Grief management: Understanding and navigating grief

Sammar Hafeez, Clinical Psychologist, India

Grief, although personal, is a universal experience. Every individual – young or old – will have had at least one experience that might have altered their lives in one way or another.

Significant life losses such as divorce, tragic accident, death of a loved one (bereavement), end of a relationship, discrimination, major life transitions like moving away from home, shifting jobs, loss of job/unemployment, loss of a home, financial instability, physical disability/ losing health, end of dream or goal and even losing a pet can be difficult to cope with, which even the Holy Prophet Muhammad^sa validated by providing comfort to a child whose pet died (Sahih al-Bukhari, Kitab al-adab, Hadith 6129).

Grief as we know it, is a natural response to loss or any disadvantageous situation. It is a complex phenomenon that has physical, emotional and psychological reactions associated with it. Coping with the loss of something or someone that has been vital in your life can be an immense challenge and is very likely to cause waves of multiple emotions as we proceed in its depth.

The process of grief is known to be non-linear. It usually does not follow timelines or schedules. It might either be continuous or can be intermittent and some individuals might take weeks, while others take years to grieve.

While everyone can grieve differently and every grief journey is unique, there are however, some commonalities in the way we tend to process grief.

The five stages of grief: Psychiatrist Kubler Ross introduced the five stages of grief based on her extensive work on thousands of terminally ill patients.

It should be noted that these stages don’t usually occur in the same order as they are mentioned and may shuffle back and forth. Some may experience a few stages instead of all five. Hence, the occurrence is highly subjective and unpredictable.

So, here’s what we know about each stage.

Stage 1: Denial “This cannot be happening to me?”

Grief is an overwhelming emotion. The shock around how your world has changed in an instant can make a person go numb. It is normal for someone to deny the strong feelings by pretending the change or loss is not occurring. They might even go on with life as if nothing had happened.

Denying is a common defence mechanism that helps us cope with a highly distressful event. It gives the person time to absorb the shock and process it slowly, in a more realistic way.

Once the denial stage passes, the healing starts and other suppressed feelings are bought into light.

Stage 2: Anger “Why me? Why is this happening to me? Who is to blame?”

Once someone starts to accept reality, he/she can start feeling angry and may look to blame oneself, family members, friends, doctors or even the person who died for the cause of their grief.

Anger is a natural emotion that occurs in reaction to immense pain, discomfort and uncertainty that surrounds the grieving process. Anger can be masked as feelings of resentment and dislike, and sometimes it could manifest in forms of outbursts and rage at insentient things. One might also feel disconnected, abandoned or isolated in their loss.

Not everyone goes through this stage, but if one feels that they are lingering in this stage long enough, then it is advisable to seek help from a therapist in order to resolve deeper reasons.

Stage 3: Bargaining “What if I could negotiate my way out of it”?

In extreme pain, it is difficult for us to accept that there is nothing we could do to change the uncomfortable situation.

It is not uncommon that one might go over and over the events that occurred in the past and ask a lot of “what if” questions such as – “what if I had left my house 5 minutes later, then the accident would not have happened”, “what if I worked more during weekends, they would have seen how useful and efficient I am”, “What if I had gone to the doctor few weeks early, then they would have diagnosed the disease earlier” – by thinking in this manner, a person attempts to find moments of peace and tries to regain control over an unexpected and extremely helpless situation.

Stage 4: Depression “I am too sad, and I don’t know how to move forward from here”

While denial, anger and bargaining may seem like active stages of grief, depression, however, is called the quiet stage.

Feelings of sadness, loneliness and longing are predominant in this stage. A person might also think that life no longer has any meaning attached to it, which can be particularly alarming for those around a griever.

Depression is commonly related to a grieving process, but if the griever shows signs of extreme hopelessness and suicidal ideation, then the caregiver/guardian will want to seek help and guidance for the griever immediately, as this might be indicative of a condition called prolonged grief disorder or a major depressive episode.

Stage 5: Acceptance “I am at peace with what has happened”

This stage sees a lot of realisations around the unexpected event that had passed. A person’s emotions may begin to stabilise and they may start to opt for a balanced way of thinking by adjusting or readjusting their perspective around pain and loss.

There will be good days and bad days, and sometimes one might even end up getting unintentionally sad, but always remember that this is normal. As one goes through life, the bad days will outnumber good days and one may also realise that finding purpose and the will to live again by keeping the memories of your loved ones close to us is practically possible and that is what they would want you to achieve too.

As we move through these series of stages, we might perceive a grieving cycle as a combination of ups and downs, which is, however, a very natural way of healing from grief.

Overcoming grief

Everyone responds to loss differently, some may feel the need to cope with it alone, while others may find talking with friends and family members to be soothing.

Whatever the approach may be, there are some general strategies that can aid in overcoming grief across all ages:

1. Accept your emotions, feel free to feel: Do not stop yourself from experiencing the variety of emotions that loss ignites. Accept that whatever you are feeling is genuine and you should not be feeling any other emotion other than what you are presently feeling.

Do not feel that you are overreacting and do not downgrade or negate the grieving process. Sometimes, someone around you might ask you to move on, even before you are ready for it, but do take the time you need. Suppressing emotions that arise during the grieving process only increases them in intensity.

2. Talk about your feelings to those capable of offering comfort: Express yourself whenever you feel, to people whom you think are non-judgemental and understanding.

Sharing your loss can lessen the burden and allows you to process the whirlpool of emotions better. Just try to be around people even if you don’t want to talk just yet. The key is to not isolate yourself for long.

Alternatively, you could also express your thoughts in writing, keep a journal and pour your feelings and thoughts into it.

3. Reach out to individuals who have been through the same situation: Talking to people who personally understand grief, can offer new practical perspectives and genuine hope, which can be of paramount value during hard times.

