Theories on grief are not new. Reverend Howard Gorle of the Bereavement Education and Counseling Center outlines in his Web site (bereavement.org) a number of the theories that have made the rounds in our culture.
Gorle notes that Sigmund Freud offered psychodynamic or "griefwork" models based on the premise of the process of letting go. Task models were made popular by others who spoke of the bereaved needing to complete certain tasks if they were to "reconcile" their grief. Stage models were espoused by the likes of Elisabeth Kubler-Ross, who in her book Death and Dying described the stages that terminally ill patients seemed to go through: 1) denial and isolation, 2) anger, 3) bargaining, 4) depression, and 5) acceptance.
There has been much speculation and criticism of the stage models in recent years. An editorial authored by The Grief Center, suggests that these stages are really more descriptive of "The Five Stages of Receiving Catastrophic News" or "The Five Stages of Coping with Trauma." The editorial notes that they do not have to involve death. The Center claims that grieving can only start at the point where the five stages of grief trail off.
The Center instead recommends griefwork through the acronym tear — where T stands for accepting the reality of the loss, E stands for experiencing the pain of loss, A alludes to adjusting to the "new state of things" and R stands for reinvesting in a "new reality." This process starts with acceptance.
Another theory, which uses family function models, says that grief is not something that occurs in isolation, but rather, as part of the patterns of interaction amongst family members.
Reverend Gorle concludes that "we use grief models as the‘skeletons’ for our understanding of grief. But we must remember that we, as human beings, do not‘fit’ the models — the models are an attempt to describe human activity. At this point in history there is no emerging model that answers all our questions."
For those particularly concerned with how to help bereaved children, Debbie Sims, MS, R.N.C.S., L.C.S.W. and Editor-in-Chief of Death and Dying Grief Support, has authored a practical and helpful article entitled "The Grieving Child."
Sims discusses myths about grieving, the developmental stages in a kid’s understanding of death or loss, the task of explaining death to a kid, symptoms of grief, and tips for parents of bereaved children and adolescents. The article is available in three parts as the last three installments of a newsletter. If you’re interested in seeing a slightly more complete version of the piece, email Sims at deb@death-dying.com.
Other helpful articles on the topic and at death-dying.com are "Understanding Grief in Yourself and in Children;" and "Stages Children Go Through When They Are Grieving" by Susan Andrey, M.S., York Hospital’s Child/Adolescent Behavioral Health Services.
According to Tom Golden, L.C.S.W., psychotherapist, author, and speaker, it was previously believed that children had delayed grief. Now psychologists understand that children wait for the parents to heal. Much as airplane flight attendants ask that parents put on their masks first, before putting on their kid’s, psychologists urge that grieving parents take care of themselves. Typically, says Golden, when parents heal, so will the child.
Director of Bereavement and Volunteer Services Cheryl Muller, Seasons Hospice, points out that children, like adults, experience grief in many ways. For that reason, it can be helpful to arrange to be available for your children to be able to speak with you — after dinner, for example, or while taking a stroll. You can ask them open-ended questions, allow them to attend the funeral, tell them that death is not a horrible thing, and reassure them that you, the surviving parent, aren’t very likely to go anywhere in the next week. You can tell them that you’re very healthy, that probably nothing is going to happen for a long while, and if something did, they would go and live with aunt Cheryl [for example]. Children want to feel that they’re safe and that someone will take care of them.
Bailey Stenson, the mother of three who lost her oldest child to suicide, thinks a big part of healing boils down to making time to be together with the surviving children. "Children will naturally tell you how they’re feeling," says Bailey.
After the death of a loved one, sometimes the surviving family — and even the friends or relatives of the bereaved — need a little help, too. Sometimes they’re angry at the patient for dying, sometimes at life or their spiritual force. Cheryl Muller, director of Bereavement and Volunteer Services, Seasons Hospice, recommends taking a chair and having the person who’s angry sit down and mentally place themselves in "a safe place" in their home. You can even take a chair to the cemetery. Then, begin having a conversation with the person who has died.
There are a number of phrases that can help them get started. Seasons Hospice even offers a handout, entitled "Opening Line Ideas for Empty Chair Discussion or Bibliography," written by Kirsten Levin Randall, LCSW. It offers the following prompts:
"Hello ________________...
"I want you to know that...
"What I remember most about you is...
"What I remember most about our times together/life together is...
"I’m most concerned about...
"I feel sad about...
"I feel mad about...
"I feel guilty about...
"Please forgive me for...
"I feel good about...
"What I learned most from you is...
"I appreciate most/Thank you for...
"I hope...
"The most important thing I want you to know is..."
One of the most painful aspects of any loss is the feeling of having left things unsaid. Offering time and space for a last conversation can help the bereaved move on from a state of frustration to a healing path.
In his book Swallowed by a Snake, Tom Golden, LCSW, psychotherapist, author, and speaker, offers an analogy of the grief process that’s creative and concrete. It’s the story about a gifted flute player who lives in a village that is completely peaceful — except for a huge boa constrictor whose favorite snack is humans. One day, after hearing a mother tell how one of the beasts ate two of her children, the flute player decides to go to the jungle and wait for the boa constrictor.
He knows it will take a while to kill the snake, so he goes prepared with a small supply of maize and a small knife. After the boa constrictor snaps him up, the flute player lives in its belly. Whenever he gets hungry, he slowly and deliberate cuts a bit out of the snake’s belly. This causes the snake great pain, and the snake tells his friends never to swallow up another human lest they want this type of misery. Eventually the flute player finds the snake’s heart and cuts it. The huge snake dies. The flute player goes back to the village and shares his story — and the snake’s heart — with the other villagers.
Golden agrees that “going into grief may at times be like being eaten by a snake. We are cut off from our everyday life, we feel that our existence is confined, and we are surrounded by our grief like the flute player was. Our world is completely changed, going from life as we know it into the belly of a snake. Imagine being in the belly of a huge snake. Dark. Every place you turn, there is the belly of the snake.
Golden adds that often, people have a sense “that the grief we are experiencing is never going to end. Part of a significant grief is the feeling that the grief has become the only reality. The flute player must have sometimes felt the same as he experienced his struggle. He took his bag of maize and knife with him, realizing that this was not a short term project. He knew he that he must cut away a little bit of the belly at a time, and he seemed to have faith that eventually he would get to the ‘heart of the matter.’
“Grief,” explains Golden, “is not a short term project.” For that reason, we must, when we are grieving, learn a different way to live. “The situation calls on us to use parts of ourselves that are not our usual strengths. Instead of seeing clearly what is before us, we might have to grope around, using our sense of touch rather than our eyes.”
Fortunately, there is an established method for getting around in this darkness. That method is ritual. “Ritual,” writes Golden, “is a way for us to consciously take a small sample of our chaos, our grief, and to process that sample in our own time. By doing this, we get to know our grief and our chaos a little bit at a time.” Ritual activity “allows you to move out of ordinary awareness and into the experience of grief, in a safe way, for a period of time.” It is in that experience of grief, explains Golden, that healing results.