Chapter Three The First Grief Phase; Early Grief - Robert Zucker (PDF)

Chapter Three The First Grief Phase: Early Grief Whether a death is sudden or anticipated, we often start out grieving in a state of shock. Even with time to get ready, deal with unfinished business and say good- bye, we’re often left unprepared for the absolute finality of death itself. This profoundly disconcerting period, called Early Grief, is a time when we’re struggling to face what seems absolutely unthinkable. This chapter will address three common reactions during Early Grief: Denial of Fact, Anxiety and Numbness. Denial of Fact Grief can be crazy making. While you do know that a death has occurred, on some level you still don’t believe it is true. We typically begin grieving with a shout of denial: “No! This is impossible. It can’t be true!” You may find yourself in this sort of state of absolute, irrational disbelief. The time frame of Early Grief varies, and sometimes, as in the example below, extraordinary circumstances may entrap us in this early response period for a long, long time. During a morning break at one of my seminars, a woman shared with me that she had been struggling with a kind of immobilizing disbelief for three years. When I  asked her what had happened, she explained that both her husband and her son had been murdered three years earlier. Understandably, the trauma of two violent and shocking deaths followed by the drama of a prolonged and public trial kept her in a state of denial longer than most of us ever have to endure. Only after the trials associated with the deaths of her husband and son were over could she finally move beyond Early Grief. Later in this book we’ll examine challenges that families face when deaths are traumatic or violent. More typically denial of fact lasts hours, days, or sometimes months during the phase of early grief. This is normal and is often a very effective way of managing the news when something terrible has happened. Denial during Early Grief manifests itself in various ways. For instance, it would be normal to find yourself dialing your loved one’s phone number, thinking you see him in a crowd of people, or believing you hear her car pull into the driveway. You may also wonder if you are in the middle of some sort of bad dream and imagine that when you finally awake you’ll return to the world you once knew. Perhaps the reason so many of us experience denial in Early Grief is because we need time to grasp the immensity of the loss in our lives. To take it all in at once would be too difficult, so denial allows us to look at what has happened in small, more palatable doses. However, denial does become problematic if it starts interfering with some of the normal challenges that you face during Early Grief. For instance, there are usually a slew of decisions to make and actions you need to take: choosing a funeral home, deciding whether to bury or cremate your loved one, and designing funeral or memorial services, to name a few. After denial kicks in, it sometimes becomes difficult to move into this more active, decision-making mode  typically required of us in Early Grief. If you are feel immobilized, it is important to remember that you don’t have to do everything alone—that there is often no better time than now to lean on your loved ones. As you move in and out of denial during Early Grief, consider calling on trusted family members and dear friends to assist you on your journey. Time and time again I’ve seen grievers start to take necessary action steps during early grief once their family and friends have joined them on the journey. There are times, however, when extraordinary circumstances separate you from those you need and love. For instance, you may be far from home as you face your loss; or, perhaps, a disaster has scattered your friends and family and left you and your child to face your loss alone. If circumstances make it difficult or impossible for you to connect with the people you would otherwise count on for support, then I urge you to contact a hospice in your area and request their support services. Hospices are committed to bringing people together during early grief, regardless of whether or not they cared for your loved ones. Hospice bereavement support services are typically free, and bereavement coordinators and volunteers are available to help you. Here’s how hospice support can make a difference. In Biloxi, Mississippi, a hospice team invited me to facilitate support groups after Hurricanes Katrina and Rita had devastated their city. As I toured the city, I saw homeless people roaming barren streets where houses and stores once stood. A large tent city had formed amidst the ruins in one downtown neighborhood. Thousands of residents were separated from loved ones and many survivors of the storms were scattered for hundreds, even thousands of miles. The entire city was grieving, but those who  established some semblance of a community connection fared much better than those who did not. In one support group that I facilitated, all group members were homeless, dealing with deaths and a whole range of other