Surviving Grief ... and Learning to Live Again

By Catherine M. Sanders

An insightful, compassionate account of the grieving process thathelps us through the pain and isolation experienced with the lossof a loved one.. We're never really prepared for the loss ofsomeone we love. Thrown into a state of emotional chaos weexperience rage, guilt, anxiety, and intense sadness all at once.It's the oldest story in the world, we tell ourselves -- millionsof people have had to cope with this before -- and yet, we alwaysbelieve that what we are experiencing is unique to us. We feelisolated in our anguish and often ashamed of what we are feeling. Aprofoundly compassionate and insightful book, Surviving Grief.& Learning to Live Again offers you the support andunderstanding you need to get you through this difficult time.Written by Dr. Catherine Sanders, a therapist and researcherspecializing in bereavement issues and one who has lived throughthe loss of close family members, it helps you to see that what youare feeling is part of a natural process of readjustment andrenewal. According to Dr. Sanders, grieving, like any other naturalregenerative process, must be allowed to run its proper course ifwe are ever to regain our equilibrium and continue on with ourlives. To help us better understand the process, she describes thefive universal phases of grief: Shock, Awareness of Loss,Conservation and The Need to Withdraw, Healing, and Renewal, andguides us through each. Drawing directly from her own experiencesand those of her clients and her research studies, she delvesdeeply and compassionately into the different experiences of grief,and talks about what it means to lose a mate, a parent, or a child.And she discusses the factors that can have an influence on thegrieving process, such as age, gender, and the circumstancessurrounding the loved one's death.

• Language: English
• Publisher: Wiley
• Release date: Aug 13, 2015
• ISBN: 9781119194460

Book preview

CONTENTS

Cover

Title Page

Copyright

Dedication

Preface

Acknowledgments

To One in Sorrow

Prologue: An Autobiography of Grief

Self-Profile of Bereavement

Chapter 1: The Pain of Grief

Why Do We Grieve?

Grief and Identification

Grief Work

Why Does Grief Hurt So?

What Complicates Grief?

How Do We Get Through Bereavement?

Will It Ever End?

Chapter 2: The First Phase: Shock

Characteristics of the Shock Phase

Physical Symptoms of the Shock Phase

Social Aspects of the Shock Phase

Ending The Shock Phase

Chapter 3: The Second Phase: Awareness of Loss

Ending the Awareness-of-Loss Phase

Chapter 4: The Third Phase: Conservation and the Need to Withdraw

Ending the Conservation and Need-to-Withdraw Phase

Chapter 5: The Fourth Phase: Healing—The Turning Point

Ending The Healing Phase

Chapter 6: The Fifth Phase: Renewal

Ending the Renewal Phase

Chapter 7: When a Child Dies–Parental Bereavement

What Causes Parental Bereavement To Be So Severe?

What Makes Parental Grief Different From All Other Losses?

Effects on the Marriage

Finding Meaning in the Loss

Chapter 8: Death of a Spouse—Losing a Mate

Breaking the Connections

What Marriage Means

What Separation Means

Comforts in Bereavement

Chapter 9: On Becoming an Adult Orphan—A Parent Dies

Our Parents: Our Buffers

What We Lose When a Parent Dies

When We Lose Both Parents Within a Short Time

When Our Parent Dies From Chronic Illness

When We Must Institutionalize Our Parent

Our Need For Support in Bereavement

Chapter 10: How the Family Grieves

Family Balancing

Factors Creating Problems in Grief

Open and Closed Families

Children'S Bereavement

Siblings' Bereavement

Chapter 11: The Power of Mourning Rituals

Rites of Passage

The Value of Funerals and Memorial Services

Leavetaking Rituals

Planning a Ritual of Our Own

The Power of Self-Generated Rituals

Chapter 12: Transcending Grief—Alive Again

Love: The Guiding Force

The Lessons of Grief

Transcendence

Appendix: Support Groups That Offer Help

References

Index

About the Author

End User License Agreement

Surviving Grief . . . and Learning to Live Again

Catherine M. Sanders, PhD

Wiley Logo

Copyright © 1992 by John Wiley & Sons, Inc.

All rights reserved. Published simultaneously in Canada.

Reproduction or translation of any part of this work beyond that permitted by Section 107 or 108 of the 1976 United States Copyright Act without the permission of the copyright owner is unlawful. Requests for permission or further information should be addressed to the Permissions Department, John Wiley & Sons, Inc.

