Characteristics   of   Grief     
  The manifestations of grief  
    Introduction

How are you supposed to feel and behave while grieving? You’ll have a picture in your mind from the depictions of grief that you’ve seen on TV and on film. But grieving is often far more complicated than these stereotypes portray:

If you have any questions, comments, or would like to discuss your own experiences of grieving, then you can do so here.

    Emotional Distress

Emotional distress is the most common characteristic of grieving. It comes and goes in episodes, typically lasting from about twenty minutes to an hour [1].

These episodes manifest as “waves” that seem to wash over you, and when they occur you may be unable to interact with anything or anybody until they have passed.

Once an episode has passed, you may well might find that an emotional numbness sets in: you are too fatigued and exhausted to experience anything, and you need some time to recover. However, before too long some small incident, some reminder of the deceased, will set you off, and the process will repeat all over again.

    Emotional Numbness

It’s not uncommon to feel partially dissociated from your body, as though your body was almost an independent entity, moving and speaking all by itself, while you seem somehow to be watching what is happening from a distance [1]. There can be a feeling of unreality; the people around you seem oddly distorted, more like cardboard cut-outs than real people.

People may find you withdrawn and emotionally unresponsive. And you may find that engaging with people, even when it comes to practical matters, involves a great deal of effort (Dawson’s Creek, Season 5, The Long Goodbye):

*Gale: Honey, you don’t have to be so strong all the time. You can fall to pieces just about any time you want. There’s nothing to be ashamed of.

*Dawson: I’m not ashamed. There’s ... everybody keeps on asking me, “How you doin’? How you feelin’?” Truth is, I don’t feel anything. Not a thing. I’m numb. Which, to tell you the truth, is really not so bad.

*Gale: Um, that’s great ... until it all comes crumbling down.

*Dawson: Well ... until then.

This absence of an emotional response was once assumed to have negative consequences for the bereaved, and to lead to prolonged grief, to delayed grief, or to delayed somatic symptoms – one of the many “old wives’ tales” that surround grieving. However, the evidence suggests that emotional avoidance during bereavement may well be beneficial and may well serve an adaptive function [2].

So, if you experience an absence of emotion don’t assume it’s a bad thing (you can safely ignore the counsel of any “would-be-wise” around you who assert that a healthy grieving process and a profusion of tears are synonymous). While an emotional response may, or may not, follow at some later stage, don’t feel pressured into forcing your grief in any particular direction in order to satisfy misguided, societal expectations.

    Volubility – Incessant Talking

You may find yourself talking incessantly. The topic of conversation might be the deceased, or it might be anything but the deceased:

*Talking about people who have died can serve as a useful means of keeping them alive in an odd sort of way: if they are always part of the conversation, then, in a sense, they are not really dead.

*Not talking about people who have died can represent a protective mechanism that prevents those waves of emotional distress from arising: you’ll deal with the death later, but not now. Now, would be just too difficult. You need to process the death at a subconscious level first, before you can start thinking about it, and come to terms with what it might mean for the future.

In normal conversations, there are expectations on both parties as to how the conversation should progress. Not so, when you’re grieving. The normal internal controls that moderate the brevity of what you say in response to a question can get turned off, making your questioner feel very uncomfortable. In the following exchange (Dawson’s Creek, Season 5, The Long Goodbye), Dawson is selecting a coffin for his father at the local funeral home:

*Funeral Home Manager: And you? How are you?

*Dawson: People ask me that a lot. It’s a weird question. Every time I start to give too long of an answer, which I’m starting to do right now, those same people get very uncomfortable. Not you, though, huh? I guess you’re an old pro at this.

*Funeral Home Manager: You could say that.

Even though others may find you talkative, and, even perhaps relatively normal, you may find that you seem to exist outside of these conversations – a ghostly presence that hovers somewhere inside your own head, one that hears what you have said, but which does not actually say or do anything!

    Physical Distress

Physical distress (what psychologists term somatic distress) accompanies the waves of emotional distress. You may have difficulty breathing, you may experience a tightness in your throat, and your mouth may always seem dry. You may find yourself holding your breath, and then letting it out in long exhalations [1].

An overpowering sense of physical weakness and fatigue is common. Even standing up may be an effort. The emails I receive typically contain phrases such as “I have no energy” and “I feel exhausted.”

Digestive complaints are very common [1]. Food loses its taste. Appetite disappears. The normal flow of saliva which is induced by the thought of eating is reduced. Digesting food becomes more difficult. You may prefer eating very light meals, taking liquids, and may develop a preference for food that dissolves in the mouth and does not have to be chewed.

    Unvarnished Truth Telling

I was once at a gathering following a funeral when an effusive relative approached the grieving widow and started talking about how wonderful the widow’s husband had been. The window stared stone-faced at the relative, and then said in a listless voice, “There was no point coming. He hasn’t left you anything. He never even liked you.”

Funerals often bring distant family members together, gatherings which, even in the best of circumstances, can be awkward. Even when people are doing their best to say the right things, they can all too easily say the wrong things. In the following exchange (Dawson’s Creek, Season 5, The Long Goodbye), Dawson is about to take a suit to the local funeral home so that his father can be buried in it, when Joey tries to be helpful:

*Joey: Is there anything I can do?

*Dawson: Um ... yeah, actually. You know what? There is. Would you mind watching Lily for a little bit? My mom fell asleep. I’ve gotta get to the funeral home.

*Joey: Of course.

*[Dawson takes a suit from the back of the door.]

*Joey: Is that what you’re wearing? It’s nice.

*Dawson: Uh, no. Actually, it’s for my dad. He’s gonna be buried in it.

