The experience of grief

Saturday 1 April, 2017

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On this page: Emotions | Thoughts | Physical wellbeing | Behaviours | Beliefs | Relationships


Grief is not just sadness. It can involve a whole range of reactions and may affect every part of your life – emotions, thoughts, physical wellbeing, behaviour, beliefs and relationships. All these effects can interact with each other and make the experience of grief seem overwhelming at times. The tips in this section may be useful as you come to terms with different aspects of your loss.

"I knew he was going to die, but nothing prepared me for the depth of my sadness when he did. Even though I was surrounded by family, I felt so very alone." – Vanessa

Emotions

Sometimes people are overwhelmed by the intensity of their feelings or find that their mood changes quickly and often. These are natural reactions to the experience of loss and may take some months to settle. Explaining how you are feeling can help family and friends be more understanding of your behaviour at this time.

Numbness

When someone dies, you may feel nothing at first. This may be because you can't believe it's true. It may feel like the person who died will suddenly walk through the door again.

This numbness can be helpful during the first days and weeks after a loss, when you may be making practical arrangements, such as planning and attending the funeral. Don't feel you have to push yourself past this. The sense of numbness will start to fade in a few days or weeks, although it may return from time to time. The reality of your loss will become clearer as time passes.

Sadness

Sometimes you might feel like you will never stop crying. You may long to see the person so much you don't know what to do with yourself and find that the tears are simply beyond your control, sometimes coming when you least expect them. This could mean you avoid going out because you can't predict or control the crying. You might also feel unable to cry, even though

you are terribly sad. Both reactions are common. Often the sadness is ongoing, and it can be hard to work out if this is simply the natural course of your grief, or a sign of more complex grief or depression.

Anger

Many people feel very angry when they are grieving. You may feel angry with your god, the person who has died, the fact of death, yourself, those involved in caring for the person who died, even the person behind you in the supermarket queue, or for no reason at all.

Anger that comes and goes is a natural part of grief. Some people find it helpful to express their anger in a safe environment, such as with a trusted friend or counsellor. Others find that physical activities such as gardening or exercise provide an outlet for their anger.

Relief

You may feel relief that the person has died, especially if they have been unwell for a long time.

Sometimes it's a relief that it has happened at last, that the death you have been worrying about for months is finally a reality you can deal with. You may also feel glad that their suffering is over.

Not everything experienced after a death is negative. While grief can certainly be painful and disruptive, there are often small joys and connections with others. Many people experience positive growth and discover that they have a natural resilience.

If your relationship with the person was challenging or complicated, you may experience a mix of emotions at their loss. Along with sadness, you may feel relief that you are free of the stress. It's hard not to feel guilty about this. We often are expected to idolise or `put someone up on a pedestal' when they have died – but a cancer journey will inevitably show all sides of the people involved in it. The person who died was human, with good traits and bad ones, and you are too.

Guilt and regret

You may feel guilty about the things you did or didn't do. You may wish you had behaved differently towards the person in the recent or distant past or made different decisions about their care, or you might feel that there are things you left unsaid. When someone dies, we lose the opportunity to change things. Try to remember that no-one is perfect. Often, talking it over with someone else helps.

Sometimes people feel guilty when they find themselves joking and laughing, feeling happy at times, or getting on with life. But it is normal to experience a range of emotions as you learn to live with the loss – it doesn't mean that you didn't care about the person or that your grief is not genuine. Emphasising light-hearted or joyful moments can help to counter the lack of control that grief can bring.

Tips for coping with your emotions

  • Accept that your feelings are normal and natural given the loss you have experienced. You might sense pressure from yourself or others to feel a certain way, but everyone has their own style of coping.
  • Be patient with grief. You may feel that after a certain time you should be coping differently to how you are, but your adjustment to the loss is likely to be gradual and may take longer than you expect. (See when to seek professional help.)
  • Remember that it's normal to feel angry. Find safe ways to show emotions such as anger – play vigorous sport, scream in your car with the windows up, paint or draw, or hit a pillow. You may feel silly, but action often helps.
  • Try reflecting on your caring role – you may feel you are stronger than you realised and proud of how you have supported someone as they were dying.
  • Forgive yourself for the things you didn't say or do. Some people find it helps to write a letter to the person and then burn it.
  • Read a book, play a round of cards with a friend or watch a movie that may take your mind off your grief for a little while.
  • Consider whether you would like to try complementary therapies, such as meditation or art therapy, to help you manage any feelings of anxiety or depression.
  • Try to develop a sense of your personal coping style (the things that work best for you). Remembering how you have coped in difficult situations in the past may help you feel more able to cope now.

Fear and anxiety

People often become very fearful when they have a major loss in their life. You may be afraid of what the future holds and how you will cope, or you may feel terribly worried about other people you love, or fear for your own health.

