Mental Health Moment – Grief and Loss

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Nancy Bergeron, RPsych, [email protected]

Contributed by the Parkland Community Association

The following is an adapted article written by an exceptional colleague of mine, Rob Weiss. It speaks volumes to how many, if not all, of us are feeling during the COVID-19 Pandemic.

Today we are all grieving. We are grieving the loss of our freedoms, a predictable future, the lives and roles left behind in our communal rush away from the coronavirus. All of us are fearful about work, health, our families, and our shared future in ways that were unimaginable just a short time ago. We are afraid for our parents and grandparents, our children, our jobs, our country, our way of life, and, perhaps most deeply, our own mortality. That said, our individual responses to these fears can vary quite a bit. I’d like to suggest, however, that by using the universally shared experience of grief, perhaps we can gain a bit of insight into our individual as well as our collective reactions. Perhaps the stages of grief can offer each of us a potential framework in which we can better identify our reactions and feelings about the times we are in.

Elisabeth Kübler-Ross gave us our first clinical insights into the somewhat universal process of how human beings grieve. Essentially, she provided us with a listing and explanation of the five common stages of grief: Denial, Anger, Bargaining, Despair, and Acceptance.

They might or might not occur in the order presented, and some people may experience variations of the same stage multiple times, while some may skip a stage (or stages) altogether. But as a general rule, these are the basics of our grieving process.

Denial is the intellectual and emotional rejection of something that is clear and obvious. Interestingly, denial is actually a much-needed survival mechanism – an evolutionary imperative developed over the millennia. Consider our hunter/gatherer ancestors. If one of them was out foraging for food and a sabretooth tiger attacked, and the full pain of the tiger’s attack was immediately experienced, this unlucky ancestor would have been unable to either fight back or flee and seek assistance. Luckily for our hypothetical ancestor, the ability to temporarily ‘deny’ physical pain evolved, providing that person with a fighting chance at survival.

Emotional pain can be denied in the same way. Evolution has created in humans the ability to deny both physical and emotional pain for a short period of time in the service of self-preservation. Today, denial sounds like:

  • This whole thing is so overblown. What a media circus.
  • It’s the same as the flu. People get the flu every year and hardly anyone dies.
  • I’m not (old, immune-compromised, susceptible to lung ailments), so I’ll be fine.

The feeling of anger is empowering. We move toward anger in an attempt to gain control over our fears. Rather than accepting and dealing with the problem, we turn hostile, blaming others, engaging in power struggles, externalizing the issue, and, sometimes, refusing to comply with the rules. Today, anger sounds like:

  • This is all China’s fault. If they’d quarantined earlier, we wouldn’t be having this problem.
  • I don’t care what the premier of my province says about sheltering in place, I’m going to work today.
  • Forget what they told us. I’m bored and I’m having some friends over.

Bargaining occurs when denial breaks down and we start to acknowledge reality but we’re not ready to give up the illusion that we still have control. Basically, we try to compromise to find an easier, less painful way out. Today, bargaining sounds like:

  • It’s OK to spend time with others as long as they wash their hands before they see me.
  • This will all be over by Mother’s Day, Father’s Day, Canada Day, Stampede, etc. I’ll be safe until then, and then we can go back to normal.
  • I know when people look sick. I will be fine as long as I stay around people who are healthy.

Despair and depression occur when reality fully sets in, when there is no more room for denial. There is a sense of hopelessness, a feeling that we are fully disempowered, and all is lost. We engage in self-pity. We think that nothing can help now, despite evidence to the contrary. We rue the fact that our attempts at bargaining haven’t worked. Today, despair sounds like:

  • I can’t go to work; I can’t earn money. Pretty soon, I’ll be broke, and homeless.
  • This epidemic is the new normal. I can say goodbye to my hopes and dreams.
  • I am high-risk and likely to die alone. No one will come to help me when the time comes.

Acceptance occurs when we finally acknowledge and surrender to the facts, whatever those facts happen to be. When we reach this stage, we can stop denying and fighting reality, and we can start dealing as effectively as we can with what has happened and what is happening. Today, acceptance sounds like:

  • I can’t control the pandemic, but I can do my part by sheltering in place, washing my hands, helping others where I can, and staying positive.
  • The fact that I can’t leave my house doesn’t mean my life has to stop. I can work from home, and I can still connect with my friends and family via phone and the internet. I can also enjoy the extra time I have with my spouse, my kids, and our pets.
  • The world is going to change, but maybe when all this is over, we will be kinder to one another.

There is another concept from the grief process that may also be useful here. That concept is role loss. Role loss occurs when we lose someone or something meaningful. We don’t only suffer the pain of the physical loss (my dog died, and I loved and miss my dog), we lose the experience of that role (taking care of my dog, being a dog owner). We miss what we lost, and we are reminded of our loss by the fact that we no longer have a role to play. Thus, the loss of my dog also comes with the loss of the ‘me’ I was when I was a dog owner.

I think there is a lot of role loss going on right now. And with this in mind, grief becomes a much larger arena. We grieve not being a helpful leader at work, not being able to support the new hire, and not being able to throw that work birthday party with the cookies that everyone likes. We are grieving our roles – our routines, our journey, and most of all our regular contact with those on who are on our journey with us. It’s all hard. It’s all grief.

Sadly, I can’t fix this for you (or me). But maybe I can give some psychological perspective to our collective experience, which I think is the job of any good therapist – to help people normalize and understand what they are going through. Please, allow yourself some anger, denial, bargaining, and a bit of despair. Go ahead and grieve. You have earned it. We all have.