Denial is a defense against that brutal reality. It blunts the impact of the loss, offers you a temporary respite and allows you to process those overwhelming feelings more gradually. On one level you recognize that your loved one has died; on another level you?re unable to grasp all the ramifications of that reality.

As the fog of shock and denial begins to lift, you will find yourself headed into the very heart of grief, and you?ll become painfully aware of how very much you have lost. An entire gamut of feelings washes over you in overwhelming waves of sorrow. You are flooded with intense, raw feelings of anguish, sadness and fear as you realize that life will never, ever be the same. You may be flooded with questions: Why did this happen to me? How will I be able to go on? How will I be able to face the future without this person? When will I get myself together?

The sorrow of grief saps your energy, making even simple tasks like getting out of bed in the morning, tending to personal grooming, fixing a meal or going somewhere with friends seem overwhelming and exhausting. You may feel negative and critical toward everything and everyone, including yourself. Even in the company of others you may still feel lonely, and may prefer to avoid gatherings of any size.

You may be flooded with bittersweet memories: all the things you would have, could have, or should have said and done, and now will never be able to say or do. You may have difficulty concentrating and remembering, and feel incapable of making the simplest decision. You may experience nightmares, dreams, and phobias, and you may fear that you?re going crazy.

You may find yourself crying at the slightest provocation or at unexpected moments. On the other hand, you may fear that if you show your sadness, there will be no end to it? that if you permit yourself to cry the tears will never stop. As a child you may have been taught that crying is a sign of weakness, and strong people (especially men) don?t cry.

If it is the style of some in your family to be strong and silent in front of others, you may have to accept it and allow for it. Nevertheless, it is far better to let the tears come, and welcome them as a natural and helpful form of release. When you permit yourself to let go for a time and release what you feel, you?ll be better able to function afterward.

And get rid of the notion that you?re crying too much; there is no such thing. It is physically impossible for anyone to cry 24 hours a day. Let others (especially children) see you cry. It shows them that you care deeply about the person who died, and reassures them that it?s all right to express sad feelings in front of others.

You may have the pessimistic belief that things will never get any better, as if life and living are useless, and you may even want to die. Be aware that thoughts of suicide are not unusual when you?re grieving. It is difficult for you to imagine life without your loved one, and you may feel a compelling need to join or to be with the person who has died. Nevertheless, there is a vast difference between thinking about suicide and acting upon such thoughts. In grief, thoughts of suicide are usually fleeting and reflect how desperately you want the pain of loss to end.

Suggestions for Coping with Emotional Reactions

Understand that denial serves a normal function, especially in the beginning. It is your mind?s way of protecting you from more pain. Besides, your brain doesn?t ?get it? because it is loaded with memories of your loved one. Although the person has died, the one you love continues to exist in your memory and in the memory of others.

Know that it?s normal to ask questions for which you cannot have all the answers. Asking such questions can be the beginning of dealing with loss.

Put yourself on a regular, daily routine, and set goals that are manageable and achievable. Schedule activities you enjoy, knowing you will feel moments of sadness as well as pleasure, and accept both sets of feelings without guilt.

Resist the urge to be all by yourself. Find someone you can trust who will listen to you.

Try setting aside a certain crying time each day when you can deliberately immerse yourself in grief. Use triggers and props to help bring on your tears (music, photographs, writings, sad movies).

Avoid the use of drugs and alcohol, which may add to your feelings of depression.

Seek professional help if after a reasonable period of time, despite everything you?ve tried to do, you still feel no relief from these feelings. If you feel you are "coming apart", no longer in control, isolated with no one to turn to; if you are turning to alcohol or drugs to cope with stress; if you feel hopelessly depressed; if you feel suicidal, call someone immediately: a friend, clergy person, therapist or counselor, or dial O or 911.

Copyright (c) 2003 by Martha M. Tousley, RN, MS, CS All rights reserved

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