Grief.  Even just saying the word out loud – there’s a heaviness to it.  In these past 12 months, our world has been confronted with grief and loss at a scale never before seen in our lifetimes.  It seems that nearly everyone worldwide has been personally affected by COVID-19 or knows someone who has.  Naturally, there has been much focus on how to cope with loss, how to deal with it, how to keep moving forward… as if grief can be packaged up and put away once we’re “done” with it.  But before we rush to throw some coping skills at the problem, I suggest that we take the time to understand more about what grief is.

Grief is an emotion characterized by deep, poignant sorrow or distress caused by an experience of loss.  However, a single loss can have a ripple effect that cascades into many different facets of life, making the grief that much more complex and all-encompassing.  The original loss is known as the primary loss, and the losses that occur as a result of the primary loss are known as secondary losses.  It’s hard to fathom a primary loss that isn’t accompanied by secondary loss.  For the families and loved ones of the more than 500,000 lives lost in this country (not to mention the 2,000,000+ additional lives lost worldwide), the death of their loved one may be compounded by secondary losses such as loss of companionship, loss of an imagined future, loss of family traditions, loss of faith or belief in a higher power, and loss of financial security, to name a few.  Each of these losses leaves behind a gaping hole in those who are left behind to bear the burden.  Importantly, those mourning the death of a loved one are not the sole proprietors of grief.  Grief is a normal reaction to many other types of loss as well.  Throughout the COVID-19 pandemic, people have also grieved the loss of employment; loss of in-person school; missed milestones such as graduations, proms, and weddings; loss of social connectedness and face-to-face gatherings; loss of travel; loss of childcare; and loss of a sense of normalcy, predictability, and safety.

Grief is slippery and ever-changing.  Just when you think you have a handle on it, it comes roaring back unexpectedly.  Many people liken grief to walking through a landmine.  You’re happy and at peace one moment, and a puddle of tears the next.  Or, you’re numb one moment, and full of rage the next.  Sometimes these reactions can be anticipated, such as around holidays or the anniversary of one’s passing.  Other times, the triggers can be tiny and seemingly innocuous.  In a matter of seconds, the serenity garden you’ve been sauntering through reveals itself as a war zone; the explosive device detonates and your peace is disturbed, leaving you covered in shrapnel, wounds re-opened and exposed.

Many people are familiar with Kubler-Ross’s 5 Stages of Grief framework.  This theory posits that individuals go through five different emotional and mental processes when mourning a loss.  The stages are denial (“I can’t believe they’re gone”), anger (“This is so unfair!”), bargaining (“I’ll do anything to bring them back”), depression (“How can I go on without them?”), and acceptance (“They are really gone and I must refocus on moving forward”).  What may be lesser known is that grief does not necessarily progress through these five stages in a linear fashion.  Some people may return to a particular phase repeatedly, some may experience different stages simultaneously, some may stay in a stage for months at a time while others shift between them by the hour or minute, and some may skip one or more stages altogether.  There is no right or wrong way to grieve (nor is Kubler-Ross’s framework the only conceptualization of the grief process).  What we do know, though, is that grief serves an important purpose.  In its varying forms, grief helps us slow down and explore our feelings, escape our feelings when they are unbearable, find new meaning in life, honor our loved ones, learn to connect to that love in a new way.

COVID-19 has presented unique challenges for those in mourning.  Due to safety precautions and social distancing mandates, many people have not been able to mourn their loved ones according to their typical cultural or religious practices.  Funerals are being forgone or held with limited guests.  Visits (and hugs!) from friends and family are prohibited.  What may further complicate one’s grief is if it is the result of a stigmatized loss, which is a loss that may be attached to stigma due to possible blame assigned to the victim or if the circumstances were seen as preventable.  For example, death due to suicide, miscarriage, or drug overdose are often stigmatized in our society.  Some non-death-related losses are stigmatized as well, such loss related to divorce or homelessness.  Unfortunately, some people who are mourning COVID-19-related deaths are feeling that their loss has been stigmatized too.  Some people view COVID-19 as a hoax, blame victims for not having been careful enough, are numb or desensitized to others’ losses due to the sheer magnitude of COVID-19-related deaths, or minimize others’ pain by saying that their loved one was elderly or had underlying conditions and therefore was bound to die soon anyway.  Having your loss viewed in this way is incredibly painful and invalidating.  Such stigma reduces social support and increases isolation for those who are grieving, which increases the likelihood of grief developing into complicated bereavement.  Complicated bereavement is when grief is prolonged, the symptoms intensify rather than diminish over time, and when such symptoms develop into clinical disorders, such as depression, PTSD, or panic attacks.

Grieving a loss is not a one-time thing.  We can’t simply “cope” with a loss and get on with our lives, as coping refers to time-limited management of a single event (Corr and Doka, 2001).  Rather, we need to focus on loss adaptation, which is the active and continual process of adjusting to loss and grief (Humphrey, 2009).  For many, this is a lifelong process, even if the intensity of one’s grief changes over time.  If you are having difficulty navigating grief and loss, please consider reaching out to a therapist.  Therapy may help you sit with and tolerate your feelings, validate your multiplicity of emotions, make meaning of your loss, find ways to honor and remember your loved one, reduce survivor’s guilt, and identify a way forward even if the path ahead looks treacherous, lonely, unrecognizable, or simply one you wished you didn’t have to go down.  Don’t walk it alone.

Ashley Kaplan, Psy.D.

Licensed Clinical Psychologist