Moreover, be authentic when people reach out to you, in order to check your well-being. If you respond to “how are you?” with “fine”, then it doesn’t encourage the person to further evaluate your emotional status. So be honest in the way you respond and give your loved ones an opportunity to share your sorrow.

4. Manage your self-talk: We often feel that we should not be thinking or feeling the way we are. But in grief there are no right or wrong ways to feel. Be flexible in whatever you might be experiencing while grieving.

Also, be kind and compassionate to yourself and do not force yourself out of a grieving process thinking that is unrealistic or unfeasible.

5. Adjust unhelpful thinking patterns: Grief can bring strong thoughts and feelings. It is common to blame oneself or others, and express hurt and disappointment when overwhelmed, but these patterns of thinking can prolong the grieving process. Here are some common thoughts that occur with grief, along with the helpful ones.

• “I will always feel this awful and I can never regain meaning and purpose of life again” can be replaced with more balanced ones – “There is no guarantee that I would always feel miserable or awful; the situation can improve; I will with the help of God and well wishers overcome this challenge and regain new perspective”.
• “Where did I go wrong”, “It is my fault” or “I should have done more to prevent this” can be replaced with – “I did whatever I could in the time that was given to me; it was God’s will and I will try my best to remain steadfast and patient; everything belongs to God and returns to him”.
• “It should have been me” can be replaced with – “All I can do is be present in the moment of acceptance and healing; the decisioning belongs to a higher power, He knows who goes first and who follows; I should let myself believe that they are in a safe and better place”.
• “It is their fault” can be replaced with – “blaming won’t help, it does not resolve the situation, all I can do is focus on what I can do in the present moment to support myself and family through this difficult period”.

6. Practice self-care: Although it seems difficult, try restarting or maintaining your daily work and hobbies, routine brings back comfort and a sense of normalcy.

Furthermore, eating and sleeping well can aid in providing the energy to keep on going.

7. Draw inspiration and courage from faith: Spirituality has been found to be a protective factor in managing grief. People who are connected to spiritual, religious and community practices during grief seem to heal more quickly than those who are not.

Shared community values, meaningful social interactions, structured prayers and spiritual beliefs give a sense of belonging.

It also provides solace by giving meaning to a loss and offering sustained hope. “Those who believe, and whose hearts find comfort in the remembrance of Allah. Aye! it is in the remembrance of Allah that hearts can find comfort” (Surah ar-Ra’ad, Ch.13: V.29).

You can also find a way to honour your loved one, for instance: you can create a community project that was close to their hearts, support a cause which they wanted, or offer a tribute or donation to a non-profit organisation. Helping others can help you rediscover yourself through grief.

8. Join loss support groups: Therapist-led groups can help people who share a loss come together and discuss their thoughts and feelings. These groups provide non-judgemental options and ways to cope with your personal grief journey.
9. Get all the support you need: Talk to a professional who focuses on prolonged grief. There are evidence-based strategies that can help with unhelpful thinking and belief patterns.

For friends and family members of a grieving person

Mindfulness practices that can offer meaningful support:

1. Understand the grieving process and be fully present: Educate yourself in the psychological process related to grief. Give the griever your undivided attention by avoiding any type of distractions. Let them know that you are always available to listen to how they feel.
2. Give space: Do not force them into healing quickly. Give them space to heal at their pace.
3. Reach out: Do not let any types of fears of saying or doing wrong prevent you from reaching out to the griever.
4. Listen with compassion and empathy: Avoid any type of judgemental statements or opinions that might not be suitable depending on the griever’s background or belief system.
5. Acknowledge their feelings: Validating feelings can help connect deeply with the griever; this increases the receptiveness for future aid. Talk however and about whatever is best depending on the emotional capacity of the griever.
6. Simplistic solutions: Avoid unsolicited or unwanted simplistic solutions like “you have to be strong”, “it happens to everyone in this world”, “get over it”, “you are overthinking or overreacting”, “you are being unreasonable” etc…

Do not jump to conclusions and downplay their feelings, as if the grief they are experiencing is not significant or important enough.

7. Allow grief: If it’s a child, then avoid forcing the child to mourn like others. On the other hand, don’t tell a child to stop crying because it can upset others. Allow them into the grieving process by creating a safe environment through honest conversations.
8. Offer practical support: Assist in funeral arrangements, take them to the place of interment, cook for them, run errands, take care of their children etc… in order to provide active presence. Continue such support over the long haul.
9. Be mindful of grief triggers: Keeping in mind the sensitive dates like family milestones, anniversaries and holidays can assist in reaching out to them when it matters. This can bring a sense of belongingness and emotional strength to the griever.
10.  Look out for signs of depression: Kindly encourage the griever to seek  help if you think they are struggling with daily functioning. You can also schedule an appointment and accompany them to the therapist’s office.
11.  Seek professional help: For some people the grief around a loss slowly  starts to decrease over time and does not seem to negatively disrupt their daily functioning. If with time these feelings do not show signs of improvements, and it has been causing serious distress in the griever’s daily functioning capacity, then it is always better to get in touch with a therapist/psychologist to check for the presence of a condition called prolonged grief disorder (PGD) and depression.

By actively engaging in healing and processing of unresolved grief, you might be preventing serious physical and emotional health consequences in the future.

As Muslims, we are extremely fortunate that the Noble Prophet^sa has provided us with so many examples of how to deal with grief, such as the prayer:

“O Allah! I seek refuge with You from worry and grief […]” (Sahih al-Bukhari, Kitab al-da’waat, Hadith 6369)

Rest assured, as we proceed through the loss, the emotionally difficult periods tend to become more manageable and less threatening. And with God’s help, we would see a light at the end of the tunnel and find a way to revive, repurpose and rebuild our lives using pain as an opportunity.