Psychological Obstacles to Grief and the Grieving Process

We tend to talk about grief and the grieving process as if it were a separate category of emotional experience altogether,  different somehow from all the others.  Because it means confronting death, mortality and ultimate loss, the grieving process does have a uniquely large and pervasive impact on our psyches; from another point of view, however, grief is but one of the  emotions and when it becomes unbearable, we will ward it off in our characteristic ways.  In other words, when people go through the grieving process, you will often see them resort to their habitual defenses.  As discussed in my post on the tenacity of defenses, as we grow up, our modes of warding off pain become entrenched; even when we’ve evolved and developed new ways of coping on a day-to-day basis, when confronted with a feeling as difficult to bear as grief, we may fall into the familiar rut of our oldest defenses.

We had to put our dog Maddy to sleep yesterday.  While it’s not quite the same as losing a human member of our family, she has been a beloved part of our lives for the last ten years.  Her death has made me notice how we’re all responding to our grief, reflective of our particular defenses, and in not such unusual ways, I believe.  It has also stirred a lot of memories from 20 years ago when, within the space of a few months, my dear friend Tom Grant died of kidney cancer at the age of 45 and my mother-in-law Eva, then in her late 50s, succumbed to metastatic breast cancer.  These untimely deaths — Tom and his wife had two small children and my mother-in-law was fit, dynamic and vitally alive — have been among the major losses in my life and on occasions such as Maddy’s death, the feelings I had back then are still very much present to me.

Splitting and Projection

For the last year or so, Maddy has had a laryngeal problem common in older Labrador Retrievers; she was scheduled for corrective surgery on Monday.  In the four or five days leading up to the surgery, her condition had deteriorated badly and she basically stopped eating.  We thought it might have to do with her medications, but when we took her to the surgeon Monday morning, he immediately said, “This has nothing to do with her larynx problem.”  Her lungs were so full of fluid he couldn’t even read her X-ray.  He believed she had some fatal condition and presented euthanasia as an option, although he told us that congestive heart disease, a treatable condition, might also be to blame.

Maddy’s loss of appetite had filled me with dread.  Both my friend Tom and my mother-in-law lost their appetites as their conditions worsened; I felt sure Maddy had some form of cancer and I wanted to have her put to sleep that day — to prevent further needless suffering, I told myself.  The rest of the family felt otherwise and wanted to make sure of her condition first before taking such a step.  I felt very rational and level-headed but kept my opinions to myself.  This was my defense:  in order to evade the pain of loss, I split it off and projected it into the rest my family for them to carry; I became a bit detached and efficient, as I am wont to do at such a moment.  I’m good in crisis situations; my defenses help me put emotion aside and do what needs to be done, though in this case, it stopped me from feeling my own grief.

Extensive tests at the vet school revealed late-stage metastatic cancer.  No hope of any kind and we had her put down.  The rest of the family felt relieved to know the actual cause, to accept her death without wondering if treatment might have helped her; I could see that my opinion had been the “wrong” one, reflecting my defensiveness rather than clear thinking.

Blaming

It seems fairly clear now that our trusted vet missed a lot of warning signs that should have told him Maddy had a more serious illness than he believed.  There’s a great temptation for all of us to blame him for what happened, though we realize the cancer was so pervasive that even had he spotted the symptoms earlier, she still would have had to die.  Tom’s physicians took months to identify his condition as kidney cancer, mis-diagnosing it as a respiratory problem and later putting him on blood thinners to avoid clotting in the lungs.  My mother-in-law’s physician recommended that she not aspirate the breast lump he found because he believed it to be benign like others she’d had before.  By the time he realized his mistake, she’d advanced to Stage 4.  In both of these cases, the temptation to turn on the physicians was strong; neither Tom’s wife and nor my father-in-law succumbed to that temptation.

I’m sure many of you have had similar experiences, either in your own families or with people that you know.  Sometimes a medical malpractice lawsuit is justified; in other cases, the blame and anger allow grieving family members to evade their pain, at least at moments and for a limited time.  I think it’s a special kind of projection where the “bad” feeling inside (unbearable grief) becomes a “bad” object outside (evil and incompetent physician).  And although I’ve tended to discuss blaming as a characteristic defense against shame, it has broader defensive uses.  In this case, blaming the vet would allow us to feel angry instead of terribly sad.  The mechanism is akin to one I described in an earlier post, where hatred and anger may function as a powerful kind of psychic glue holding us together when we’re experiencing the disintegration anxiety stirred up by unbearable emotion.

