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About Grief and Loss

Introduction How Can a Social Worker Help?
Healing and Time When Someone You Know Is Grieving
Stages Needing More Than Just an Open Ear
Living With the Overwhelming Loss

Introduction

If you are grieving the loss of a loved one, no one needs to remind you just how devastated you may be feeling. It is perhaps one of the darkest, most stressful periods in your life. As painful as it is to be in this state, it is a normal, healthy reaction to a loss. Thankfully, it does not last forever.

Although some people who are grieving become physically ill and are unable to eat or sleep, others report feeling numb; still others may isolate themselves, preferring to be left completely alone to their sadness. Everyone experiences grief differently.

Regardless of exactly how grief manifests itself, trust that the upheaval you are feeling is normal and universal. Most people experience a range of emotions, which can include the following:

  • Anger
  • Denial
  • Disbelief
  • Shock
  • Confusion
  • Sadness
  • Guilt
  • Yearning

Likewise, many people who are grieving speak of very real physical symptoms, such as:

  • Loss of appetite
  • Low energy level
  • Stomach upset
  • Headaches
  • Sleep disturbances

Mourning can seriously deplete your body's natural defenses, leaving you vulnerable to infection and illness. Existing conditions can worsen or new symptoms may develop. Sadness can give way to major depression, which necessitates professional treatment.

Healing and Time

Many people are surprised by the intensity and duration of their feelings and how quickly their emotions may swing from despair to anger and then back again to shock. This too is normal. Often, the feelings come in waves and can be quite overwhelming.

Grief is a process that takes time. Trust that, while you will never stop yearning for or missing your loved one, the pain will ease eventually.

Also keep in mind that grieving isn't always the result of a death. People grieve after other major losses such as a divorce or a move away from a familiar, comfortable place.

Stages

Immediately after the death of a loved one, people experience bereavement, which is defined as "to be deprived by death." This is a period of deep grieving.

Mourning is the actual process you go through to help you to accept a major loss. This may include religious rituals honoring the person or getting together with friends and family to share the loss. Like grief, mourning is highly personal and can last for months, even years, depending upon your background and traditions. In some Mediterranean cultures, for example, widows were once expected to dress in black for the rest of their lives. In other societies, those in mourning forgo special events or celebrations out of "respect" for the dead.

Losing a loved one is always difficult, but how you react will depend much upon the circumstances of the death. A shocking, unexpected death will unleash different feelings than a death that followed a long, drawn-out illness. Likewise, your relationship to the person is a factor in how you react.

  • Death of a spouse can be very traumatic. In addition to the actual loss of a loved one, you may face potential financial woes, especially if that person was the family's main breadwinner. In addition, a surviving spouse may suddenly have to assume all parenting and household responsibilities solo, which calls for a major readjustment.

  • Death of a child can evoke an overwhelming sense of injustice and guilt. No matter what the circumstances were, a parent may feel completely responsible for the death, as irrational as it may seem.

  • Death via suicide may leave the survivors feeling angry, ashamed, guilty, and even responsible for the death. Suicide is one of the most difficult, disturbing deaths to mourn.

Living With the Overwhelming Loss

Suppressing your feelings does not work. Allowing yourself to grieve is perhaps the healthiest, most effective way to deal with the loss. You can do this in a number of ways, including these:

  • Express your feelings – Whether you write them down in your personal journal, or confide them to a trusted friend, it's important to vent your feelings.

  • Look for caring people – Join a support group with others who're experiencing the kind of loss you face. Spend time with relatives and friends who understand your situation and are willing to listen to you. Not everyone has this gift.

  • Avoid making major life changes – Changing jobs, moving, or deciding to have another baby is not advisable just now. It's better to wait a while and gradually adjust to the loss.

  • Look after your own health – The hard work of grieving is stressful and depletes you. Don't ignore regular check ups with your physician. Be mindful of how easy it is to become dependent upon alcohol or medication to ease your pain. Hard as it may be, it pays to eat well, exercise, and get adequate rest.

  • Be patient. It can take months, even years to fully process and accept the loss. Ignore those who urge you to "snap out of it," or those who question why you're not "getting over it." Grief is experienced very personally on an individual time-line.

  • Seek professional help – If your grief is unbearable, or if you are simply unable to function, it's a good idea to speak to a professional to help work through your grief.
How Can a Social Worker Help?

From linking you with an appropriate support group to helping you make sense of the barrage of official paperwork you must fill out (death certificate, insurance forms, medical bills), social workers can help in a big way. They can point you in the direction of services to which you may be entitled, such as local organizations that can assist you or federal agencies such as the Veterans Administration, which also offer death benefits to families.

A social worker can also help you to determine whether you would benefit from a few sessions with a skilled therapist who can help you sift through the overwhelming, even conflicting feelings you may be experiencing.

Remember, help starts here.

While some social workers work in a hospital, school, or other institutional setting, others in private practice may be self-employed. Social workers make up the largest number of mental health practitioners in the country, and are located in every community.

