The Tasks of Mourning

The Kubler-Ross five stages of grief can be a helpful model to understand and make sense out of our loss experiences however alternative theories have developed more recently that focus on specific actions or what William Worden (Grief Counseling and Grief Therapy, 2008) terms “ the four tasks of mourning” otherwise known as the TEAR model of grief. Like the stages of grief, this approach emphasizes that the grieving process has no timeline, has no set order, and is different for each of us that is specific to the nature, relationship, and individual factors associated with each loss.  Worden suggests that mourning is a process to be completed so that balance in our lives can be restored. Here are the tasks:

Task #1: To accept the reality of the loss

The focus of this task is to gain recognition of the reality that the deceased individual is gone from our lives forever.  This usually begins to happen after the initial feelings of shock or denial dissipate. The reality of a loss can be accepted by steps that are taken (funeral/memorials) or talking about a loss by using past tense vocabulary when talking about the deceased individual.  Acceptance also occurs on a deeper level that addresses the significance of the loss and its impact.    

Task #2: Experience the pain of grief

The focus of this task starts with building awareness of the emotional experiences we go through that result from a loss.  In order to do this, we must recognize and acknowledge the different emotions we feel, whatever they are (sadness, loneliness, fear, guilt, worry, anger, etc). We work through these emotions by talking about them so that we can gain insight, perspective, and understanding about what happens for us. Over time, the complex emotions associated with grief can diminish as we work through them and our confidence in managing future difficult situations increases.

Task 3: Adjust to an environment in which the deceased is missing.

This task involves the process of assimilating to new ways of living with the loss.  Depending on the nature of the relationship with the deceased individual, this task can often occur over an extended period of time and involve changes to our everyday life (roles, responsibilities, routines), thoughts, beliefs, and expectations about our self, and spiritual belief systems and views about the world.  It is during this task that an individual goes through the process of redefining who they are without the presence of the deceased individual.  

Task 4: Reinvest in the new reality

For some it can be common to feel guilty about feeling happy again or we may fear that we may forget about the person who is no longer with us if we go on living our lives.  The focus of this task is to promote a healthy way to stay emotionally connected to the deceased by welcoming memories and thoughts about them while at the same time allowing new relationships, activities, and things that bring pleasure and joy to take place.  Like the previous tasks, this process may be challenging and take an extended period of time \

It is important to remember that like all of the other theories of grief, the tasks of mourning is just that, a theory.  Some may find this model helpful in understanding and navigating their grief while others do not. Grief is idiosyncratic in that it is different for everyone therefore it is important to find what feels right for you in terms of approaches, support, and coping strategies. 

Cory Stege, M.S., LMFT

Bouncing Back From A Break-UP

Relationships can be satisfying and rewarding, especially when strong emotional and physical connections develop.  Unfortunately, these aspects of attachment can make the end of a relationship painful and challenging. Break-ups come with potential changes in our day-to-day activities and routines, emotional health, physical health, and social life.  The act of moving on with life may seem daunting and impossible for some of us after a break-up however there are some strategies we can incorporate into our lives that can promote growth and resilience during these difficult times.

• Allow time and space to grieve.  The end of a relationship is a loss and should be experienced as such.  Healthy grieving involves feeling and experiencing each emotion that comes up as a result of the break-up and engaging in healthy coping skills such as journaling.
• Lean on your support system.  In order to prevent isolation, reach out to friends and family on a regular basis who can listen and support you in ways that you need. 
• Stick with your responsibilities. Just because a relationship ends, does not mean that our responsibilities also end. Continuing to follow through with regular tasks and routines can offer structure and promote positive feelings of accomplishment.
• Establish a new normal. Think of this time as an opportunity to create a new life for yourself.  This is a time to be selfish in order to nurture your needs. Make plans that will you believe you can benefit from and consider participating in new hobbies or activities you may find enjoyable.     
• Engage in regular self-care.  It can be challenging to remember to eat healthy, get enough sleep, and exercise when we are grieving or going through a transition however these activities of daily living are more crucial to attend to than any other time. 
• Seek professional help. Receiving guidance and support from trained professionals in the mental health, medical, and legal settings can provide tools that we may not otherwise utilize on our own.  Professional help can provide objective support so that we are able to function and make sound decisions. 

Every relationship is different and each of us will experience a different reaction when going through a break-up.  However, regardless of the circumstances and our individual traits, we can all benefit when we take care of ourselves during loss and change.