Self-Pity

We’re all feeling sad and sorry for ourselves.  Despite what some of you dog-owners out there may believe about your own pet, Maddy was the greatest dog in the world.  It seems unfair that we should have had to lose her; it seems wrong that only two weeks ago, she was her normal energetic self; her death seems so ill-timed, given everything else (i.e., normal life) that we have on our plate.  I believe that a lot of rage and anger usually lurks behind self-pity; in the case of mourning, however, it seems a very natural response, a way of offering oneself sympathy and consolation.  Only when it becomes excessive does it become a psychological obstacle to the grieving process.  You will recognize this in other people by the impatient way they begin to make you feel.  Enough already, it’s time to move on.  Everybody has to deal with loss at one time or another … you’re not unique.

The truth is, Maddy had a long and wonderful life.  The average lifespan of a lab is 10-12 years and Maddy had recently turned 12.  She was beloved and in good health for nearly all of that time.  We were fortunate to have had her as a part of our family for those years, but death comes to all in the end.  Time to grieve now.  For us, as for most people, the grieving process will be neither quick nor easy.  You can’t rush your way through it; part of mourning involves re-living your memories of the loved one and grieving for the loss.  The only way to process your grief is simply to bear with it.  The passage of time alone can make it more bearable.

Finding Your Own Way:

Everybody has to deal with death and grieving at some point or another.  When you look back, can you see your characteristic ways of coping with the pain?  Did you resort to any of the defensive maneuvers I’ve described?

What about friends and family?  When you think about other people you know who’ve lost a loved one, can you see how they coped with it in their habitual ways?  Maybe you’ve known someone who became embroiled in a medical malpractice lawsuit; whatever the suit’s merit, can you see how it absorbed that person and took up the space that might otherwise have been occupied by grief?  Did they eventually reach the point where they could bear it?

Joe is the author and the owner of AfterPsychotherapy.com, one of the leading online mental health resources on the internet. Be sure to connect with him on Google+ and Linkedin.

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18 comments

    I’m glad you mentioned the part about how other people can be impatient in this process and the things they say. I’ve had 3 immediate family members, 2 friends and 3 cats pass in recent years. While I am a feeler and pretty much grieve til its over, I know others who seem to not shed a tear and I almost wish I were them. I’d love to see you do a piece on impatience…what it really means and hides in general – not necessarily in the grieving process. I know someone who is very impatient, drums fingers on any available surface, doesn’t like surprises, pushes people for responses even if they’re not ready, hurries through vacations, shopping, etc. It’s difficult to be with a person like that.

    I am reminded of how many times I am asked how long it takes to “get over it”, (“it” being the death of a relationship, or a dream, or the pain which comes with knowing your life partner has been unfaithful) and my response is always, “It will take the time it takes”. But it doesn’t happen by trying to “get over it”. Or under it. Only by walking through it.

    When my parents both died suddenly within 5 months of each other, my family fell apart, due in no large part to my siblings inability to cope with their grief and their need to defend against the pain. 12 years later and those rifts have not healed, my brother and sister’s “story of what happened” has become their absolute truth and their armour. Unable or unwilling to allow themselves to feel anger and abandonement, or to acknowledge the “irrational” feelings of betrayal by parents who could just “leave them like that” they fell back on their usual defenses and found reasons to feel betrayed, let down and outraged by each other’s behaviour instead. Self righteous indignation helped to protect them from the terrible pain.

    Meanwhile I too fell back on my usual defensiveness.. like you Jo, I’m a fixer and do-er. Until there was nothing more “to do”, and I realised I couldn’t fix it.

    I wonder to what extent our chosen professions are part of our own defensiveness? Or as overheard on a CPD training workshop (entitled “the Concept of Script Cure in Transactional Analysis”) “I’ll know when I’m cured, when I don’t have to do this *blank blank* job anymore…..” .. the phrase of note being “have to”.. :)…

    Being a “do-er” did help me for a while.. there’s much to do when parents die, and being busy does help filter the pain so it doesn’t overwhelm. You just need to know when to stop and just “be with it” for a while and let it wash over you in waves rather than a tsunami.

    Thank you for yet another thought provoking blog.

    My therapist used to refer to it as the psychotherapeutic “professional neurosis”. I think so many of us get into the profession because we’re “doers” or “fixers”, as you say; others because we want to deny that we have problems of our own. I’ve been guilty of both. Once you get past it, something else hopefully makes our profession fulfilling to us — a sense of its intrinsic meaning and value to us personally. If not, time to move on.

