(Reading this section offers very specific information on different types of death. For more generalalized information on the grief journey and coping skills, please refer to the brochure sized information titled, “Hope, Hurt, Healing towards Health” or the booklet sized information titled, “The Journey of Grief.”)

The following is an article that I wrote for the local newspaper several years ago. It was titled, “A Stitch in Time.”  Although I was talking about all types of injuries in this article, I feel that it is applicable to how people grieve in their own unique ways, and how society responds to their grief.  “Any one in the Emergency Department would have known that I’d never played on an organized hockey team.  It just never occurred to me to ask how many stitches my doctor had put in my thumb. I wasn’t aware of the importance of the number of stitches.  Over the past week, I’ve learned to regret overlooking that detail.  It’s the second question everyone asks me. The first question?  “What happened to your thumb?”  My response isn’t too exciting.  I bought new kitchen knives.  They work really well.  I was preparing a salad for my daughter, Rachel’s family birthday party.  I chopped the green pepper as well as my thumb.  Being a typical Mom, I didn’t want it to interfere with her party.  So I just put pressure on it and took a little break from cooking, for the pain.  I knew a few minutes was all I was going to need to heal and get back to the meal preparation.  Then, I began to feel dizzy, and needed to sit down, before I fell down.   Anyhow, that’s when I gave in and agreed to call my doctor.  I went for help. At least being in the emergency department gave me an opportunity to gain my pride back. What?  Me need freezing to get the stitches put in?  Heavens, I gave birth to four kids. Comparatively, this would be a walk in a park. Ouch!  It’s at times like this, that you really appreciate having a Family Doctor that understands you and knows you well..  He just cracked jokes and kept me busy with verbal banter, even making jokes about my cut.  He’s a wonderful man. He honoured my coping mechanisms - sarcasm and humour.         All week long, people asked me, “How many stitches did you get?”  Their disappointment was obvious when I couldn’t respond.  It diminished the respect they had for my injury.  Eventually, I just started saying, “It hurts, okay?” Physical pain is similar to our emotional or spiritual wounds. Often we compare our wounds and lives to others.  We’ve all done it.  Those  ridiculous comments:  “It’s more painful to bury a child than a spouse.”  Says who? “It’s more painful to lose a marriage than a career.”  Says who?  “It’s more painful to resign yourself to blandness, than go after a dream.”   Says who?  “How many stitches did you get?”   It just hurts, okay? Should we really be qualifying each other’s pain? Or should we be offering support?  We all react differently when we’ve been hurt.  Some of us “˜carry on’.  Some of us laugh and cry.  And some of us act dizzy.  Most of us try to keep our pride. We either tackle the pain head on, or “˜freeze and block’ for awhile, until we’re ready to deal with it. What’s the most important aspect?  Some things don’t heal on their own.  The bleeding just won’t stop.  You need stitches to hold yourself together.  To recover in  a healthy way, that won’t leave ugly scars.  You need a place (or a resource), to go for help.  Someone you can tell, “It just hurts.” No two people grieve the same, and types of death should not be compared in terms of “˜who hurts the most.’ However, there are basic differences in the grief journey depending on the circumstances surrounding the loved one’s death. These differences need to be recognized, in order to competently support the griever. The following are some examples:

Even when the death is expected, grief may strike very strongly, leaving people shaken and shocked.  Caregivers have often pushed themselves past their own limits and are feeling the effects of that. Most, even with the best of help have lost sleep, ate erratically, and skipped their own routine health checks. Many caregivers admit afterwards they don’t know how they did it. They were running on sheer willpower or adrenaline. They didn’t realize how deeply fatigued they were until after the end of their loved one’s illness. They need to be reminded to take time for their own self-care. They have made someone else their top priority for so long that they automatically put their own needs on the back burner. Although it makes most people feel guilty, a sense of relief is a natural response. Finances can be low due to medical expenses and leave of absences due to care giving. Relationships within the family may be strained as well, due to the stress of changed roles, added tasks, differences in decision making, and anticipatory grief.  Ideally, in a long term illness people had a chance to get their affairs in order, say good bye, I’m sorry for anything they need forgiveness for, and say, “I love you.”  However, depending on personality types, this isn’t always the case.