serious losses. They huddled together in a church parlor and shared their stories. A retired minister and his wife had recently re-located from Portland, Oregon to build their dream house in Biloxi. Their house had washed away in the storm. Now they were strangers in a city in ruins. They were impatient with one another and angry with God for their misfortune. A young married couple was trying to make the best of their new makeshift home, a tiny, claustrophobic FEMA trailer standing alongside the foundation of the washed-away structure that was once their house. A friend had just died, struck by a collapsed beam at his home. They had no family, and none of their other friends remained in Biloxi. Before Katrina, the husband was physically disabled with a back injury and his wife suffered with debilitating anxiety, but they had always found work “under the table” and could make ends meet. Now they were penniless. “All we have now,” she said to the group, “is our love for each other.” It didn’t seem enough to them, and they were desperate. A Vietnam veteran and his Cambodian wife had worked for many years together at a large casino now demolished in the storm. He told the group how, as the water in their home rose rapidly, he tied his wife onto his back and swam out through a window onto dry land. While swimming to safety, they saw their neighbor floating dead in the water. During the group his wife recalled how long ago in Cambodia her home there had been destroyed in a typhoon and many loved ones had died. Now, in America, she was frightened, homeless and bereaved once again.  A single woman could barely speak. She described how the debilitating flashbacks of death and destruction she was suffering interfered with her ability to concentrate at work. She feared she would be fired from her job. An elderly African-American woman was the last to speak. She told how she’d always been proud of her self-reliance, especially since her husband’s death a year earlier. Now she was living alone in a tent outside her demolished home, depressed and physically exhausted. Her children, displaced by the storm and living in Houston, were trying to hold their own families together. They were too far away to help their mother in Biloxi, and she was ashamed of herself for needing them. After everyone had shared their stories, there was silence. Then the disabled young man sitting with his wife rose from his chair and walked over to the older African American woman. He reached out to her and gently wrapped his arms around her. Everyone stood up to join them in a long and silent group embrace. A new community had been formed. Later, cell phone numbers were exchanged and plans were made to meet again. You don’t have to remain isolated. Like the group members in Biloxi, if your normal support network is unavailable to you at the moment, Hospice and other community resources can help you muster up the strength you’ll need right now to face the reality of your loss. In Appendices B and C of this book you’ll learn how to find hospice and other bereavement supports near where you live. Anxiety High Anxiety often occurs alongside denial. When I worked with doctors and nurses delivering bad news in the Emergency Room and ICUs of a large medical  center, I saw all sorts of anxiety reactions. I remember walking with a physician into the waiting room outside the pediatric ICU to tell a completely unsuspecting woman, only one hour after her son had been admitted to the hospital with “just a fever,” that her son was dead. Her disbelief and terror were palpable. She started to scream, and with remarkable strength, lifted heavy wooden tables and chairs over her head and threw them around the room. A wise nurse called the woman’s husband, who rushed over to the hospital. He found the doctor and me in a corner, nervously eyeing his wife, who was still out of control. Approaching her calmly, he waited until their eyes met. Then a deep, guttural groan emanated from them as they embraced, dropped to the floor, and wept together. Not every grieving person acts out violently, but all of us have intense feelings that can be just as paralyzing and intimidating. Some other common reactions during early grief include deep sadness, fear, confusion, forgetfulness, fatigue, irritability, longing and loneliness. In addition, you may have one or many of the following symptoms: you find that you lack energy, have headaches, backaches, muscle tremors, dizziness, digestive problems, tightness in your chest or throat, and are more sensitive than usual to noises in your environment. Appetite changes and erratic sleep are also common reactions in early grief. Think of these reactions as your emotional and physical responses to an unthinkable circumstance in your life. They are all normal reactions. Grief is exhausting and very hard work and you have only just begun to grasp the magnitude of what has happened. Numbness For some people, the reaction is delayed. Numbness sometimes comes very  soon after learning of a death. While this is normal, you may feel odd and uncomfortable as you realize your own absence of any emotions. In