Types of Grief

By Kellie Calderon, MA, LPC

"Grief I've learned is just love. It's all the love you want to give but cannot. All of that unspent love gathers up in the corners of your eyes, the lump in your throat, and in that hollow part of your chest. Grief is just love with no place to go."- Anonymous

As if grief weren’t complicated enough to deal with, there are a few different types of grief to be aware of. The importance of knowing these different types of grief is that you or a loved one can understand what you or they are going through to better process the grief and manage the emotions that go along with it. If you would like to get a recap on symptoms of grief, head over to the previous blog here!

Anticipatory Grief

This type of grief occurs when there is either a terminal or progressive illness that causes you to anticipate the grief that will occur when the individual passes away.

What you may experience:

• Anger

• Loss of emotional control

• Helplessness

• Loss of other things, such as dreams, future or family structures

How to help:

In situations where you may be anticipating the loss, it is important to use the time to process the loss with that person. It can be difficult to accept the fact that a loved one is going to pass away, but it gives an opportunity to spend time with them to find meaning in your relationship with that person and gain closure and peace for when they actually pass.

Complicated Grief

This type of grief lasts longer than “normal” grief (I put normal in quotes because there really is not a normal way to grieve, so use this term lightly), and may affect your daily living if you are not receiving help. If someone has an underlying mental health diagnoses such as depression or anxiety, it can also make the grief feel more intense. Someone who has depression or anxiety may have a harder time finding coping skills that are effective without additional help from a therapist.

What you may experience:

• Grief lasting a long period of time with no improvement

• Delayed grief (experiencing grief long after someone passes)

• Extreme or intense reactions to the loss (self-destruction, changes in behavior)

How to help

Since complicated grief is just how it sounds, complicated, the best route to process it would be to speak with a counselor. It may also be beneficial to set up an appointment with a psychiatrist if you feel you may have an underlying mental health condition as well.

Disenfranchised Grief

This type of grief occurs when a society, family member, friend or community invalidates the grief. This could be if the death is a suicide, overdose or something similar. This may also be if the death is someone that was not necessarily a close part of their life such as a coworker. These can be tough because although you may not be a close friend or family member, you still can feel the loss. Friends or family may wonder why you are experiencing grief, but it is important to remember that grief can manifest itself in different ways within different people. It could also be a trigger of a another time someone felt grief.

What you may experience:

• Feeling isolated

• No validation of your grief/feelings

• Feeling shameful or guilty for grieving

• Suppressing the grief

How to help

It can be helpful to find others who may have experienced that type of grief to help normalize the feelings (support groups, etc.). It may also be a good idea to talk to a counselor to find support and an outlet for your feelings of grief. Remember that everyone experiences grief differently, and just because others do not validate your grief, does not mean what you are feeling is not real.

Other types of grief

Along with the types of grief mentioned above, there are other types that may not be as common but still should be discussed.

Traumatic Grief - When a loved one dies in a traumatic and/or violent nature. This could cause nightmares, flashbacks (if witnessed), etc.

Cumulative Grief - Experiencing a loss while still grieving a different loss

Masked Grief - Experiencing grief that affects daily functioning but is not recognized by the person grieving. This person may be masking the symptoms with other behaviors (overeating, physical symptoms, self-sabotaging, etc.)

Collective Grief - Refers to grief experienced by a group. This is becoming more common with school shootings, natural disasters or if there is a death in a close knit community.

Absent grief - When the person is not showing any signs of grieving and is in denial of the loss. This might look like someone who goes about their normal life as if the person had not passed away. This person may be in complete shock and unable to recognize the loss.

There is no “right” way to process grief. However, if you notice that the grieving process is affecting your daily life and functioning, we encourage you to seek out counseling. This will help with processing the grief as well as learning how to manage the emotions that come along with it.