    Great comments as usual, Liz. Thanks.

    My dad died back in December and I’ve been trying to figure out how to unite my family. They’re a bunch of hermits and their way of coping with things is to avoid each other. I’ve also been battling with my feelings towards my dad- good VS bad. I feel like he was the one that kept the family together and now that he’s gone it’s my responsibility to gather them, but I’m at a loss.

    I understand that when someone dies there are natural tendencies and I’ve watched them approach and take hold of me. It has been helpful understanding the natural processes though because I haven’t seriously taken myself to blame- he died of cancer, there’s no way it could be my fault. That’s not to say I don’t go back and wonder what else I could have done and how much of it could have been helped had I pressured him more to seek Western medical assistance sooner (he was all about alternative medicine).

    I have also noticed that old coping skills have reared their ugly heads. Lashing out or lashing in, and (as my dad called it) “playing argument games”. Sometimes I just become irrational, acting on the frustration/feelings rather than responding in “real time” to what is being said/going on. It takes patience, awareness and a loving/understanding partner to get through times like this, and I am so fortunate to have these things when I do.

    Someone was telling me about death- the normal responses to a traumatic situation are the “fight, flight or freeze reflexes”. The body tries these things because something sudden and often traumatic has occurred, but it’s fighting something intangible so it gets confusing. Trying to rationalize emotions and thoughts and feelings towards the death stop making sense at certain points. You’re angry or (insert other emotion) at an antagonizer that you can’t take issue with. It made a lot of sense to me.

    and yes- thanks again for another thought provoking blog

    Ryan, I don’t think there’s any way to avoid going through your turmoil. At least you’re IN it, struggling with it, feeling conflicted … rather than avoiding it as the rest of your family seems to be doing. As for them, all you can do is make yourself available; the rest is *their* responsibility.

    Here’s a question. 4 years ago, 2 of my sisters were brutally murdered. It was a very public event that I unfortunately was witness to. I have been through counseling, etc, but I am struggling with something. I know that I resorted to splitting/projection and just doing in order to get through, and I feel in a lot of ways I’ve disconnected from my grief. I have grieved, but I have the feeling that I locked a part of grief away that I can’t get to. It is pulling me down, I find myself exhausted daily and in general, depressed. I just need to know how to get through and unlock whatever my subconscious is holding captive so I can deal with it. Any thoughts?

    What you have been through is unimaginable to me; I think there are some kinds of grief from which we never recover, and witnessing the brutal murder of your sisters may be one of them. On the other hand, I’m always hopeful that a way can be found to bear pain. And of course, that’s what you “subconscious is holding captive” — a lot of pain. Even though it’s an extreme kind of pain, you will most likely cope with it in characteristic ways, using your usual defenses, as I’ve said. What are your usual ways? Feel free to write more; if you prefer to make it confidential, use my email: AfterPsy@gmail.com.

    I split and project easily. Mostly the splitting. I detach from my own pain in very painful situations. That’s probably my worst defense. The problem being, once I detach, I don’t know how to get back there.
    This has happened at 2 distinct times in my life; the day my Grandpa died when I was 15, and 3 years later when I heard my 2nd sister had passed away. Both times I knowledgeably pushed away my pain for the sake of another person. The first time, it was for my friends. The second time, it was for my 3rd sister who is still living; I am the older sister and was trying to “stay strong” for her.

    After reading your blog religiously and learning so much from it, do you have any helpful words for us now? I mean, I’m Norwegian and this one guy just shot 86 kids trapped on an island. Some were young. One surviour who actually talked to the killer and begged him not to kill him, was only eleven. I don’t know how much news there had been about this overseas, but here, it’s been non stop. I’ve been watching for hours, checking internet newspaper, waiting for som piece of news that would somehow comfort me, but the death tolls are rising at it’s just getting worse (he used exploding bullets!). I don’t think anybody I knew was on the island, but still, I’m so very sad and wonder how I’m ever going to get to work tomorrow. My sister tells me to think of something else, but I need to know everything. Nothing will ever be the same. I will never be the same. My country will never be the same.

    I don’t think there’s anything I could say that would make you feel better. We’ve been following the story over here and I can’t find any consolation anywhere. I’ve been thinking just exactly what you said — that your country would never be the same. There are some things that happen from which you can never fully recover. Some people try to look the other way and move on; you apparently need to go deeply into your grief and the horror of this experience. As painful as it is, I think yours is the right approach. You just have to suffer, go through the pain, grieve deeply. It will lessen in time, but you’ll probably carry this pain and this memory with you in some defining way for the rest of your life. My heart does go out to you and your countrymen, if that offers any consolation.