When Someone You Know Is Grieving

When a friend, neighbor, or relative has lost someone close, you can help them to grieve through their loss.

  • Listen. Allow or even encourage them to talk about their feelings and to share their stories and memories of the deceased.
  • Avoid offering false comfort. Telling someone, "you'll get over it," or "don't worry, it was all for the best," is not helpful. A direct expression of sympathy, "I'm sorry," is far more effective, as is lending an ear.
  • Think practically. Offer to prepare a meal, baby-sit a child, or run errands. A grieving person is overwhelmed and may simply need an extra pair of hands to tend to the practical realities of living.

Do They (or You) Need More Than Just an Open Ear?

If you find yourself using alcohol or drugs (and that includes prescription drugs) excessively following the loss of a love one, do seek out professional help.

Likewise, if you are deeply depressed to the point of feeling suicidal, or simply unable to cope with even the simplest tasks of daily living, contact a mental health professional. Remember, it's not a sign of weakness to admit that you need help. It's a sign of strength.

It's also important to know that you will get through this stage. People the world over endure the losses of loved ones, and do survive. You will, too.

For additional information, contact these organizations:

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Addictions Tip Sheet: What To Do If Your Partner Is Alcoholic

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My Partner Is Alcoholic.   What Can I Do?

Many problem drinkers are unable to admit to this problem. The cry for help may therefore come from someone close who suffers as a result. The cry often comes at a time when he or she is unable to cope any longer with the drinker. As such, the drinker may self-righteously feel they do not have a problem as they had been drinking like this for years. They may resist treatment and often blame others for their problems. Many marriages fail at this point. One spouse can no longer tolerate the alcohol and the alcoholic refuses to take responsibility. This makes treatment of alcoholics extremely difficult.

It is important for people to understand the stages of recovery and that each stage carries challenges that some alcoholics will struggle for a long time to overcome. Five stages of recovery are discussed: precontemplation, contemplation, preparation, action and maintenance.1

The Five Stages of Recovery

In the precontemplation stage, the alcohol problem has not yet been identified let alone accepted by the alcoholic. During this stage, their defences, most notably denial, are strong. They actively reject any notion of alcohol problems and show anger towards anyone suggesting a problem. They reject treatment and may rely on the support of their drinking buddies to affirm that they do not have a problem.

In the contemplation stage, the alcoholic toys with and finally accepts that they have a problem with alcohol. This acceptance can be overwhelming, at times leading to depression and/or anxiety. These intense feelings must be expected and planned for as part of a treatment process.

In the preparation stage, the alcoholic learns what treatment is necessary in order to recover. Depending on the severity, this can include detoxification, inpatient or outpatient counseling and marital and/or family therapy and possibly even prescription medications.

The next stage, action, is when the treatment plan is implemented and activities are undertaken to address the alcoholism. The support of family and sober friends is crucial here as alcoholics learn to defend themselves, not from admitting alcoholism, but from being pulled back towards drinking by former drinking buddies. Also crucial at this stage is developing an understanding of one's own family history that may have contributed to their drinking problems.

The final stage involves relapse prevention and is referred to as maintenance. This stage is life-long. One of the best-known maintenance programs is Alcoholics Anonymous (AA). This program is based upon self-help, group model. Members meet regularly to manage the challenges of sobriety.

Recovery from alcohol starts with clear, blunt information from friends and family, and by trained professionals such as physicians, social workers or psychologists. Some family and even some professionals beat around the bush when confronting an alcoholic. This is music to the alcoholic's ears. Fuzzy messages allow them to maintain their denial. Thus, one must clearly and fully confront the alcoholic. Clear messages leave no wiggle room.

If you think your spouse has a problem with alcohol:

1. Confront him or her forthrightly. If you are concerned for your safety, then do so in the company of a friend or professional.

2. Get help for yourself too. Learn about alcoholism, your role in the recovery process and of the impact on your family's well-being.

3. Recognize that it may take some time if your spouse is in the first stage of recovery. He or she has yet to even acknowledge a problem. This can be an insurmountable challenge for some people.

4. Recognize that alcoholism can pose a risk not only to the alcoholic but also to those around him or her. At all times, make sure children are appropriately supervised and cared for. Alcohol related problems are a major cause for referrals to child protective services.

Lastly, can a therapist help? Yes, but unfortunately, not in all cases. Much will depend on the stage of recovery, the willingness of the alcoholic to change, the social supports available and a good treatment plan.

1. DiClemente, C.C., Bellino, L.E. and Neavins, T.M. Motivation for Change and Alcoholism Treatment. National Institute on Alcohol Abuse and Alcoholism. Alcohol Research and Health .23:2. 1999.

To read more articles by Gary Direnfeld, MSW, RSW, go to www.yoursocialworker.com

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The opinions expressed in this article are those of the writer, and do not necessarily reflect those of the National Association of Social Workers or its members.

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