An excerpt from A BRIEF GUIDE TO GRIEF

brown and white rocky mountain during night time
Photo: Kym MacKinnon

In the days of pandemic, we are all facing some form of grief as the life we knew before has been taken from us. There are those of us who not only are facing a collective loss of life as we knew it, but also, sadly, are confronting personal losses of friends or family to the virus.

Dr. Moody has counseled thousands of grieving people to understand the nature of grief. In the video and print excerpt below, Dr. Moody shares his knowledge and experiences through stories and insights.

In addition to the five stages of grief described by Elisabeth Kübler-Ross, Dr. Moody reveals how we might also face a variety of unexpected emotions, ranging from anxiety, to guilt, to bewilderment. He assures us that we will learn to live with the never-ending feeling of grief, and in the process deepen our appreciation and understanding of ourselves and others.

********************

Grief is a universal human phenomenon, and it goes back as long as there have been human beings. As a matter of fact, the whole Western intellectual tradition, which began with the Ancient Greek philosophers, began with a concern about how to help people with grief. Grief is, first of all, a process. That is, it’s not something that happens instantaneously, but it takes place over a long period of time. And this process of grief involves, first of all, the physical body; it creates changes and disturbances in the physical body. Secondly, it creates disturbances in the emotions and the feelings. And also, over a period of time I think, it touches into the spiritual dimension of life. And what this emotional and physical and spiritual process has to do with is coming to terms with the loss, primarily of a loved one, to death.

However, it is very important to remember that the same feelings, the same process that goes on after we lose a loved one to death, also goes on after, for example, someone loses a limb of their body, one of the senses, such as vision or hearing, or a relationship, like through a divorce, or a pet. These same kinds of responses to loss take place no matter what the particular loss is.

Everybody grieves in a little different way, but there are definite patterns. And any sort of loss that you suffer can bring about these standard sort of aspects of the grieving process. Grief doesn’t necessarily unfold in one fixed order. People grieve in all sorts of different ways, and there’s no such thing as a strict or rigid order in which people go through the so-called phases of grief. In reality, it’s more that everything is all sort of mixed up at once. Grief can be a very confusing time for people. Grief causes confusion in people because it brings all sorts of emotions to the fore that often they’re not familiar with.

There are two major different kinds of situations that we need to think about in grief. One is the situation that I’ll call acute grief, and that’s where the loss comes out of the blue. At one moment the person seems to be fine and healthy, and the next moment, unexpectedly, they die. Now, the other situation is what we call chronic grief, and that’s the situation where, for example, we learn that Grandma has Alzheimer’s Disease – and usually it takes about, say, seven years for someone to die from Alzheimer’s Disease – and so while Grandma is still alive, we are going through the grieving process beforehand; that’s called anticipatory grief. And that is why so often when somebody dies after a long period where they’ve been ill, the loved ones say, “Well, we’re glad that Grandma’s died,” or “We’re relieved because now we know she’s not suffering anymore.”

sea under white clouds at golden hour
Photo: Sebastien Gabriel

However, the emotions and the feelings that are involved in acute and chronic grief are really the same. The only difference is that in the chronic grieving situation or anticipatory grieving, we’ve gone through most of those things before the death actually occurs. We will talk here about the acute situation as though the person dies suddenly, but these same things can be applied to the chronic situation where we have advanced warning of someone’s death. But in a situation where suddenly someone finds out that their loved one is dead, the most common thing that they report in those initial moments is what we call numbness.

And this is something that any doctor who works in an emergency room will well understand. When people learn that their loved one has died suddenly and unexpectedly, they just sit there with a complete look of blankness on their face. People describe at this point how they have no feelings. They are unable to feel.

Now, as this process progresses, the first thing after the numbness that typically comes about is what we call denial. And that is that you hear from people words to the effect, “I can’t believe it,” or “It’s not possible,” or “I just don’t believe it.” And having had this experience as a physician in the emergency room, many times I’m still impressed with how almost uncanny it seems. For example, back in the eighties I remember talking with a young man who was 26 years old, and he had brought his father into the emergency room. His father was ill, and we were treating the father, but the father died. So I was the one appointed to go out and to talk to the young man.

So I told him, “I’m sorry, sir. We did all we could, but your father died.” And the young man said back to me, “Oh, yeah, I understand, Doc. He’s had these little spells before. When are we going to be able to take him home?” So at this point then you have to come back again and say, “I’m sorry, sir. Your father died. We did all we could.” And again it was, “I understand, Doc. Are you going to give him some of his medicine when we take him back home?” And you just have to keep going back to repeat it and insist on it, until people finally break down and become tearful and sad. And then – this is of course an aspect of the grieving process that we all understand – it’s normal and natural for people who are grieving to cry, to have tears, to feel sad, and so on.

Then, as this continues to unfold, people begin to have emotions that they find difficult to understand in this context. And the most frequent one of these which people have a great deal of difficulty with is anger. It is a very common and expectable thing that when you lose a loved one to death, people feel angry toward the person who’s died. Because they generally can’t understand why they should be angry at the person who died, especially in the circumstances that the person who died didn’t mean to die: from a cancer, or an accident, or whatever.

