Health & Wellness

Living With Grief

There’s no “right” way to grieve, but understanding the process can help you get through it


By Wendy Haaf

After Ann B.’s husband died suddenly in August 2011, the grief the Ottawa woman experienced defied her expectations, and those of some of the people around her, in a number of ways. One example was the belief that bereavement has an expiry date—that once someone returns to work or a year has elapsed, the grieving person is “over it.” On the contrary. “There is no timetable,” she says.

You’d think that because it’s a universal experience, our collective knowledge about grief would reflect reality. In truth, however, we’re surrounded by myths and misconceptions about it—so much so that when grief researcher Susan Cadell talks about her area of expertise, that’s where she begins. “People believe things that aren’t helpful, either when they’re grieving themselves or when they’re trying to support someone else,” says Cadell, who is a professor in the School of Social Work at Renison University College, University of Waterloo (in Ontario).

First and foremost is the notion that grief takes a predictable path through five stages—the well-known Elizabeth Kübler-Ross model, which was, in fact, based on interviews with people who had been diagnosed with life-threatening illnesses and not those who had suffered the loss of a loved one. Over the past two decades, the five-stages-of-grief paradigm has been been widely abandoned by experts in grief and bereavement, and yet Kübler-Ross’s roadmap “is still the dominant model for medical and nursing education in North America,” says psychologist Christopher MacKinnon, executive director of the Monkland Psychology Group in Montreal and a psychosocial consultant for Canadian Virtual Hospice. And while, according to MacKinnon, aspects of the approach aren’t without merit, “the problem is that people have interpreted it like an Ikea instruction sheet: ‘Okay, so I get through these stages, and then I’m done.’”

So, what can you expect when you lose a beloved friend, family member, or partner? Is there such a thing as “normal” grief?

The Dual Process

To begin with, “grief is not something that is standard,” stresses Grace Tallman, a grief counsellor in London, Ont. “It’s a very individual thing—even members of the same family grieve in completely different ways.” Cadell concurs: “It doesn’t follow any script.”

That’s not to say there isn’t a more accurate and useful framework for explaining grief. Both Cadell and MacKinnon say that in their experience, many people grappling with grief find that something called the dual process, or oscillation model, mirrors their feelings. “It’s the idea that we face grief and the reality of the death, and we also face forward in rebuilding our lives, and we ping back and forth between these two positions constantly—like several times in a minute, a day, a week,” Cadell explains.

MacKinnon elaborates: “On the restoration side, it’s being distracted, going to the movies, going for a walk, getting on with tasks of life. On the loss side, it’s going to your bereavement group, crying, looking at photo albums, and talking to the notary.” While spending too much time at one extreme can be damaging—for example, distracting yourself by binge-gambling at the casino—ricocheting back and forth aids healing. “The stress of one pole is relieved by oscillating to the other,” MacKinnon explains. “So you have a big cry, and then you go for a walk. Over time, the swinging back and forth lessens.”

This explanation resonates with Jenny Hauser of London, Ont., whose sister, Marni Webb, died of cancer at age 57, while she was in her second year of law school and finally thriving after a difficult life. “There are days when you feel so sad that you just want to stay in your pyjamas—if you can do it, give yourself permission to do it,” she says. “Let yourself feel, and then get outdoors, go for a walk, go for a bike ride.”

The bouncing to and fro will eventually begin to subside, though even years later, the pendulum can swing back to loss territory for a time—months or even years after the acute bereavement has passed. Significant dates—anniversaries, birthdays, and holidays—can often bring on a wave of sadness, but this doesn’t always follow a predictable pattern. For instance, a loved one’s birthday a dozen years after his or her death may be far more difficult than those first few birthdays if it marks a significant milestone—such as when he or she was slated to retire or would have turned 60. Or, as a fellow widow Ann B. connected with online told her, significant dates might be harder during the second year than the first. “She was 100 per cent right,” Ann B. recalls. “The first year is a blur—you’re literally in robot mode. The second year, the fog has lifted and reality hits.”

This resurgent phenomenon has led many people in the bereavement field to conclude that grief is not about detaching from the departed. “We have come to realize that it’s about having a new and different relationship with the person who died,” Cadell says.

“And it continues throughout life.”

“Life will never be the same, but you adjust to your new normal,” says Ann B. “It doesn’t get easier for quite a while, but it does get easier.” According to MacKinnon, losing someone often brings a crisis of meaning, causing someone to wonder “Who am I now?” This was certainly Ann B.’s experience. “I remember thinking, ‘Okay, what future do I have now?’” she says.

Another facet of grief that many people find surprising is that in the acute phase, it can manifest itself physically. In the days after her husband’s death, Ann B. couldn’t stop shaking, and she was briefly convinced something was terribly wrong with her when her urine suddenly turned dark brown. Her mother, a former nurse, quickly discerned the cause: dehydration, due to constant crying and forgetting to stay hydrated. “Your body is in shock,” Ann B. says.

