Death is a topic that invites fear and fascination at the same time—both, our reactions satisfying a need for information and reassurance. For some, death is a yawning chasm of finality that steals away those we love. For others, death is an evolutionary process, in which we emerge more healed, wiser, or shrouded in light and love. Regardless of our beliefs, we will all die one day-- our physical bodies challenged beyond our capacity to recover from injury, illness or age. We will cross that point at which we no longer walk the earth in the same way we once walked. On that day, the rhythm of our hearts will cease and the days of our life on earth will end. Although we may not like it, we accept that fact. But, what about the one’s that we leave behind?

When we lose someone that we love, we are often shattered by the enormity of our loss. We may initially feel as though the loss did not occur. We may experience confusion, as though the loss was just a dream. We might even delude ourselves into believing that our loved one is simply away and will return to us. We may wrestle with feelings of anger or disbelief as we attempt to integrate the loss into our understanding of how our lives are unfolding versus how we may have expected them to unfold. We will all have a different reaction to losing someone that we love. Most of us will be changed by grief, never returning to who we were before the loss.

The famous poet, Maya Angelou, spoke of the pain of loss and her subsequent struggles for acceptance in her poem “When I think of Death”.

When I think of death, and of late the idea has come with alarming frequency, I seem at peace with the idea that a day will dawn when I will no longer be among those living in this valley of strange humors.

I can accept the idea of my own demise, but I am unable to accept the death of anyone else.

I find it impossible to let a friend or relative go into that country of no return.

Disbelief becomes my close companion, and anger follows in its wake.

I answer the heroic question ‘Death, where is thy sting?’ with ‘It is heart and mind and memories.’

When we lose someone we love, we are often showered with cards and flowers as expressions of sympathy from those around us. We may hold a funeral or ceremony to honor the dead and busy ourselves with the formalities of death. What follows days or weeks later is an echoing silence, filled with the gnawing pain of the loss. Inevitably, the offerings of support and sympathy fade and we can easily interpret this as a sign that it is time to move on. In truth, we do not allow much time for grief. We often rush through the grieving process without ever allowing the pain and truth of this loss to be understood or accepted. If we are employed, we are usually only afforded a few days off of work while we hold a funeral and clear away the details of our loved one’s unfinished life. Most people report that they never really had time to grieve because they were too busy trying to bury their dead. The problem is that we believe grief, like death, is an event with a clear and certain end.

Grief is a process. People are often surprised by the length of time they spend in the acute stages of grief. Research indicates that most people will experience intense symptoms of grief and related depression for six months to one year following the death of a loved one. Although symptoms may improve within that time frame, it is not unusual to experience grief for an extended period of time. Uncomplicated grief tends to improve over time, while complicated grief can worsen over time, leaving the sufferer to withdraw from friends and family and experience a diminished quality of life.

Grief is fluid like the ocean, with waves crashing in and receding back again. This ebb and flow is unpredictable and uncomfortable for those who suffer from grief. Most people prefer the entropy of funeral planning and memorial services to sitting in the silent aching finality of their loss that may occur weeks or months later. Those who suffer from traumatic or complicated grief experience the ocean of pain as it swells in a tsunami of agony and disbelief. This type of grief offers little reprieve and can create a lifetime of suffering and sadness.

Complicated grief occurs when a person experiences a loss that resulted from trauma or violence, a loss that is unexpected, or a loss that significantly impacts an individual’s quality of life. In short, complicated grief is a loss that “broke the rules”. This type of loss violates an individual’s expectation of how their story was supposed to go and challenges their view of themselves, others, and the world around them. Complicated grief can damage a person’s internal narrative regarding farness of life, the trustworthiness of others, or the worth of self. Complicated grief also bears similarities to Post-Traumatic Stress Disorder. In fact, studies indicate that the rates of complicated grief and co-occurring PTSD are estimated to be between 30-50%.

Today more than ever, we are inundated with stories of mass shootings, violence and terror. We are experiencing a dramatic rise in suicide and overdoses that leave loved ones of the deceased standing among the rubble of the inexplicable loss of a loved one. These types of experiences and subsequent symptoms of grief are much different than symptoms resulting from a predicted or expected loss. This type of loss is devastating and can alter a person’s ability to function for many years. In addition, individuals who experience complicated grief are at increased risk for long-term depression and even suicide. The symptoms of complicated grief can include depression, loss of appetite, ruminative thoughts about the person who died, an ongoing desire to join the person who died, withdrawal from family and friends, confusion, and high levels of anxiety. In short, those who experience complicated grief related to a traumatic event or unexpected death of a loved one may require significant supports to recover.

Recovery from grief is not an event, it is a process. While we tend to put much emphasis on saying goodbye to the deceased, those who grieve want nothing more than to hold on. In fact, our interventions or well-meaning words to this end may exacerbate feelings of sadness or hopelessness in those who grieve. If we can consider teaching the bereaved to find ways to hold on to their loved one, then we can be far more successful in helping them to comprehend and heal their loss. While we use words like “saying goodbye”, “Your loved one has passed on”, “Rest In Peace”, we may unintentionally push the bereft person to move forward into a world where their loved one no longer belongs. For many grieving people, that is a world they cannot begin to fathom and it is a world in which they no longer want to be a part. Our supports to those who grief should include encouragements to move forward, while carrying the sacred gifts and love given to them by the one who has died. We must encourage them to explore the depth of their connection to the deceased and to find a place that their loved one can continue to exist. In this way, we allow a link to remain between the griever and the deceased which can often free the person to heal differently than they might otherwise experience.

Some individuals take comfort in embracing ideas about heaven or a life beyond death. Others find solace in seeing their loved one at rest. Ongoing healing will also occur when a person is able to find meaning in their suffering or in the experience of loss. For example, what did the event mean to them then and now? Where did they find evidence of love, peace or kindness during the event(s), where do they see evidence of their loved one’s ongoing imprint in their life? Some find peace in continuing conversations with their loved one who died or in creating ceremony to honor the bond or love shared. There is no roadmap for grief, no timetable and no instructions. We cannot measure the volume or depth of love or subsequent grief.

While there is not solution or formula for grief, we will all find ourselves in a position where we are wounded by a loss. Sometimes, the loss isn’t of a person but involves an experience, illness or change of status in our lives. These type of experiences are less recognizable as grief but should be explored and understood in terms of the ways that it may alter our thoughts, experiences, lifestyle, perceptions or relationships. Individuals with grief related to events such as these can also be at risk for depression, anxiety, or substance use disorders.

Grief recovery is truly an ongoing experience. While symptoms generally improve, we will be prone to moments of sadness for that which we lost. While may be surprised by the voracity our grief and the duration of our symptoms, it is also evidence of our capacity to be absolutely vulnerable to another and to love selflessly and unabashedly. Grief is a void of sadness and longing that can either absorb us or alter us. In the end, if we are to truly heal from grief, we must consent to being altered by it. In doing so, we allow a part of ourselves to be a living memorial for the one who is gone—the keeper of a memory of what it means to love and be loved.