An Open Letter To Those Coping With Grief, With Love From Dr. Jess
As a Resident Psychiatrist, I’ve cared for people who have experienced the death of loved ones. In the days and weeks that follow the loss, they experience acute grief – that deep yearning and despondence, as their thoughts are focused on the person who died making it impossible to concentrate on anything else.
This is normal and healthy. That deep pain speaks to how deeply rooted our relationships are with those we love. During therapy, I provide support as they grapple with the stages of grief, described by Swiss-American Psychiatrist, Elisabeth Kubler-Ross as Denial, Anger, Depression, Bargaining, and Acceptance, though not occurring in any particular order. However, I spend a great deal of time throughout this acute period helping them to identify who makes up their support system.
I want to know who they can call to sit with them in their darkest hour, who will listen to stories of the life of their loved one, or who can whip up a good meal for them when eating seems futile. Asking my patients to identify their support system is important in the journey towards, Integrated Grief, a period when the thoughts, feelings, behaviors associated with their loss become integrated in such a way to honor the memory of their loved one. It gives grief a place in their life because grief is permanent – some say the final act of love.
Because we’ll all experience loss and the daunting nature of grief, here are some useful tips to cope with grief as well as recognizing when it is time to seek professional help — although seeking grief counseling is recommended at any point you could use additional support.
There is no rulebook for how you will experience grief.
While there are stages most can expect to experience during the initial (or acute) period of grief, you are an individual and how you express your emotions is unique to you. During grief, your anger may look like silence, while another’s may look explosive. Your sadness may present as weeping while another’s as social isolation. Your support system can be there for you by helping you talk through difficult feelings and keeping you from going into your shell. And, usually, as our elders say, “This too shall pass.”
In the acute grief, it can be normal to be “okay” one moment and “not okay” another.
There is a saying we use in psychiatry, “Grief comes in waves”. During the acute grief period, which can last weeks, your emotions may show up in their own way at any time. It’s okay. Give yourself time and space to feel by taking a day or two off from work in anticipation of the waves. However, remember to make plans with those you love to help prevent the lows from feeling too low. If this isn’t possible, consider other activities such as attending religious services or support groups to experience a sense of community. The purpose is to keep feeling, moving and staying connected to people you love.
If grief takes hold and doesn’t let go, you may be experiencing complicated grief.
With acute grief, we expect the pain to lessen with time. However, if you notice that months later you are longing for your loved one as strongly as when they first died or find yourself reacting strongly to reminders of them, this is concerning. Complicated grief affects 10-15% of the population, especially those that experience sudden, unexpected, or violent loss. It is a sign that it’s time to seek professional help to begin the process of acceptance and adapting to this tremendous loss. In the meantime, your support system can be there to help you process the experience of accepting help or even sit with you as you make the call for help.
Seeking professional help at any point in your experience is not an indication of weakness. It is behavior of someone taking responsibility for their health and wellbeing — and that’s power. Taking the steps to seek help isn’t easy, but can be the most important steps you can take to help you find the grace and courage to live on.
You are not your pain. You are love.
Dr. Jessica Clemons, MD is a Senior Resident Physician in Psychiatry at NYU Langone Hospital. She is the founder of Ask Dr. Jess, a mental health advocacy organization. You can connect with her on Instagram where she hosts weekly Q/A’s Live on IG every Saturday or Sunday at 12PM EST via @askdrjess