Charting Your Course : Seminar IV - Setting Your Sails : Loss and Grief

The only way to avoid grieving is to avoid having loved.

Few of us know how to cope with grief or how to talk to a grieving person. Each person grieves in his or her own way. Grief cannot be avoided. We can try to ignore it, but eventually we must feel and work through our grief. Experiencing grief includes experiencing a myriad of other emotions, such as anger, loneliness, depression, guilt, sorrow, and fear.

A terminal illness can give you time to say goodbye to the people you love. Being very sick, you face a changes and losses. Each loss may demand grief: loss of independence, of abilities, of dreams.

Dr. Elisabeth Kubler-Ross defined five stages people experience in coming to terms with terminal illness: denial, anger, depression, bargaining, and acceptance. The process is grieving often moves fluidly back and forth between these stages rather than progressing in a linear fashion. Some people cycle from anger to acceptance to depression and back again. As people work through their grief the general pattern is to experience the loss and accept its reality, to adjust to the loss, and to reinvest emotionally in life or hopes.

Stages of Grief

StageBehaviorFeelings
Denial Shock
Verbal denial
Behavioral denial
Fantasy/Reality struggle
Numb
disbelieving
confused
Isolated
Panicked
Anger Anger words
Questioning
Crying
Shouting
Belligerence
Hostility
Sarcasm
Bitterness
Bitterness
Guilty
Hurt
Irritated
Cheated
Angry
Enraged
Bargaining Shopping for doctors and diagnosis
Making bargains with God
Making promises to others
Losing control
Panic
Wish to postpone
Guilty
Depression Withdrawn
Less communicative
Focus on loss
Physical upset
Emotionally liable
Life pattern upset
Quiet
Empty
Helpless
Sad
Lonely
Hopeless
Useless
Overcome
Dejected
Acceptance Contemplative
Tired
Weak
Gradually withdrawing
Illusions
Separation from reality
Quiet
Not demanding
Sharing with others
Expressing love
Expressing forgiveness
Tranquil
Feeling less hurt
Sorrowing
Resigned
Accepting
Able to feel pleasure
Loving
Trusting
Forgiving

As you experience the turmoil of all these emotions you may also:

These reactions are normal. They will dissipate as you come to terms with your grief. Things that may help:

Living with Loss

"There is a sort of invisible blanket between the world and me. I find it hard to take in what anyone says….Yet I want the others to be about me. I dread the moments when the house is empty. If only they would take to one another and not to me."

- C.S. Lewis, "A Grief Observed"

Losses are a part of life and a part of cancer. Some of these losses, like hair loss and loss of fertility, are physical, but there are emotional losses as well. You may have to learn to live with some limitations or you may have to alter your hopes and goals to fit your situation.

Every loss requires mourning and grief, but many people are uneasy witnessing grief. Sensing this discomfort, you might try to hide your feelings. However grief must be expressed in some way. It may be transformed into feelings of anger, guilt or helplessness. Sometimes your family and friends may not understand the magnitude of your loss. They may make you feel guilty for feeling sad.

Four tasks have been identified in the grieving process:

  1. Accept the reality of the loss
  2. Experience the pain of grieving
  3. Adjust to the changed circumstances
  4. Emotionally relocate the loss and move forward

Some people may be able to deal with hair loss in a relatively short time. Another person may grieve for their lost hair until it begins to regrow at the conclusion of therapy. Some losses are not reversible. If you have lost a limb or a breast or a testicle, you will need to adjust to a permanently altered body image, and it may take a long time to work through your grief.

Be gentle with yourself. It's very difficult to adjust to illness, treatment, and all the emotional factors involved. Give yourself time to heal. Verbalize your feelings.

It may help to attend a peer support group meeting or to talk to a counselor. One of the major benefits of a peer support group is that you discover you are alone with your problems. You can share your fears and concerns with others in similar situations. If a group makes you uncomfortable, try talking to a counselor or clergy member. Or, ask your doctor for a referral to an oncology social worker.

Here are some suggestions for things you can do to help yourself as you grieve:

Transforming Suffering

Meditation and prayer can help you transform suffering and grief into peace. You can create your own prayer or ask your pastor or spiritual advisor for guidance. This is a Buddhist prayer for transcendence, courtesy of Roshi Halifax, Upaya House [ www.upaya.org ].

May sorrow show me the way to compassion.
May I come to recognize the gift of my loved one's death by opening my ear of compassion.
May I realize grace in the midst of suffering.
May this experience in some way be a blessing for me.
May loving-kindness sustain me.
May love fill and heal my body and mind.
May I be peaceful and let go of expectations.
May I find peace and strength that I may use my resources to help others.
May I receive the love and compassion of others.
May all those who are grieving be released from their suffering.
May I offer love, knowing that I cannot control the course of life, suffering, or death.
Forgiveness:
May I let go of guilt and resentment.
May I forgive myself for mistakes made and things left undone.
May I forgive and be forgiven.
May I forgive myself for not meeting my loved ones' needs.
May I accept my human limitations with compassion.
Coming home:
May I be open to the true nature of life.
May I open to the unknown as I let go of the known.
May I offer gratitude to those around me.
May I be grateful for this life.
May I and all beings live and die peacefully.

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This content is derived from the "Charting Your Course Seminars: A Whole Person Approach To Living With Cancer", provided by Norris Cotton Cancer Center.
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