Grief: Coping with reminders after a loss

[David Baxter PhD]

Grief: Coping with reminders after a loss
September 8, 2006
Mayo Clinic

When you lose someone close, your grief doesn't just magically end in time. Reminders often bring back the pain of loss. Here's how to cope and heal.

When a loved one dies, you often don't experience the grief of loss just once. You're likely to relive your grief on the anniversary of your loved one's death and on special days throughout the year, such as a birthday or religious holiday. Even memorial celebrations for strangers who died in catastrophes, conflicts or disasters can trigger the familiar pain and sadness of a loss.

The return of these feelings of grief is not necessarily a setback in the grieving process. It's a reflection that the lives of others were important to you, and that you grieve their loss. Learning more about what to expect and how to cope with reminders of your loss can help make the grieving process a healthy, healing one.

When grief returns
The memories and emotions rekindled through reminders are called anniversary reactions. These reactions, which can last for days or weeks at a time, often give rise to a host of emotions and physical problems.

You may experience sadness, loneliness, anger, anxiety, nightmares and lack of interest in activities, just as you did when you first grieved. You may weep unexpectedly or replay images or scenes related to your loved one. You might have trouble eating or sleeping, or develop headaches, stomach pain or intestinal upset.

Anniversary reactions can also evoke powerful emotional memories ? experiences in which you vividly recall the feelings and events surrounding the death. You might remember in great detail where you were and what you were doing, for instance.

Common triggers of grief
Some reminders are almost inevitable, especially during the first year after a death. That's when you'll face a lot of "firsts" ? the first holiday after your sister died, for example. The first Mother's Day after losing your mom. The first anniversary of a national tragedy. Your reactions to these firsts might be intense, but you'll probably find it easier to cope with subsequent anniversary dates as years pass.

Common reminders that may trigger your grief also include:

• Weddings and wedding anniversaries
• Family gatherings or celebrations
• Childhood milestones, including the first day of school, prom, homecoming and other child-oriented days, such as Halloween
• Special days ? when you met, when you became engaged, when you last saw your loved one alive, when you took a big trip together, for example

Reminders aren't just tied to the calendar, though. They can be anywhere ? in sights, sounds and smells, in the news or on television programs. And they can ambush you, suddenly flooding you with emotions when you drive by the restaurant your wife loved or when you hear a song your friend liked so much.

Even years after a loss you may continue to feel sadness and pain when you're confronted with such reminders. Although some people think grieving should last a year or less, grieve at your own pace.

When grief becomes depression or PTSD
On the other hand, protracted or intense grief can be unhealthy. If you find that your feelings interfere with your ability to function in your daily life ? you miss work deadlines, have conflicts with family or friends, neglect your appearance or stop socializing, for instance ? you may no longer be simply grieving. Your grief may have progressed into depression or post-traumatic stress disorder (PTSD).

Depression
Symptoms of depression include self-criticism, feelings of guilt about the loss and even thoughts of suicide. If you're experiencing any of these symptoms, it's time to get treatment. Start by visiting your primary care doctor to discuss treatment options, such as psychotherapy or medication.

PTSD
In some cases, anniversary reactions can trigger PTSD. This is more likely to occur when you have recurrent distressful memories of something that happened to you personally, such as a mugging or a car accident. Signs and symptoms of post-traumatic stress include fear and anxiety, a lack of focus, sadness, changes in sleeping or eating habits, bouts of crying, or recurrent thoughts or nightmares about the event. If you have these disturbing feelings for more than a month, if they're severe or if you feel you're having trouble coping, see your doctor or a mental health professional.

Prepare for episodes of grief
Be prepared for the occasional return of feelings of grief. Knowing that you're likely to experience anniversary reactions can help you understand them and even turn them into opportunities for healing. Some people create new holiday traditions or ways of honoring loved ones who have died. You may find that symbolizing or expressing grief helps you cope better than denying or avoiding it.

Attending public memorials and ceremonies that mark the anniversary of tragedies, disasters and other events that claimed lives also can help. These kinds of ceremonies can help draw people together and allow you to share feelings with others who feel similarly.

You might find yourself dreading upcoming special days, fearful of being overwhelmed by painful memories and emotions. In some cases, the anticipation can be worse than the reality. In fact, you may find that you work through some of your grief as you cope with the stress and anxiety of approaching reminders.

Tips to cope and heal
Here are several ways to cope with reminders of loss and to continue the healing process:

• Be reassured that anniversary reactions are normal and that their intensity will diminish in time.
• Reminisce about your relationship with the person who died. Try to focus on the good things about the relationship and the time you had together, rather than the loss.
• Plan a distraction, such as a weekend away or a visit with friends or relatives.
• Start a new tradition in your loved one's memory. For example, make a donation to a charitable organization in the person's name on birthdays or holidays.
• If you find yourself becoming more anxious, sad or distressed by news coverage, limit your exposure to news reports about tragic events.
• Draw family members and friends close to you, rather than avoiding them.
• Find someone who will encourage you to talk about your loss. Stay connected to your usual support systems, such as spiritual leaders and social groups.
• Allow yourself to feel sadness and a sense of loss. Conversely, allow yourself to also experience joy and happiness as you celebrate special times. In fact, you might find yourself both laughing and crying.

 

[Lana]

I?ve been mulling over this issue for a while and figured I?d seek other perspectives because mine is not working very well for me ☺ This is a bit long.

