A look at the most common psychological and emotional responses to loss.

Whether an individual copes with a significant loss or death in a positive and constructive rather than in a negative or destructive manner depends on the types of coping mechanisms used and the quality of support being given. There are two major psychological responses by individuals when adjusting to loss: (1) the use of coping mechanisms; and (2) emotional reactions. If we wish to help friends and loved ones in time of sorrow, we need to understand how these are expressed by them.

Coping mechanisms

Coping mechanisms operate to psychologically protect individuals and are used to reduce the level of anxiety they feel at a given moment. This allows them to better adjust to the loss and begin the grieving and healing process.

1. Disbelief or denial: This response reduces anxiety by allowing individuals to limit their awareness about the reality of what has happened until the pain can be let in more slowly. Everything inside shouts “No”! and the mind struggles to escape. Unable to tolerate the pain that would emerge if reality were faced, the individual experiences “emotional anesthesia.” Numbness and confusion are often predominant responses. Sighing and crying can be readily observed. Others cannot cry and may withdraw. This stage is relinquished more easily if people will listen to the bereaved person and help them express their whole range of feelings. Listening to feelings without giving advice is the best helping strategy.
2. Disorganization and dependence: Characterized by a period of confusion in which the grieving person may feel out of touch with the ordinary proceedings of life. They may exhibit very dependent behavior and a time-orientation that focuses solely on the present. They may become quite demanding, asking others to do things they normally can do themselves. Some of their talk and actions may seem foolish and out of character to others. It is wise not to make major decisions, such as selling one’s house or moving, during this period.
3. Intellectualization: A coping mechanism in which the grieving person attempts to master the loss by gathering a great deal of knowledge and information and analyzing in detail the situations leading to the loss. They may find out the most intricate medical data of a fatal disease, for example. Or, they may plan in detail what will happen after the loss occurs. Surviving individuals may rationalize the loss by saying “He’s better off in the long run,” or “She suffered so much.” This allows the individual to remain emotionally detached and to become an “observer” of the situation. If it remains within reasonable bounds, intellectualization can give the individual and family members a greater sense of control.

Emotional Reactions

Emotional responses coexist with coping mechanisms, but they do not necessarily protect the person from the trauma of loss. They are means for the individual to express emotions and feelings associated with the loss.

1. Anger and resentment are common emotions of bereaved individuals. It is often expressed as a protest against what seems to be a cruel, unfair and incomprehensible fate. It is a reaction to frustration—the source of which cannot be removed, so the person feels trapped and helpless. When this happens, the individual may project this anger onto more accessible targets (e.g. spouse, family member, hospital, physician, the government) or others involved in the loss chain. Overt expressions of anger, such as verbal outbursts, sarcasm, and unreasonable or persistent demands, should be recognized as an understandable response to a traumatic situation and not necessarily as a personal attack. For most of us, talking openly about our feelings helps reduce the anger.
   
   Friends can help by listening empathetically and resisting the temptation to return anger with anger, or becoming defensive if they make accusations. Unexpressed anger may be turned inward and may be replaced by silent bitterness, indifference, apathy, aggression, and ultimately, depression.
2. Guilt feelings are frequently a part of the grief process. These feelings become focused as the individual searches for the cause of the loss thinking thoughts like these:
   • “What did I do wrong?”
   • “Could I have done anything differently?”
   • “If only I hadn’t _____.”
   • “If only I would have _____.”
     
     When you live with someone for any length of time, you will say things you regret. When that person dies, you suddenly realize all the things you wanted to say and didn’t. You remember words you wish you had not said or actions you wish you had not taken. It is human to feel guilty and to want another chance to erase neglect or failure. If the individual openly expresses guilt, it is better to encourage talking about it rather than clamming up. Saying “No, you’re not to blame” doesn’t really help either. A caring person will encourage the full expression of feelings rather than blocking them, which would make the person feel even more guilty.
3. Fear and anxiety is another emotional component of bereavement. The grieving person may exhibit feelings of helplessness, hopelessness, hurt and anxiety. Sudden loss means rapid change and demands great adjustment. Starting over, with a new job, with a new career, new relationships, can be a frightening experience. Since the loss usually is not of one’s own choosing, there may be great anxiety about an unknown future. The greater the loss, the greater the potential change, the greater the anxiety and fear. Joining a support group where people can freely express their worries in a supportive environment can help reduce needless anxiety.
4. Shame occurs when a person is in a situation that is incompatible with the image that one wishes others to have. Shame, guilt, anger and regret often intertwine and are overlapping. A farmer who involuntarily leaves the farm may believe that this reveals an intrinsic weakness or unworthiness in himself. When friends and family try to be encouraging and reduce guilt, it may undermine one’s sense of dignity and self-esteem. Accepting the individual as an “OK” person and being there when needed, is true friendship.
5. Loneliness and depression are considered the most painful processes. When a loved one is removed from their lives, people often are overcome by feelings of utter depression and isolation. Gradually the finality of the loss sinks in—an empty chair near the TV, an unused pillow, a family photo, a missing phone call. Sadness and depression follow and self-pity is frequent.
   
   Problems which are manageable when shared with a partner become magnified when faced alone. Sometimes an individual may search for a quick replacement. However, healing and recovery are more likely achieved if the bereaved person completes the grieving process before seeking a new partner or making any new lasting commitments. Delaying major decisions allows people to see new perspectives, to make decisions more easily lived with during the years ahead.
6. Relief and recovery: Feelings of relief are difficult to admit and acknowledge openly. Relief is so intermingled with our sense of loss that we cannot see it isolated enough to take it for what it is—a normal, human response. A feeling of relief does not imply any criticism for the lost relationship. There is an overlap between relief and recovery—in fact, feelings of relief may signal recovery. As the individual brings closure to bereavement, and as hope softens the intense feelings of loss, a new life begins. The person reaches out and makes constructive efforts to rebuild by responding more readily to phone calls, attending meetings, and seeing social gatherings as opportunities.

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Reprinted from “Understanding Grief and Loss” by Herbert G. Lingren, File HEG223, University of Nebraska-Lincoln.