Understanding and Processing Loss
This week, we will continue to pursue a better understanding of grief with the help of Dr. Merrill Hawkins. Today's post discusses different types of losses and how we process those losses. If you missed last week's post about defining grief, we'd encourage you to read it first! As always, we are so grateful to Dr. Hawkins, and we hope these posts are helpful to you as you deal with your own grief.
Since 1995, Merrill Hawkins has been a member of the faculty at Carson-Newman University,
currently serving as Professor of Christian Studies in the School of Biblical and Theological
Studies. In addition to teaching several different classes required first year classes in the Liberal
Arts Core, he teaches upper division and graduate classes in religion, spirituality, and health, with a particular focus on spirituality and mental/emotional well-being. His wife, Kimberly, is Dean of
the School of Education and Graduate Counseling. They have two adult children, Anna Lee and
Conner. When they are not working, they are grilling, eating out, reading, and watching either the
Houston Astros or something on Netflix. They travel as much as they can!
Six Types of Loss
Grief responds to the many different kinds of losses we experience as humans. In All Our Losses, All Our Griefs; Resources for Pastoral Care (Louisville: Westminster/John Knox Press, 1983), Kenneth R. Mitchell and Herbert Anderson point out six broad types of losses.
Losses can be material losses—the loss of familiar surroundings or objects. If your house burns or you lose a beloved piece of jewelry or you move to a new city, you have had a material loss.
Relationship loss is the one we think of most often and that we associate with death. This kind of loss is certainly major and it certainly includes death, but it is not limited to the death of a person. Relationship loss occurs anytime the opportunity to be in the physical or emotional presence of another person ends.
We also experience loss when our dreams die. What do Mitchell and Anderson mean by the loss of a dream? They refer to this type of loss in a formal term—intrapsychic loss. An intrapsychic loss is an internal loss of some idea about myself or the failure to achieve some goal that I’ve set or the abandonment of some plans I have had. Other people do not necessarily see what I’ve lost, making this experience even more difficult. It’s the loss of some kind of image or goal—perhaps I had a certain job in mind or an athletic goal—and it ended. I saw myself in one particular way and it did not work out. That’s an intrapsychic loss.
Functional loss is the loss of full physical mobility. Persons experience this loss in kinds of ways and at all ages. A gifted athlete might experience a torn ACL that can never be restored to its previous health. Their body is now different (and that person will not only definitely have a functional loss; additionally, an intrapsychic loss or a loss of a dream will coexist. The same incident can involve multiple forms of loss). A person can have a spinal cord injury and become a quadriplegic. In addition to sudden functional losses, the act of aging, itself a gift, is also an act of change involving slow and chronic loss of physical functioning.
Role loss occurs when a person ends by choice or by force an accustomed function in some social location. A high school senior who graduates, which is a good thing, has a role loss because that person is no longer a high schooler with all the social networks of friends. Good things lie in the future, to be sure, but the current role has ended. The people loving their work as supervisors in some business or teachers in some school experience a role loss if and when that job ends. The people in a relationship as a couple who break up experience a loss of roles (among other losses).
Loss also occurs at a collective or systemic level, in addition to its personal and individual level. We are social beings and we exist as persons in relationship to other persons in many different systems. Our first and primary system of which we are part is our family system. We don’t choose our family of origin. We are born into that system, but it is a part of our identity—our social identity. We do choose other systems of which we become a part, even though it happens organically and we don’t think of joining a system. But our friendships provide a system to which we belong. Our faith communities provide systems in which we move and exist. The work environment, especially when it is part of chosen career, provides a system. These systems are more than a bunch of individual people. The system itself is a community and systemic loss refers to the collective loss that a group feels. If a tenth grader dies, the entire school collectively feels that loss. These losses are systemic losses.
So, if grief is a complex interaction of thoughts and feelings to loss and if loss comes in at least six varieties, how does grief operate? Grief is a dynamic experience that shows up in different ways. There are multiple approaches to how grief works. These different approaches do not necessarily contradict each other. They just emphasize different aspects to the process of grief. Awareness of these different approaches allows us to understand the different ways we could experience grief and to work more consciously with the process for our own healing and to accompany others in their grief journey.
Stage Approaches to Grief
Some persons emphasize grief as a series of stages that a person experiences. This approach to grief focuses on the different states of mind that a person will experience in grieving. Stage approaches to grief (and many different stage approaches exist) focus on the different conditions I enter at different times. Understanding grief this way sees grief as a condition I have that changes, rather than something I actively do. However, when I become aware of the different stages of grief, then I can experience the stages more constructively and cooperate with them in my thoughts and attitudes and actions to help the grief work better.
Elisabeth Kübler-Ross (1926-2004), a Swiss-born psychiatrist who spent her career in the United States, created the best known stage approach to grief, as well as to death and dying. She first developed these stages in observing how people experience a terminal diagnosis—calling them stages of death and dying. However, she determined that the experience of dying paralleled the experience of grieving other losses. The six stages consist of: denial, anger, bargaining, depression and acceptance.
