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Saturday, March 9, 2013

Coping With Grief: It's Common For the Emotional Pain to Get Worse Before It Gets Better

Often, the grief you feel when you've lost someone close to you feels so overwhelming that you might wonder if you'll ever feel better.  Unfortunately, it's a common experience for the grief to get worse before it gets better.  But, with help from a professional mental health professional, you can work through the grief.

Coping With Grief

Elisabeth Kubler-Ross and the Five Stages of Grief
Many people, who are experiencing grief, are somewhat familiar with Elisabeth Kubler-Ross's book On Death and Dying (1969) and her hypothesis that people go through five stages of grief:  denial, anger, bargaining, depression and acceptance.  Dr. Kubler-Ross never wrote that these stages were experienced in any particular sequence, but this is a common misunderstanding.

In fact, people often go through a combination of stages at the same time and they can cycle back and forth through these stages.  But this misunderstanding that the stages follow in a linear process has been the cause of a lot of confusion.  It has often been at the heart of people feeling that they are, somehow, "abnormal" if they're not going through the stages in a particular order, and especially if they start to feel worse.

The following vignette, which is a composite of many cases, illustrates the common experience of grief getting worse before it gets better and how grief can be worked through with help:

Jane
After a long battle with lymphoma, Jane's husband, Ray, died peacefully at home with the assistance of hospice care.  Jane and other family members were there as he passed away.

Initially, after his death, she was very busy with funeral arrangements and relatives who came from out of town.  Afterwards, there was plenty to do to take care of with insurance policies, thank you notes, and going through medical bills.

Coping With Grief

Shortly after Ray died, Jane felt that she and Ray had said what they needed to say to each other before he slipped into an unconscious state and then died.  But after everyone went home and she had taken care of paperwork and bills, she realized that she was only just beginning to grieve for her husband of 20 years.

Everyone told Jane that "time would heal all wounds."  After the first year, well-meaning friends were encouraging her to put Ray's death behind her and to start dating again.  Jane knew her friends meant well, but even the thought of seeing another man made her feel sick to her stomach.  She knew that none of her friends had ever lost a husband and they didn't understand what she was going through.

If anything, after a year, she was feeling worse.  It took about that long for her to fully realize what it meant that she would never see her husband again.  Until now, she understood this as a fact, a piece of information.  But now, she was beginning to understand it on an emotional level, and she wasn't sure how she would be able to cope with this.

Jane missed Ray terribly every day.  She often had dreams about him at night where he would come back to tell her that he wasn't really dead, and then he would disappear.  The dreams were so real that Jane would wake up not being sure if the dream was really a dream or if she had really seen Ray.

After a while, it got to the point where Jane preferred to go to sleep and dream about Ray than to be awake and live without him.  When she talked to her friends about it, everyone had a different opinion about it.  Some people told her that Ray was trying to contact her from "the other side."  Other people told her to forget about these dreams, "life was for the living"and she should "move on" with her life.

After Jane began to spend more and more time sleeping just to be able to feel she was having some contact with her husband, she realized that she couldn't go on with this.  She was starting to neglect herself by eating poorly and, in general, not taking care of herself as well as she normally would.

At that point, Jane sought the help of a therapist who specialized in helping clients to deal with grief and loss.  After she began therapy, Jane was relieved to hear that her experience was common.

Jane talked about her husband in her therapy sessions, and she felt free enough to cry in the sessions without feeling like she needed to "get over it," as her friends advised her.  She even brought in pictures of her husband and her, including their wedding pictures and other pictures at important stages of their life together.

After a while, Jane felt an emotional shift.  She still missed her husband, but she felt like he was with her wherever she went.  Her therapist helped her to understand that the emotional shift occurred because in their therapy work together Jane had internalized her husband on a deep level so, as Jane might say, "I feel I'm carrying him in my heart."

Gradually, Jane began to feel better.  Two years after her husband died, she was able to start dating.  She knew that no one would ever take Ray's place in her heart.   But she also realized that her heart was big enough for the possibility of someone new.

Complicated Grief
As I mentioned, Jane's experience is common among people who have had significant losses.

There are also people who experience what is called "complicated grief" where the loss feels as fresh years later as it did when it happened.  It's not just that they feel worse after a year or so.  It's that there is no relief from the anguish people feel about their loss even after years have passed.  People who experience complicated grief can benefit from seeking the help of a licensed mental health professional.

Getting Help in Therapy
If your grief feels like it's getting worse rather than better and you're having a hard time coping with it on your own, don't suffer alone.  You could benefit from working with a licensed mental health professional who has expertise in this area.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist.
I work with individual adults and couples.

I have helped many clients to work through their grief.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.