San Diego Grief Counseling
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Grief and Bereavement

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Counseling for Grief and Bereavement Available

What is Grief or Bereavement?

Grief or bereavement is a natural human response to a significant loss.  Most people experience bereavement after the death of a loved one, but it is also possible to experience grief in response to other losses such as a divorce or a romantic breakup, the loss of your health, home, or job.

Grief and Bereavement Counseling
Bereavement is usually thought of as the emotional suffering we feel after such a loss, and the emotional “roller coaster” one may experience while grieving is difficult, confusing and exhausting.  Depression and anxiety are frequently experienced.  But grief is more complex than just the emotional response.  It also affects us spiritually, physically, cognitively, behaviorally and socially.  The important thing to keep in mind while you are grieving is that, while it may feel unbearable and disorienting at first, grief is actually a healing process and time will help.

Everyone experiences grief differently and the variation in response is vast.  Some of the more common responses include having nightmares, feeling empty or numb, feeling deep sadness, guilt, regret or anger.  One may have a spiritual crisis or notice physical changes such as nausea, dry mouth, weakness, and trouble eating or sleeping.  You may find yourself being absent-minded, withdrawing socially, or not wanting to participate in activities you used to enjoy.  People often express that they feel like they are lost, going mad, or are out of control.  It may seem impossible to make the adjustments you will need to make in the wake of your loss.  All of these are normal reactions.

Will Counseling Help Me?

First, it should be noted that bereavement is a normal part of life for everyone and people often are able to work through the loss on their own with the support of family and friends.  Having a grief counselor, however, may be beneficial for a variety of reasons. Time with a therapist allows the grieving person to focus on their experiences and explore them without external distractions, such as the needs of other people or the demands of daily life. Frequently, people who are grieving need to talk about their story over and over again and do not want to burden family and friends with the retelling; a therapist will listen willingly, knowing how to make that process therapeutic.

If one does not have a lot of support from family and friends, which often happens when they too are grieving, it can help to have outside support.  Grieving people often find that others have unrealistic expectations about the timeline of their recovery or about how one is experiencing grief.  A therapist will be able to help one understand what is normal and realistic.

Grief and Bereavement Counseling
Bereaved people also may need a “time-out” from their roles as a parent, spouse, or from their job, where they are allowed to express their grief and receive support.  If grieving is put off and not dealt with, it may prolong the grieving experience and one may find they feel drained, depressed and exhausted long after the initial loss because their wound has not had a chance to heal. 

Finally, a lot of grieving is about expressing emotion and these emotions may be difficult to deal with, may be unfamiliar, or unacceptable to oneself or others, e.g. anger, guilt, remorse. It is helpful to have a safe place and an accepting person for support while working through these emotions.

Thus, while many people are able to work through their grief independently, accessing additional support from a professional counselor may promote the process of healing.  Learning what is normal, having someone to talk to who will not tire of hearing your story and getting support and guidance from a professional can greatly facilitate the grieving process.

The Grieving Process: The Five Stages of Grief . . . or Not?

Dr. Elisabeth Kübler-Ross and others believe that the grief process can be broken into the “five stages of grief” including (1) denial and isolation, (2) anger, (3) bargaining, (4) depression and (5) acceptance.  The stages may overlap and/or you may experience emotions from different stages at the same time.  Under this theory, it is possible for people to get stuck in one of the first four stages. Their lives can be painful until they move to the fifth stage – acceptance – and it may take some counseling or support for one to move on to this stage.

For many people, the 5 stages of grief model works well.  However, as research has progressed over the past 40 years, many people found the stage model too simplistic and instead began to look at the grieving process more broadly.  John Bowlby, a noted psychiatrist, outlined common experiences and processes such as Shock and Numbness, Volatile Reactions, Yearning and Searching, Disorganization and Despair, and Reorganization.  These processes are described as follows:
  • Shock, numbness and denial: Feelings of unreality, depersonalization, withdrawal, and an anesthetizing of affect. Unable to come to terms with what just occurred.
  • Volatile Reactions: "Whenever one's identity and social order face the possibility of destruction, there is a natural tendency to feel angry, frustrated, helpless, and/or hurt. The volatile reactions of terror, hatred, resentment, and jealousy are often experienced as emotional manifestations of these feelings." (from The Grieving Process by Michael R. Leming and George E. Dickinson)
  • Yearning and Searching: the desire to understand why we lost someone or something and to place the loss in a bigger picture, often includes questioning or rethinking one’s religious or spiritual beliefs.
  • Disorganization and Disrepair: these are the processes we normally associate with bereavement, the mourning and severe pain of being away from the loved person.
  • Reorganization: the assimilation of the loss of something or someone and redefining of life and meaning without the deceased.

