a psychotherapist's guide to surviving grief

the nation is dealing with a sense of collective grief, an overwhelming loss of not just friends and family, but of a way life that may never return. while swiss author elisabeth kubler-ross famously theorized that processing the complex emotion involves navigating five distinct stages — denial, anger, bargaining, depression and acceptance — the reality is much more complicated.

grief is seldom simple, but it’s a healthy, natural response to loss that helps humans process the past and face the future, according to andrea warnick , a registered nurse, psychotherapist and thanatologist (an expert in the study of death). as canadians struggle to come to terms with everything they have lost, warnick offers some wise words on helping friends and family say goodbye and survive the pain of grief.

what is grief? what are the emotions one grapples with while grieving?
grief is a response to any significant loss. it’s not just specific to death — that’s where we think about it the most — but in covid, we’re seeing that loss is our usual way of life. sometimes there’s this thing we call disenfranchised grief that tends to be unacknowledged grief. it’s all consuming. it’s not just our feelings — it’s the thoughts too. some people are way more cerebral in their grief process. it affects our ability to concentrate on every level — mentally, socially, spiritually on every level. i think part of the challenge of grief in our society right now is that the five stages (proposed by kubler-ross) have really just been etched into our public consciousness around this is how grief should work. like you go through these processes and end up at acceptance. but it doesn’t work this way.

what impact does not being able to say goodbye to a loved one have on those left behind?
it heaps additional loss on top of this already really significant loss. there are more things to grieve. even when it’s not covid, that’s where i find that often we can help people. sometimes it might be writing a letter to the person who has died. for others, it’s just the therapeutic effect of externalizing and capturing all the things they couldn’t say. after 9/11, there was a lot of work done, even if there was only parts of people’s bodies, to be able to lay them out as though they were attached to a body. then they were covered in a sheet, and family members were invited in. i think there can be therapeutic benefit in helping people integrate the reality of death. i encourage this for the families i’m working with — even with little kids. they can ask their child if they want time with daddy’s body. however, even when you can’t be there, it doesn’t mean that’s going to derail the grief process. we want to help to make sure that how a person’s life ended doesn’t overshadow the whole life that was lived and all of the connections and moments that were shared together.

how do you help children understand what’s happening?
kids are what we often call disenfranchised grievers. the younger they are, the more likely they are to get pushed to the sidelines and people say things like, ‘oh, they’re too little, they won’t understand.’ but there’s a lot of literature now that really supports including kids. i would explain what’s happening, for example, say something like, ‘daddy has something called cancer.’ and then you make cancer cells out of play-doh. or talk about how cancer  is stopping the body from working. a lot of adults get tripped up because they start thinking existential with the big questions, the mystery questions that most of us as adults don’t even know the answers to. with kids, just start with the physical. we know what physical death means, we need to start there and help them understand. it’s a teachable moment about death when there’s a squished squirrel on the street: ‘oh, the squirrel’s body has stopped working. it will never work again. the squirrel’s body has died.’

do you have any advice for moving forward after losing a loved one? 
first of all, allow yourself to feel heartbroken. so many people come to my practice in early sessions and ask what the point is in grieving. they will say things like grief and mourning won’t bring their brother or their child back. this is where i work really hard to help them understand that yes, there is a reason to grieve. i often jokingly refer to half the road rage on toronto’s don valley parkway is unexpressed grief. it’s all just bottled up and them someone cuts someone else off and there it is. if we don’t make space for this really natural, very difficult, but absolutely healthy and natural human emotion, it’s going to come out somewhere else.

but grieving is really hard. it’s not hard to understand why some people choose not to acknowledge their emotions.
we are a grief-illiterate society. there’s this idea that somebody dies and then our job is to break the bond and move away from them. but throughout much of history — and in many places in the world today — there are clear rituals and traditions that instil a sense of when your person dies, you still have ongoing responsibility to them. you’re still connected. and part of a healthy grief process entails finding ways to maintain those connections — keep telling those stories. make sure generations that haven’t been born yet are still going to know the stories of the person who died. in most traditions around the world, there’s very rich storytelling rituals about people who have died, but in our society, a lot of people don’t necessarily have those handed down. and that’s where a lot of the work in a healthy grief process happens — figuring out what it looks like to stay connected to someone who has died.

what does a grieving person do with feelings of regret or anger over things left unresolved?
it’s really natural to replay all of the things that we wish would have gone differently. there’s still a lot of processing of a relationship that can happen even after a death. i encourage people to write out how they are feeling, what they are angry or regretful about.  this could also happen by talking to someone, or through art — these are ways of expressing and externalizing feelings. often when somebody dies, other people don’t want to talk about the person because they think they’ll upset the family, but and not talking is far more harmful. there is a great quote by a bereaved parent that says, ‘mention my child’s name and i may cry; don’t mention my child’s name and you’ll break my heart.’ nobody wants the person who died to be forgotten.

how do you know when you (or a loved one) need professional help?
if it feels like the person is quite stuck, and there’s not enough room for a healthy grief process, then sometimes professional support can help them work through it. certainly, if there’s self-harm or thoughts of suicide, or if there is a loss of interest in things that used to be enjoyable, that for me would be signs we might need additional support.

the sense of loss can show up in a lot of ways, not just death. the pandemic has taken a lot away from us, and many of us are grieving the loss of normalcy. how can we manage this kind of grief?
in my sessions, even with kids, i’ve started checking in, asking questions about what has been the hardest things about the pandemic, what are the things we are missing the most and what things feels most unfair. take summer camp being cancelled again. this can be big for kids. we talk about strategies to work through the disappointment. last year, camp was cancelled, we gave my nine-year-old a pile of scrap metal and said she could throw and smash it as long as nobody got hurt — it was a safe way to express the anger.

any tips for schools as we prepare to get kids back into classrooms?
i’m hoping that schools are not just business as usual, but that they take some time with more of a recovery curriculum. we need to acknowledge what has happened and all that was lost, but also the good things. not that we would ever wish for [a pandemic], but i find that kids are really quick to say, ‘i enjoyed the slow down, i enjoyed having more time with my family.’ some kids acknowledge that they hated summer camp. it’s important to open those conversations up. i can guarantee that sweeping it under the rug and pretending it didn’t happen is not going to serve us well as a society.

dave yasvinski is a writer with    healthing.ca

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a psychotherapist's guide to surviving grief

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