~ Cory Stege, M.S., LMFT

Mindfulness As A Tool For Grief

When we experience some form of loss it usually prompts change to take place in our lives, which can be very difficult to cope with. Loss bears a mix of emotions, thoughts, and behaviors that are unique to each of us.  Unfortunately our society tends to place expectations on how we should react when we experience grief, which just adds to the stress of an already stressful situation.  Comments of ‘you should be over this by now’ or ‘you need to be strong’ minimizes the degree of the impact loss may have.  Comments like these can influence grieving individuals to think and feel like they are not coping very well despite the fact that what they are experiencing is normal.  This in turn can cause grieving individuals to alter their expectations of how they should be thinking, feeling, and behaving which can increase symptoms of depression and anxiety. 

One of the most powerful and effective tools we can turn to during times of loss is mindfulness.  Mindfulness prevents us from ruminating in the past or worrying about the future and instead allows us to focus on the present moment.  Mindfulness techniques can help grieving individuals to challenge and minimize the pressure of reacting or being a certain way because of mindfulness’ crucial aspect of being non-judgmental with whatever thoughts and feelings that exist at any moment.   In other words, mindfulness allows us to pay attention to, acknowledge, and sit with our experiences so that it just is what it is, instead of being what we think it should or should not be.

Here are a few mindfulness strategies that can help us to acknowledge our thoughts and feelings in the present moment in a nonjudgmental manner:

• Body scan: Take a moment to notice what feelings and sensations you are currently experiencing starting in your toes, calves, knees, thighs, hips, abdomen, chest, shoulders, neck, cheeks, eyes, and scalp.  Then notice what types of thoughts you are having as you try to focus on your body and allow yourself to just sit there for a few seconds and focus on your breathing. If any judgmental thoughts or worries come into your mind, allow yourself to let them go and bring your attention back to your body. 
• Breathing exercises: Focus solely on your breathing by taking 4-5 deep breaths
• Use your five senses:  Sight: Identify 1-3 objects you can see. Sound: Focus on the sounds/noises you hear. Touch: Feel something within reach and identify the texture. Taste: Do you notice any specific tastes in your mouth. Smell: Pay attention to any odors you may pick up on.

~ Cory Stege, M.S., LMFT

The Dating Dilemma Following The Death Of An Intimate Partner

The loss of an intimate partner or spouse comes not only with the process of bereavement but it also presents the question of whether a future romantic relationship is desirable.  Grief is a very idiosyncratic process, which means it affects each individual differently and has no instruction booklet for how to navigate it.  The same goes for the decision to form new intimate partner relationships after a romantic loved one has passed on. For some, seeking out a new relationship can offer solace and comfort in the face of pain. For others, the loss of a significant love may cause avoidance of new relationships in order to prevent the pain and discomfort of subsequent losses. 

For individuals who engage in a new romantic relationship, it can be common to experience a sense of guilt that stems from the idea that they are being unfaithful to the deceased partner.  There may also be a fear that the deceased partner may be forgotten once a new relationship is established.  Understanding the reason for the desire to date again can shed some light on feelings that become triggered and provide insight in whether being in a relationship is truly desirable.  Individuals who successfully develop new romantic relationships and are not just filling a void following loss have the ability to both honor and let go of the deceased partner. 

One significant factor that contributes to finding this healthy balance is the ability to minimize the amount of comparison between the deceased partner and the new romantic partner. Love and longing for the deceased partner can grow over time which can lead individuals to feel like they are unable to experience love like they did when their partner was alive. However it can be helpful to acknowledge that being in a new relationship means new circumstances exist and thus the feelings and experiences associated with it will be different than those felt with a deceased partner. 

There is also the question of how soon is it okay to start dating again? Depending on whom you ask, the answer will be different and like grief, there is not a right or wrong answer.  Some individuals fall into a new relationship immediately whereas others wait years to do so. Unfortunately our society tends to place a spotlight on individuals who are grieving to see how they are coping and whether we feel it is appropriate or not.  However what truly matters is what feels right and brings comfort to the bereaved.

