Pathways of Grief



Ongoing Grief Group for young adults and adults, age 19-39, who are living with the loss of an important person in their lives.  Participants will learn in-depth about the grief process, share their grief experiences and challenges with peers, and learn and practice skills to manage and move through grief.

The cost is $45 per session in addition to a pre-group individual session.  Some health insurance plans accepted. The group will meet on Thursdays, from 7 p.m. to 8:15 p.m.  Contact Maxine Sushelsky at 617-458-9072 or Maxine@transitionstherapist.com.
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Pathways of Grief I: Frequently-Shared Aspects of Grief

Each individual’s grief journey is unique.  At the same time, there tend to be commonly-shared aspects of the grief process.  Grieving might include feelings of shock, numbness, anger, sadness and guilt. The grieving person becomes preoccupied with the deceased (or other loss) and disconnected from others and the goings-on of the external world.

Another’s death reminds us of our own vulnerability and, consequently, our own mortality. We might think, "This person died, and so will I."  The death of a spouse, parent or older sibling might place the griever as the oldest living person in the family, creating an expectation that he or she will be the next person in the family to die.

An additional aspect of the grieving process is that death or loss often will remind the griever of past losses, and the feelings and circumstances associated with those losses. If grief over past losses is incomplete, the grief process might be more complicated. If the griever has integrated past losses, they likely won’t overwhelm the griever or overshadow the current loss; rather they will tend to be experienced as gentle remembrances.

Over time, these various feelings and behaviors tend to alternate with feelings of well-being and increased involvement with others and with life. The griever puts into perspective the awareness of his or her own mortality, and begins to reformulate an identity and a life that does not include the deceased. At the same time, the griever forms a new emotional relationship with the deceased, finding a way to keep alive a memory of the deceased, and perhaps finding an ongoing way to honor him or her. This is referred to as forming a continuing bond with the deceased.

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Pathways of Grief II: Complicated Grief

What is Complicated Grief?

With complicated grief, the griever either avoids or denies aspects of the loss, or remains preoccupied with the deceased, loss of the deceased and the feelings accompanying the loss.  He or she tends to remain isolated from others, and does not re-engage with life.  It is not the feelings themselves that define complicated grief.  It is the inability to accept and work through the feelings and move beyond them.  Rather, the griever often feels “frozen in time.”
  
When is grief likely to be complicated?

Factors that can lead to complicated grief:

o   when a loss is sudden or unexpected, creating a feeling of chaos or loss of control in the survivor.

o   when the circumstances of the death involve violence, such as suicide, homicide, or motor vehicle accident, creating an increased sense of horror and vulnerability in the survivor.

o   when the relationship with the deceased was enmeshed, ambivalent, conflict-laden or abusive.  In these circumstances, the survivor is often left with unresolved feelings towards, or interactions with, the deceased.

o   when the death is untimely, such as a child’s death.

o   when multiple losses occur at the same time, or the survivor has unresolved losses from the past.  When multiple losses occur at the same time, the survivor’s ability to grieve becomes overloaded, tending to cause an emotional shutting down.  When past losses were not grieved, those losses and accompanying feelings and circumstances come up with an intensity that can overwhelm the griever and make it difficult to focus on processing the current loss.

o   when the survivor has mental health issues in addition to experiencing grief.


How can one move beyond complicated grief?
Psychotherapy, also called counseling, can help a person move beyond complicated grief.  Generally, a person suffering from complicated grief will benefit initially from individual counseling.  As healing progresses, some people engage in group counseling, which can provide connection with others dealing with similar issues.  A psychotherapist/counselor can help the griever sort out and resolve issues that are blocking the ability to grieve.  Through counseling, the griever can develop skills to manage, tolerate and understand intense and disturbing feelings in a way that provides a sense of safety, structure and coherence.


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Unique Features of Grief in Young Adults

What is unique, and challenging, about the experience of grief for young adults?

Research studies have identified certain characteristics that make the bereavement process particularly challenging for young adults, age 19 through 29, including college students.  Here are some of reasons why a young adult might find the bereavement process difficult.

o   The death might be the first ever experienced by the young adult.  Additionally, a death might be the person’s first real awareness of his or her own mortality.

o   The young adult’s previous sense of fairness, safety and security in the world may be shaken. 

o   The young adult might be living away from home for the first time.

o   The loss might be of a parent or other role model, occurring during a significant transition from childhood to adulthood.

o   The death might result in emotional loss, as well as loss of practical support from the other parent, who is also grieving and, therefore, unable to provide much support to the young adult.

o   The young adult might need to assume responsibilities previously provided by one or both parents, such as financial, housing or transportation.

o   Young adults are at a crucial stage in their personal identity formation, as well as developing their skills and confidence in forming adult relationships and intimacy.

o   Young adults might be confused by the emotional intensity and potentially conflicting emotions brought on by the death of a significant person in their lives.

o   Young adults are at an early stage of defining or re-defining life purpose and life path, values, and spirituality, conceptions which might be altered by a death.

o   College students generally experience pressure not to miss classes and might experience difficulty keeping up with studies or employment.

o   Young adults might feel internal and external pressure to engage in extracurricular activities, to socialize and to “have fun.”  

o   Peers may be unsupportive due to their own inexperience and limited understanding of death. Research shows that young adult grievers report that their friends and peers expected their grief period to be shorter and easier than actually experienced. 