Types of Grief. (2017, March 28). Retrieved from https://whatsyourgrief.com/types-of-grief/

Understanding Grief: Symptoms and Ways to Cope

By Kellie Calderon, MA, LPC

Everyone experiences grief at some point in their lives. This can be through the death of a close loved one, or through other losses such as the loss of a job, the loss of a pet, or even the loss of a lifelong dream or goal. When a loss occurs, there are many different emotions someone can experience. Reactions can range from crying and sadness, to anger and disbelief. The difficult part about experiencing a loss is that there is not a one-stop-shop solution. Grief is not linear. There is not a specific set of things you can do to make it better, and what works for one person may not work for another.

The first part of this series is going to be covering the symptoms of grief as well as a few ways to cope. It is important to be able to identify these symptoms when you may be grieving yourself, or when someone you know may be grieving. By identifying the symptoms, you can begin the healing process, or help guide someone going through it.

There are many different symptoms that can manifest when someone is grieving. They can be separated into feelings, cognitions, physical symptoms and behaviors, and many of them are listed below. (Freeman, 2005; Worden, 2005). 

-Feelings:

- Sadness

- Numbness

- Anger

- Guilt

- Anxiety

-Cognitions:

- Obsessive Thinking

- Intrusive Thoughts

-Physical Symptoms:

- Tight Chest

- Lack of Energy

- Muscle Weakness

- Dry Mouth

-Behaviors:

- Sleep Issues

- Changes in Appetite

- Social Withdrawal

- Absent Mindedness

Many of these symptoms are very normal when it comes to the grieving process. However, one thing to be aware of are symptoms of depression versus grief. There are some similarities between the two but they are also very different experiences, and if left untreated, depression can become very serious. Below are some symptoms of major depression:

- Worthlessness

- Exaggerated guilt

- Suicidal thoughts

- Low self-esteem

- Powerlessness

- Helplessness

- Agitation

- Loss of interest in pleasurable activities

- Exaggerated fatigue

 Coping with Grief

 As mentioned earlier, grief is not linear. This is very important to remember because someone’s grieving process may take a few weeks, while others may take a few years. It is essential to be sensitive to someone who is grieving and to not force them through the grieving process. Below are a few strategies that may help when going through the process of grief (Note: many of these reference death; however, as we have stated loss can take many different forms).

 -Talk about the death. Many people deny the death which can cause isolation and may make it more difficult to accept the death and move on with life.

-Experience and accept feelings. It is important to remember that feelings of sadness, anger, numbness, etc. are all normal. In order to process the loss you must accept these feelings and try to experience them.

-Prioritize Self-Care. Many people neglect themselves while grieving. There is a lot happening and it can be distracting. Make sure you focus on your eating habits, exercise and sleep. Try Mindful Meditation to help as well. Apps such as “calm” or “headspace” can help with this.

-Accept support and help from others. It can be easy to feel like a burden to people when you are grieving, but the people around you are there for you to lean on. Surround yourself with your support people and accept the help they offer.

-Remember your loved ones in a positive light. It can be difficult to think about the positives in a time where everything seems so negative. Celebrate the life of the deceased and remember them in ways that make you feel good. Sometimes it can help to memorialize them in ways such as planting a tree, creating a memory book or advocating for a certain charity that is in their name.

 If you or someone you know is experiencing grief and is having a difficult time, please seek out professional help from a mental health counselor.

Sources:

Freeman, S (2005). Grief and Loss. Understanding the Journey. Belmont, CA: Thompson Brooks/ Cole

Grief: Coping with the loss of your loved one. (n.d.). Retrieved from   

        https://www.apa.org/helpcenter/grief

Schwartz, A., LCSW, PhD. (n.d.). The Difference Between Grief and Depression, The DSM V. Retrieved

      from https://www.mentalhelp.net/blogs/the-difference-between-grief-and-depression-the-dsm-v/

Worden, J.W. (2005). Grief Counseling and Grief Therapy: Handbook for Mental Practitioners (3rd ed.).