 

Most people who experience the sudden death of a loved one have a feeling of never having had a chance to say good-bye. If the last time they saw the person was one of conflict, the feelings of remorse are magnified. The initial phase of shock seems to be longer and of deeper intensity after a sudden death.  It is impossible to understand that one moment the person was alive, and then you will never see them again.

 

Suicide is perhaps most associated with feelings of guilt or shame.  There is still a stigma attached to suicide.  Concerns about how others view the survivors, placing blame or refusing to recognize the cause of death can cause unnecessary shame. People who have had a loved one complete suicide need to be reminded that it was not their fault, and that they could not have prevented it.  If there has been a long history of mental illness, the client may actually feel relief, and then a sense of guilt for doing so. When  a loved one dies from suicide, people can question just how much they meant to that person and feel very abandoned. In the book “Night Falls Fast,” Kay Jamison describes the impact of suicide well, by writing, “Suicide is a death like no other, and those who are left behind to struggle with it must confront a pain like no other.  They are left with the shock and the unending “what ifs.”  They are left with anger and guilt and, now and again, a terrible sense of relief. They are left to a bank of questions from others, both asked and unasked, about Why; they are left to the silence of others, who are horrified, embarrassed, or unable to cobble together a note of condolence, and embrace, or a comment;’ and they are left with the assumption by others-and themselves- that more could have been done. Other matters compound the nightmare: suicide is often violent, which means that family members either discover or must identify severely mutilated or damaged bodies, police need to be involved in the death scene, and insurance investigators often make matters worse by intrusive and offensive questionings.  Friends may or may not respond to a suicide death with the same level of consolation and community support that most other deaths commands.” Besides medical conditions, other types of sudden death can include: accidental death and those caused by homicide. Both of these carry similarities to some of the components and reactions to suicide.   The media can be involved, and this creates extra challenges to the person grieving. In the book, The Pilot’s Wife, author Anita Shreve, captures these feelings well.  Her main character, Kathryn was just informed that her husband was killed in a plane crash.   Kathryn says, “Later, I would come to think of the news bulletins as bullets.  Word bullets that tore into the brain and exploded.” Court cases and legal proceedings almost leave the injuries of grief as open wounds, never allowing them to heal. It is a challenge to get through feelings of anger, revenge, guilt, vulnerability and forgiveness in order to heal. Homicide often creates a sense of people talking about you, yet avoiding direct contact.  It seems that if people can find a reason to “˜blame’ the victim for why the murder happened to them, it will distance anything so violent from happening to themselves.

 

The loss of a spouse expresses itself in many ways.  There are practical issues that must be dealt with such as settling the estate, banking, home maintenance, a sense of security, meal planning, shopping, cleaning, automobiles, lawn mowing, snow shovelling, and many other tasks of daily life.  At times, depending on what roles you each played in the relationship, these can seem overwhelming. An overall sense of loneliness is prevalent for the first two years of spousal loss. The many intimate things that you talked about don’t seem as if they can be discussed with outsiders. Privately shared jokes and the history you have created together no longer seem to hold meaning. Regular routines of daily living are changed, and a sense of confusion results. Decision making is difficult because there is no one to “˜bounce’ your opinions off of.  Meal times can be especially tough as they were usually a time of conversation and togetherness. Often people find themselves just snacking, or eating in front of the television. It seems as if there is no sense in cooking elaborate meals for “˜just one person.’  This is alright as long as a person still eats nutritionally. Physical intimacy can be greatly missed after the death of a spouse. There is a longing to be touched and share affection. Sleeping can create a real challenge. Many people continue to sleep in the marital bed- often on the side of the bed their spouse used to sleep on.  Some people find this too difficult and sleep in another room.  Typically, sleep patterns become quite disrupted. Either it is difficult to fall asleep and people often find themselves nodding off in a chair in front of the television, or they wake up in the middle of the night and have difficulty getting back to sleep.  Eventually sleep should return to a normal, healthy pattern. People say that one of the most difficult times is after having been out when they return to an empty home.  They can feel lonely and some people feel frightened.   It can be a good idea to leave a radio or television on so that it doesn’t seem so quiet, or to ask if someone will call you when you return home.  An aspect of grief that might surprise people is if they had a conflictive relationship with their spouse, they might feel as if they won’t grieve their death. Just the opposite can be true. They might grieve the things that they never got to experience together, or grieve the opportunity to reconcile their relationship. Many people continue to “˜sense’ their spouse alongside them through memories and feelings as they grieve. It is necessary to be good to yourself and patient with your progress. Recovering from the loss of a spouse or partner is a long process.   Allow yourself the work it takes to heal.