This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If legal advice or other expert assistance is required, the services of a competent professional person should be sought. From a Declaration of Principles jointly adopted by a Committee of the American Bar Association and a Committee of Publishers.

Library of Congress Catalqging-in-Publication Data

Sanders, Catherine M.

Surviving grief and learning to live again / Catherine M. Sanders.

p. cm.

Includes bibliographical references.

ISBN 0-471-53471-4 (pbk.)

1. Grief. 2. Bereavement—Psychological aspects. I. Title.

BF575.G7S263 1992

155.9′37—dc20

91-43605

Dedication

I dedicate this book To the wonderful people in the Tampa Bereavement Study who, with broken hearts and spirits, willingly shared their stories with me in the hope that they could be of some help to others. My deepest gratitude goes to each one.

Preface

When I was writing Grief: The Mourning After, my earlier book for caregiving practitioners, I kept slipping into sentences that were speaking directly to grieving persons rather than to the professional caregivers. I think I had already decided that a second, more personal book, written for those who are experiencing grief firsthand, could reach and help many more people.

I've drawn from a wide variety of resources to write this second book: my own research, therapy with bereaved individuals, and my personal experience with deaths in my immediate family. A large part of the information here is based on a research project I conducted in the Tampa, Florida, area. I met with 125 bereaved individuals who had lost a spouse, a child, or a parent. I followed each person through his or her first two years of bereavement. I met with each of them several times, and we usually became good friends. Throughout the book, I refer to my research project as the Tampa Study. The information gained from this study has given me valuable insight into the course of bereavement, and it is the cornerstone for the phases of grief I describe in Chapters 2 through 6. I call this whole approach the Integrative Theory of Bereavement.

Most of us don't know what grief is like until we lose someone we love, and no two experiences of loss are exactly the same. The closeness to us of the person who dies; the time in his or her life—and in ours—when death comes; and the unique circumstances of each death all make a difference in the way we grieve and in the length of time we take to heal.

Grief's common denominator for us all, however, is pain. When we lose a dearly loved person, we feel unbearable emotional pain. There is no getting around the pain; we must move through it if we are to heal. Trying to avoid the painful emotions of grief only leads to greater problems—illness or serious chronic distress. Worst of all, avoiding the painful feelings of grief leaves us psychologically stuck where we are, unable to change and grow.

Grief is felt on many levels at the same time. Physically, the symptoms include headaches, gastrointestinal discomfort, palpitations, dizziness, and, possibly, panic attacks. Psychologically, the distress can be experienced as yearning, crying, anger, frustration, and feelings of guilt and shame. Social deprivation is another level of grief. When we lose a significant person, we experience social isolation and alienation because we see ourselves as different from others and different from ourselves before the death occurred. When our husband or wife dies, our roles in the community and in our close circle of friends can change drastically.

What heals us finally? When we actively move through the phases of grief, we work toward restoring a healthy perspective. We can't deal with grief passively; we have to participate fully.

Each of us experiences each loss of a loved one in a unique way, often depending on how close we were to the person during life and how prepared we were, together, for the reality of the person's death. Still, the best preparation cannot protect us from the intense pain that follows the loss.

My prologue is a description of my own losses, across three generations of my family. Read it, and you will understand that I do know a survivor's devastating pain.

I think it is important for you to know the level of your own pain. Draw your own Self-Profile of Bereavement by answering the questionnaire on pages 19–21. Put a date at the top of your answer sheet. A few months after you finish this book and actively put into effect the help I am offering, fill out the Self-Profile of Bereavement again, and compare your results against your present score. This will give you an idea of the progress you have made toward resolving your grief.

My book explains the complete process of bereavement. As survivors, you move through five phases of grief: shock, awareness of loss, conservation/withdrawal, healing, and renewal. You're in one of those phases now. When you understand those phases, it will become easier for you to move more calmly into each new phase. You may often wonder whether you're going crazy; this book will help you to accept grief as a natural experience. You'll see your reactions as part of a normal process that you must move through, to accomplish healing and renewal. The stress you are feeling will then be greatly reduced.

In surviving the death of someone dear, we face one of life's most agonizing challenges. We have the opportunity, once we have worked through the phases of grief, to surface as a stronger, more competent, new individual. The working through takes time, energy, and a persevering heart. Many times, we feel like quitting. In these times of loneliness and defeat, our courage is at its lowest. And yet, something carries us through: something, call it what you will—God, providence, or a higher power—gives us the strength to begin again. I believe that unless we can rely on some higher power to help us through the long and arduous journey of grief, we can't deal with the need to forgive, to love, or to fully belong to other important relationships.