two examples below, early grievers were disturbed that they seemed to have no feeling reactions. They found it helpful, though, to learn that numbness is normal and feelings would emerge in their own time. At the deathbed of her husband, one woman whispered to me in a small, child-like voice, “I feel nothing. What am I supposed to feel now?” I told her that it was OK not to have any feelings at all, and that some feelings might show up a little later on. A few weeks later when we spoke on the phone, she told me that for the first several days after leaving the hospital, she clung to my words because they helped her feel more normal and begin to trust herself. At a bereavement seminar, a participant recalled that for the first year after her husband’s death she had no feelings at all, and that still, even ten years later, she was ashamed and felt inadequate as a widow, even though many feelings had surfaced after the one-year anniversary of her husband’s death. Like the woman I met in the ICU, she revealed that it was a relief just knowing that she was not nearly as odd as she felt she was and that her feelings were normal. If you are feeling numb right now, take comfort in knowing that this is a common way of processing our losses early on. Be patient. Sometimes numbness might occur a little later on during Early Grief, after a period of intense feeling. This is also quite common, and is often followed by a rather shocking re-surfacing of deep pain bursting forth, seemingly out of the numbness. Some refer to this rather disconcerting yet normal phenomenon as “the  calm before the storm.” In the anecdote below, Joan was able to sense that some painful reactions are coming soon. My client, Joan, started working with me after her eight-year-old daughter died of Leukemia. While she had many intense early feelings, about four months into our work together, she reported noticing an absence of any feelings at all. I’ll never forget what she said to me during a session: “I don’t know what it is, but I can feel something changing. This numbness is only temporary, I’m sure. I can’t quite describe it, but I just know it is going to be extremely difficult and intense when the feelings come back, as if I were sticking my finger into an electric socket!” Most of us don’t have Joan’s sixth sense. In fact, most grievers are alarmed by the second storm of grief that Joan felt coming. Try to remember that while it is easy for numbness to lull you into believing that your grief has ended and that the worst of your grief is over, your grief will probably reappear in full force. Later in Part Three, we’ll explore this Second Storm of Grief that typically follows Early Grief. For now, take comfort in knowing that a delayed reaction and numbness in Early Grief are quite common. Perhaps they provide ways that enable you to take your loss in small, more palatable doses. Whether your reactions have been overwhelming, hidden, or something in between, remember to trust that your feelings will emerge at the right time for you. In summary, denial, anxiety and numbness often come with the territory when grief is new. If this been your experience, consider the following suggestions of what to do when your grief is very new.  Reach Out to Others Grief can be immobilizing, especially when it is new, so start gathering your support network. Right now you need friends, family, or other support people close by to help you face what is happening and take necessary action. Cultivate Your Strengths As you face the unthinkable, you might lose sight of your unique strengths. It is normal to be unsure about whether or not you have what it would take to really handle what has happened to you. Ask someone you trust, someone who really knows you, to remind you how you’ve faced adversity well in the past. Gather your spiritual resources. For some, this means turning to a trusted clergy person or having a conversation with a hospital chaplain. For others, it may involve listening to inspirational music, practicing meditation, or watching the sunrise and sunset. Do small tasks that can be completed with success. Even doing the laundry or mending something that needs to be fixed can leave you with a sense of competence and accomplishment. Grapple With Your Anxiety Have you felt this way before? If so, how did you cope then? What did you learn about anxiety that can help you now? There are many effective ways to deal with anxiety. I often think of coping strategies for anxiety on a continuum, from meditation to medication. Certainly medication can be an effective way to manage  overwhelming anxiety, but you might also consider guided relaxation tapes, meditation, prayer, listening to soothing music, taking a warm bath and physical exercise. Have a conversation with a trusted friend or professional about various anxiety reducing strategies. Once you have begun to meet the challenges of your own early grief, you will be better prepared to start helping your youngster understand the meaning and the cause of the death that has touched your lives. The next chapter will explore how to walk with your child during Early Grief.