      New York, NY: Springer Publishing Company

Becoming a Therapist- My Personal and Professional Journey

I’ve often been asked by others, how did I become a therapist? What motivated or attracted me to embark on this long and intensely challenging professional journey? Throughout my lifetime, both personal and professional experiences contributed to my choice of practicing psychotherapy and specializing in complex trauma.  

I was born in Poland during the 70s, the era of the communists' regime. As a child, it came naturally to me to be a caring, empathetic and compassionate person. I often tuned into my feelings and expressed myself well. I would spend time alone to attune to these passing feelings and the state of my body trying to figure out why I felt this way, often expressing them through art and writing poems. This growing self-reflection in me lead to my curiosity towards what other people think and feel as well as why they behave in certain ways. I often wondered about why some people were so loving and caring while others so authoritative, abusive, or self-absorbed?

In school, I became aware of my abilities to listen and have empathy towards others' suffering. Friends and others often came to me to unburden their wounds or to share their deepest secrets - we would sit there and puzzle on the best way to resolve or to cope with their struggles. I was the person who stood up for others, was concerned for my peers' well-being, even being there for bullies to help them see the hurt they were causing to others. Science, art, writing, reading novels, poems, and war stories were my daily inspiration. I remember being able to visualize so vividly characters from books, draw nature, and write poems about self and others. Listening to my grandma's heroic war stories was the most inspiring experience, and I learned that even in the most atrocious times there was always room for helping others. She was the first source of inspiration for the trauma work I do today.

At the age of 11, I experienced and witnessed relational/parental separation, which had become a norm in my country, by overwhelming migration and adjustment struggles of losing a parent or a caregiver. My mother also immigrated to the USA to search for a better life for us (my two brothers and me). As a middle child and the only female in the family, it came to me naturally to acquire the role of a mother to my both brothers, especially to youngest one. I grew close with my brothers and often soothed their distress and grief. I found a ''safe haven'' in my grandmother’s and auntie's arms.  I grew in strength, resiliency, and understanding of the importance of being there for my brothers. These relationships helped me to value the quality of family connection and strong bond on children's well-being.

As a 13 year old I experienced revolution, known as the ''Fall of Communism''. The post-communism times brought on economic turmoil, declining of the well-being of the country and the quality of life of many families, dramatically spreading poverty. In the face of collective suffering, political imprisonment, censorship, Martial law, cruelty, absurdity, and misery, relational closeness and support was the only ''safe haven'' for many - comforting others become an essential part of all human life.

At age 16 I was able to join my mother in the USA, where I began a time of a huge transition and adjustment as an immigrant - aspiring to fit into a new culture and communities was challenging, but also rewarding. Meeting people with similar experiences brought up for me this lingering drive of wanting to do more and to be able to help others in a similar situation. Relating to one another as immigrants was helping us to move forward, and we would meet on a regular basis to unburden our grievances and challenges. My new friends often found me genuinely supportive and encouraging, always there for them and listening to their stories and secrets.

Living as an undocumented immigrant for over 12 years brought a lot of fear in my life. I tried to lead a normal life; I did my GED in preparation to go to college to study psychology, I got married, had a child (daughter) and got divorced. I re-married and had a second daughter. As both my children were U.S. citizens, I feared that one day my husband or I might be removed from them. I did not know my country anymore, and the idea of going back was scary.  My family and I left the USA in 2005 to await legalization of our status. For the next 13 years, we embarked on a journey of trying to give our children a similar life as what they had in the USA, so we relocated to different countries such as the Czech Republic, the United Kingdom, Canada, and eventually back to America. It was a challenging period of readjustments, personal transformation, and an incredible opportunity to connect with people from various cultural and ethnic backgrounds.  The move to the United Kingdom presented an excellent opportunity for me; I finally enrolled in a higher education program in psychology and community studies as a prerequisite for the BSc in Counseling and Psychology, and then onto an MSc Counseling and Psychotherapy.