Hauser began having periodic episodes when her heart raced and she found it difficult to catch her breath. “My doctor told me they were panic attacks and suggested I get back into exercise,” she recalls. Ann B., who had struggled with anxiety earlier in her life, also experienced panic attacks in the weeks after her husband’s death. One, in fact, was so severe that it sent her to the ER. “I thought I was having a stroke,” she says.

Other physical expressions of grief can include “problems digesting and muscle pain,” says MacKinnon, as well as difficulty sleeping, lack of appetite, and problems with memory and attention. “All kinds of physical and mental aspects can be touched by grief,” Cadell says. “It’s important for people to know that it’s very common, and it doesn’t mean they’re ‘doing it wrong’ or just being dramatic.” In fact, so-called somatic expressions of grief are so common, MacKinnon says, that one study “suggested that people in bereavement use 80 per cent more health care resources than the general population.”

However, since many of these issues overlap with symptoms of depression, it can sometimes be difficult to differentiate between the two. One potential clue that it’s more likely depression is sadness so pervasive that it persistently interferes with daily functioning combined with a lack of even momentarily enjoying an activity that was previously pleasurable. (Suicidal thoughts, of course, constitute an emergency.)

“If somebody is questioning whether they’re experiencing grief or depression, they should probably seek professional help—either a counsellor or a family doctor,” Tallman advises. Your funeral home or primary-care provider may be able to direct you to a grief counsellor in your area.

Dealing With the Emotions

People can have a wide variety of emotional responses to loss, too. For one thing, you can find yourself deeply affected by the death of someone who hasn’t been a part of your life for a long time. Cadell cites the example of her mother, who had been divorced from Cadell’s father for decades prior to his death. “I think everybody was surprised, including my mom, how hard it was for her when he died,” she says. Similarly, grief can strike even after the death of someone who abused or hurt you repeatedly. (Under such circumstances, you can have feelings of relief, too, and MacKinnon says that that can be doubly difficult if you can’t express them openly because, for example, the person was well loved by the community or the rest of your family.)

Anger, too, is normal (or at least as normal as anything to do with grief can be). “A lot of people who are grieving get very angry,” Tallman says. And people often have good reason to be angry or bitter— perhaps in response to the stress of dealing with mountains of death-related paperwork or the sudden disappearance of a good friend. “Anger is just some people’s way of saying ‘My life isn’t the way it used to be.’”

Similarly, guilt and feelings of inadequacy and even shame (for instance, over not “coping better”) aren’t uncommon and, like other responses to grief, have to be felt rather than avoided if you’re to find a way through.

Grief can also bring up long-buried memories and emotions. “All sorts of things come up, about yourself and your childhood, once you have this kind of opening of the floodgates,” Hauser says. “You start thinking about stuff you haven’t thought of in years, and it’s hard to process.” Or, MacKinnon says, “at times, people will have certain behaviours that surprise them and they think ‘I can’t believe I said that’ or ‘I can’t believe I made this impulse purchase.’ This is very common.” However, when such behaviours become potentially harmful and/or repetitive—for instance, turning to alcohol or overspending—it may be time to seek professional help.

Only a minority of people in bereavement, however, get “stuck” (though not through a lack of effort) or experience complicated or prolonged grief. According to MacKinnon, studies suggest this happens to just 10 to 20 per cent of the bereft population. For the remainder, strategies such as retelling the story of one’s loss over and over again, seeking support (from friends and family, a faith community, a bereavement group, a counsellor, or a combination of these), or expressing oneself through journalling or painting can help with the transition to a new normal.

One place to find suggestions for constructive methods of coping is, which also serves as a portal to local resources. The site consists of written material and video interviews with both experts and people experiencing grief. “The goal of the project is both educational and supportive,” explains MacKinnon, “so people get some sense that there is a way through this and that there are choices you can make to facilitate a process of healing, coping and adapting.”

Which brings us to another often unexpected face of bereavement: it can lead to changes that, while they don’t ease the pain of mourning, can bring growth, new meaning, or strengthened bonds. Ann B., for example, began pursuing new interests after being widowed and developed a new sense of confidence and independence. The death of Hauser’s eldest sister eventually brought Hauser, her surviving sister, and their mother much closer. And when she finally heeded her doctor’s advice to get more exercise by joining a gym, Hauser fell in love with yoga and the tai chi-like Chinese practice of qigong, paving the way to a personal passion and a teaching career she might never have otherwise discovered. “It’s a huge part of my life,” she says.

And while the seedling of hope that can sprout from a devastating loss doesn’t change what happened, “it changes how you go forward,” Ann B. says.