 

It is often thought that children don’t grieve.  They do.  Children grieve in their own unique way, according to their personality and their environment.  They also grieve at their own developmental level.  They need consistent, loving support from honest, caring adults.  They need someone who they trust to answer their questions. Their main concerns are: Who will take care of me now? Did I cause the death? Will I die too?  Children continue to grieve as they develop.  Each new phase of their life allows them to view the death in a more mature way.Young children do not always have the verbal communication skills needed to express their pain. Arts, playing, drama and music are good alternatives. As much as possible, children should be given control over their own choices during and after the death of a loved one.

 

Whether a child dies during a miscarriage, infancy, childhood or adulthood, it is a death that goes against the natural order of life. Parents can feel as if it is their “˜job’ to take care of and protect their child, and no matter what the cause of death was, they often feel as if it was their fault, or they should have prevented it. Outsiders often minimize the death of an unborn or infant child, saying that the parents never “˜really’ knew the child.  It is this very fact that is so hurtful to the parents. It has often been described as, “The Death of a Dream” -a life time of yearning and wondering what that child would have been like.  A life has ended before it was barely begun. Often the parents have little or no time to grieve the loss of a child, because of responsibilities towards other children, aging parents or work. They may find themselves wanting to be over protective of any other children, and worrying constantly when a child isn’t at home with them. Parents sometimes struggle with feelings that the child they lost was one that they were closer to, or had more in common with. There are many dynamics that can be involved in their grief such as: losing their only daughter/son, losing their youngest or only child and having to change their lifestyle even more, regrets that they didn’t have time to do more together, watching other families celebrate life’s milestones such as graduations, getting driver’s licences and such. There is a feeling that the family circle is forever broken, and parents worry about their other children dealing with the loss of their sibling. Grandparents are often described as grieving twice-once for their own personal loss of their grandchild, and secondly for the pain that their own child is experiencing during this loss. When it is an adult child who dies, the parents often question why it wasn’t they themselves who died, and their child be allowed to live. (a type of survivor’s guilt) They also have concerns about who will take care of them as they themselves age, and can be saddened that the possibility of grandchildren is gone forever, or that their grandchildren might be separated from them, because of the death.

 

Some of the most challenging grief journeys are those from unresolved or conflictive relationships.  Following a divorce, there can be a lot of “˜unfinished business’ between people. If death occurs during this time, people can be left with consuming anger, regrets, hurts, financial concerns, and worries about child care. Sometimes one adult still loved another very much.

 

No matter what the reason, there are distinct differences in how the genders grieve. Most men tend to feel that they need to be “˜strong,’ protective of others, and refrain from crying.  They are often very task oriented during the funeral and their grief journey. Because of having analytical tendencies, men often try to figure out the death, or become involved in an agency dealing with the death.  Men often express their grief through activities.

 

Society continues to have stigmas towards certain deaths.  Some of these have already been mentioned in the homicide, children, and divorced descriptions. Disenfranchised grief is most easily defined by saying that the person grieving is not recognized for the closeness and importance of their relationship with the deceased, and they are given little or no support during their grief journey. This is often the case with Aids, people having an affair, or even the intimacy of a best friend or neighbour.   Disenfranchised grievers feel very lonely and isolated.