~ Cory Stege, M.S., LMFT

Journaling: A Tool For Grief

When life throws us curveballs that pose significant impact on our lives as grief does, it can often leave us feeling helpless and overwhelmed.  What do we do with the thoughts and feelings that accompany trauma and loss? We may not always feel comfortable sharing our experiences with other people for various reasons however we need to be able to find an outlet that allows us to manage our grief in a healthy manner.  Loss and trauma imprints some form of emotional, physical, and psychological distress that will seep into all aspects of our lives if we do not honor and express it. 

Journaling is a very simple, yet powerful tool that can allow us to identify and process our grief experiences in a confidential and safe way.  Journaling can also serve as an instrument to tell our story, which we can choose to look back and reflect on in order to uncover insight to our struggles and growth from them. Like grief, everyone’s experience will be different which means that there are no rules or right or wrong way to journal.  However you choose to write or express yourself is up to you.

Journaling can be done in either formal or informal manners depending on our needs and preferences.   Some of us may prefer to just write down words or phrases that come to mind whereas others may prefer to follow some type of structure or prompt.  Some people establish a ritual in which they journal at the same time each day or week whereas other people carry their journal with them and use it whenever it seems relevant to them.  Since journaling is for you and about you and your experiences, establish your desires and expectations of it based on that.

There may be times when we experience a block or feel stuck in how we can express our thoughts and feelings so here are some prompts related to grief that may help get the juices flowing or may be beneficial to those of us who prefer structure to our writing:

Today I feel…

I remember when…

What I have learned is…

My life has changed by…

The first time I…

My support system includes…

What brings me joy is…

The most difficult time of day is…

My fondest memory is…

I am grateful for…

Like most tools and coping skills, the more we practice and use a journal to express and process our experience, the more likely we are to reap the benefits of it. 

~ Cory Stege, M.S., LMFT

Grief: Empowerment Through Self-Care and Rituals

Loss is a natural part of life that we each will experience in one form or another throughout our lifetime.   The end of a significant relationship, the loss of a job, a change in social status, or the death of a loved one a few examples of how grief may enter our lives.  Loss can be sudden and unexpected or prolonged and anticipated however the manner in which it manifests and affects each one of us cannot be predicted.  Although research has indicated that grief tends to follow 5 primary stages that include denial, anger, bargaining, depression, and acceptance (Kubler-Ross, 1969), how grief exists from person to person is vastly differently from duration and intensity and the degree to which it affects an individual’s level of day-to-day functioning. 

The reason that grief is idiosyncratic is the result of specific factors related to each of our unique tendencies and personalities, degree of self-care before and after a loss, level of external and internal stressors prior to a loss, pre-existing mental health or medical conditions, social connections, and degree of resiliency.  The presence and ability to be resilient in the face of hardship or adversity is a primary determinant of whether an individual will cope effectively while grieving, despite the aforementioned factors that exist prior to a loss. 

One of the common aspects of grief is the sense of feeling like our world is out of our control because the familiarity we once knew before a loss may no longer exist.  When we feel out of control, we feel helpless which has the power to negatively infiltrate our thoughts and feelings, making it difficult to function.  In order to counteract our feelings of helplessness associated with grief, we can direct our focus and attention to aspects of our lives that we do have control over.  Here are two examples of how we can take control of our lives after loss:

Self-care, or the ability to purposefully engage in daily activities that nurture our physical, mental, and emotional selves, is one manner in which individuals can build resiliency after a loss.  Self-care begins with identifying and addressing our basic needs by intentionally engaging in healthy eating habits, sleep hygiene, physical exercise, and social engagements.  Creating and maintaining a routine to follow can be effective an effective strategy for developing healthy self-care habits as well as provide us with a sense of structure and accountability. 

Rituals are actions or activities that we engage in with the purpose of promoting a sense of comfort and familiarity during times of chaos and stress. Rituals can be done either publicly or in private and provides meaning and perspective in powerful ways.  Examples of public rituals involve funerals, obituaries, and memorials.  Private rituals may involve prayer, talking to the deceased out loud or in our heads, or maintaining activities and routines that were done prior to a loss.  For example, widows or widowers may continue to go to places that were a significant part of his/her life with a spouse prior to a loss. 

~ Cory Stege, M.S., LMFT

The 'Do's and Don'ts' of Comforting Those Who Are Grieving

Loss is an inevitable part of life that each and every one of us will experience, whether it is related to the death of a loved one, the end of a relationship, or the loss of a job.  Even though grief and loss are experiences that impact us all, the process associated with it looks different for each of us.  This means that there is not a “right” or a “wrong” way to grieve or a specific length of time that grief should last. The nature of the loss, an individual’s support system, additional stressors, and typical coping styles are some of factors that make the process of grief unique to each person. 

