Stages of the Normal Grief Process
Some never go through a prolonged stage of shock and are able to express emotions immediately. Others will say "I feel numb" an no emotions or tears come. Sometimes there is denial. Gradually, the bereaved become aware of what has happened, and they are able to cry or show their emotions.
Many people begin at this point. It is good to cry in grief. Usually, if one does not express this emotion, it will be expressed in some other way – on a physical or emotional level. Some people may need to be induced to cry or need "permission". This is particularly true of men as our culture makes them feel uneasy about crying.
Pre-occupation with the Deceased
The bereaved may try to think of other things but finds her/himself unable to shift her/his mind from thoughts about the deceased. This is normal.
Symptoms of Physical Distress
These distresses come in waves lasting from 20 minutes to a full hour.
The most common distresses are:
- Tightness in the throat
- Choking, with shortness of breath
- A need for sighing
- Empty, hollow feeling in the stomach
- Lack of muscular power – hard to climb stairs – everything seems heavy
- Digestive symptoms – food tastes like sand, etc.
Closely associated with physical distress are emotional alterations:
- Slight sense of unreality
- Feeling of emotional distance from people
- Sometimes people appear shadowy or very small
- Auditory or visual hallucinations – especially of the deceased
These symptoms cause many to fear they are approaching insanity so it is important that they realize their emotional reactions are normal.
There is often disconcerting loss of warmth in relationships and a tendency to respond with irritability and anger. These feelings are surprising and inexplicable to the bereaved. This often makes the bereaved feel they are going insane. Anger may be directed at the doctor, the nurse, the mortician, God, the minister (who is the representative of God) or oneself. This is a normal part of the grief process.
There is always some sense of guilt in grief. The bereaved think of the many things they felt they could have or should have done, but didn't. They accuse themselves of negligence. Furthermore, if a person was hostile toward the deceased, there will be guilt.
The bereaved often feel there is nothing to live for – nothing seems worthwhile. They feel helpless or hopeless and sometimes talk of suicide.
The bereaved often withdraws from social relationships and may find normal daily routines of conduct are disrupted. This is normal.
The bereaved begins to re-enter relationships
Time and ventilation of feelings will finally produce a better situation. Some light starts to shine through all the gloom and darkness of despair. The person readjusts to his/her environment from which the deceased is missing and forms new routines and relationships.
Resolution and adjustment to the new reality
This gradually comes, but the scar is still there. There will be times when these grief stages might reappear, even though the bereaved may have thought it was "all over". This is normal – for many years, possibly forever to a some degree.
To move through these stages, it is necessary for the bereaved to express whatever tears, anger, guilt and despair they may experience. The biggest obstacle to moving through stages 9 and 10 is that many people try to avoid the intense pain involved in the process. It is important to ventilate all of one's feelings during the grief process.