Helping clients with grief
Manifestations of grief
Although grief responses, in general, differ from one person to another, there are many predictable manifestations of grief. These manifestations occur on physical, intellectual, emotional, social, and spiritual levels. Before, during, and after loss, grief may appear in several of the following forms.
Crying, sobbing, wailing, shock and numbness, dry mouth, a lump in the throat, shortness of breath, stomach ache or nausea, tightness in the chest, restlessness, fatigue, exhaustion, sleep disturbance, appetite disturbance, body aches, stiffness of joints or muscles, dizziness or fainting
Denial, sense of unreality, confusion, inability to concentrate, feeling preoccupied by the loss, experiencing hallucinations concerning the loss (visual, auditory, and olfactory) a need to reminisce about the loved one and to talk about the circumstances of the loss, a sense that time is passing very slowly, a desire to rationalize or intellectualize feelings about the loss, thoughts or fantasies about suicide (not accompanied by concrete plans or behaviors)
Sadness, anger, depression, guilt, anxiety, relief, loneliness, irritability, a desire to blame others for the loss, resentment, embarrassment, self-doubt, lowered self-esteem, feelings of being overwhelmed or out of control, feelings of hopelessness and helplessness, feelings of victimization, giddiness, affect that is inappropriate for the situation (nervous smiles and laughter)
Feelings of withdrawal, isolation and alienation, a greater dependency on others, a rejection of others, rejection by others, a reluctance to ask others for help, change in friends or in living arrangements, a desire to re-locate or move, a need to find distractions from the intensity of grief (to stay busy or to over-commit to activities)
Bargaining with God in an attempt to prevent loss, feeling angry at God when loss occurs, renewed or shaken religious beliefs, feelings of being either blessed or punished, searching for a meaningful interpretation of a loved one’s death, paranormal visions or dreams concerning a dead loved one, questioning whether or not souls exist and wondering what happens to loved ones after death, the need to “finish business” with a purposeful ending or closure to the relationship (a funeral, memorial service, last rites ceremony, good-bye ritual)
When you have learned that your beloved animal friend has a terminal illness and may soon be gone, it is very natural to experience grief while your pet is still with you, prior to his or her actual death. This is called anticipatory grief.
Many deaths occur with some forewarning. Thus, it is often during this period of anticipation that people begin to experience the various feelings and manifestations commonly associated with grief.
One of the most common feelings during this period is an increase in anxiety. For many people, anxiety increases and accelerates as the time of death draws closer. When there is some anticipation of death, it is common for people to mentally “rehearse” the event and its aftermath. Typically, people may ruminate on questions like, “How will I handle the death?” “Will I make mistakes?” and “What will it be like for the one who is dying?” This is called the “work of worry,” and when used in appropriate ways, it has been found to play an important role in people’s overall ability to cope. During these times, it can be helpful to discuss your feelings with the people around you who understand your relationship with your pet. Making plans for the death of a pet can help to ease some anxiety and allow you to focus solely on loving your pet.
It is important to stay aware of spending too much time engaged in worrying. This can lead to emotionally withdrawing too soon from the one who is dying. This withdrawal can provide a false shield from the ongoing intensity of strong feelings, while in truth, it simply masks the emotions which remain disregarded, yet very intense.
Children’s understanding of grief
Children ages 1-2
Their world is experienced through their senses. At this age, they do not understand death. Instead, they respond to their caregiver’s emotions and behaviors. They may express grief as irritability, changes in sleep and eating patterns, and quietness. For caregivers, supportive actions include continuing nurturing interactions and maintaining routines.
For children at these ages, death is like sleeping. Death is temporary and perhaps reversible, not final, and the deceased pet can come back to life. Children may ask and repeat many questions, such as, “When will he be back?” “Where did he go?” “What will he eat in the ground?” They may also believe that their own magical thinking can have realistic results. “It’s my fault. Barkley chewed on my toy and I got mad at him. Now he’s dead.”
At this stage, children can be very focused on the concrete details, often very curious of the physical aspects of the dead body. Still, they are very sensitive to their caregiver’s emotions and behaviors. They may express their grief as irritability, change in regular patterns, regression, and acting out behaviors, so maintaining schedules is important. Children often process their emotions through play, so themes of death, dying and funerals may be displayed with toys. Parents and caregivers are encouraged to answer questions truthfully, using simple and appropriate language.
“Barkley is sick and suffering with cancer.”
“We will have the doctor give Barkley medicine that only animals can have to help him to die.”
“When Barkley dies, his body will still be here but he will not be alive anymore.”
This is also an opportunity for adults to model appropriate expression of feelings. This not only helps the child identify what they are feeling themselves, but creates a sense of safety about experiencing emotions and expressing them appropriately.
Children in this age range begin to understand death as final. They may be curious of the physical and biological aspects of the deceased. In the earlier years of this developmental phase, children may believe death is something that occurs to only the old, and only to others. Soon an understanding will occur that death can happen to anyone as well as themselves. Fear of death may occur. Acting out behaviors at home and at school may be exhibited. Social development is occurring so children may imitate how others around them respond to death or may hide their feelings in attempt to not appear “different.” It is important for parents to continue to model appropriate behaviors and be honest and factual with children.
These young adults are able to think abstractly about death. They understand it is the end of a physical life. At this age, teenagers are searching for identity and attempting to find a balance between independence and dependence of their caregiver. They may struggle with needing support and not wanting it. It is important to help them find personal ways to express their grief, such as writing, drawing, and talking.
In all areas of development, the ways in which parents process and display their grief will greatly impact their children’s ability to grieve. It is an important time for parents and other adults to teach children how to express grief in emotionally healthy ways free of shame or embarrassment, as these lessons are carried into adulthood.
At your own pace
The tortoise and the hare
The classic tale of the tortoise and the hare reminds us that different people take life at different speeds and that one way is not necessarily superior to another. In fact, in the story it is the slower animal that ends up arriving at the destination first. In the same way, some of us seem to move very quickly through the issues and obstacles we all face in our lives. Others need long periods of time to process their feelings and move into new states of awareness. For those of us who perceive ourselves as moving quickly, it can be painful and exasperating to deal with someone else’s slower pace. Yet, just like the tortoise and the hare, we all arrive at the same destination, together, eventually.
People who take their time with things are probably in the minority in most of the world today. We live in a time when speed and productivity are valued above almost anything else. Therefore, people who flow at a slower pace are out of sync with the world and are often pestered and prodded to go faster and do more. This can be not only frustrating but also counterproductive because the stress of being pushed to move faster than one is able to move actually slows progress. On the other hand, if a person’s style is honored and supported, they will find their way in their own time and, just like the tortoise, they might just beat the speedier, more easily distracted person to the finish line.
It’s important to remember that we are not actually in a race to get somewhere ahead of someone else, and it is difficult to judge by appearances whether one person has made more progress than another. Whether you count yourself among the fast movers or as one of the slower folks, we can all benefit from respecting the pace that those around us choose for themselves. This way, we can keep our eyes on our own journey, knowing that we will all end up together in the end.
Making Decisions resource guide
By offering strategies for evaluating healthcare choices, assessing quality of life, making end-of-life decisions, and coping with the loss, “Making Decisions When Your Companion Animal is Sick” acts as a standalone resource for animal caregivers or as a tool to foster veterinarians and clients working through these challenging conversations.
For consultations, questions, or to arrange a referral for your client. We are happy to provide expertise over the phone to you or act as a resource for your clients.