In this book, I join the disciplines of experimental research and clinical application with spiritual dimensions. I am firmly convinced that grief deals with issues of the soul as well as emotional and physical issues. To understand the grieving process, it is important to be able to embrace all three.

My hope in writing this book is that you will understand that grief has a progressive course and that your grief will move through the steps of that course. Through all your pain, I hope to reassure you that you will survive and, in time, you will feel alive once more.

Catherine M. Sanders

Charlotte, North Carolina

April 1992

Acknowledgments

First and foremost, I want to thank all the bereaved people who have contributed their stories, their suggestions, and their enormous courage and wisdom to this book: participants in the Tampa Study, patients who allowed me to share their journey, and the many other bereaved persons I have met along the way. Their stories are all here, although I have changed their names and shifted some of the situations surrounding the deaths in order to preserve their privacy and confidentiality. I am deeply indebted to each of them.

I am grateful to my daughter, Catherine Merrill, for her careful reading and professional comments as well as her strong support all during the writing of this book. How lucky I am to have a writer in my family.

To my long-time friend, Mary Howerton, I owe two debts of gratitude. Not only did she spend many hours scanning each chapter as I finished it, but she allowed me to use her beautiful poem, Flight, which is in print for the first time. I appreciate having it become a part of this book because she has become a part of my life.

Ours and Mine, another original poem, was written by my dear friend, Harold Boysen, shortly after the death of his first wife, when he was in deep grief. It is with a great deal of love and pride that I include his poem.

In Chapter 11, on mourning rituals, I have drawn extensively on the work of my good friend, Virginia Hine. Virginia was a teacher for me in many ways, and I miss her deeply. I am grateful for the time we had together.

I am most appreciative of the interest, patience, and support I received from Herb Reich, senior editor at John Wiley. He was brave enough to attempt a second book with me, thank goodness.

Maryan Malone, of Publications Development Company of Texas, the manuscript editor for the book, did an outstanding job in adjusting the text to read more smoothly. I am fortunate to have had such an experienced and capable person handling this end of the production.

Particular mention goes to my office manager, Kay Burns, who typed all the drafts, deciphering my marginal hieroglyphics with amazing accuracy. I am grateful for her help.

Finally, appreciation must go to my daughters, Sue Labella, Sally Bowers, and Catherine Merrill, and to my sister, Mary McKinney, who encouraged and supported me all along the way. They shared the losses and the griefs that provided the springboard for the writing of this book. I am fortunate indeed to have such staunch fellow journeyers.

C.M.S.

To One in Sorrow

To One in Sorrow

Let me come in where you are weeping, friend,

And let me take your hand.

I who have known a sorrow such as yours,

Can understand.

Let me come in. I would be very still beside you in your grief;

I would not bid you cease your weeping, friend,

Tears bring relief.

Let me come in—I would only breathe a prayer,

And hold your hand,

For I have known a sorrow such as yours,

And understand.

Grace Noll Crowell

To One in Sorrow from SONGS OF HOPE by Grace Noll Crowell. Copyright 1938 by Harper & Brothers; copyright © renewed 1966 by Grace Noll Crowell, reprinted by permission of HarperCollins Publishers Inc.

Prologue: An Autobiography of Grief

I was four years old when my Aunt Ada died. She was living in our home when she became ill with cancer. Mother nursed her through her long illness and was with her when she died. I don't remember any of these events but, from age four, I had an image of Aunt Ada lying in state on our sunporch, in a white wicker casket. The casket wasn't made of wicker, yet I retained that memory for many years without ever questioning the use of wicker as a casket material. Because we rarely talked about death in our family, I was a teenager before I asked Mother, Is it true that Aunt Ada was buried in a wicker casket? She laughingly assured me that it was not true. The fact that Aunt Ada's casket was white had confused my memory.

I did not look at my aunt in her casket nor did I attend the funeral. All the children in the family were quickly whisked away for some time in the country with close family friends. Children then, as now, were sheltered from morbid sights that might traumatize them. My mother had a realistic acceptance of death, for she had dealt with many family deaths herself, but that was the way things were done then.

