21st Century Aging

Living longer and better.

How We Misinterpret Grief

What People Who Are Grieving Should Know

Grieving is often a familiar term to mental health professionals. Given my experience with patients, however, I think it is a mistake to assume that this term makes sense to everyone. In our fast-paced world and one in which we are frequently kept moving and distracted, the concept of grieving, at least as psychologists understand it, is not well understood. Especially in today’s times we can keep ourselves so busy, we can avoid absorbing loss.  

People react to loss in different ways, however. One mistake, as I see it in the medical and psychological literature, is that there is an assumption that we all grieve the same way. Further, there is also a disquieting trend to label grief reactions as normal or abnormal. 

As a point of departure, grief involves sadness and other feelings (that may or may not be overwhelming) related to the loss of something, often a relationship.  These losses can be varied but include the loss of someone because of death.

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Many in the fields of medicine and psychology have articulated ways of how people should grieve. This is not a stance I wish to take. There are a number of problems with prescribed methods of grief and so-called stages of grieving.  The main problem with this literature is that grieving is as individual as relationships and intrapersonal psychology are. In other words, there is no right or wrong way to grieve.            

Regarding the death of someone close, some professionals have tended to categorize grief into two categories:  so called “normal” grief and “pathological” grief.

I am wary of descriptions of pathological grief or even descriptions of so-called normal grief.  In almost 20 years, I have seen people react to loss in a variety of ways.  People I have seen in decade-long marriages that have experienced the death of a partner, has made me hesitant to diagnose people who are bereaved.  I have seen many men and women reporting good relationships who have lost their partner in the 4th, 5th or even 6th decade of their marriages. Such a loss cannot be comprehended by those who do not have close marriages or who do not have marriages that have lasted this long. 

I remember one man telling me after his wife of nearly 60 years died, “Everything we did, we did together. What am I supposed to do now?  We talked about it—death, we did, but we never really knew how each of us would manage.”  This man did go on to develop symptoms consistent with depression, but I found myself thinking, “Who am I to judge his response? This hardly seems abnormal, given the context.”  Especially at the time, I was relatively young and felt ill-prepared to pronounce his condition, as we often do when we diagnose people. But even now, I find myself critical of models of grieving that are so prevalent in the fields of medicine and psychology.

In contrast, I have seen people in long marriages seemingly move on quite well after losing a spouse.  Some people might look for another partner right away and some never think of being with a partner again. Either way, as long as people are comfortable with how they do things, I feel uncomfortable making a determination about how someone is coping.

Relationships are all very unique. We can never really know what two people mean to one another. When we diagnose grieving, we assume some special knowledge about a relationship that we have had no part of. Though diagnosing actual mental illness can provide a benefit to patients, I am dubious of those in psychology and medicine that feel a need to label and categorize grief.

I am not alone in this thinking.  Other authors have criticized North American models of grief including the assumptions that grief follows a specific pattern, the experience of grief as finite, that grief occurs in stages, that prolonged grief is abnormal, and that the “working through” of the grief process is necessary. These authors, Breen and O’Connor, go on to point out that the way some have framed “normal” grief reactions sets patients up for being pathologized; when patients show too much emotion, or contrastingly, not enough, they are set up for the perception of not grieving in the “right way.” Indeed, there is a curious tendency of some to evaluate where someone is in the grief process.

An article in a 2010 The New Yorker furthers the argument about the limitations of a one-size fits all model for grief. The author, Megan O’Rourke, points out the inherent problems in stage models of grief. People fluctuate in their feelings about loss—sometimes they feel okay and sometimes they do not. The article points out that some people can be remarkably resilient about grief. Some people simply do not need to grieve intensely, even if someone they love has died. 

There is no right or wrong way to grieve.

People have all kinds of different strategies for managing emotions. Individuals as well as relationships are complex and unique. Grieving is similar.

Ideas about what is normal about grieving should not be imposed; as outsiders we never really know the true story of a close relationship.

Perhaps as a culture we should let go of ideas of “normal” grief and what this should mean. Let’s permit people who are actually grieving tell us what they experience.  

 

Tamara McClintock Greenberg, Psy.D., M.S., is an Associate Clinical Professor of Psychiatry at the University of California, San Francisco.

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