Stages of Grief

What follows is a summary of some of the common stages found in our reactions to grief and loss. Each of us may react a little differently but don’t be surprised to find yourself going through any or all of these stages. It is important to keep in mind that although some of these reactions include strong emotional upset, they are normal reactions to such situations and do not mean one has "emotional problems."

Many people have a strong immediate emotional reaction to loss. For many other people the first reaction to trauma and loss seems to be no reaction at all. They go into a state of shock and only feel numb. Sometimes people will deny to themselves that the event has happened, saying "it can’t be true." This is an automatic self-protective reaction that many of us use in order to cope with the initial shock. How long this stage will last varies from person to person but eventually the realization of the loss sinks in and they are able to cry or feel other emotions.

It is important to realize that whether your initial reaction is a very emotional one, or one of numbness, the reaction is normal. Once the emotions begin to be felt they could be a strong sudden surge or come in slow, gradual increments. Once they come, whether they be anxiety, grief, or anger, allow yourself to experience and express them. Don’t hold back the tears. Let them flow. If you try to hold back the emotions they will find expression in some other way on either the physical or emotional level. This may be difficult for some to do, especially men who are supposed to be "strong" and not cry in our culture, but the tears are needed as part of the healing process.

You may find it difficult to stop thinking about those who you have lost, or to get the frightening images of September 11 out of your mind. You may also find yourself unable to stop worrying about the potential loss of loved ones in the future.

There are several emotional reactions to loss, any number of which you may experience. One of the most common is a feeling of overwhelming depression which may include feelings of total despair, intense loneliness and hopelessness, and a feeling that nothing seems worthwhile. You may want to withdraw from social contact and be unable to follow your normal routines. With the despair may come the wish to run away or harm oneself. These feelings are especially intense for those who live alone or have few friends or family to turn to. In addition to these depression-related feelings may come anxiety, which at times can reach the point of panic, or one may have a feeling of "unreality."

Physical symptoms you may experience include sleeplessness, tightness in the throat, choking and shortness of breath, a hollow empty feeling in the stomach along with poor appetite and digestive symptoms, and a loss of muscular strength. You may experience some, all, or none of these reactions, but if you do they too are normal and natural parts of the process. They can be expected to be especially intense at the loss of someone we are close to, but the impact of what we witnessed on September 11 can produce them even if we did not personally know the victims.

There are two other reactions you may undergo. One, which almost all of us are having, is feelings of intense anger towards those we see as being responsible for these losses—those who have attacked our country. A danger in the current situation is that some will place blame where it does not belong, blaming people who share some similarity to those who are actually responsible. One may also feel an inexplicable anger towards friends and loved ones who, for various reasons, may not be able to provide the emotional support that was hoped for. The last emotional reaction to be mentioned here is that of guilt which will hit some people as they think of things they "should" have done to be of help but didn’t. Also, those who survive often will feel guilt that they survived and others did not.

Healing

Time, the ventilation of feelings and the acceptance of support from those around us leads to a lessening of the painful reactions previously discussed. The healing process can then be accelerated by actively doing the things we once enjoyed, such as doing things with and for those we care about. Although the healing will eventually occur the emotional scars do not fully disappear. There may be times when the cycle of grief will again hit you. This too is a normal part of the process, and the pain will again subside. Holidays and anniversaries of the person’s death are particularly difficult times.

The process, from numbness to re-adjustment, is often thought of as being comprised of discrete stages. Each of us, however, will have our own path to follow, moving back and forth between the "stages" at our own pace. Progress towards re-adjustment will be facilitated by expressing and sharing the feelings as we experience them.

Two important points need to be kept in mind when we consider this process. First, remember that the people you share your feeling with may not be in the same "stage" you are in and therefore may not give you the response you are expecting; you may be expressing anger or sadness and they may be "numb" and therefore be expressing no feelings at all.

The second point is to realize that the above discussion outlines what one might experience in response to a single traumatic loss. If we enter a lengthy war, then we may be exposed to a lengthy series of traumatic losses. Americans will die even in successful military engagements. Our adjustment may then be much more complicated and difficult. We may cycle back and forth between stages or find ourselves "stuck" at one stage (i.e. always angry). When one feels repeatedly assaulted some degree of numbing, or "tuning out" to protect oneself emotionally is often the response that occurs.

Utilizing available resources

While all the emotional reactions presented above are normal natural reactions to trauma and loss, it is recommended we utilize the resources available to us. By far the most important resources are our close friends, family, and loved ones.

With the support of those who care about us we can all weather these tough times.