It takes roughly three to six months before we begin to think of a loved one freely after their death. In fact, any major loss blocks our ability to think and feel and act as we previously did. Grief makes the thought of our loss or our lost one too hard to bear and our pain locks us into past times where resentment, guilt and other negative emotions colour our thinking. We cannot plan or look to the future. Sometimes we cannot remember or of think about the past at all and at other times we desperately try to hold on to our memories, only to see them slip away, We may not even be able to picture a loved one any more.... all this is is so distressing that we may believe that there is something wrong with us, or that we are failing the one we have lost.
Kubler-Ross has suggested that there are 5 stages through which people go following a serious loss: denial and isolation; anger; bargaining; depression; acceptance. Sometimes people get stuck in one of the first four stages. Their lives can be painful until they move to the fifth stage - acceptance.
This is a useful way to bring understanding and relief to people trying to cope with their reactions to loss, but in suggesting a step-wise progression through predictable stages, it is untrue to the reality of our experience. Everybody does not experience these stages; those who do may not experience them in this order, and nobody experiences them as discrete steps; they are are not necessarily a progression - we pass through a so-called stage only to revert; or hover somewhere between them, or swing back and forth. We begin to mourn only to regress and go through earlier phases all over again. Yet this is all a normal, natural experience.
“Normal” grief is easier when the loss is timely (which is why it is so much harder to come to terms with the loss of a child than a grandparent), where there is little emotional confusion or ambivalence about our relationship or feelings about the lost one, and where the needs of the bereaved person are understood and met ~ where they are accepted and supported.
This suggests we need an adequate social support network to help us deal with our losses. It is possible to come to terms quite quickly with even major loss when it is clearly final and the implications can be explored with others who do not require us to behave in any particular way. This is the forte of the Grief Counsellor, but friends and family can provide the same listening ear, as the bereaved goes piece by piece over the nature of the changes in their relationships and expectations. This is how we gain a new orientation to life.
When the grieving process fails and the bereaved is not able to accept and move on with their life, to the point where their is significant damage to their relationships or health, it is generally referred to as “pathological grief”.
Not all unresolved loss issues produce the degree of distress referred to as pathological however. This term should be reserved for distinct and major failures of the process of grieving and achieving peace through acceptance. After loss of her baby, mothers will eventually recover from the shock, numbness and disbelief. But for those who cannot face the finality of the loss, the feelings of rage, guilt, and depression can be overwhelming and unremitting. If the initial numbness and disbelief no longer serve to protect from these emotions, if they persist too long, the consequence to the mother and to those around her may be extreme: We have all heard news reports of bereaved mothers stealing a child, convinced it is their own, but many less obvious, but equally traumatic experiences flow, not from the loss, but from the failure to deal with that loss - to grieve.
It is easy to understand this in the context of the loss of a child, but the same issues affect all who suffer loss. Grief is the normal process in coming to terms with any loss: in some degree it affects people who lose a job, a loved one, go through a divorce, lose a limb, are diagnosed with a serious health problem. All involve loss (health problems involve loss of freedom and the ability to control one’s life and in some cases, the loss of life itself confronts us before we expected to prepare for our own deaths).
Adequate coping with minor loss may or may not prepare us for more significant losses, but dealing with loss poorly, relying on denial and projection (essentially, blaming others) always undermines our ability to effectively grieve major loss.
Where grief is totally inhibited and denied, and the grief “goes underground” it must still have an outlet: perhaps as over-protection of other children, or in controlling and intrusive behaviours, chronic irritability, or unexplained depression.Defending against the pain of loss becomes who we are, part of our personality.
Not all expressions of unresolved grief are unconscious. Some hold their grief close to their hearts, secret but fully aware, reserving the expression of their distress and their weeping times for when they are alone and their breakdowns for anniversaries and special days.
Pathological grief is related to other forms of emotional damage. It leads to decompensation under stress, making the sufferer vulnerable to psychiatric disorders such as Major Depression, Dysthymia and Panic Disorder.
It can also result in relating styles which are defensive against any possibility of loss. Alert avoidance of anybody who might leave them (by deserting or by dying)may make them unable to commit to relationship; in the case of a parent who has lost a child, to avoid babies or to be unable to build a new family.
Commonly it results in an inability to experience warm attachment to others in case they lose them. Over-protection is also common and in some cases, an inability to communicate intimate subjects to others and inhibition of sexual expression. These and others defensive patterns can become part of a rigid adult personality. Such people get by, but in a very limited manner because of their experience of loss.
Unlike people with similar, lifelong coping styles who are described as having a personality disorder, people whose personality problems developed in the context of poorly resolved grief can adapt and recover. They are amenable to help, and although they may not seek treatment for their grief, their many other issues often bring them to the attention of helping professions, where a proper history and exploration will reveal the probable role of loss and potentially lead to a resolution of this underlying cause of so much distress.
