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We live by losing and leaving and letting go. And sooner or later, with more or less pain, we must all come to know that loss is indeed a lifelong human condition. -- Judith Viorst

Life changes that involve significant loss--the death of a loved one, divorce, career crises, decline in health, or other irreversible and unwanted situations--evoke a natural emotional and behavioral response called grief. Making it through the grieving process--learning how to live with a significant loss--necessitates hard and very often painful emotional work over a period of many months or even years.

When someone is permanently deprived of something they love, the loss can affect their very identity, for instance, how they perceive their role as a husband, wife, parent, son or daughter. Often the loss brings a sudden and unsettling change in life's basic circumstances (such as a marked decline in financial means, having to live alone, or not being able to continue to live in a familiar setting) that can provoke extreme levels of anxiety or depression.

Throughout the grieving process, it's important that the individual not judge themselves harshly or measure their experience against what they think they 'should be' feeling or how they imagine others expect them to be acting. There is no one way to grieve'and certainly no one right way. People's coping strategies vary and can be influenced by many factors that are exclusive to each situation. In addition to cultural and religious beliefs, these factors can include the nature of the attachment to the lost loved one, the circumstances of the loss (for example, was it unexpected, the result of violence, or the culmination of a long illness), previous experiences with loss, and the availability of others to extend caring support.

Phases of Grief

Following the death of a loved one or the loss of a critical relationship (for instance, through divorce), it can seem as though the intense, sometimes overwhelming, and often conflicting physical and emotional reactions completely take over a person's life. Many find that it can take up to a year to experience the deepest aspects of the grieving process and begin coming to terms with their loss. Understanding that there are natural and commonly experienced symptoms and 'phases' of grief can often help. Although there are certainly variations in the intensity, duration and highly personal nature of each person's experience, most go through the following three phases:

o Shock and/or denial
o Emotional and physical pain
o Reorganization and integration

It is very important to understand that these phases are by no means experienced as a linear 1-2-3 sequence. Most people find that the phases frequently overlap and often re-occur (sometimes quite unexpectedly) as they mourn their loss and in their own time change the relation to their loss from 'presence' to 'memory.'

Shock and/or Denial

A sense of numbness or disbelief weighs heavily on the grief-stricken individual. Many later describe having a 'flat' or 'empty' feeling, some say their mind felt 'closed' and they were unable to accept all or even part of what had just occurred, and still others describe having felt completely detached, as if the experience of loss was happening to someone else.

Emotional and Physical Pain

People often describe this phase of grief as a seemingly never-ending roller coaster ride of emotions and physical reactions. Throughout the first year, as birthdays, anniversaries, and holidays that hold special meaning come up, it is not uncommon to become repeatedly overcome by levels of emotional and physical pain that can feel nearly as intense as when the loss first occurred.

Commonly experienced emotional symptoms include:

o Depression
o Despair
o Confusion
o Irritability
o Rage
o Guilt
o Loneliness
o Distraction or preoccupation
o Passivity, a sense that 'life has lost all meaning'
o 'Out of the blue' crying jags

Many people express such feelings as 'a part of me has died,' or 'I wish I was dead, too.' During this phase it is also not uncommon to feel angry with those one feels are 'responsible' for the loss, including God, physicians, or even the loved one who has died.

Commonly experienced physical reactions include:

o Decreased energy and extreme fatigue
o Loss of appetite (or in some cases, eating excessively in an attempt to fill a void)
o Anxiety that can manifest in hyperventilation or panic attacks
o Shaking, tremors
o Memory loss
o Specific aches and pains, such as headaches, abdominal discomfort, back aches, or a stiff neck that are unrelated to any medical problem
o Tendency to push self to extremes at work, school or in a demanding exercise regime

Reorganization and Integration

While sadness, pain and disbelief may continue, the individual progressively comes to terms with the reality of their loss and finds they are gradually more able to develop renewed interest in work, family, friends and life in general.

Getting the Necessary Help

Time can be a great healer. However, crucial to recovering a sense of self and learning to live with loss is the ability to acknowledge and openly share grief's full range of thoughts and emotions. Friends and family can often prove to be invaluable support systems. But often it is difficult for the grieving person to know how to understand what they are feeling or to feel safe expressing their thoughts (even to best friends) during the vulnerable period of trying to adjust to the reality of their loss. For many, even those who have never before sought therapy, sharing what's going on with a therapist provides the essential opportunity to gain the insight needed to most effectively work through the painful grieving process and come to terms with their loss.