There is No Prescription for Grief

“The one thing that unites us in this room is that we will all die and we will all lose people that we love, every single person here. Yet we don’t talk about it.”

As geriatric psychologist, Dr. Dara Schwartz often helps seniors cope with the intense grief of losing a husband or wife of decades.

It’s a complex task. She can’t simply set a fractured leg or stitch up a gash and send her patients on their way. Broken hearts aren’t easy to mend.

“There is no prescription for grief, even though great people before us have tried,” says Schwartz, a lead clinical psychologist for the Senior Intensive Outpatient Program at Sharp Mesa Vista Hospital. “It’s a very personal process.”

It’s also something that links us all.

“You go into a theater, you look around at all these people that you don’t know,” she says. “The one thing that unites us in this room is that we will all die and we will all lose people that we love, every single person here. Yet we don’t talk about it.”

Learning to cope with grief, then, is something most of us have to learn. As Schwartz and other experts in death, grief and bereavement explain, grieving is a difficult process that not only is painful emotionally but can have harmful physical effects, too.

A 2014 study at the University of Birmingham’s School of Sport, Exercise and Rehabilitation Sciences in England showed that surviving loved ones — especially older spouses — are at risk because of increases in blood pressure and blood clots, loss of appetite and aggravated physical pain caused by stress and a weakened immune system. A study published in the medical journal Circulation in 2012 also noted that the risk of heart attack or stroke for a surviving spouse is significantly higher in the days and weeks following a loss.

Also, grief can push survivors into self-destructive behaviors, says Jim Reiser, the bereavement services coordinator at Hospice of the North Coast in Carlsbad.

Reiser says we’re conditioned to find a cure for pain. If we pull a muscle or have a headache, we can take a pill. Many try to find a similar cure for grief.

…they no longer enjoy the things that used to give them pleasure — be it reading, exercise, food or relationships — a condition called anhedonia.

“So you can imagine some of the really maladaptive coping skills,” he says. “It can get pretty bad when you’re getting into habits that are hurtful, like alcohol or drug use or … risky behaviors, that sort of thing.”

Others simply choose to withdraw, pulling away from family and friends. They try to fight through grief on their own. In their depression, they no longer enjoy the things that used to give them pleasure — be it reading, exercise, food or relationships — a condition called anhedonia.

“Like most emotional things, it does have a direct link to the body,” says

Reiser. “Some people, especially when they’re elderly, start having a lot more symptoms and break down because of the stress.”

Process of grieving

So how can someone in grief best negotiate that stress and find a new normal, where life can be enjoyable again?

Part of it, says Schwartz, is acknowledging there is a grieving process. Author Elisabeth Kubler-Ross explained her theories about the stages of grief in her book “On Death and Dying,” published in 1969. Those stages are: denial, anger, bargaining, depression and acceptance.

But Schwartz says people react differently, and the process isn’t linear, as Kubler-Ross later acknowledged. People can get stuck, or slide back into a previous stage.

“We don’t view it as stages anymore but, rather, a process,” says Schwartz.

“You’re split open like an acorn…”

Reiser describes that process in four stages:

Shock: You can’t believe what’s happened. You have trouble accepting it.

Deconstruction: Your whole life changes. If your spouse is gone, your routines and even who you are and how you behave is altered.

Reconstruction: You start to rebuild. “It’s like, who do I want to be? What do I want to make this mean? How do I honor my wife?” says Reiser.

Living again: You finally lean in to a new life.

“You’re split open like an acorn,” says Reiser. “You have every opportunity now to really start searching yourself, who you’ve been and what you like and don’t like about you, what you’ll change and who you want to become.”

Schwartz, Reiser and others point to these strategies to help people through grief:

“The brain rewards us.”  “We’re here, we’re still alive. It’s when people don’t get that reward … that you can see grief take them down a darker road.”

Let them know grief is powerful. They may feel strange physically, can’t focus, forget things and feel in shock. They need to know they aren’t going crazy. They must give themselves time to mourn.

Acknowledge loss and accept reality. This can be a long, hard process. Getting involved with group or individual counseling or meeting with clergy can help. Reiser says it’s not a sign of weakness to ask for help. Hospices and hospitals often have group bereavement sessions available.

Address the guilt. Reiser says almost all survivors have some type of guilt, for things they did or didn’t do. It’s important to get those out in the open. “Really facing it, and tapping into it, you can imagine starting to release it,” he says. Often, just talking about the guilt can help a person to accept it or realize they actually were supportive and loving.

Schedule activities. “We ask people, what are you going to do that’s going to stimulate your body, your brain, that’s going to make you feel connected, that’s going to give you a sense of pleasure?” says Schwartz.

Write in a journal. Just the process of getting it from the brain to paper can help a person work through feelings.

Be with people. Schwartz says the inclination of most is to be with others when grieving. “The brain rewards us,” she says. “We’re here, we’re still alive. It’s when people don’t get that reward … that you can see grief take them down a darker road.”

Take care of yourself. Get outside, exercise, eat and rest.

Know it takes time and grief comes in waves. It’s a loss they’ll carry for the rest of their lives.

“People say ‘I should be over this by now,’” says Schwartz. “Really? You’ve been with this person 63 years? I don’t think you can put a timeline on that.”

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