My husband and I have been trying to have a baby since we got married, 10 years ago. In that time, I have suffered 3 miscarriages. First one was ?oh, it?s normal?, but it carried other damage with it, where we were both confused and somewhat resentful of one another. Our families knew what happened and in their attempt to help, just about everyone minimized the event. Second time ? nothing spoken, nothing shared. My husband and I endured on our own. I cried a lot and he held me a lot. Third time was the hardest. To make matters more complex, the entire ordeal was during Christmas and New years. I was a basket case, but this time around, I attend therapy. I?m getting to my point, I promise ☺

Recently, a friend of mine told me that her daughter was pregnant, followed by an email few days after that she, too, miscarried. It was her first and she is enrolled in the army where during conception, she underwent many inoculations, as well as breast reduction surgery. She was heartbroken, while none of them were ready for a baby, they, in the very short time, became attached to the idea of having an addition to their family. I understood where she was coming from?perfectly.

But, she needed to keep talking about it..how sad they were..how it was the wound that never healed?how it?ll never heal?.how attached they got?how hurt she was. I felt each and every one of those words 10-fold. Thinking that she is simply in the grieving mode, I attempted to remind her that I too have had my share of such aches, and still do. I told her that I understood her and was completely empathetic and was very sorry that it had to happen to them. To which she curtly said that she had lost a child in the past and she, too, knew. I instantly felt like I was in the middle of ?my grief is bigger then yours? and just kept my mouth shut. I suspect she sensed it and we ended our conversation shortly after. However, I was trigged in a bad way and to date, have not been able to shake it off completely.

My friend sent a letter to me and one other giving us an update on her situation and that her daughter had moved on but that she felt sad because she really wanted to be a grandmother. I also emailed and was hoping to explain myself for what I said last time, that I wasn?t trying to upstage her in any way and that the whole thing triggered me and that I really felt their loss, as well as my own. I have not heard a thing from her since then. It?s been about 3 weeks now.

I feel awful. I feel like I did something wrong. Maybe I was insensitive to my friend? Maybe, somehow, I wasn?t fair to her, stealing her moment, or something like that? I?m just so at odds with myself on this.

I?ve spoken with my therapist telling her how I felt and that I thought I had dealt with it?until that time. I was completely off guard with that one. She said not to rush anything and that my reaction was understandable. But?(there?s always a ?but??)What puzzles me is that I feel guilty! My loss is as raw as it was during the holidays, and the more intense it gets, the more I allow myself to feel that loss, the more guilty I feel. I know it?s totally out of whack but I can?t seem to snap out of it. It?s like I want to have a good cry, but instead I grunt and then I?m silent?nothing comes out. I need to let things happen but I?m afraid I?ll fall apart again.

I should add that this doesn't go on day after day....but it doesn't quite leave either. It just....lingers. I carry out my days at work, school, and home just fine...but the minute things calm down a bit, this is what I think about.

 

[David Baxter PhD]

I think there's a common misunderstanding that people somehow "get over" grief. They don't, ever. They just learn to accomodate it to a greater or lesser extent in their lives. Maybe your friend doesn't understand that yet.

I don't think you have any reason to feel guilty, Lana. Perhaps in time, your friend will understand that, as you say, it is not and never was a contest, and that when triggered your grief can be every bit as painful as hers, regardless of how long ago it happened.

Of course, it's also possible that she will reply in time and that the reason she hasn't replied yet is because she and her family are still grieving, or perhaps because she is embarrassed and trying to figure out how to respond.

 

[Lana]

Thank you for your kind and insightful words, David.

I?ve discussed this during my therapy session and to my surprise, broke down (again!) talking about it. My doctor said that I?m too good at suppressing feelings and the whole incident tripped me and I?m spilling all over the place.

Yeah, I still feel guilt, and since my last post, I added embarrassment to it. I realized that the other girl that our other friend (there are 3 of us) lost a partner. He died about 2 or 3 months ago after battle with illness. I feel ashamed for reacting the way I am because I have this thing in my head that says her loss is bigger then mine. Is that not warped? What is it that makes it so hard for me to just accept it for what it is and not look for excuses or reasons not to feel what I do?

I just can?t find that middle ground?at least not yet. Forever work in progress.

 

[David Baxter PhD]

Indeed. But it is progress, Lana...

 

[Into The Light]

lana, i have a loss to process too and i also struggle thinking that it's not as bad as what happens to other people. i've been feeling embarrassed a lot about it too, because in my case, no one has actually died, so what am i so sad about. it's like i feel i don't have the right to grieve. but what i am starting to realize is, it doesn't really matter what the loss is. loss is loss, and it all hurts. we can never compare our pain to another's, simply because we cannot feel what they are feeling. i've been slowly accepting that yes, this is grief, and yes, it is valid, and yes, i need to deal with it. other people's grief is really irrelevant. why would someone else's pain be more valid than our own? who decides when something is worth grieving? where do you draw the line?

i hope you won't feel guilty for too long because you have nothing to feel guilty about. you've lost 3 babies and that is incredibly sad. it's just as much a loss as losing a spouse, or the end of a relationship with someone very important to you, or anything else that changes your life irrevocably. it's a loss of a life that would have been, along with all the hopes and dreams that went with that life. your loss is valid, and nothing to feel embarrassed, ashamed, or guilty about. :hug:

 

[ThatLady]

There's no guilt here on anyone's account, as I see it. Each of us grieves loss. It doesn't matter what the loss is, if it's important to us, we grieve. One person's loss cannot outweigh that of another, since each person's feelings are related to how important that loss was to the person whose loss it is. Another cannot measure the grief that follows the loss. We can empathize with each other, but that's about all we can do. We can't retrieve that which is lost.

Hopefully, Lana, you'll be able to work through this issue with your therapist. In the meantime, there's nothing wrong with crying it out, and nothing wrong with feeling your grief. You're a human being. :hug:

 

[David Baxter PhD]

ladybug, you are absolutely right. Grief is grief. And when you are grieving, at that point in time, your grief is what one of my therapists called "the landscape of your life". It is what it is.