When to Be Concerned

There are times when the grief experience can be overwhelming and individuals and/or families may need more extensive counseling and support. Clues to more complicated grief and mourning include:

• Lack of basic self-care
• Unusual and alarming behavior patterns
• Suicidal threats or attempts
• Multiple losses that can be overwhelming
• Severe withdrawal and/or depression
• Substance abuse
• Radical lifestyle changes.

Healing Strategies for Helping Families Grieve

It is important when working with anyone who is grieving to do the following:

• Become aware of your own personal issues around grief. This means becoming aware of your own fears, attitudes, and beliefs about grief. For example, if an individual were raised to believe that “We don’t air our dirty laundry in public,” then that individual may have difficulty helping a family who needs to vent and share their pain openly and/or with great emotion.
• Acknowledge the family’s grief. Label their experience as one of grief. Let them know they have a right to have their feelings.
• Be there. One’s presence can be the greatest gift given to a grieving individual. Sometimes holding someone’s hand, offering a hug, or just acknowledging, “This must be so hard for you,” can be enough to support someone in their grief process.
• Listen. Grieving people need to share their pain with another person who will not judge them or give them advice and suggestions. Listening to someone tell their story over and over can often be an invaluable gift to them in helping them sort through their feelings and release their pain.
• Offer “permission to grieve.” Teach grieving families that it is important to express the emotions of grief, but that there are ways to express the pain that are more healing than others. For example, an angry parent can learn to express their anger through physical activity such as yard work, tearing up old phone books, writing letters, or screaming in a pillow. The key is to help grieving people find constructive ways to release their feelings of grief rather than to take it out on others or themselves.
• Help families create a memory book. This might include photos, drawings, funny things someone said or did, etc. This is especially helpful to families who have experienced a death.
• Develop and encourage support groups. Support groups give families a chance to share their pain with others experiencing loss.
• Children love, therefore they grieve. Encourage children to participate in all of the above suggestions. By teaching children how to deal with the pain of loss early in life, we can teach them how to grieve the losses that are an inevitable part of their future lives, losses such as moving, divorce, the break-up of a relationship, or the death of a friend, loved one, or pet. Children can draw pictures or write letters to an ill sibling or grandparent as a way to express their love and concern.
• Encourage families to write letters to someone who has died or is ill. Frequently they can express many unresolved emotions in letters that need never be sent. Writing a letter or note to a family member who is in crisis respite may offer a caregiver a healing release of feelings of frustration and despair.

Emotions of Grief

People experience the pain of grief with a variety of emotional responses which include shock (“it can’t be true”), denial (“the tests were wrong”), anger (“why did she get AIDS and not someone else?”), guilt (“why did I smoke [or drink alcohol] during my pregnancy”), fear (“how will I manage to care for him?”), exhaustion, depression, confusion, and bargaining (“if only we could have a miracle”). These are just a few of the myriad of emotions people in grief experience. It is also important to understand that people experience these emotions in a roller-coaster fashion: sometimes feeling up and hopeful, other days feeling deeply depressed, other days coasting along and feeling virtually no emotion. All of these emotions are a normal part of the grief and mourning process.