    I’d like to thank you, Joseph, for brining up the issue of shame as being one of possible obstacles to grief and grieving process. Actually, it would be nice if you could right more about that important topic one day. Anyway, I’ve been suspecting recently that self-pitying has indeed become my big problem. In many occasions I found myself feeling/thinking “It’s not fair,” feeling powerless and in pain for not being able to change the situation in a way that I wanted. In many situations and about many issues in my life, it was a lot about giving up control and even hope to ever get this something but still holding the attitude of entitlement to really have it. And so the pain continued. But you’ve helped me to realize that I have been really pitying myself and kind of enjoying that role. Now, I sat and wrote different things I’ve been refusing to accept and instead enjoying the role of the victim. And it’s easier already. I mean it’s hard to accept so many things but if we cannot change them, accepting is the only way. And the words of the following prayer come to mind:
    God, grant us the serenity to accept things we cannot change,
    Courage to change the things that we can,
    And wisdom to know the difference.
    Appreciation for all that we have,
    Patience fot the things that take time,
    And tolerance for those with different struggles.
    Freedom to live beyond the limitations of our past days,
    Ability to feel your love for us and our love for each others,
    And the strength to get up and try again even when we feel it is hopeless.

    Having just lost my beloved mother, i enjoyed reading your posts and thoughts..

    My mom died HARD…44 days of bedridden suffering..our family argued about whether to keep her alive, she never told us her wishes and refused to deal with it when asked… in the end, i feel i have been grieving for some time and her passing was a relief, a closure and fall off a cliff…all at the same time.

    As I’m sure many people do in my situation, i googled grief process seeking advice and thoughts..

    I believe I have been grieving for quite some time…so i am trying to be thankful for that…i know it takes time

    My thought (and it’s consistent with this post) is that my best moments come when I’m reaching out to help other people. Somehow comforting others brings me up and out of my own suffering in a way that i did not expect. It works every time…

    I tell my daughter that she can cry and be strong at the same time…she says’ “thanks mommy” and i am filled up….i am good… I hug my dad, and plot out ways to keep him busy, and i feel good… and on it goes… by doing for others, i help myself…
    I do not believe i am delaying the inevitable.. I cry and cry…i sob, i wail…i mutter “oh no” and “my poor mom” through my sobs…. I am hurting badly, but in between i find myself actively trying to help others much more than ever…this has been going on ever since my mom hit that hospital bed…(her terminal diagnosis was 2 years ago)

    I also noticed in the acute care facility where she died, as we took her off life support, the last 2 days were filled with nurse after nurse coming into our room , and telling us either, “i’m sorry” OR “my mom/dad died X years ago”, they shared their story, and told us it will be alright someday and comforted us simply by thriving…they were all doing the same thing I’m talking about!!!

    Anyway, I hope no one minds the unsolicited “advice” but i hope someone out there reaches out with support in their own grief and finds out the same thing i found out..

    Before i wrote this , I was crying in desperation, almost throwing things around in anger at my mom’s fate…and now for a moment, its ok…

    All the best
    Kate

    Dear Kate, I found your words inspirational. Melanie Klein (or was it originally Freud?) once wrote that, when someone we care about dies, it stirs up an anxiety that, because we’re so attached to that person, that we’ll “die” along with him or her. I think reaching out and helping others, continuing to give to those people still living, helps us hold on to life and to thrive.

    Thanks for sharing Kate. Yes I’ve found a similar experience. My Dad passed from Parkinsons in 2011. Since I began fundraising to support our Parkinson’s society, I feel like at least I’m doing something about what happened to him and our family. At the same time though I’m finding my involvement with supporting others is bringing back some of my own grief from losing dad. I expect that’s part of the process. But because I’ve had depression, it’s scary to feel sad. I worry down deep if its a slippery slope that will take me into depression again. But I don’t want to stop helping either. Just not sure how to find a balance.

    I recently lost my beloved husband and best friend to Cancer. Death and I have met before, our eight month old daughter a cot death, parents and pets. Yet we never seem to become de sensitised to grief, do we?. Even though I know this raw pain Will lessen in time, I hate the fact that it will only fade in it’s own time. Even though his death was inevitable we hoped, false hope, right up to the end. Isn’t hope part of the human condition too?.

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