Richard Tedeschi, Ph.D., is a licensed psychologist who specializes in bereavement and trauma. He also is a professor of psychology at the University of North Carolina at Charlotte, where he teaches psychotherapy.
Dr. Tedeschi, who has led support groups for bereaved parents since 1987, spoke to Discovery Health Online about coping with grief — whether you're the bereaved, or someone who wants to help the bereaved.
Q: What are some common emotions someone can expect to go through following a loss?
A: Well, depending on the kind of loss, all kinds of emotions can be involved. Sadness, of course, is the most predominant. Depending on the circumstances, perhaps, anger, guilt and, in some circumstances, relief. It's really a whole gamut of things. Emotions change over time, too; the emotions initially experienced may not be what people feel down the road.
Q: Is there a time frame for the grieving process?
A: There used to be these old models of grief that said that people go through certain stages and it takes a certain amount of time — those have been discredited. People now see grief much more as an individual process, so it's hard to put a time frame on it; it's hard to say that it goes through certain particular stages or phases for any individual. Some people manage to resolve the most intense emotions of grief relatively quickly, for others it takes a long period of time.
Q: What are some examples of how the grieving process may differ from person to person?
A: If you have a parent who is 95 years old, and you've had a good solid relationship with that parent, and then that parent dies because of declining health, you're not going to be surprised by this occurrence. You are going to be able to look at their life as a good thing, and this life is not particularly tragic, but natural. Because of your good relationship and the anticipation of the death, you've done your personal business with them. There's nothing that's really left unsaid or undone, and it feels that the relationship is somehow complete. So the emotions after that may not be particularly disturbing ones or difficult to manage, although there will be emotions none the less. Let's take a different example. Let's take a parent with a young child who dies and someone is clearly to blame, something went wrong. It's an unexpected death, it's shocking and it seems incomprehensible that your child would die, especially so young, and if somebody is at fault you'll have all sorts of feelings about that. So these feelings will be more intense and difficult and strung out over a longer period of time because of the unexpected nature of this — the fact that there has been some sort of wrongdoing involved, that this life has been cut artificially short. In other words, there is going to be a lot of unfinished business. It's going to be a lot different kind of grief than in the first situation I mentioned.
Q: What are some general suggestions for coping with grief?
- Don't be afraid of the feelings you're feeling.
- Don't think you're crazy for feeling the things you're feeling.
- Accept your feelings and don't let other people tell you how you should grieve.
- Trust your own judgment about your feelings and what you need to do to help yourself.
- Don't fall for the supposed grief formulas that some people talk about, that you go through the stage of anger, that you go through the stage of bargaining, that you go through the stage of resolution. It's all a mixed-up process — expect to be confused by it to a great degree.
- Talk to people. Find a good listener and someone who can hang in there with you for a long period of time.
- Expect that some people will be uncomfortable being around you. And not everyone will be someone you can turn to.
- Expect that in the immediate aftermath of the event, you'll get much more support than you will down the road, and maybe you'll feel like you still need support when people don't realize it anymore.
Those are some of the expectations people should have, and one of the most important ways of dealing with those things is to trust yourself. Realize that this is a process that may take some time, and find a good listener.
More Coping Q & A
Q: Do you have any suggestions for those who are helping a friend to cope with loss?
A: Listening is the most important thing. There are not going to be solutions to this problem of this loss. You can't bring the person back. You're not going to be able to find some magic words to make them feel better. So just being open to what this person needs to discuss will be useful. Respecting their particular way of grieving so that you don't become pushy and you don't disappear either. And following the lead of the person who is grieving. Paying attention to what they need in their own personal situation rather than feeling like you should know the answers or have a solution or have any kind of a formula for them. They'll let you know about their own needs if you're a good listener.
Q: You've been suggesting ways to cope with grief. Are there ways of coping that may be unhealthy?