And I’ve had many people come to me over the years with that problem, saying that very thing. I remember an admiral, for example, back in the eighties, who had lost his wife of over 30 years, came to me, and the reason he did, he said, “Dr. Moody, I don’t understand it. My wife died of cancer, I loved her very much, and now that she’s dead I feel angry at her. And I just don’t understand why.” Now, if you’re angry at someone, and you don’t have any reason to be angry at them, then you start feeling guilty. And that’s exactly what this admiral did. He told me that he felt that he must be a bad and despicable person because he was angry at his wife for dying when she didn’t mean to die. Fortunately, it’s very easy to help people with this particular kind of feeling, because what I explained to the admiral, as I have explained to so many other patients over the years, is that we have two levels in our mind.

We have a conscious level where we’re aware of what’s going on, and we have a deeper subconscious level which we’re not aware of; and so what happens when we lose a loved one to death, even if it’s an illness, what happens is that the deep level of the mind interprets death as an abandonment. The conscious level is aware that that’s not true, but the subconscious level interprets someone dying as though that person simply walked away and left. And fortunately, when we explain this to patients through a process of psychoeducation – in other words, simply educating them about what the grieving process is like – when they understand about the difference between the level of the subconscious and the conscious level, the symptom of anger immediately goes away. So this can be very helpful to people.

There is another aspect of guilt in the grieving process that is very common, and it has to do with the fact that, let’s face it – every one of us, no matter how much we love someone – we’ve had moments where we said things like, “I hate you,” or wished people were dead, and so on. This is just part and parcel of being a human being. And it happens all the time that when somebody loves someone very much, and then they lose that person, what happens is they  start going back in their mind to that time that they said “I hate you” or “I wish you were dead.” And even though they fully realize that this is not rational, it’s not like they’re psychotic; they realize that it’s not true, but nonetheless they begin to dwell on thoughts like, Oh, if I only hadn’t said that thing 20 years ago about wishing he were dead or wishing she were dead. And then this is very troubling to them, they can’t get it off of their mind.

And I have learned in my counseling practice over the years that this is very common with people, and also that people are very embarrassed about it, because they know it’s irrational. And so over the years I’ve developed a sort of sixth sense where I can tell when that’s on someone’s mind. And so what I say to such a person, is I say, you know, I hear all the time from people that after somebody they loved very much dies they get into these thought cycles where they think back to that time they said, “I wish you were dead” or whatever, and then they wonder, “Oh, did that cause the death?” If I hadn’t said that, would things be better? And of course they know the real answer, that it doesn’t really work that way. And when you say that to people, you see them take a big sigh of relief, and they say, “Yes, I’ve been torturing myself with this for long periods of time.” But just talking about it, I think, in that case, will alleviate that symptom.

golden hour photography of rock formation on body of water
Photo: Jessica Ruscello

Now, all of the feelings we’ve talked about thus far – denial, numbness, anger, sadness, guilt – those are feelings that we experience in other contexts than grief too. So we’re familiar with them even if we’ve never grieved. However, there are other parts of grieving that are unique to the process of adapting to a loss. And what I have found with those over the years is that the most common thing that people say when they have these other symptoms of grief is, “Doc, I must be losing my mind.” And that is a refrain that I have heard so many times from people over the years. They come into your office and they say, “Dr. Moody, I must be losing my mind.” Now, to put this in context, I worked for a long time in a maximum security unit for the criminally insane, with paranoid schizophrenic murderers and severely psychotic people who had done these awful kind of murders that you read about in the newspapers. And in all of that time, not one patient ever came to me and said, “Dr. Moody, I must be losing my mind.” And my point with that being that, paradoxically, in the situation of grief, when you hear people say, “Dr. Moody, I must be losing my mind,” that’s a symptom that they’re not losing their mind.

These things that happen to us in grief are just strange. And because they’re so strange, people don’t talk about them, and then they start obsessing about it, and they think that there’s something wrong with them; when in reality all they would have to do is just to talk about this and they would find all sorts of other people have the same symptom too. For example, my mother died in 1994, and for about six months to as long as a year after that, every time my wife and I would get into the car to drive down to the city where my parents used to live, and where my siblings still live, I would be sitting in the car and I would start going through my mental list of things I would ask my mother when I got to her house. And about several items into the list I would wake up and I would say, “Oh, my god. Mom’s dead.”

Now, if I hadn’t have heard that from hundreds upon hundreds of patients by the time it happened to me in 1994, I would’ve thought that same thing. I would’ve thought I was losing my mind. But no, in reality, it’s just part of grief that people will actually forget that their loved one is dead. Had a dear friend, Milton Friedman, who died April 28t​ h 2005, and still a couple of times a month I will think about going over to the telephone and giving Milton a call. For some reason we’re set up so that we actually forget that our loved ones have died.

Want to hear and see more?

Discover Raymond’s

Brief Guide to Grief with companion video.

Leave a Reply

Your email address will not be published. Required fields are marked *