Early Stages of Grief: The First Seven Days
by Deb Sims, MS,RNCS,LCSW
When my father died, I was told about his death by the minister and my seventh grade teacher. I was 12, and the words they used were so obscure that I didn't know they were telling me he was dead. It was the boy who sat in front of me who told me. They sent me back into class to get my books. As I did, he turned to me and said, "I'm so sorry your Dad died?" That was the end of my life, as I knew it.
The rest is a blur with only vague memories. I remember bits and pieces of the viewing, none of the funeral, and some remarks that people made.
My experience is not unique. I heard the news and couldn't even process it. I was a child and hearing words like "passed away" had no meaning for me. It made me realize that when death occurs, few of us know what to do.
Hearing the news for the first time. If you have just heard the news of the death of your loved one, then know that you are most likely in a state of shock. It is as if a hazy confusion has set in. We have a built in protective system to handle pain that is too great to bear. On one hand, we realize what is happening but, on the other hand, a part of us goes numb. Those early days are a blur. For at least the first seven days after the transition of someone we love, there is little that we remember later.
There is no right or wrong way to react to the news. Some people will sob almost hysterically, others will be overly calm, another may be chosen to fill the role of organizer, and still another may become angry with God. Whatever the reaction to traumatic news like this, it is normal. Just because you don't fall apart doesn't mean you cared any less. If you are crying, it doesn't mean you are weak. Tears have a wonderful cleansing effect and in the long run are healthy. But some people go into autopilot and organize and help the others, then break down later. Many people find they are comforted by their spiritual beliefs. Others want nothing to do with God or spiritual comfort at that time. There isn't a right or wrong for this; each person's reaction will be different. Grief is grief and for each of us ours is the worst there is.
When to get help As a general rule, if you haven't let the grief out after three months, you should probably seek counseling. By letting it out, we don't mean that you will be over it. Rather, the process of expressing it needs to begin. You will question constantly if what you are feeling is normal.
Grief feels sort of like you are falling apart or having an emotional breakdown. You aren't, but it feels that way. The more you share with others who have experienced a loss, the more you realize these intense emotions are normal. So, by the end of three months, we need to begin to let the grief out.
Getting through those early days It is extremely important to take care of yourself when you have a major loss. However, that may be the last thing you think to do. Grief is so all consuming that, at first, it is all you can focus on.
Initially, there is the shock of what happened. You will not believe it is real. Many people say they feel like they are in a dream or a nightmare. They are sure they will wake up to find out it isn't real. In those early days, you will be sure that your loved one will come through the door any moment. The acceptance that this is final will take some time.
C. S. Lewis in his book, A Grief Observed, described grief as feeling like fear. Some of the sensations are like that. Your heart may be pounding, you may feel anxious, restless, and you may not be able to sleep. You may not think to eat unless someone reminds you. You may want to be alone; you may want someone with you all the time. Your concentration will not be good. You may hear people talking around you, yet not understand what they are saying. Or, what they are saying may hold no interest for you.
Guidelines for getting through the initial days:
- Be aware you will be shaken. No matter how well you feel prepared to handle death, it is hard to deal with it when it actually happens. Death will shake the very core of your belief structure. If you are aware that this might happen, it will help you not to be so afraid when it happens.
- Take care of yourself physically. If you have a health problem yourself, you may not think to take care of yourself. If you have been under a doctor's care recently, or have a history of heart problems, stroke, high blood pressure or any other serious health problems, it is vital to contact your physician immediately. You have just experienced a traumatic shock. That will affect your body. You may forget to take your medication or it may need to be adjusted. Let your physician know what you are going through so he or she can be of help if needed.
- Remember to eat. As, I mentioned above, you might not think to eat. You will need your energy for the days ahead, yet food may have no interest for you. Be careful to eat regularly. Don't allow long periods of time to elapse without your eating, and be alert to consume things with nutritional value. Pie may be the only thing that tastes good, but when the sugar boost is gone, you will crash physically and emotionally.
- Avoid mind-altering substances. If you can, avoid caffeine at this time. This will only contribute to more difficulty sleeping and increased anxiety and agitation. Perhaps try herbal tea instead. Also, avoid alcohol. Alcohol will numb the pain but create many problems later. There are many people who allow themselves to drink initially to numb the grief. It helps, so they continue. Later, they not only still have the grief with which to deal but they also have a problem with alcohol.
