A person. A relationship. A job. A dream. Health. Security. Whatever the nature of the loss, it hurts. And,

“Nothing! No matter whether your grief seems too deep or too long-lasting or too shameful, you cannot make it go away any more than you can will a broken bone to knit overnight. And, like the shattered bone, a shattered heart needs two things before healing can happen: proper attention and sufficient time. In the meantime, it’s going to hurt a lot.” (Luebering, 1988).

Although we most often associate “grief” with death (the death of a person), I frequently remind clients that “grief is the normal, necessary response to loss” – whatever the nature of that loss. I do so especially to distinguish grieving from depression which also implies loss. The losses identified at the beginning of this blog resonate with some readers, but not others. For example, one reader may know the loss of a family member or friend, while another reader knows the loss of a relationship or job. For still another reader, it’s the loss of a dream, or health.

I’m reminded of the wonderful book by Judith Viorst, Necessary Losses (1986). Her name may ring a bell for some; especially readers of children’s literature. She is the author of the classic: Alexander and the Terrible, Horrible, No Good, Very Bad Day. In the “Introduction” of Necessary Losses (1986) she writes:

“After almost two decades of writing essentially about the inner world of children and adults, I decided I wanted to learn more about the theoretical underpinnings of human psychology….In 1981, after six years of study, I became a research graduate of the Washington Psychoanalytic Institute….During those years….[it] seemed to me that wherever I looked, both inside and outside of hospitals, people—all of us—were struggling with issues of loss. Loss became the subject I had to write about.

When we think of loss we think of the loss, through death, of people we love. But loss is a far more encompassing theme in our life. For we lose not only through death, but also by leaving and being left, by changing and letting go and moving on. And our losses include not only separations and departures from those we love, but our conscious and unconscious losses of romantic dreams, impossible expectations, illusions of freedom and power, illusions of safety – and the loss of our own younger self, the self that thought it always would be unwrinkled and invulnerable and immortal.

Somewhat wrinkled, highly vulnerable and no-negotiably mortal, I have been examining these losses. These lifelong losses. These necessary losses.”

Viorst then explicates these “developmental losses” in her book (a wonderful, helpful, very good read!) J

Much has been researched and written about “grief”. Certainly, one of the more prominent and respected bereavement specialists has been Elizabeth Kubler-Ross who identified five stages of grieving (the five stages being almost common knowledge):

* Shock/denial (the “not me” stage)

* Anger (the “why me” stage)

* Bargaining (the “what can I do” stage)

* Depression (the “who cares” stage)

* Acceptance (the “get on with it” stage)

There is, however, another grief model that I find particularly helpful with clients in therapy. Therese Rando, Ph.D (1993) identifies six processes of mourning (six “R”s), without which “complicated mourning” may result. Unlike many other grief specialists, Rando distinguishes “grief” from “mourning” (“mourning” encompassing not only grief, but active coping with loss). She uses the term “complicated mourning” to indicate some form of compromise, distortion, or failure of one or more of the six “R” processes of mourning (taking into consideration the amount of time since the loss).

The six “R” processes are as follows:

1. Recognize the loss

2. React to the separation

3. Remember and reexperience the deceased and the relationship

4. Relinquish the old attachments to the deceased and the old assumptive world

5. Readjust to move adaptively into the new world without forgetting the old

6. Reinvest

Although Rando’s use of the term “deceased” may imply physical death, I submit that “deceased” encompasses loss in general, whatever its nature; something has died, or is dying.

While commentary on each of Rando’s processes would require another blog, I have one observation which I sometimes share with grieving clients informationally. “Grief work” seems to shift between phases three and four in Rando’s model. As we give ourselves permission to feel and express the pain of loss (with appropriate self-soothing and support), we begin to move forward – without forgetting or minimizing who or what has died, or is dying.

Bill Bray, Colorado Springs, CO

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