Understanding and Holding Acute Grief

Acute grief occurs immediately following the death of a loved one. It is characterized by intense feelings of loss, sadness, anxiety, despair and ironically, nothingness. You may experience mood swings, changes in sleep, changes in appetite, difficulty concentrating, headaches, stomach aches, dissociation and a host of other mental and physical symptoms. Simply put, it feels like being hit by a truck. Many of us may actually prefer being hit by a truck to experiencing acute grief. It can last for a period of days to weeks. For many people, acute grief is a mental health crisis. It pushes you to the absolute limit of your ability to cope, think, reason and problem-solve. Acute grief is never a situation that I recommend for anyone to walk alone. If you are or someone you know is in an acute state of grief, some general considerations and guidelines are:

1. Rally the troops. Holding grief by yourself can feel almost impossible. I highly suggest surrounding yourself with loving and supportive people who can listen to your story without judgment. If you do not have anyone in your life who can do this for you, consider finding a therapist who can hold that space for you while you work on developing relationships. This is repeated from last week but still essential.

2. Be aware of any suicidal thoughts. Some losses can cause us to feel as though your life no longer has meaning, purpose or joy. The prospect of living with this unending pain is too heavy and death seems a viable option. If this happens, call 211 and ask for a list of local crisis units where you can go to be monitored.

3. Lean on the wisdom of others. Your thinking will be impaired during acute grief. Empower your support team to help make decisions regarding funeral arrangements, medical decisions and financial decisions, to name a few. Ask for clarification and reassurance over the most basic of questions if you are in doubt about anything.

4. Avoid major life decisions. Do not quit your job, sell your house or leave the State. Again, your thinking is impaired and will remain as such for a while. I generally recommend a period of 6 months before making major life decisions.

5. Share your grief story. This is critical when experiencing acute grief. Acute grief can turn into trauma if not properly shared and processed. Talk about your story as soon as you can with a safe person.

6. Consider taking time off from work. This may not be financially feasible but there are options that can help. Speak with your HR department about bereavement benefits and short term disability benefits. A diagnosis of Acute Stress Disorder following the loss of a loved one is a qualifying diagnosis for disability.

7. Allow others to support you. If your friends and family want to send you meals or gift cards for meals, take them. If they want to start a go fund me page, let them. If they want to come do your laundry and drive the kids to school, let them. It’s okay to receive help and lean on others during this time.

Recap of Topic: Understanding Acute Grief

The grief following the sudden or even expected loss of a loved one is a period of acute grief. For many of us, acute grief is a mental health crisis as it tests our limit to cope, think, and regulate emotion. While not uncommon, thoughts of suicide should be monitored for and taken seriously. Sharing your grief story with a safe and supportive person is one of the best things to do during this stage of crisis.

Holding Chronic Grief

Contrary to the thought that time heals all wounds, the loss of a beloved is one wound that never really goes away. For some, it may feel as though a part of themselves died along with their loved one. Living after the loss of a child, spouse, or parent, will be different. While that may seem obvious, learning to coexist with that difference is the hardest part of holding chronic grief. In 1996, Dr. Lois Tonkin wrote an article entitled, Growing Around Grief: another way of looking at grief and recovery. In her article, she shared the story of a mother who lost her child several years ago. What she learned from the mother was that her grief never changed. It didn’t shrink, diminish or cease to bring her pain; however, the woman’s life was able to grow around her grief and continue to being meaningful and enriching. In the beginning of acute grief, it may be impossible to consider that your life could be meaningful again. That’s okay! Your process is your own. Furthermore, we already discussed that your thinking will be erratic and your emotions unpredictable. If you or someone you know is in the beginning of your grief journey, my hope is that you can hear the possibility that your life can grow with and around grief even if those words are not true for you today. Below, you will see an illustration of Tonkin’s model for holding chronic grief. With time, your ability to hold the fullness of life can grow.

Recap of Topic: Chronic Grief

Holding chronic grief is a daunting an unenviable task. The work of Dr. Lois Tonkin has helped us to understand that grief may not diminish over time, but you can grow around it. For me, one of the hardest parts of acute grief was thinking that this wasn’t supposed to happen. Over time, I have come to accept that loss is supposed to happen and I have learned to live a life that coexists with my loss.

Honoring and Holding Space for Loved Ones Who Died

The concept of honoring deceased loved ones is pervasive and shared across numerous cultures. The Egyptians built pyramids to honor the passing of Pharaoh’s. Mexico has a national holiday, Dia De Los Muertos, to remember and celebrate deceased loved ones and the residents of New Orleans, Louisiana like to fill the streets with music as a celebration of the person's life as much as a mourning of his or her death. A typical jazz funeral begins at a church or funeral home and leads the way to the cemetery. In honoring the passing of a loved one, we create a space to hold the person in our heart indefinitely. In my opinion, this the is closest thing to immortality we can experience on Earth. Finding a way to hold space for your deceased loved one, is part of your journey of growing around grief. Below are a list of suggestions, but, ultimately, there isn’t really a right or wrong way to do this. Your beloved will continue to take up space in your heart and mind even though he or she is no longer here.

1. Consider how to hold space for your loved one during holidays and traditional celebrations. Do you want to reserve a seat at the table or put up a stocking, if you celebrate Christmas?

2. Consider how to share the story of your loved one with others who never met him or her. In the case of a parent that has passed, what stories do you want to share with your children about who he or she was? Do you want to make a scrapbook or photo collage to tell the story of their life?

3. Consider how to connect with your beloved on an ongoing basis. Do you need to visit their grave or the location where his or her ashes were spread? Do you need to be in nature and find quiet places to speak with him or her?

4. Consider what mementos can bring you peace and remembrance. After my miscarriage, a co-worker gave me an angel figurine holding a small child. I went on to place that figurine in my girls’ nursery. It brought me tremendous peace to feel as though their sibling was with them and watching over them.

5. Consider how to honor your loved one in your words. You may have a child who has passed. You are still a parent. You may have a spouse who has passed. You are still a husband or wife. Your relationship with your beloved is still alive in you and can be honored within you. When I am asked how many times I’ve been pregnant, I happily say four.

Recap of Topic: Holding Space For Your Deceased Loved Ones

Honoring and remembering the dead is a pervasive practice across many cultures. For many, it is an essential piece of learning to grow around grief. How and if you choose to do this is unique and right for you. Some suggestions I offer for consideration are deciding how you want to honor your loved one at celebrations and in your words.

^{Recommended Product of the Week}

This week’s recommended product(s) is the book It’s Okay to Laugh: Crying is Cool Too. Nora McInerny shares her heart-wrenching story of grief and loss through humor, wit and pain.