Awkward conversations are usually eased by those “little white lies” that people tell each other. But when you’re feeling numb from grief you often have an acutely heightened sense of what others around you are doing, are thinking, are expecting. This heightened awareness is often accompanied by an unaccustomed disinhibition, by an inclination to tell the plain unvarnished truth. It’s not as though you have any particular motive in mind; you don’t really want to say anything; but when pushed to speak you just tell it as it is.

The observations that you make in these circumstances can be particularly cutting, especially when you don’t like the person who is speaking to you or you detect evidence of insincerity. In the following exchange (Dawson’s Creek, Season 5, The Long Goodbye), Dawson is sitting at the foot of the stairs holding Lillian, when the next door neighbour, Grams, engages him in conversation:

*Grams: Why don’t you let me take her for a while, dear?

*Dawson: I’m afraid I can’t do that, Grams. Lily here offers a great buffer. As long as I hold her, people tend not to come up to me and offer their platitudes.

*Grams: Where’s your mother?

*Dawson: She’s upstairs. She won’t come down. So, what’s yours?

*Grams: My what?

*Dawson: Your platitude.

*Grams: I’m afraid I’m fresh out.

*Dawson: Really? I thought for sure you’d whip out “the lord works in mysterious ways.”

Most people will forgive your disinhibited bluntness, and those who will not are perhaps not the sort of people you want to include in your future in any case. But, if you’re concerned, then this tendency to speak the truth may be another reason for temporarily avoiding people.

    Disrupted Daily Activities

When it comes to carrying out daily activities, your behaviour might vary from that characterised by apathy to an intense busyness. You may hope that by being busy you can take your mind away from the death that has just occurred, but this expectation is rarely fulfilled in practice. Activities that require focus and concentration become impossible, and carrying out those routine tasks that don’t require concentration readily allows your mind to drift, so that you focus once again on the deceased.

Rather than acting as a distraction, carrying out everyday activities can act as a constant reminder of how closely the deceased was involved in your life, even when it comes to the most mundane of daily activities. As one email put it, “I had prepared a meal and brought it into the dining room. Then I suddenly realised that no one had laid the table. He always laid the table.”

Instead of being able to carry on with routine daily activities, you may find that following a bereavement you have to entirely rearrange your life, that those habits which have been part of your day for many decades have to be altered, that your entire life has to be rejigged. The loss of these comforting routines can be a source of intense irritation and can amply the loss you feel from the absence of the deceased.

    Hostility to the Deceased

Relationships have their ups and downs, and your relationship with the deceased at the time of death may well have been problematic. Unfortunately, the presence of anger or other negative feelings towards the deceased can interfere with the grieving process.

The problem is that hostility towards the deceased is often repressed. In the following exchange (Dawson’s Creek, Season 5, Text, Lies, and Videotape), Dawson has had an argument with his father on the day his father was killed in a car accident, and is now discussing his feelings about a seemingly unrelated issue (the signing of a codicil to a trust) with his psychotherapist:

*Rachel: So ... you were mad?

*Dawson: Yeah. Yeah, I was.

*Rachael: At your mother ... or at him for not signing it?

*Dawson: At him, but I can’t be mad at him right now.

*Rachael: Sure you can. Wasn’t your father mad at you? You told me he laid down the law, bought you a plane ticket.

*Dawson: Yeah. I gave it right back to him.

*Rachael: And you had reasons for that.

*Dawson: Yeah, but he obviously had reasons for wanting me to go back to USC.

*Rachael: Yes, he did. And maybe he was wrong. If he were here and we could ask him, we’d probably find out that all those reasons were more about him ... his hopes, his expectations. And just because he died, doesn’t mean that he gets to win the argument.

*Dawson: When I remember that night, all I feel ... is furious.

*Rachael: That’s ok. That’s how you feel.

This vignette illustrates several important points regarding feeling of hostility:

*Hostility towards the deceased is usually perceived to be unacceptable and so is often displaced, “I can’t be mad at him right now.”

*There is nothing wrong with feelings of hostility, “That’s ok. That’s how you feel.”

*Death doesn’t negate culpability for past actions, “Just because he died, doesn’t mean that he gets to win the argument.”

In order to progress, it’s important to understand that a death does not extinguish the past: you may be sad that someone has died, but you can still, legitimately, “feel furious” at him for things said, for things done.

    Anniversaries and Reminders

Anniversaries or other special occasions, such as holidays, can readily lead to a spike in grieving. To minimize the impact, it’s helpful to plan for these occasions in advance. In order to distract yourself from spending too much time reminiscing, you may find it helpful to keep particularly busy, to surround yourself with friends who will encourage you to engage in activities that require some degree of mental focus, and to avoid those locations that remind you of the deceased.

While you can plan for special occasions, there will be many unanticipated reminders of the deceased that just keep presenting themselves, as in the following recollection (Dawson’s Creek, Season 5, The Long Goodbye):

*Joey: You know, a long time ago ... it must have been a couple of months after my mom passed away ... I was digging through this drawer in the kitchen looking for a pen or something, and I came across this grocery list she had made, and it was filled with all these little heart-shaped doodles, and I just ... lost it. I cried like a baby for hours.

    References

[1] Lindemann E., “Symptomatology and management of acute grief”, American Journal of Psychiatry, 1944, 101(2), 141-148.

[2] Bonanno G.A., Keltner D., Holen A., et al., “When avoiding unpleasant emotions might not be such a bad thing: verbal-autonomic response dissociation and midlife conjugal bereavement”, Journal of Personality and Social Psychology, 1995, 69(5), 975.