Grief, American Style

Dealing With Loss

Medically Reviewed by Gary D. Vogin, MD

In 2001, we learned as a country what it feels like to be really scared, really sad, really angry. It was a rough year. Some of us experienced tremendous loss firsthand when loved ones perished at the hands of terrorists. But even those of us far from "ground zero" were deeply affected. What should we do to prevent sadness from following us intothe future? How, exactly, should we grieve?

"When there is a national disaster such as Sept. 11th, or a plane crash, we can reduce [our experience] to five losses -- of safety, trust, freedom, control, and innocence -- plus we have a collective broken heart," says Russell P. Friedman, executive director of The Grief Recovery Institute, a non-profit organization headquartered in Sherman Oaks, Calif. He has personally spoken with more than 50,000 bereaved people and is co-author, with Institute founder John W. James, of The Grief Recovery Handbook and When Children Grieve.

For the majority of us -- those who did not lose a loved one in the attacks, "the brain goes back over every loss we've ever had," says Friedman. The grief we feel is founded in empathy, based on our own experiences, even though they differ from the current situation. "As a human being who has experienced loss, others' losses touch our hearts."

Our need to hold vigils, to create makeshift memorials, "has less to do with the people who died than with the losses we've each experienced individually in our lives." And while it is sad, it is also positive. "What happened [Sept. 11] opened up our humanity to ourselves, if only for a while," Friedman tells WebMD. The reason for these large demonstrations is that we're all part of the family of humanity. It's proof positive that we are not emotionally or spiritually dead. In that respect, it's positive."

And for many of us, these rituals do help us work through our pain and anxiety, put things in perspective, reach a sort of closure, and move on.

But what about those who were directly affected by the attacks? Those who lost a child, a spouse, a best friend? And what about all of those who have experienced a more 'run-of-the-mill,' untelevised personal loss? With or without terrorism, parents die, children succumb to cruel diseases, marriages end, jobs are lost.

As people born and raised in Western society, the way we deal with these losses leaves a lot to be desired, says Friedman. In fact, it leaves many of us haunted, and in real pain, for years. "Loss is inevitable, but we're given no feasible structure with which to handle it," he says.

"The truth is, almost everyone in the western world, with very few exceptions, is socialized with six major myths regarding grief," he says. These pervasive behaviors and attitudes are fully entrenched in our psyches, "and in times of crisis, we go back to them." The problem is, the myths don't help us. Indeed, they may deny our healing.

The Six Myths of Grieving

1. Don't Feel Bad

"It sounds stupid to tell someone not to feel good when they feel good, but when they feel bad we tell them not to," says Friedman. Although it's perfectly natural to feel bad when something bad happens, we tell mourners 'be glad your loved one is in a better place,' or 'God won't give you more than you can handle.' This is especially harmful because "telling someone 'don't feel bad,' implies that there's no reason to feel bad," he says. Instead, simply listen and acknowledge their grief, says Friedman. "You don't have to do anything more, because they've been heard. And if they're heard, they don't blow up -- or blow up others."

2. Replace the Loss

"When my partner John was 6 years old, his dog died," says Friedman. "His parents said, 'Don't feel bad, on Saturday we'll get you a new dog.' This is diabolical because it doesn't honor that all relationships are unique and irreplaceable." And while no one would ever say, 'Don't feel bad, you'll get another mommy,' to a child who's lost his mother, we often tell couples who've lost a child that they 'can have another,' or women who've lost a spouse that 'she can start dating again.'

3. Grieve Alone

The adage 'Laugh and the world laughs with you, cry and you cry alone' is patently false, says Friedman. "Witness the fact that we just spent three months crying together!" In fact, he says, infants cry together. Only later are we taught and expected to cry alone. But grieving alone can be deadly. "Heart attacks shoot up 250% following the death of a spouse, compared with non-widowed people of the same age," he says. This doesn't mean we should never be alone when we mourn. "There's a very important distinction between solitude, which we need, and isolation," he says. "Solitude is a choice; isolation is not."

4. Time Heals All Wounds

"This is perhaps the most life-threatening myth," says Friedman. "You wouldn't sit and wait for air to come back into a flat tire. You'd take action. And a broken heart is remarkably like a flat tire." But time is not an action. It can no more fix your heart than it can put air back in your tire. "When the will to live, to do, to go on, are drained, you need to take action." How? By focusing on your lost relationship -- the good and the bad, coming to terms with what was left undone or unsaid. It can also mean seeking professional help if you need it.

5. Be Strong for Others

Most of us are taught to hide our emotions, especially from our children. But this is false and misguided protection, says Friedman, and in times of loss, it can backfire. As children follow our example, they end up swallowing their emotions. These bottled up feelings may eventually explode. "Kids are very resilient," he says. "You can share your emotions in a constructive way. You can be strong and human at the same time." By teaching kids not to ever be sad, "you're also teaching them not to be happy."

6. Keep Busy

Often when we experience a major loss, we fill every waking hour with activities and projects, anything to keep from focusing on what has happened. "But keeping busy doesn't fix unfinished issues between you and whoever has died," says Friedman. "It's an illusion, and at the end of the busy day, you haven't done anything to heal." Again, we should focus on and analyze our lost relationship. It's the only way to come to terms with it and move on, he says.

It's Not a Thinking Thing

What these six myths and the countless variations on them have in common is an attempt to intellectualize something that is sheer emotion. For example, says Friedman, "the idea of 'not letting them get us' is an intellectual construct." And while it may have helped galvanize our country in the aftermath of the attacks, for those who lost loved ones, it is nearly meaningless.

"Osama bin Laden won't be in their houses to see how they feel," says Friedman. "And feeling bad doesn't mean the bad guys won. The intellectual, political, philosophical notion of 'not letting the bad guys win' has nothing to do with [personal] grief."

For many, especially those who've lost someone to violence, accident, or disease, a key to moving on is "shifting off of the cause and onto the fact that the loved one is gone," says Friedman. "The fact that someone dies is an important emotional event. How they die is intellectual. People tend to become angry at, and focus on, the cancer, or Timothy McVeigh, or the terrorists, rather than focusing on the person who has died." But this merely prolongs and perpetuates the pain, he says.

For healing to occur, "you have to look at your beliefs and question them. If you believe time will heal, you'll take no action, and you won't heal," says Friedman. And the most important action, he says, "is getting back to the essential issue of your relationship to the person who is dead or lost to you. You need to look at what you remember about that person -- good, bad, or otherwise, and address the things that have emotional importance to you, whatever is emotionally unfinished."

Then what? Will you stop missing your loved one, or maybe even forget them?

Of course not, says Friedman. "An honest assessment of your relationship ... allows you to move on. Seeing and addressing what issues remain unresolved, allows you to have fond memories, rather than pain. Getting emotionally complete doesn't mean you'll never be sad again, but there's a difference between sadness and pain," he says. "And that's an important distinction."