How to Cope with Grief and Loss

By Mika Ono

Why grieve? According to Scripps Research Institute Counseling Psychologist Daphne Lurie, who spoke recently as part of the Scripps California Lunch & Learn series for employees, we grieve because it is a necessary part of coping with loss—loss of health, a job, a relationship, a dream, but especially of people close to us.

"The Scripps Research community has suffered a number of profound losses over the last year," she said. "Perhaps nothing is more universal than loss, yet coping with the pain of loss is perhaps the hardest work we will ever do."

Lurie noted grief is multifaceted, and its effects can creep into many parts of our life. Grief encompasses physical symptoms such as fatigue, loss of appetite, and dizziness; cognitive symptoms in which your thoughts are clouded by your experience of loss; emotional reactions—which can change with dizzying speeds—including fear, anger, relief, despair, guilt, agitation, sorrow, and numbness; social/behavioral signs including anger and disappointment with others; and spiritual effects, either deepening or undermining previous religious or philosophical beliefs.

Myth Versus Reality

Myths about grief abound, said Lurie, and these unrealistic expectations can interfere with our ability to cope.

MYTH: Grief is time-limited. REALITY: Grief has no schedule. It's common that the people around you will offer support for the first few days or weeks following a loss, but then they start to tell you that it's time to move on. But that's not the way it works. Lurie compared the experience of grief to a roller coaster, with ups and downs, highs and lows, affecting you even years after a significant loss. The hope is that, with enough time, the lows will be less low and that they will hit less often.

MYTH: Grief is a sign of weakness. REALITY: Grief is a necessity, according to Lurie, and it takes a great deal of courage to face what devastates us. "Grief is one of the most natural processes in the world," she said. By giving yourself permission to grieve, you also send the message that it's okay for the people around you to grieve, too.

MYTH: The emotions of grief follow a clear step-by-step process. REALITY: Swiss psychiatrist Elizabeth Kubler-Ross, in her 1969 book On Death and Dying, laid out a five-stage process of grief: denial, anger, bargaining, depression, and finally acceptance. However, subsequent research has shown that people go in and out of all of these steps, as well as other emotions, in no particular order. "It's a back and forth experience," said Lurie.

MYTH: A failure to cry means that you aren't affected by the loss. REALITY: People have different ways of coping. "Some people have easy access to tears," said Lurie. "Other people go into shock, feel numb, or simply grieve in their own, individual way."

Tips on Coping with Grief and Loss

The intensity of your reaction to loss will be affected by factors beyond your control, such as how the person died and how close you were to the person. However, your reaction can also be mitigated by your attitude towards loss and the support of people around you.

Lurie offered the following tips for those coping with loss:

• Set fair expectations. Don't expect too much of yourself too soon. Do what you can, rather than worrying about what you "should" do. Sometimes you need to focus on just taking care of yourself—getting enough sleep, eating well, exercising, and avoiding drugs and alcohol. "Sometimes the simplest things are the most important," she said.
• Practice patience. Remind yourself that plenty of things can wait. Don't make big decisions in a time of grief, as your judgment may be clouded. Take time to rest, to be with the people who support you, to be alone with your thoughts...
• Gather information about grieving. Talk with others who have experienced a significant loss, such as friends, members of bereavement groups, or individuals in your spiritual community, if you belong to one. Lurie also recommends books including How to Go on When Someone You Love Dies (1988) by Therese Rando, Understanding Grief: Helping Yourself Heal (1992) by Alan Wolfelt, and The Year of Magical Thinking (2007) by Joan Didion.
• Decide to survive. Make a conscious commitment to surviving intense emotions. Don't avoid painful feelings because you are afraid of falling apart, said Lurie. Look for a quiet place to let yourself go, talk to a friend, or reach out for support, such as at the Scripps Research Counseling and Psychological Services Department.
• Participate in rituals. Formally say "goodbye," for example by attending the funeral or memorial, to help you accept and integrate your loss. Mark anniversaries in a way that is meaningful to you.
• Express yourself. Ways of expressing yourself include writing in a journal, creating a scrapbook, or getting involved in a cause that was important to the deceased.
• Plan for triggers. Even when you start to feel better, certain events—holidays, birthdays, anniversaries—will trigger intense emotions. Know that this will happen and plan ahead. Some people like to keep an "honor box" of letters, photos, emails, ticket stubs, and other mementos as a way to help recall important memories.
• Seek and accept support. Let people who care about you know what you are going through. Let them help; it usually makes them feel good. At the same time, remember that other people may not always say the right thing, even when they mean well and are doing their best.
• Volunteer. Sharing your experiences, time, and talents can help others, and make you feel better, too.
• Cultivate perspective. You will have good days and bad days. Slowly, your focus will move away from your grief towards the outside world. "Give yourself permission to be human," says Lurie.

How to Help Others

If you are in the position of offering support to someone who is grieving, it can be hard to know what to do. Lurie offered some concrete suggestions.

• Be patient. Accept that the person may do less than their best for a period, while setting clear expectations about what is necessary.
• Respect privacy. Honor closed doors. And if the grieving person chooses to share new information with you, make sure not to share that news with others.
• Stay in touch. While self-isolation is a natural part of grieving, reaching out and staying in touch with the grieving person can be helpful and meaningful.
• Make social plans. Don't assume that someone who is grieving would rather be alone without checking in. Sometimes getting out is just what is needed.
• Offer practical help. It's nice to say, "Let me know if there's anything I can do to help," but it's much better to make a specific offer—to cook a meal, watch the dog, cover a task at work...
• Acknowledge the loss. While there is no one right thing to say, in general choose to acknowledge the person's loss, by saying, for example, "I was so sorry to hear about your father." You can draw on your personal experience as well, with a phrase like, "I loved my father, too."
• Expect repetition. Storytelling is part of the healing process.
• Don't allow yourself to become overwhelmed in your support role. If you find being present for the grieving person is becoming too much of a burden, Lurie recommends referring them to professional help with words like: "What you are saying is important. I'd like to connect you with someone who can really take time with you and listen."

To make an appointment with Lurie or her colleague Jann Hill, call the Scripps Research Counseling and Psychological Services Department at x4-7297.

Send comments to: mikaono[at]scripps.edu

"Give yourself permission to be human," says Scripps Research Counseling Psychologist Daphne Lurie. (Photo by Kevin Fung.)