- Loss in concentration. Be aware that your concentration will be affected in those early days and perhaps even for months. If you must make decisions, take a trusted friend or advisor with you. A second pair of ears is always good. Things are thrown at you so quickly that later you may not even realize what you agreed to.
- Don't drive unless you have no other choice. If you must drive, be very careful. In fact, if at all possible in those early days, have someone else drive you where you need to go. Since your mind will be focused on other things, it is important to keep yourself and others safe.
- Talk about the person who has died. It is important as well as normal to talk about what has happened. You may find yourself telling the story over and over, but that's okay. Let yourself remember past good times and tell stories about the person who died. Talking is a vital part of the grief process. If you can, talk with others who have been through the process. However, if someone tries to push you into doing or feeling a certain way, it is important to say no. This is a time of great stress for you and not a time to allow anyone to tell you how to react. If you feel there is something you will have trouble answering, ask a family member to stand close to you to help out. I had a friend who felt that if one more person said that her husband wasn't suffering anymore, she felt she would scream. So, at the funeral her brother handled most of the comments made by people, and she was able to concentrate on receiving hugs. For her that worked well.
- Allow yourself some time alone. At some point before the funeral, take at least an hour to be alone. During this time, say out loud the name of the person and that he or she is dead. Use the word, "dead"; you need to hear yourself say it. There will be emotions connected with this but don'tbe afraid of them. It is important to hear yourself actually say the words. Later you may change the terminology to transitioned or whatever is comfortable for you. But right now you are coming to grips with the concept of death.
- Sleep may be a problem. Try to go to sleep close to your normal bedtime. You may not feel like sleeping, but keeping your routine is critical. If you stay with your same nightly ritual, whatever that may be, normal sleep will return more easily. Avoid tranquilizing yourself with medication unless allowed by your doctor, and stay away from drugs and alcohol. It is normal to have difficulty sleeping in the beginning, and we will talk more in other articles about how to address this problem over the long run. Right now, just try to stick with a routine.
- Fatigue will be a problem and, at first, you may not want to be alone. Fatigue is a very common complaint and it may last several weeks. In the initial days, you may want someone to stay with you for that reason as well as others. That person could make sure that you have a hot meal and run interference for you. However, it needs to be someone who will respect your need to talk and your need to be alone and contemplate.
- Allow others to help. Whether it is your church, friends at work, synagogue, members of a lodge, the military if that is appropriate, a club or any other group outside your family, let them help, They may not know what to say but they will be willing to help with tasks.
- Honor your emotions. Your emotions will feel like they are on a roller coaster. You will have many feelings.You might even feel anger. It may be anger at the world or anger at God. These are normal emotions. Also, for a long time you will be asking, "Why did this happen?" Eventually, the question will change to "How can I work through these feelings of grief?" However, for now, it is important to get through those early days. Again, there is no right or wrong way.
Life is very fragile. We tend to live it as if nothing bad will ever happen. When it does, we are not prepared for the emotions we will have. Those who have been through a major loss assure us that slowly but surely the good days eventually begin to outnumber the bad. Right now it won't seem that way. So, just file this insight away for the future. You are in the first few days, and nothing will seem like it will ever be right again. This is grief, and the only way to heal is to go through the grief. However, others who have walked the path ahead of you can help ease your journey through this grief.
References
Deits, Bob. Life after Loss. Tucson, AZ: Fisher Books, 1988.
Fitzgerald, Helen. The Mourning Handbook. New York: Simon and Schuster Inc., 1994.
Lewis, C.S. A Grief Observed. San Francisco: Harper San Francisco, 1961.
Levine, Stephen and Ondrea. Who Dies? New York: Anchor Books, 1982.
Marshall, Fiona. Losing a Parent. Tucson, AZ: Fisher Books, 1993.
Debbie Sims is a Certified Clinical Nurse Specialist in Adult Psychiatric Nursing, has a Masters degree in Clinical Psychology, is a Licensed Clinical Social Worker, and a Licensed Marriage and Family Therapist. She maintains a private practice in counseling but her devotion is to her position as Editor for Beyond Indigo an Internet web site for those who are grieving.