Denial is almost obvious in its meaning. A person states in one way or another, “This isn’t happening.” Anger in response to a loss, likewise, has an obvious meaning. That anger may be directed toward anything or anyone. Some people feel anger at God or at a person they hold responsible. Some people misdirect their anger—whoever walks in the door, so to speak, is the target of the anger. And some people respond to loss in the anger stage by simply having an angry disposition. Angry people often are grieving people. Bargaining is less obvious without thinking about it, but once one understands the concept, it is easy to spot in others and especially in oneself. A person with a committed faith may bargain with God, making promises to achieve certain goals if the loss is alleviated or the illness removed. A person who feels guilty about certain life actions or who has ceased religious activity may promise God to make changes. A person in a relationship loss may bargain with the person who left to win them back. Sometimes bargaining is, in fact, constructive and helpful in correcting the loss. Often, though, bargaining is a necessary stage that, when done well, does not return that which is lost, but helps the person process the loss. Depression as a form of grief does not refer to clinical mental illness. Grief is not a mental illness, although it can feel similar. People with diagnosed mental health illnesses will often need pharmacological approaches to the ailment. Medicines help the brain work. The depression of grief is small “d” depression. It is not a diagnosis, but a description of how one feels—down and low and depleted.
How can you tell if it is grief or depression? A person should always check out concerns of clinical depression with a medical professional. Two differences, however, offer clues. First, the depressive stage of grief has a very clear loss that can be identified. Two, the depressive experiences of grief do not involve feelings of worthlessness or low self-esteem. With the depression stage of grief, a person’s self talk will not be, “I feel bad about who I am.” Instead, the self-talk will be, for example, “I feel down and low because I lost ___________________ (my job, boyfriend/girlfriend, my scholarship, my mother’ died, and so forth). The last stage in this approach is acceptance, which means that a person has worked the other stages and has come to a realistic and calm embrace of reality.
While Kübler-Ross used the term "stages," and she observed that a person experiences these stages one at a time, she did not think of them as static and fixed. Instead, Kübler-Ross argued that grieving persons experience these in cycles and waves and in no particular order after the initial experience of shock and denial. One day a person may feel anger and the next day a person may be in denial. While entering acceptance is the goal, a person can enter acceptance and move back toward bargaining or depression. The process is dynamic. We might think of this as a person having good days and bad days. However, once a person has experienced the stage of acceptance, the likelihood of returning to that stage is high.
Task-Centered Approaches to Grief
Another approach to the process of grief focuses not on the mental condition or state of the griever, but on the actions grievers take. This approach to the process of grief is called the task-centered approach. This approach observes that well-functioning, constructive, and healthy grieving involves the completion of different actions or tasks. Becoming aware of these tasks allows a griever to be more active in working the tasks and helping the grief process achieve its natural aim of dealing with loss.
William Worden is one of the main proponents of task approaches to grief. According to Worden, grievers have four tasks to accomplish. First, grievers have the task of accepting the reality of the loss. Unlike Kübler-Ross’s final and passive state of entering acceptance, Worden sees acceptance a first step and an active task that one undertakes by cultivating thought patterns. This task, by the way, reflects one particular part of the complex interaction of grief, the mental aspect.
The second task of grief involves working through the pain of grief. This task centers around the affective, negative emotional dimension of grief and it involves what we might call leaning into the grief rather than running away from it. Losses feel bad and understanding those feelings and allowing them to exist without becoming overwhelmed is the second task. We might think of this task as giving ourself permission to feel the pain and not thinking we have to put on a happy face or always be strong.
The third task Worden describes is making adjustments to a world without that which has been lost. Again, this task focuses on mental adjustments and behavioral adjustments. If, for example, a person has lost a spouse, this task involves very practical aspects of assuming the responsibilities the deceased may have held. If a person is grieving the loss of a job, adjustments include the tangible adjustments of looking for new work and the emotional adjustments of seeing oneself in a new career.
Finally, Worden provides a fourth task that is especially relevant for losses resulting from deaths (although not limited to these kinds of losses). The fourth task entails reentering life as a fully functioning person while also creating a new way of being related to what was lost or WHO was lost.
Early twentieth century approaches to loss focused on grief as a limited process that had as its goal forgetting and moving on. The formal term is decathexis—withdrawing energy and attention from one object and placing it on another. This old approach to loss held that that healthy grieving involved getting over losses and moving our attention to something else. Decathexis still has value as a psychological concept. And there is a sense in which a person can be unhealthily fixated on some loss. However, current understandings of grief, including that of Worden, and especially with regard to losses connected to death, do not think in terms of ended relationships that need to be pushed out of minds. These approaches do not think of us as getting over some losses that are especially big. They think of us as getting through the losses, though. A person does not necessarily go back to normal in some instances, but a person can move ahead to a new normal. The new normal does not have to mean forgetting or obliterating a positive relationship. Instead, a person who has experienced loss works in this fourth task of finding new ways to be in relationship with that which was lost. These new ways include our internal memories we cultivate, as well as external practices we observe, such as marking anniversaries.
Being human means change and change means loss. All humans start to experience loss from the moment of birth because change starts immediately. With loss, comes the natural experience of grief, which, when we understand it, allows us to work through the grief. Grief never feels good. It is a negative experience with painful feelings. However, it is a negative feeling with a positive goal: processing the loss and living out our lives in full and meaningful ways. When we grieve, we honor what has ended and we give ourselves a new beginning.
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