My curiosity was growing, but it wasn't until my practicum where my passion for psychotherapy and specializing in complex trauma come to light. During my 17 months of volunteering at the National Health Services in the UK as a support worker, I primarily worked with individuals diagnosed with borderline and anti-social personality disorders, who presented as complex and at times exhibited challenging and risky behaviors. Providing emotional, practical and crisis support for these individuals came naturally to me. I thought a great deal about their wounds and the overwhelming effect they had on their lives. I have learned that regardless of the importance of diagnosing these individuals based on DSM (Diagnostic Statistical Manual) criteria which are used by many professionals, every individual deserves to be treated as a person of worth with compassion, empathy, validation, and integrity. Today, as a psychotherapist and trauma professional these values represent my professional identity and practice.  

Like many others, I have experienced and witnessed distressing events that have impacted my family and myself. In my journey to become a therapist I suffered and hoped, I have experienced anxiety, distress and satisfaction, I developed a unique relationship with my true self, found meaning and the purpose in suffering - providing me with an opportunity for self-growth and self-actualization.  As Carl Rogers who inspired me both professionally and personally once said ''the organism has one basic tendency and striving - to actualize, maintain, and enhance the experiencing organism. The good life is a process, not a state of being. It is a direction, not a destination''.

I was one of those fortunate people who had close family members who were always there for me, who helped me to process my distress, and develop healthy ways of coping - they were my healers. Even though they left this earth, they still live in me, in my memories, they become a part of me. Today I am a therapist, a healer, a person who is devoting her life to help others find the meaning and purpose in their life within their struggles. I listen acceptingly and attentively to my clients, I struggle, puzzle and am curious with them and we search together for ways to help them heal and reach their potential in life.

Becoming a therapist combines both my personal and professional experiences. Through those, I grew in genuine love for all people regardless of their cultural or ethnic background. They shaped my personality and professional identity as well as practice. I find being a therapist specializing in trauma as an enriching career, even though at times it can be mentally and emotionally exhausting. I enjoy every aspect of it, the honor of being entrusted with deepest secrets or overwhelming experiences, the incredible human connection/intimacy, the possibility to be authentic and present and to actively listen, empathize and validate their wholeness is invaluable. To experience with and to ''hold'' another human being through the process of struggle, changes, healing, and transformation is the greatest reward one can experience. To witness a person’s face light up in hope for the future and witness their wounds becoming their strengths and meaning for the future are the greatest rewards for me as a therapist.

Using Dialectical Behavior Therapy as part of Holistic Wellness

Owner Danielle Zawadzki, LMFT talks about using DBT in therapy and its role in holistic wellness with Dr. Serena Wadhwa. Episode recorded on July 23, 2017.

Coping with Emotional Trauma During the Holidays

Holidays are supposed to be joyous and happy, but for many, it is a time of overwhelming stress. We may overextend ourselves emotionally and physically with a strong desire for belonging and connecting with others. For many of us, getting together with our families and friends brings joy and happiness; however, for others, it is the worst time of the year as it reminds them of an extremely stressful or disturbing event where they felt hopeless and emotionally out of control – traumatized. It is a time that can trigger all sorts of complicated feelings, memories, and anxieties. Trauma happens to everyone and if not resolved can have a detrimental effect on an individual and their relationships. While holidays bring bright spots for many of us, it can bring unique struggles undeniably faced by trauma survivors as they may have to meet family or friends that were the source of the psychological trauma, were unsupportive or toxic, or did not value their mental or personal well-being. For many survivors of emotional trauma, holidays may represent anniversaries and reminders of the past hurt or traumatic experiences. For those individuals even the slight prospect of visiting family or friends can bring up feelings of shame, fear, dread or ambivalence, leaving them trapped and unable to cope.
Emotional and psychological trauma is extremely painful, even without physical injury. Part of the reason is that it is invisible to others and difficult to share. Many of you will have different trauma histories involving very different triggers and varying levels of responses as well as stages in recovery. It is important to know that although emotional injuries will not merely go away, healing from trauma is possible although it may take days, months, or even years. Know that you are not alone and help is available, and that having self-care strategies at hand can help many of you to not only to speed up your recovery but also to cope during the holidays.


