pull away from others while we grieve? A griever's tendency toward social withdrawal is made worse by the loss of interest, motivation, and energy that relationships require. So much of our energy during grief is focused inwardly that there are not a lot of reserves for the maintenance of existing relationships, let alone the development of new ones. In addition, there is an alienating quality to the griever's experience of the world. It is hard to relate to the day-to-day concerns of most of the population when it feels as though the ground has fallen out from under your feet. Making casual conversation can be insufferable.

Second, people sometimes pull away, even unconsciously, from those who grieve. Afraid of saying or doing the wrong thing, they do or say nothing at all. Even the carefulness of another person's words and actions can be experienced as alienating. When people treat us differently, even if it is because of their sensitivity to our feelings, they are still treating us differently. Sometimes we welcome this as compassionate, but at other times it highlights the isolation we feel, when what we need and long for most is a sense of connectedness. And no discussion of grief and relationships would be complete without acknowledgement of those who cavalierly do and/or say the wrong thing without any sensitivity at all. Their words and actions open and deepen our wounds and are not easily forgotten. Because this is retraumatizing, those of us who have suffered exponential loss can often, even years later, quote verbatim the worst things people said to us when we were raw with grief.

Relationships are changed and sometimes lost, when we are grieving. Mental health folks refer to these as "secondary losses." Secondary losses can include not only the shifting or ending of significant relationships, but also the loss of role and identity, places, patterns, and routines that have been a significant part of our lives, hopes and dreams about the future, or any of the cluster of losses...