A: Some of the things that would be unhealthy would be turning to alcohol or drugs to buffer the pain of this. There are a lot of similar avoidance maneuvers that people can engage in — such as overeating or anything with an addictive nature to it that people can turn to just because they get some temporary relief from the pain of things. Some people may start to think things like, 'I wish I were dead and I would be reunited with my loved one in heaven.' This is not particularly unusual in grieving people, but if they are taking that very seriously, then I would become concerned. Those are the kinds of things that are unhealthy in grieving, though I'm very reluctant to label things in general as unhealthy because people in grief experience so many things that feel odd and unusual. For the vast majority of people that I've seen who are bereaved, all these odd and unusual things, things that look odd and unusual from the outside, things that may even feel odd and unusual to themselves, all these things end up being helpful for most people. People have all kinds of thoughts about the death after it has occurred that some of us might think are kind of strange. This [the death of a loved one] just brings out in most normal people all sorts of unusual considerations and thoughts and reactions, and I hesitate to think of any of them as pathological in any way.
Q: Many people will have to deal with an anticipated loss at some point in their life — such as losing someone to a terminal illness. How do people cope with these expected losses?
A: When people are terminally ill, there are a number of things that will go on with them and the family around them. To some extent they will be hoping that maybe this won't happen. Depending on the circumstances and the changing circumstances, that hope may be dashed or strengthened by what is going on. In the best of circumstances, people are in some way preparing for this. They're open to it and they're open to discussing it, which is usually helpful. For the loved ones who are going to be left behind, even when the death occurs, even if they've done a lot of preparation, it still has a quality of some shock and additional sadness. You just can't get used to it all ahead of time. So even when you do this preparation and continue the process of living and are open to the discussion of what might happen, you deal with all the declines in the person's capabilities. And when the death occurs — it's still a death and it's still hard.
Q: Will children grieve differently than adults?
A: Many, many years ago people thought that children didn't really grieve, but that's not true — they grieve in different ways. In some ways, of course, children are confused — depending on the age you're talking about — about what has happened. They may not understand death. It's a difficult concept for them to grasp in some ways; they don't understand what happens after some people die, but neither do adults very much. Of course, if they had a close relationship with the person who has died, they will miss them. How they express that may be a little different than the way adults do. Some children express it more in their behavior, rather than expressing it directly in a description of what is going on inside of them. Children are good about expressing their grief in their play and art and different kinds of actions like this. They'll draw pictures very well, and that will help a whole lot and you'll be able to see it in what they draw … they [the pictures] end up being expressions of how they're feeling about things, but they often don't have the words to do it.
Q: What can parents do to help children through the grieving process?
A: Again, let the person take that lead to some degree. Don't tell the child more than they want to hear. Let the child ask questions about the situation and answer them honestly and at a level they can understand. It's best to kind of open up topics and let the child ask additional questions. For example, if you are going to a funeral, tell them: "We're going to be going to the funeral, and these are some of the things you're going to see and some of the things that will happen. There may be some people who cry. There'll be some people who talk about Uncle Charlie, and what kind of person he was. We'll be singing some songs." Just describe some general things and then the child will ask questions as they need to. You can just answer them at their level and without a lot of unnecessary elaboration.
Q: What steps can someone take toward resuming a normal life after loss?
A: I think it's very important to recognize that it's a part of living that all of us are going to have to be involved with. It's very important to be able to talk about it and not to avoid people who are in grief. But again [for the person who's grieving], it's important [that those around them] take the lead, take the signal from the person in grief about what they need. And maybe there will be times that they won't want to talk about it, so you shouldn't push yourself on them. Being open means being ready when they're ready and not avoiding them or being nervous about being around them. There are a lot of books written about grief, so that's a good resource for people, and also to talk to other people who are in similar circumstances. That kind of support can be helpful so they can learn that what they're thinking and feeling is not so unusual, and they don't have to be worried on top of their grief — worried about their own reactions and if they're OK. And of course, if they don't have a good listener, someone who is open and supportive to them, then they may need to find some professional or organization that can help them and act as those listeners and supports. Most communities have bereavement services of some sort, and they should not hesitate to seek them out.