Little things that were no trouble to you before can unsettle you, and you may feel very anxious even if you can't put your finger on any particular worry. Shock and stress can release chemicals such as adrenaline that make it hard to switch off anxiety. Even day-to-day activities such as leaving the house to go for walk or doing the shopping can fill some people with fear. If anxiety or fear is making it hard for you to cope with daily life, talk to your GP or call Cancer Council 13 11 20.

Depression and despair

When the reality of the loss sinks in, you may find your sadness overwhelming and even feel like your life has lost its meaning.

A loss of enjoyment in life and a lack of direction or purpose are common, especially for people who take a long time to come to terms with the loss. However, if these feelings persist for what you consider an extended period of time, it may be a sign of depression. For more information, see if you feel `stuck' or desperate.

For some people, the grief feels so unbearable that they feel that they can't go on. If this happens to you, it is important to seek help. Lifeline provides 24-hour crisis support on 13 11 14. The services listed here also offer support.

Thoughts

Because of the intensity or unpredictable nature of your grief, you may find it hard to get your thoughts in order and may even wonder if you are losing your mind. However, grief often affects the ability to think clearly for a time.

Many people find they become confused and forgetful, and even getting a simple task done seems like a big hurdle. You may feel very indecisive, or you might make rash decisions. If you can, it is best to put off any major decisions for a few months after a bereavement until you can think more clearly.

Tips for managing jumbled thoughts

  • Try not to make any significant changes for a while and take your time with decisions that do need to be made. People may hurry you to sort out clothes and personal items, or decide where you will live long-term. Don't be rushed – you are already having to adjust to a huge change.
  • Ask a family member or friend to help you sort out paperwork. If you have school-age children, a fellow parent could help you keep up with school activities. Writing lists can also help you keep track of things.
  • If you are working, talk to your employer about how much time off you need or negotiate a temporary reduction of hours. Ask them to ensure that your job will be there for you – this will give you peace of mind.
  • Keep a journal. Putting your thoughts on paper can help you process the experience.

Physical wellbeing

Grief is experienced in your body too. The shock of the loss, even if you were expecting it, can trigger the release of adrenaline and other chemicals that can make you feel anxious and lead to a range of other symptoms. Feeling tense, experiencing headaches, feeling sick, unexplained aches and pains, and a tight feeling in the chest and stomach are all common physical responses to grief.

Physical reactions caused by the emotional strain of grief can, in turn, affect your ability to manage your emotions and think clearly. It is a good idea to talk to your doctor about any physical issues that are worrying you or making it harder to cope.

Tips for looking after your physical wellbeing

  • Get some exercise every day. A walk in the morning can shift your mood, clear your head, raise your energy levels for the day and make it easier to sleep at night. You might also like to try swimming, dancing or playing a team sport. Even giving the house a vacuum or mowing the lawn can help if you're feeling tense.
  • Try to maintain regular sleeping hours, going to bed and getting up at set times. Oversleeping can leave you feeling even more exhausted.
  • Don't panic if it is hard to sleep. Get out of bed and do something relaxing, such as reading a book or having a bath, and then try going to bed again. Check with your doctor before trying sleeping tablets or natural sleep remedies.
  • Talk to your doctor about seeing a psychologist for some simple strategies (such as tracking and adjusting your night-time routines) if your lack of sleep is ongoing.
  • Encourage yourself to eat a healthy, balanced diet. If you have lost your appetite, snack frequently on nourishing, easily digested foods.
  • You may find you are eating unhealthy foods or large amounts for comfort. A poor diet can affect your mood, so explore other ways to help yourself feel better, such as getting fresh air and exercise in a park, listening to music, or having a bath or massage.
  • Consider learning meditation or relaxation to help with the anxiety that may trigger sleep issues and stomach upsets. Call 13 11 20 to ask if Cancer Council's meditation and relaxation recordings are available in your area.

Sleep issues

Many people who are bereaved find that their sleep patterns change. Some people find it hard to get up in the morning and end up oversleeping, while others struggle to fall asleep and/or stay asleep.

Exhaustion

Don't be surprised if you have no energy and feel constantly tired. Adjusting to any major change is exhausting, and too little or too much sleep can make you feel even more tired.

Changed appetite

Having little appetite or an increased appetite are both common responses. Some people may also experience an upset stomach.

Behaviours

You may behave differently while you are grieving. Some people make themselves extremely busy, while others may sleep a lot or find it hard to make an effort. Many people avoid reminders of the person who died because of the intense emotions. This can make it difficult to get back into your usual routines.