It can often be challenging to support and comfort someone that we know who is grieving and we can find ourselves at a loss for what would be helpful to say or do.  Here are some tips for what we can do as well as what we can avoid in order to be supportive to those who are in the midst of grief:

 DON’T:

• Think about grief as a problem that needs to be fixed.
• Avoid or ignore someone who is grieving because you don’t know what to do or say.
• Tell someone ‘to get over’ their loss and move on.
• Put a time limit on grieving.
• Give unsolicited advice.
• Assume that someone who is grieving does not need your help or support because they don’t ask for it.
• Make statements like “it is for the best”, “everyone is in a better place”, or “everything happens for a reason.”
• Make any judgments about an individual’s grieving process.
• Ask detailed or intrusive questions about the nature of the loss unless the individual wants to talk about it.

DO:

• LISTEN! Offer an ear and allow the grieving individual to navigate conversations about his or her loss.
• Separate your own thoughts, beliefs, and feelings about grief from the individual who is grieving.
• Be available and contact the grieving individual regularly.
• Anticipate possible needs of someone grieving and offer to assist (cook, clean, etc.)
• Be patient with the individual’s pace of grief.
• Offer to ‘just be’ with the grieving individual. The mere physical presence of others can send a significant message of support.
• Initiate plans (meals, walks, movies, etc.) with the grieving individual and understand that he or she may decline.
• Validate and empathize with the individual’s thoughts and feelings associated with grief. 

~ Cory Stege, M.S., LMFT

Emotional Responses to Grief and Loss

Grief and loss can be the result of various circumstances that may include losing a job, ending a significant relationship, or experiencing the death of a loved one.  Even though these circumstances can be specific to an individual and carry different meanings, the experience of grief and loss tends to involve common emotional reactions in us all.  Based on research conducted by Swiss psychiatrist Elizabeth Kubler-Ross (Death and Dying 1969),  5 common stages or emotional experiences to some form of significant loss were identified.  These stages are better known as DABDA:

Denial: Typically our first reaction to a significant loss involves some form of denial in which we may feel like the loss is not real.  We can feel like we are in shock and that there must be a mistake with what has really happened.

Anger: Once our denial has precipitated and the significant loss becomes more realistic, we tend to experience frustration and anger about why the loss occurred. Our anger and frustration can be expressed through looking for someone or something to blame the loss on, focusing on feeling like the loss is unfair, and seeking a desire to understand the reason(s) that the loss occurred.

Bargaining: This emotional stage involves some form of negotiation or compromise with ourselves or others in order to avoid any additional grief or loss. Typically this negotiation and/or compromise involves some form of lifestyle changes or shift in our perspective on certain areas of life. This reaction highlights our need to feel like we may have some type of control over certain circumstances.

Depression: This stage involves exactly what it is named...depression.  The depression stage mimics what a Major Depressive Episode looks like: sadness, difficulty sleeping, fatigue, loss of interest or participation in hobbies/activities, feelings of shame and guilt, feelings of worthlessness, difficulty concentrating, and thoughts of death.  In normal grief reactions, the depression stage does not last for longer than two months following the grief/loss event.  In the event that these symptoms continue, further assessment is recommended.

Acceptance: We enter the final stage of grief and loss when we are able to recognize that we cannot change what has happened and we possess the mindset that things will be okay.  During this stage, our emotional reactions are more stable and we feel that the loss is no longer significantly affecting our daily functioning.

Although the research has identified these five stages, it is important to understand that everyone grieves differently and that there is no “right or wrong” way to react to a loss.  There is not a set order in which these stages are or should be experienced; it varies from individual to individual. Some people go through all of the stages more than once while others only experience two or three stages.  Many factors can influence our grief experiences such as other stressors we may be experiencing at the time of the loss, our strengths and resiliencies, our support system or lack thereof, and our self-care skills to name a few.   

When we experience a significant loss and are grieving, engaging in self-care is the most crucial action we can engage in.  Consider how you can take care of yourself physically, emotionally, and socially during this time. Seeking therapy for additional support carries multiple benefits as well so if you or someone you know has or is currently grieving, don’t hesitate to take action now.  

~Cory Stege, M.S., LMFT