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Module 4Lack of knowledge about the grief process - age old wisdom

It is important to talk a bit about grief because while your personal experience with grief might be your strongest asset, grief is a very personal and unique experience for every person. Therefore, understanding some of the conventional wisdom about grief is important.

What is grief?

Grief is the emotional response to one's loss.

  • Grief is a natural response to a felt loss; our way of repairing emotional damage.
  • Grief is individual.
  • Grief consists of a variety of normal responses that seem to fluctuate like an emotional roller coaster ride.
  • Grief is very often expressed differently by men and women.
  • Emotional response is expressed differently for various cultural & ethnic groups as well.

When someone has a loss, we also talk about mourning. Mourning refers to the rituals defined by family, culture, or society that are a part of the expression of grief. When families do not conform to these rituals, others in their family and community may express to them that they are doing something wrong. There is no right or wrong way to grieve over the loss of a baby. The feelings expressed are neither right nor wrong--they just are. By allowing parents and caregivers to express and be honest about their feelings, we help them in the grieving process. [Stroebe and Hansson, Handbook of Bereavement, 1988.]

What do we mean when we talk about the grief process?

It is helpful to have some framework to think about the grieving process. These ideas about what happens as people grieve are helpful, but are not rules for how people should grieve. William Worden (2001) has developed a model that is useful. It describes four phases of the grief process.

  1. Accepting the reality of the loss: When someone dies, there is always a sense that it hasn’t happened. The first task of grieving is to come full face with the reality that the baby is dead. When people are struggling to accept the reality of the loss, they may deny or block out the facts of the loss, the significance of the loss to them, or the fact that the baby is gone forever. To accomplish this task, the parent must talk about the dead baby and funeral as well as the circumstances around the death.
  2. Experiencing the pain of grief: It is necessary to acknowledge and work through the pain of grief, or it may manifest itself through some symptoms or aberrant behavior. Not everyone experiences the same intensity of pain or feels it in the same way, but it is impossible to lose someone you have been deeply attached to without experiencing some level of pain. Sometimes people have trouble with this phase and block out the pain. People may avoid feeling pain by blocking out any thoughts about the loss or by avoiding reminders of the baby. Sometimes people may use alcohol, drugs, or even food to numb their feelings. Many emotions such as shock, anger, guilt, and depression may be expressed. The bereaved need to allow themselves to indulge in the pain - to feel it, and know that one day, it will pass. When others feel upset watching the family’s pain, they may try to get them to stop talking about it. This approach can make it hard for families to move on in their grief process.
  3. Adjusting to an environment without the baby: Caring for a baby takes an amazing amount of time. Preparing for the arrival of a new baby takes up the thoughts and dreams of parents. With the loss, all of this activity stops. Where responsibility was, is now emptiness. Where there were hopes, there is now despair. During this adaptation to loss, people can work to avoid promoting their own helplessness by gradually reforming schedules and responsibilities. This process takes time and each person moves at his or her own pace. When others tell parents to “just get back to normal” it makes this phase hard. They are still trying to figure out what the new normal is.
  4. Moving on; withdrawing emotional energy and reinvesting: Survivors sometimes think that if they withdraw their emotional attachment, they are somehow dishonoring the memory of the baby. In some cases, parents are frightened by the prospect of having another baby because the new baby might also die. For many people, this is the most difficult step to accomplish. They get stuck at this point and later realize that their life in some way stopped at the point the loss occurred. Again, this phase takes time and may come many months or even years after the loss. During this phase, parents still need loving support, but too often others assume that they have moved on or should have moved on much sooner.

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