How Long Will My Grief Last?

The grief process is a highly individual experience and is largely influenced by one’s culture, religious beliefs, personality, the circumstances of the loss, and the amount of support one receives.  There is no single timeline that applies to everyone.  Depending on circumstances, it may last from months to years.  Rather than concentrating on a specific timeline, it may be more helpful to focus on how the intensity and duration of the grieving process usually proceed.

Grief and Bereavement Counseling
Initially, grief may feel overwhelming and one can feel out of control. With time, people find they are more able to choose when they relive memories and experience emotions, which allows the person to feel more in control again. The intensity of grief one experiences is difficult to quantify or compare.  It is dependant on many things - the degree of attachment to the person or thing, one’s relationship to the deceased or lost item, one’s level of understanding and social support from others, one’s own personality and the nature of the bereavement (e.g., was it a 92 year old grandmother who had a good life, or a young child?).  However, no matter the intensity level, with the passing of time, most people find that they are better able to cope and resume their lives.  The loss remains, and one may always experience a sense of sadness when reminded of the loss, but the intensity is no longer disabling.

What can I expect from family and friends?  Why does it seem like people are avoiding me?

There are several challenges that grieving people often face from their family and friends.  First, misunderstandings can arise when people experience different responses to a shared loss.  People have different needs, different beliefs and different ways of coping.  However, it can be hard for people to understand that others respond differently to grief than they do.  In this case, outside support is important.  Everyone needs to grieve in their own way and on their own timeline and doing individual grief therapy may be beneficial.  If the differences in the way people around you are grieving are causing problems in your relationships, it is also possible to seek couples or family counseling.

Another challenge bereaved people face is that it may seem like friends are avoiding them, which leaves the grieving person feeling abandoned at the worst time.  Most likely what is happening is that these people are feeling extremely uncomfortable with the strong emotions and intensity of the pain of the bereaved person. They may not know what to say or do, and this anxiety leads them to avoid the bereaved person.  However, it is important that the grieving person does not become isolated.  Unfortunately, it may require effort on the part of the grieving person to seek out family, friends, and colleagues and tell them what they need.  Most people do want to offer comfort and help, but they just don’t know what to say and wish to avoid making the grieving person’s pain any worse.  It may help to tell them that all you need is someone to listen and be caring.

Another issue grieving people often run into with family and friends are comments that are meant well but that upset the bereaved person.  Usually these comments stem from one’s lack of understanding about what the grieving person is going through and are meant well.  Try to see the underlying concern behind these comments.  If you feel strongly about it, let the person know why it was upsetting to you.  Alternately, a lot of people are uncomfortable with the pain the grieved person is feeling and will encourage them to “move on” or “let it go” before the bereaved person is ready because they do not know how to handle the continued pain.  It is okay to let these people know that you are not ready.  It may help to also let them know what you need from them at that time (e.g., patience or support).  If you are feeling like your friends and family are no longer able to support you, it may be helpful to talk with a grief counselor, who can provide you with much needed support.

What is “Complicated Grief”?

If one does not get better with time, he or she may be experiencing “complicated grief.”  With “complicated grief,” the grieving process does not progress as expected.  The intensity and duration of grief is prolonged and dramatically interferes with a person’s ability to function. It is often characterized by long-lasting symptoms of depression and anxiety. Deaths such as suicides, murders, car crashes, and almost any other sudden and unexpected death can result in complicated grief simply because they leave people in such shock that they have great difficulty in integrating what happened into their reality.  When the thoughts, feelings, behaviors and reactions to grief persist over long periods of time with little change or improvement, it is important to seek help from a qualified professional because complicated grief does not subside on its own.

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Susannah Muller, Licensed Marriage and Family Therapist #49050
San Diego Counseling & Therapy
5230 Carroll Canyon Rd., Suite 314, San Diego, CA 92121
(619) 787-2743

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