Some people use alcohol or other non-prescribed drugs to dull the pain. Risk-taking behaviours, including uncharacteristic sexual behaviour, can also be part of grief. While these behaviours may give short-term relief, they can lead to more serious problems.

Tips for establishing helpful behaviours

  • Balance rest and activity. Set small goals and congratulate yourself when you reach them.
  • Decide on a daily routine that includes getting up and dressed by a certain time. `Going through the motions' can help you maintain healthy habits and self-esteem.
  • If you or others around you are concerned about your use of alcohol or other drugs, recognise that it is a sign you need more support and ask your GP for help.
  • Recognise that the first time you return to an activity, such as going to the shops, club, school or work, is likely to be the hardest. It tends to get easier with time, but you might like to ask someone to go with you at first.
  • Pamper yourself in some way every day: a hot bath, a bunch of flowers, a massage, a special magazine, listening to music, or whatever helps.

Beliefs

Your beliefs may be challenged as you question the meaning of the loss. Some people find comfort and strength in their spiritual beliefs, but others feel abandoned at a time of great need. If your faith has been important to you, this can be one of the most unsettling aspects of grief. However, you may find that your search for answers eventually leads to spiritual growth. Whatever your beliefs, even if you are agnostic or atheist, it can be helpful to explore questions about life and death with someone you trust. This process of `meaning-making' can allow you to work the loss into the story of your life and find a new way of being.

Tips for exploring the spiritual impact

  • Draw on your spiritual resources in whatever way is best for you. For some, this will mean praying or going to a place of worship. For others, it will be a walk on the beach or in the bush, or listening to inspirational music – whatever reminds you of a different perspective on life, and a larger way of seeing your situation.
  • Talk about your feelings with a spiritual care practitioner (pastoral carer, chaplain or religious leader). There will usually be one on the palliative care team. You can also ask the hospital social worker if there is someone you can talk to. Accept that having doubts or concerns may be part of a process leading to a stronger sense of your own spirituality.
  • If it feels right to you, follow the mourning customs of your religion. Some people find these provide a reassuring structure for their grief.

Relationships

Grief affects how you interact with the world, your sense of identity and the roles you have within your family or social circle. You may find that your friendships and family relationships change.

A sense of presence

People often report that they see, sense or dream about the person who died, especially in the first few weeks. This can be deeply comforting, or frightening and unexpected. Either way it is a typical experience.

Loneliness

Loneliness is very common and can be intense. After some time has passed, you may still feel your loss very strongly, but everyone around you may seem to have moved on. This can make you feel alone even when you are surrounded by people, and you may withdraw from those around you.

Abandonment

You might feel abandoned and rejected by the person who died, or neglected by the friends you thought would be there for you. You may be surprised by who offers the best support – often it's someone who has experienced a major loss themselves.

Conflict

Because everyone grieves in their own way and in their own time, it is easy to have disagreements with family members and friends after someone dies.

Tips for managing the social impact

  • Even after death, we continue to have connection to people in our lives who have died. Read some ideas for ways to remember.
  • Know that you are not alone. Loss is part of being human. Find someone you can talk to who will listen, or ask your GP about accessing bereavement counselling.
  • Read firsthand accounts of other people who have experienced grief. Find stories online, through bereavement support groups, or through your local library.
  • Join a support or grief group if there is one available, or consider an online group. Call Cancer Council 13 11 20 to find a support group.
  • Talk with the friends, family and staff who provided support while the person was dying. Often it can be helpful to reminisce with the people who were there with you.
  • Ask others for assistance – it will make them feel valued and useful.
  • Take small steps to re-enter your social circle. Even if you are just sitting listening, you are connecting to others.
  • When you feel ready, try to join a social group or take up a new activity. Asking someone to come along with you can make the initial steps feel less daunting.
  • Aim to be gentle and forgiving – with others and yourself. Family members and friends who are also grieving may seem very angry or irrational, but it is part of their reaction to loss. Try not to take it personally, but keep in mind that you are vulnerable too and have the right to protect yourself. You can let someone else support them for a time.

Reviewed by: Kate Jurgens, Bereavement Coordinator, Southern Adelaide Palliative Services, SA; Gabrielle Asprey, Facilitator, Telephone and Internet Support Groups, Cancer Council NSW; Leigh Donovan, Bereavement Coordinator, Paediatric Palliative Care Service, Lady Cilento Children’s Hospital, QLD; Dr Kathryn Dwan, Senior Policy Officer, Palliative Care Australia; Philippa Kirkpatrick, National Policy Manager, Palliative Care Australia; Mary Klasen, Pastoral Care Manager, Mercy Hospital for Women, VIC; Tracey Newnham, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Kerrie Noonan, Clinical Psychologist, Palliative Care, Liverpool Hospital, and Director, The Groundswell Project, NSW.