Nine Essential Tips When Dealing with Grief
Defining the Loss
We grieve for what we have actually lost and for the hopes and dreams we had prior to the loss.
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Loss can be: Objective, i.e., the loss of someone or Symbolic, i.e., the loss of a role, job, etc.1
We grieve both for what we have actually lost and for the hopes and dreams we had prior to the loss
The experience of loss can be: Singular, i.e., when someone has died or a unique event that takes place) or Cumulative and recurrent, such as multiple losses experienced by healthcare workers
An objective loss can also trigger other symbolic losses (i.e. death of a husband, also includes the loss of your role as a “wife”)
The Meaning Behind Grief
When we grieve, we try to make sense of a loss. The goal of grief is to re-adjust to your new environment with this loss, and to make sense of your beliefs.
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When we grieve, we try to make sense of a loss People live with certain expectations or beliefs about the world (i.e. good things happen to good people; the world is a safe place) that can be challenged when a loss happens1 The goal of grief is to re-adjust to your new environment with this loss, and to try to make sense of your beliefs, so that you can re-establish your sense of purpose in the world, and you can move forward with both old and new relationships 1,2
Recognizing Signs of Grief
Intensity can differ and last from days to years. Signs include: sadness, anxiety, anger, guilt,isolation, unable to work, insomnia, denial, and somatic complaints.
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Different intensities of grief can be experienced which can last from days to years.
Signs of grief are2,6:
Emotional - sadness, depression, loneliness, hopelessness, anger, anxiety, etc.
Behavioural/Social - unable to perform other roles (i.e. work), isolation, sleep difficulties, change in appetite, etc.
Thoughts - denial, confusion, pre-occupation, hallucinations, etc.
Physical - weight loss, lump in throat, tightness in chest, feeling as if there is a physical separation between yourself and your immediate environment, etc.
Timeline for Grief
Grief is a loss and requires time to heal, however there is no set timeline. Take the time you need. Loss stays with you, but the intensity may come and go. There is no real end point to grief. You may need to delay grief if other responsibilities need attention, thereby shifting the timeline.
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Like physical injury, we can think of grief as an emotional injury that is experienced when a loss occurs, thus it requires time to heal 2,3
Grief is a natural process that takes different amounts of time for different people
There is no set timeline for grief; try to give yourself permission to take the time you need and to express your grief to a safe and compassionate person4
Delayed Grief: happens if other responsibilities need immediate action. This shifts the timeline
Identifying your Work Culture
Losses can happen as part of your job. Identify how your workplace allows for acknowledging loss. Grieving needs to take place outside of work as well and self-care can help.
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Losses can happen as a part of your professional role (e.g., nurse, doctor, social worker, porter, facilities person, administration, manager)
How does your professional or work culture mark grief? How much does this overlap with your personal or immediate needs when a loss occurs?
Even if loss is acknowledged in the workplace, remember that grieving a loss needs to take place outside of work, focusing on self-care activities allowing you to “recenter and reconnect” with yourself and your personal relationships7
Doing the Grief Work
Grieving is an active process. Here are four tasks that can help: Accept the reality, Process grief & pain, Adjust to the world with the loss, and Find a connection with the loss.
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Grieving is an active process. J. William Worden (2018) identified four tasks of grief work that can help individuals move from feelings of disbelief towards a renewed relationship with loss
These are targeted towards a physical loss (i.e. death of a person) however can apply to symbolic losses as well
These tasks are not linear and you can shift back and forth through tasks as needed
Worden’s Four Tasks of Grief2:
Accept the Reality of the Loss Gradually acknowledged what has been lost, moving past the initial experience of denial, and turning oneself towards the reality of the situation
Process Grief and Pain Society/work culture may reinforce feelings of denial by indirectly communicating that grief should be brief, or encouraging you to deny your feelings Work through your feelings by naming the feelings and thoughts that accompany them, and connecting with others who are supportive to talk about loss when it feels safe
Adjust to the World with the Loss External Adjustments: Taking on new/different roles (i.e. balancing financials, doing chores around the house) Internal Adjustments: Addressing how this loss affects your self-esteem or your belief in your ability to achieve desired goals by asking yourself: “Who am I now?” Spiritual Adjustments: Evaluating how the loss affects your beliefs, values, and assumptions about the world, and trying to make sense of any changes that challenge previous beliefs (See the Section on ‘The Meaning Behind Grief’)
Find a connection with the loss while starting your new journey Grief is not about forgetting about the loss, but incorporating your experince of loss into “new patterns of living” (p.52 Attig, 1996 as cited in Worden, 2018)
If you feel stuck in any of these tasks, take a moment to check in with yourself (see the section on ‘When to Reach out for Help’)
Grief Anniversaries
Dates, favourites, seasons, songs, places, etc., may remind you of the loss. Be aware of what might trigger you and consciously prepare yourself.
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Many dates can remind you of loss:
Special Dates4: Birthdays, anniversaries, important holidays or celebration days (i.e. Mother’s day, Father’s day)
Calendar dates: Dates that were previously mundane can pop up in your calendar as newly significant. These may include the date of a significant diagnosis or new treatment being pursued, and the date or month of the loss4
Physical Dates: As the years pass, your body may remind you of important dates before you even remember them, through physical sensations including feelings of heaviness and concentration difficulties (i.e. misplacing you items)
Engaging in Self-Care
Grief can have an impact on many levels. Focusing on self-care can help you take care of yourself as you grieve. Focus on nutrition, exercise, sleep, hygiene, health management, etc.
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Symptoms of grief can have an impact on may levels, including nutrition, sleep, exercise, hygiene, socialization, managing health, etc.
Allow yourself time to address these areas to take care of yourself as you grieve
If you are struggling with health care management, consider speaking with your family physician and/ or a mental health practitioner who may provide some guidance with engagement in self-care tasks
Knowing When to Reach out for Help
Reach out for help when you need it, there are many resources available.
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Consider reaching out for support if you are experiencing any
of the following5
When feelings of grief are absent (especially if the loss was important to you)
Physiological complaints with no medical explanation after these medical complaints have been investigated by a doctor
Unrelenting social isolation
Difficulty moving past the denial of the loss, long-term expression of intense grief symptoms (usually because of unexpected loss)
If you do need help, there are many resources available
Adapted from the following works:
Kauffman, J. (2014). Loss of the assumptive world: atheory of traumatic loss. New York, NY: Routledge.
Worden, W. J. (2018). Grief Counselling and GriefTherapy. Fifth Edition. A handbook for the Mental Health Practitioners. LLC, New York, NY: Springer Publishing Company.
Stroebe, M. (2015). Is grief a disease? Why Engel posed the question. Journal of Death and Dying, 71(3),1-8. https://doi.org/10.1177/0030222815575504
Martin, J.D., &Ferris, F.D. (1992). I can’t stop crying. It’s so hard when someone you love dies. Toronto, ON: Key Porter Books Ltd.
Rando, T. (1984). Grief, Dying, and Death. Clinical Interventions for Caregivers. Champaign IL: Research Press.
Trauma and Grief: A comparative Analysis (p. 681- 696) In perspectives on loss. A sourcebook (1998). Ed. Harvey, J.H. New York, NY: Routledge.
Papadatou, D. (2000). A proposed model of health professionals grieving process. Omega 41(1) 59-77.
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