Sunday, 3 March 2013

Grief: The Different Types

By Christine Brownlee
Grief is the result of a loss. When we are looking at grief as the result of a loss of a loved one we will find that it doesn't happen just at the end of a life but will occur over the many losses that happen during the illness and then afterwards. There will be losses to grieve throughout the journey and not just at the time of the final outcome. Examples are when you and your loved one are unable to attend a joyous family event, travel plans are put on hold or cancelled altogether, or you stop working to become a full time caregiver.
Grief can present itself in a number of ways depending on the circumstances of the death and the person who is grieving. The process of grieving is based on the person's perception of the loss. Healthy grief is a normal process but it is a lot of very hard work. It takes physical and mental energy to cope with all the changes and challenges and at times it will seem insurmountable..
Anticipatory grief is the grieving that takes place before the actual death of the loved one has occurred. This grief can begin at the time of a terminal illness diagnosis. It is the sense of impending loss with grieving beginning immediately. This type of grieving will be interwoven with the activities surrounding the treatment and care of the terminally ill person. Those that are grieving are doing so in anticipation of an expected death, date unknown. This is normal.
The above two types of grief can usually be completed when the grieving person does the work required with the help of family, friends and community. Other services such as counselling and coaching can be very beneficial in helping the bereaved person reach completion of their grief sooner rather than later.
There are times when grieving becomes unhealthy and requires some stronger intervention. Absent grief may be present when a person who has just suffered a loved one's loss and they do not exhibit any signs of grieving. They carry on as though everything is just fine and they seem to be managing effortlessly. This person may be taking great pride in coping so well. However it may also mean that they do not receive the family and community support that they do need because it looks like they don't need it. Grief will only be absent for so long. It will remain and the grief work will still need to be done whether it is now or some many years down the road. This can happen when a widow feels she needs to be "strong" for the children however, once they are grown the grief will still be there.
Unresolved grief occurs when the normal healthy grieving process cannot occur. There are different reasons for this happening. Someone who is too sick and frail to do the grief work could have unresolved grief. If there is so much guilt and the grieving person cannot move past this level of emotion and reach completeness there is unresolved grief. This type of grief can also occur if there are multiple losses such as a family is killed in a car crash or if someone is presumed dead but there is no body. Families of a missing person who has been gone for years can have unresolved grief.
Complicated grief is the presentation of the symptoms of the grieving person but they are exaggerated and continue on for a long time. When we first hear of the death of a loved one we feel some shock, denial, anger and deep sadness. Doing the work of grief we will eventually become complete with the loss. The process will resemble a roller coaster with good days and bad. Complicated grief appears as being in the valley with the initial symptoms never being resolved. There are never any "good" days or moments. The man whose son dies and five years later he has trouble managing the activities of daily living, he has lost his job because he cannot work, and his marriage has fallen apart are signs of complicated grief.
Disenfranchised grief occurs when the person grieving cannot openly display their grief. This can be because of the societal or cultural values that have been placed on them. An example would be the mistress of a man who has died. The man's wife, who is now the accepted widow can display and receive support for her grief. The mistress, if it was a secret affair, would not be able to receive the same support. She may even be shunned for grieving.
Absent grief, unresolved grief, complicated grief and disenfranchised grief can be types of grief that are not healthy and can have a detrimental effect on the person grieving. This can seriously affect them physically and emotionally leaving deep psychological issues affecting their quality of life. These types may mean the person grieving will need additional professional support in the form of mental health counselling, prescribed medications and therapies.
If you are grieving which one are you?
Christine is a RN with 35+ years of experience. She is a certified "From Heartbreak to Happiness" Grief Coach specializing in encouraging and inspiring women whose partner has died or is dying to reconnect with their life dreams and soar from sadness and sorrow to peace and happiness. She is currently working on her book 'A Caregiver's Story' - 7 Tips to Navigate and find Balance. This book stems from her being in the caregiving role for her husband on and off for the last 20 years. Visit her website http://www.griefcoach.ca for more information.
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