How can bereaved young adults get the support they need while going through the grief process?

Most counselors and psychotherapists can provide support to a person going through a difficult grief process.  Some colleges and universities, hospices, counseling centers and counselors offer bereavement support groups.  Some of these groups focus on specific populations, such as those grieving the loss of a parent, or the loss of a spouse.  Some groups focus on specific types of losses, such as people grieving the loss of someone through suicide, or through homicide.  The benefits of a bereavement group are that people often feel less alone in their grief, and give and receive support from others going through similar experiences.

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Contemporary Ways of Thinking about Grief and Grieving

Research, clinical evidence and evolving contemporary norms have all had a role in changing how mental health professionals, clergy and laypersons think about grief and grieving.  Historically, people thought that grieving should be private and mostly something not talked about.  Many people followed specific rituals established by their religion.  Ultimately, grief was something the griever was expected to “get over.”

The baby boomer generation had a significant role in re-conceptualizing grief and the grief process.  As a generation, baby boomers had access to considerable affluence, including material goods.  Boomers also were exposed to the casualties of the Vietnam War, whether directly or through intense and graphic media coverage.  Conflict and debate about the morality and efficacy of the war were prevalent.  These issues and other socio-cultural developments reflected distrust of conventional institutions, and bred a yearning for spirituality, personal expression and authenticity. 

Correspondingly, the experience and expression of grief became more open and personalized.  People began to speak more freely about their feelings, and expect a more personally meaningful experience of their loss, and from their loss.  Today, people tend to seek their unique truth, purpose and identity through their grief process.   There is more validation and celebration of the deceased’s life, and an acceptance of what is termed, “continuing bonds”—rather than simply getting over the death and moving on, the survivor’s relationship with the deceased continues, providing solace, and changing over time. 
 
The grief process is no longer seen as going through predictable “stages.”  Rather, it is thought of as “oscillating” back and forth between engaging in the “tasks of grieving,” and adjusting to life anew, which has been called “meaning reconstruction” and “relearning the world.”  Grief is a natural process and experiencing the pain and despair of the loss is a natural and necessary part of moving forward.   

For some people, support from professionals or other grievers can be helpful.  Grievers who had a conflicted or abusive relationship with the deceased, are isolated, or who have untreated mental health issues, will likely benefit from grief counseling.  Individuals experiencing “disenfranchised grief”—those who are unable to express their grief in public or are unsupported in their grief will likely benefit from grief counseling.  Disenfranchised grief happens when the deceased, the griever or the relationship is unrecognized or disregarded by society. For example, the griever is very young, very old, or developmentally disabled; the deceased died as a result of substance abuse, gang violence or suicide; or the griever and deceased were divorced, involved in a secret affair, or were co-workers.


Changes in how society views the grief process have opened the door to a more aware, accepting and individualized experience for grievers.  Although grieving a loss isn’t easy, over time it can be life-affirming, and grievers can maintain a continuing bond with, or memory of, the deceased that offers solace and the opportunity for personal growth. 


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References of Interest

Berger, S. A. (2011). The five ways we grieve: Finding your personal path to healing
      after the loss of a loved one. Boston: Trumpeter.

Jeffreys, S.J., Ed.D., C.T. (2004). Helping grieving people: When tears are not enough:   A handbook for care providers, (2nd ed.). New York: Routledge.

Klass, D., Silverman, P.R., & Nickman, S.L. Eds. (1996).  Continuing Bonds: New Understandings of Grief. Washington, DC: Taylor & Francis.

LaGrand, Louis, Ph.D.  Extraordinary Grief Experiences.

Mellick, J. (2001). The art of dreaming: Tools for creative dream work.
     Berkeley, CA: Conari Press.

Neimeyer, R.A., Ph.D. (2012). Techniques of grief therapy: creative practices for counseling the bereaved. New York: Routledge.

Rynearson, E.K., M.D.  The Violent Death Bereavement Society (VDBS). 
     www.vdbs.org/

Servaty-Seib, H.L. & Taub, D.J. (2010). Bereavement and college students: The role of counseling psychology. The Counseling Psychologist, 38(7), 947-975.

Stroebe, M & Schut, H. Models of coping with bereavement: A review. In Stroebe, M, et  al. Eds. (2001). Handbook of bereavement: consequences, coping and care.  (pp 375-403). Washington, DC: American Psychological Association.
       
Wray, T.J. & Price, A.B. (2005). Grief dreams: How they help us heal after the death of a loved one. San Francisco: Jossey-Bass.



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