Recognizing signs and triggers of emotional trauma can be helpful to you to take control of your responses in the present moment when your whole body and mind go on ''overdrive''. 


What is Emotional Trauma?

Trauma is incredibly interpersonal and does not discriminate based on gender, social class, race, sexual orientation, age, culture, religion or ethnicity. In every family or relationship that we form as adults, there is a heightened risk of experiencing strong emotional, cognitive, physical and psychological reactions. Whether you suffered childhood abuse, were in an abusive romantic relationship, an acrimonious divorce, bear a witness to a horrific event, were a prisoner of a war, or have experienced workplace bullying, the effects of psychological trauma can last a lifetime.

Emotional and psychological trauma is defined as ‘'damage to the psyche (mind) that occurs as a result of a severely distressing event''. These events are often perceived as life-threatening over which you have no control as if you are trapped without any means of escaping. When you experience an intense and painful event, all areas of your life are negatively impacted often leading to the development of depression, anxiety, posttraumatic injury, addictions, phobias or social and relational problems. This might leave you with ‘'emotional scars'', often feeling emotionally exhausted and isolated. It is important to note here that there are two components to your experience of trauma: your subjective and objective knowledge of the event. The more you believe that you or the life of other is at risk, the more traumatized you will be. It is without any doubt that trauma is psychologically overwhelming causing strong emotions and an utter feeling of helplessness. However, the details or the meaning of an event that is most distressing for you will not necessarily be the same for others. Trauma comes in many forms and is experienced differently by each individual.


You may experience emotional trauma if:


• You were unprepared for it


• It was out of your control


• You felt powerless to prevent the event


• You have experienced the event repeatedly 


• It was extremely cruel


• It happened during your childhood


Traumatic events might be related to your or loved one's physical or mental health, past traumatic experiences, coping skills, personality traits, social and emotional support at the time of the event, or specific stressful or horrific situation.


Childhood trauma can be caused by the following events:


• Growing up in an unstable or unsafe home/environment


• Being separated from or abandoned by a parent or a caregiver


• Basic needs of food, shelter, clothing were not met


• Experienced serious illness or intrusive medical procedures


• Sexual, physical, or verbal abuse


• Domestic violence or homicide/suicide/murder


• Neglect 


If your trauma happened years ago, know that there are steps you can take to recover from the past emotional injuries and hurts, by learning how to trust and connect with others and reclaiming your emotional balance.

Reactions to traumatic ordeals often may include cognitive and behavioral responses. You may experience spontaneous intrusive thoughts, have visual images of the traumatic event flashing in your mind, and hear hurtful or painful messages repeatedly conveyed to you in the past. A loss of memory or sense of disorientation, confusion, or ability to focus on daily tasks is also a universal reaction. You may experience changes in your mood or behavior such as avoiding places or activities, or even people reminding you of the traumatic event. Social and family events may no longer bring pleasure and joy; hence you may feel a strong need to isolate and withdraw to avoid overwhelming emotions. To cope with aftermaths of tormenting and overwhelming events, humans possess an innate and natural response to protect self from harm. You too have developed many coping strategies to avoid overwhelming emotions - to ''shield yourself '' from dangerous situations. As some of these may be causing further struggles, know that there are people who can help you to stand face to face with the effects of trauma and keep yourself safe.


Ways to Cope with Emotional Trauma during Holidays

Support System
Having a support system in place before holidays is a vital step in helping you to deal with strong emotions. You cannot control your past trauma; however, you can take control by planning to have someone to talk to while visiting your family or friends or while you spend the holiday alone. First, acknowledge that reaching for help is not an act of weakness, it is a strength. Then assemble a list of people in your life that you can rely on in the moment of need. They may be your close friends who listen to you or a family member who understands and validate your mental and personal well-being. Plan to connect with them before and after holiday gathering, even for 5 to 10 minutes on the phone or in person. If you have a therapist try to book a pre and post-holiday appointment to discuss coping strategies. 


