Expanding Our View of Grief

It is more than sadness,grieving takes time

Posted Jun 18, 2012

I recently read an article in the May 17th issue of the "New England Journal of Medicine". It was titled ‘Grief, Depression and the DSM-V”. The author stated that grief typically lasts from 2 to 6 months, after a death . In my mind this is in many ways a dangerous piece of misinformation. We seem to live in a world where we find it difficult to deal with pain, be it emotional or physical. This view of grief, that it persists for longer than 6 months , seems to be part of the effort to make bereavement into a psychiatric illness and offer the bereaved treatment that would lead to their “recovering”.

I have been doing research for many years, first with the widowed, and more recently with families, with children, in which a parent died. This latter research is background for this blog. I have never met anyone whose grief ended in 2-6 months. None of the families I studied, in particular in the Harvard, MGH Child Bereavement Study, found any quick resolution of their grief.

What is involved when we grieve? Dealing with grief involves much more than the sadness we typically associate with it. With the death of a key family member, the disruption in family life caused by the death leads to changes in the way the bereaved live with and experience feelings. These are often new and strange feelings, often not felt before, that are associated with the loss..This is especially true for children. However, feelings of sadness and the many ways in which this can be expressed is only one part of what a mourner is experiencing. Mourning also involves dealing with change. It takes time to find new ways to live, to reorganize lives, as well as how to deal with feelings. Each family has its own time table. The bereaved often ask if something is wrong with them when they cannot meet the unrealistic expectations of friends and family who are trying to help.

There is no quick way to make things better. In fact there is no “recovery”. It is almost impossible to return to life as it was before. Mourning is not an illness from which we recover. We all need to become experts as we face an inevitable part of our life cycle, primarily associated with aging. However, for most of you reading this blog the death of a child or a spouse is out of turn in the life cycle. If we sometimes feel unprepared for the death of an elderly parent or friend, how much more are we unprepared for the death of a spouse leaving a widow or widower to raise dependent children? If the focus is only on the sadness, the pain associated with this loss, we are only dealing with part of the problem. We need to also focus on changes in family life that result from the death. What does a widowed parent need to know as they become a single parent head of household? At different ages the meaning and impact of the death for their children with be different and the widowed parent needs to consider this as well.

I can offer several examples of what changes are obvious. I am thinking of a teen age boy who told his mother, a few weeks after his father’s death, that he would leave school and go to work to help the family manage financially. His mother reassured him that this was not necessary. Their father had left her with enough money to pay the rent and if she found a job they could manage well enough while her son finished high school. A father I met told his four children that each of them would have to help with various chores around the house. In this way they could manage to continue to live as a family. He also hired a baby sitter to be there when they came home from school so they didn’t have to come to an empty house. There are several ways the surviving family can manage when they transition from two incomes to one. Children are the beneficiaries of their mother’s social security benefits after her death. This often provides father with money for baby sitters to be there when children come home from school. All these changes do not happen overnight. We can see that dealing with change is a critical aspect of the grieving process, compounded by the sadness and all the feelings that go with this.

We need to find ways of talking about grief, not as an illness from which we will recover, but as part of living, that brings with it a range of difficult feelings but also the need to deal with change. Should we be learning about grief before we are faced with a death in our own lives? I am not sure that grief is something we can really understand until we experience it. But at least, we can learn not to give unnecessary advice or poorly informed advice. We can appreciate the importance of friendship and support.

Where do we begin to learn? I am not sure, but I think it can begin in religious communities that would focus on more than the religious traditions that deal with death. It can begin in the schools. Teachers could have age appropriate discussions when death is mentioned in books they are reading in class. I am fascinated by something I learned from the program director at the Children’s Room. She talked about a group of high school students who are thinking of ways to teach their peers about what it is like to grieve. I talk about the value of the bereaved helping each other. Can they also become teachers in their own communities?

We can learn from books written by the bereaved about their experience. I am reminded of a book I wrote about in a blog last year titled "MILO" . The author Alan Silberberg write about his own experience after his mother’s death when he was a young teenager.