There were no deaths in my immediate family until my father died, when I was eighteen. Two months earlier, he had been given a diagnosis of lung cancer. Although he became very ill, the words cancer and death were never heard, and the entire family spoke only in terms of his recovery. My parents had been separated since I was five and my father lived in another state. Yet, his three children were with him during his hospitalization. When he died, we were completely unprepared, and suffered shock more than anything else. We had been disengaged from him for such a long time that our loss was of a father figure more than of the man himself.

We had no guidelines to follow. My brother wanted to sit up all night with my father's body at the funeral home, but a vigil wasn't allowed. (The funeral industry has a tremendous control over our death rituals.) I remember being terrified when I stepped into the viewing room alone. I wanted to say good-bye, but I was not able to approach this silent, still body of the person who had been my father. I felt ashamed that I couldn't go near the casket, but it didn't occur to me to talk about my feelings with anyone. Death and one's reactions to it were simply not discussed. I accepted the rule that one must be very brave, and felt I had somehow fallen short of my duties.

I can only guess how agonized my brother must have been; he was much closer to Dad than I was. But he kept his reactions to himself like a young soldier. It was surely no coincidence that his first alcohol-related problems began a short time later.

After the funeral, our family went our different ways. Death did not touch me again for many years. Then it hit with all the force of an earthquake, and my life and my family's were changed forever.

When my husband's work took him to Florida, we moved there with our two younger children. Our two older daughters remained up north, one beginning work in New York and the other entering nurses' training at Massachusetts General Hospital in Boston. Our move left us feeling terribly fragmented, and we tried to compensate by doing things together.

Even with a busy life in our new home, I had more free time than I was used to. We hadn't yet made enough new friends nor had we become involved in the community. Jim, our son, was making a poor academic adjustment, after his transfer from a small private school up north to a large public school in Florida. I decided to enroll in some courses at the local junior college and chose subjects that were giving Jim trouble. Classes began for me the last week of August, and I plunged in determined to show him how tough school could be for some of us.

On Labor Day, we decided to stay home and enjoy our own pool, our dock, and our boat for water skiing. We would play it safe, away from highway traffic. I settled myself by the pool with my French textbook. Catherine, our youngest, went off with some newfound friends. Hersh, my husband, stretched out for a nap, and Jim, with a group of friends, fueled the boat and took off for some water skiing. I remember watching my tall seventeen-year-old walk toward the dock, and thinking to myself, How well he is developing, filling out. How fine he is becoming. He had everything going for him. That was the last time I saw him alive.

Not more than an hour later, a strange boat careened toward our dock. As it drew nearer, I made out my son's best friend, standing up and shouting, Get an ambulance— Jim's been hurt. (I get sick to my stomach again as I write this. Strange, how that awful fear and nausea still reemerge when I focus on details of that day.)

The freak accident was partly caused, we guessed, by Jim's poor eyesight. Without his glasses, his vision was roughly 20/200. Skiing behind our boat, he had made a wide swing when another boat was approaching from the opposite direction. We supposed that Jim spotted the boat too late. He dropped the ski rope and, as he slipped into the water, he was struck in the head by the oncoming boat. The impact was so great that a passenger in the other boat was hurled into the water. We didn't know it at the time, but Jim had sustained a massive cerebral hemorrhage and a broken neck. We waited for the ambulance and watched helplessly as various life resuscitative methods were attempted. We were in a confused blur, not allowing ourselves to believe Jim would die. I know he was seriously injured but somehow I didn't admit the thought that he would die. (How could he? Children don't die.)

When he was placed in the ambulance, he was intermittently breathing and his color was good. My husband and I jumped into our car and tried to follow close behind the ambulance, but we couldn't keep up. We arrived at the hospital emergency room a few minutes after Jim did. We raced toward the desk and asked for our son. When the nurse asked us to wait in a tiny examining room, a cold terror swept over me. Even then, I don't think I allowed the possibility of death to enter my awareness.

We waited about five minutes, alone, neither of us daring to speak, before a doctor appeared. He was a young man, probably a resident; he seemed angry. His first question was, What happened? I quickly countered, Never mind what happened. How is my son? He answered without hesitation, Your son is dead. Just like that. Not, I'm sorry. We did all we could. No other words to help ease the pronouncement.

I couldn't move. I couldn't respond. I sat there numb, staring straight ahead, unable to comprehend the impact of what had been said. I don't know what I thought. I was plummeting downward on a roller coaster, with sights exploding on each other, and I was incapable of separating them or stopping the ride.

The doctor said a few words to Hersh and left. A nurse came in and said to me, For God's sake, why don't you cry? Would she have been more comfortable, had I broken down then? Ironically, she may have