You have a choice
Remember that you have a right to decide not to attend a holiday gathering without explaining yourself why. If you believe that you will feel unsafe, you can set boundaries for yourself. You have the right to say no, change your mind or make choices that are right for you. If you still live with toxic people, this presents different challenges as saying no can bring more harm to you. Take control of your choices, know that you can use your voice to say no, set boundaries and have it be respected. If things get out of hand call 911 - remember that keeping yourself safe is a priority. 


Unhealthy Ways of Coping

It is very common to develop various coping methods to numb your pain and emotions. They all can be extremely harmful to your psychological and physical well-being. Developing more healthy strategies can be profoundly empowering. Remember that alcohol is highly intoxicating and can cause traumatic material to be triggered, leaving you defenseless against it. So are drugs or marijuana as they depress your nervous system. Choose healthier options, for example, rest well, eat well, and stay hydrated, and don't forget to exercise to boost endorphins (happy hormones) in your brain. Simple walking and paying attention to your surroundings is an excellent method to take your mind away from the chaos in the present situation, and it is a unique strategy to bring back your emotional equilibrium. 


Grounding & Containing Yourself

If you find yourself feeling upset and unable to settle down your emotion, grounding and containment exercises are an excellent way to self-rescue from the situation. If you notice that you can't break your attention from intense arising traumatic thoughts, images, and feelings, try to connect with and focus on your surroundings (here and now) with the intention to use all your senses (sight, touch, smell, hearing, and taste) - making sure that your feet are fully touching the ground. Then in your mind name 5 objects that you can see in the room. Be sure these are real rather than imaginary objects. Next, in your mind identify 5 sounds you hear. Make sure that these are not conversations in the room, instead, try to focus on sounds such as a sound of tapping a pen, a car passing by, squeaking chair, or your own words, etc. Now identify 5 things you can sense of feels such as your breath moving in and out, the feelings of your legs/ hands/ bottom (if you're sitting), or the sensation of the warmth in the room. If you still feel overwhelmed start from the beginning with naming 4, 3, 2, 1 things using your senses. Practice this exercise anytime, even when you don't feel upset. This will help you to teach your nervous system to respond better in the moments of high distress.


Recognize Your Triggers
It is important to recognize what are your triggers. They can range from the anniversary of the event, a song, a person, a smell, or a word. It can be anything that can trigger sensations of the original trauma prompting your body and mind to relive it. When you experience a trigger, you will start feeling as if you are in danger – it is a natural response of your body and mind in the moment of threat. When you are not in real danger, know that your body and mind react this way as it remembers the ordeal. It is an automatic response to all those cues around you that your body is picking up through your all senses. However, if you are really in danger, then your natural reaction will be to get yourself out of the situation. Do that. Keep yourself safe. Call for help. If you are in a position that is not life-threatening but you still experience triggers as if you were reliving the traumatic event, then the best thing is to acknowledge that these are triggers and try to soothe yourself.


Be Kind to Yourself

Remember that holidays are stressful for everyone, even those who did not experience emotional trauma or who have fully recovered. Yes, It’s possible to heal from past hurts and injury with the right help. Yes, you are likely to feel angry with someone, have arguments, make mistakes, or have impatient days. If you stumble or even fall apart, its ok. Recovery is difficult but not impossible. If you are having feelings that seem too overwhelming to cope with, reach out for help to others, call 911 or go to the closest ER – take control of your reactions to triggers and keep yourself safe, because you are worth it. Remember that life is a process and emotions are changeable and that every year is different. If something goes wrong, be kind to yourself, and remind yourself that in the present moment it is you who needs comfort the most. Be sensitive and gentle to yourself. Breath. Take control. Make choices and boundaries. If you are a survivor of any traumatic ordeal and you feel that you can't move past your invisible wounds, reach out for help to a professional specializing in trauma recovery. 


Have a peaceful and safe holiday!