Four Steps from Grief to Recovery
Just a few months after I began my medical practice, I met a couple who only hours prior had learned of the death of their 20-year-old son in a car accident. Understandably, they were in shock from the traumatic news and needed help to make it through the difficult days of planning and attending a funeral.
I provided a low dose of an anti-anxiety medication to help take the edge off, but no amount of medication can completely ease the pain of losing a loved one. In spite of years of training to become a physician, on that day I realized I did not yet fully understand the profound effects of grief, nor was I well prepared yet to help others navigate through the difficult journey from pain to recovery.
As I sat in an exam room and grieved with the couple, I recalled as a child when my parents received a late-night phone call informing them that my mother's 24-year-old brother had been in a terrible car accident. He died a few days later on his 25th birthday—just before Christmas. For my family—and especially for my grandparents—life would never be the same again.
My grandparents would have been better able to give advice to this couple than I could provide. As the years have passed, I have intentionally set out to glean as much information as possible from not only grief counselors and researchers, but from the experts—my grieving patients.
For many years, one of my practice responsibilities was serving as a hospice medical director. Patients who are told they have an incurable illness typically go through the five stages of death—denial, anger, bargaining, depression, and acceptance. And while we often think of mourning as involving the same phases, it is a bit different.
Many researchers have tried to describe the phases of grief. It's not surprising that different researchers come up with slightly different models due to the fact that all relationships with the ones we have lost are unique. One model I often refer to is that of Dr. Selby Jacobs, who described four phases of grief: numbness/disbelief, separation anxiety/yearning, depression/mourning, and finally recovery/acceptance.
The first three phases are inevitable and somewhat beyond our control. The recovery period is the one phase we all hope to reach as soon as possible, and to some extent we can speed our progress toward that goal.
There are many, many books and articles available on the grief process, but I have found my patients' and grandparents' advice to be words of wisdom that succinctly summarize all the books I have read and the research I have done.
Here's what I have learned:
First, accept the pain and try for tolerance.
Tolerate the unavoidable pain and yearning that comes from losing a part of your life. As a physician I am always willing to help my patients with a mild prescription for insomnia and, when requested, a short course of an antidepressant (especially when someone has lost a child). But I always tell them that there will be some pain and anxiety that medication will not completely alleviate.
Second, don't try to get over it; try to get through it.
We all wallow in our grief for a while, but there will come a time when you must find the strength to get out of bed, to do your household responsibilities, to attend to your family and to your career. Get busy as soon as you can. Become intellectually and emotionally engaged with your family and friends. Exercise regularly and eat a healthy diet. Don't overindulge in alcohol. Take one day at a time. Try to avoid any major financial or life changing decisions for several months or a year. Sometimes a grief support group helps to ease the burden.
Third, seek out "feel-good" people and experiences.
Look for opportunities that will help you on your road to recovery. After a few weeks of your loss, try to find the occasional activity to distract your mind from the loss and even something that makes you laugh. No, that will not be easy, but try a movie or other diversion that lifts your spirits—even if only for a few moments. Go to a sporting event or go window shopping. Find ways to elevate your outlook on life. Psychologists call this cognitive behavior therapy (CBT). If you can think pleasant thoughts, you can improve your mood. Consider meditation and prayer. Force yourself to think positive thoughts. Visit your favorite park or on a pleasant day, spend some time outdoors. Doing such activities can truly be a task in times of grief, but with practice and persistence, you can manage to do it.
Fourth, when you're ready, resolve to get on with your life.
When I think of those who have lived through their grief, I cannot help but think of my grandparents who in the months and years after their son died, never gave in to their oppressive grief. Certainly they cried, they mourned, and they struggled over the years, but in all honesty, I seldom remember a time with them that was not filled with love and, to put it simply, fun. Over the remaining years of their life, we as a family went through many major events—weddings, the birth of other grand- (and great-grand) children, graduations, and yes, more funerals. But I vividly remember my grandparents as a couple who took the time they had left in life to spend as much time and to invest as much energy and emotion in their family as they possibly could. I would not go so far as to say that their lives and my extended family's lives were better because of their loss and their grief. Rather, I would say it was better in spite of their grief.
Like so many of my patients who have traveled the sad road of grief, the redeeming aspect of the journey is in their response. It seems that life sends too many unexpected, unwelcomed, and uncontrollable events our way. Often the only aspect we can control is our response.
One of the many lessons I have learned from mourning is that some of the greatest deeds in life go beyond our status in society, our educational degrees, and our material successes.
For most of us, our greatest accomplishments will be our emotional support and relational investments in our family, friends, and acquaintances. Grief serves as a profound reminder of the importance of those relationships and of our limited time in life to nurture them.
D. Keith Cobb MD is an internal medicine physician and the author of The Grief Survival Handbook: A Guide from Heartache to Healing (Trafford Publishing). Learn more about him at www.drkeithcobb.com.