Grief Resources

Brief Facts and Tips

1. Grief is not solely related to the death of a loved one. The symptoms, characteristics, and process of grieving can be similar after other types of loss (e.g., divorce, transition, moving).
2. Grief is personal. There is no right or wrong way to grieve. How people grieve can be influenced by developmental level, cultural traditions, religious beliefs, mental health, disabilities, family, personal characteristics, and previous experiences.
3. Grief is often characterized by sadness, emotional pain, and introspection in adults. However, children’s grief reactions differ according to age and developmental level:
   • Preschool – Regressive behaviors, decreased verbalization, increased anxiety
   • Elementary – Decreased academic performance, attention/concentration, and attendance; irritability, aggression, and disruptive behaviors; somatic complaints; sleep/eating disturbances; social withdrawal; guilt, depression, and anxiety; repeated re-telling of the event
   • Middle and High School – Decreased academic performance, attention/concentration, and attendance; avoidance, withdrawal, high risk behaviors or substance abuse, difficulty with peer relations, nightmares, flashbacks, emotional numbing or depression
4. Grieving does not have a timeline. Schools should be aware of anniversaries, birthdays, developmental milestones, and other factors that could affect students months or years after the loss.
5. Grieving involves meeting specific milestones. Individuals are likely to experience (and often re-experience) some or all of the following adjustments/responses:
   • Accepting the death
   • Experiencing the feelings and emotional pain associated with death and separation from the deceased
   • Adjusting to changes and an altered environment that no longer includes the deceased
   • Finding ways to remember and memorialize the deceased
6. Grieving is a normal response to loss, but may require some support. Additional assistance should be provided when the following are noted:
   • Marked loss of interest in daily activities
   • Changes in eating and sleeping habits
   • Wishing to be with the deceased loved one
   • Fear of being alone
   • Significant decreases in academic performance and achievement
   • Increased somatic complaint
   • Changes in attendance patterns (e.g., chronic absenteeism)
7. Things to avoid
   • Euphemisms when referring to the deceased such as “they are sleeping,” or “they went away”
   • Minimizing statements such as “it was only your great-grandmother, (or dog, neighbor, etc.)”
   • Predicting a timeframe to complete the grieving process such as, “it has been a month, you should be getting over this,” or “the pain will fade soon”
   • Over-identifying, (e.g., “I know how you feel”)
   • Too much self-disclosure (e.g., I lost my mom to cancer) as not everyone handles self-disclosure the same way and the focus should remain on the student’s grief
8. Things to do
   • Maintain routines as normally as possible
   • Ask questions to ascertain the youth’s understanding of the event and emotional state
   • Give the youth permission to grieve
   • Provide age and developmentally-appropriate answers
   • Connect the bereaved with helping professionals and other trusted mentors and adults
   • Encourage students to adopt adaptive coping strategies, particularly ones that will involve interaction with other students (e.g., sports, clubs)
   • Educate teachers and families about what is healthy grief and how to support the student

References & Resources

© 2015, National Association of School Psychologists, 4340 East West Highway, Suite 402, Bethesda, MD 20814; (301) 657-0270, Fax (301) 657-0275; www.nasponline.org

NASP has made these materials available free of charge to the public in order to promote the ability of children and youth to cope with traumatic or unsettling times. The materials may be adapted, reproduced, reprinted, or linked to websites without specific permission. However, the integrity of the content must be maintained and NASP must be given proper credit.

Contributors:

Benjamin Fernandez, Victoria A. Comerchero NCSP, Jacqueline A. Brown NCSP, Catherine Woahn, NCSP

Grief Help

Suggestions for Coping with Grief

Understand Your Grief

• Grieving is the natural response to loss, a gradual process of healing. Each person’s grief is unique.
• Grieving is not about “getting over” the death. It is about
  expressing your sorrow, sharing your memories, and learning how to go forward with your life.
• Grieving is not a mental illness, but it can be a crazy feeling. Changes in your mood, thoughts, concentration, and energy are to be expected.
• Grieving takes time. Each person grieves in their own way and at their own pace. However, grieving is about healing, and most of the intense feelings of  grief do become less frequent and less intense over time. Eventually, you will find that your memories bring more pleasure than pain.

Take Care of Your Heart

• Many grievers feel as if they have lost control of their emotions, never knowing how they will feel from one moment to the next. Painful as these feelings can be, they are all part of the natural response to the death of someone loved. Expect ups and downs, and be patient with yourself.
• Share your thoughts, feelings, and memories with others. It may feel more painful to talk about it at first, but opening the door allows for healing. Find those who are comfortable listening to you talk about it, whether old friends or other grieving people, and let them know how it helps you.

Take Care of Your Body

• Get regular physical exercise. Whether you are starting from scratch or continuing an old routine, exercise is a good way of keeping your body and mind in balance. It can help you sleep better, lowers your risk of depression, and can boost your immune system.
• Eat well. Appetite changes and changes in eating habits are common, but try to eat regular nutritious meals as much as possible. Grief stresses your body as well as your heart and mind, so your body needs nourishment more than ever.
• As best you can, try to get enough sleep – take naps during the day if you find you can’t sleep at night, and rest as much as you need to. Lighten your schedule as much as possible, and don’t be too hard on yourself when you can’t get as much done as you’re used to.
• Consider other ways to nurture yourself, such as massage therapy, yoga or meditation, long baths, or walks in nature.

Take Care of Your Mind

• It is normal to have a hard time concentrating, remembering things, or making
  decisions. As much as possible, postpone making major decisions. If
  circumstances allow, do not move, change jobs, or make any large changes to
  your life until the intensity of your grieving subsides.
• Some people find doing purposeful work helpful. As you begin to have more ability to concentrate, use your mind. Be patient with yourself if tasks feel more difficult.
• Once some time has passed, taking opportunities to give to others is sometimes helpful. This may be as simple as sharing in a support group or may involve giving volunteer time to others.

Take Care of Your Spirit

• Grieving people often feel guilt over real or imagined wrongs. Consider writing a letter to your loved one expressing any sorrow or regrets. Find ways to forgive yourself; remember, we are all human.
• Writing in a journal is often very helpful. It can be a safe, private place to express and explore your thoughts and feelings. Looking back over earlier writings also helps us see the changes we’ve managed.
• Creative energies can help us heal. Some people prefer creative outlets for their grief, exploring and healing through drawing, music, or other artistic expression. Creating your own grieving rituals, prayers, or poems can also be very healing.
• Find peace in your own spiritual process. For some people, religion is
  exceptionally helpful in the grieving process. For some, doubts are raised.
  Remember that personal faith does not make one immune to grief, or to the
  spiritual doubts grief can raise. Find safe avenues to explore your feelings,
  thoughts and questions. Take spiritual comfort where you can.

Accept Help

• Many friends and family members do not know what to do to help. As much as possible, let them know what you need and what you find helpful.
• Find those who are comfortable listening to you, who encourage you to be
  yourself, and who can accept all of your feelings.
• Some people find a support group or grief counseling helpful; often just a few
  sessions can help you feel less alone. Your local Community Hospice Grief Center provides support groups, counseling, and referrals.

Communicating with Grieving Teens

Open communication is extremely valuable to bereaved teens. In fact, allowing
grieving persons to express their thoughts and feelings is the most important
assistance you can offer them:

• Information reduces fear.
• Information can return a sense of control.
• Talking things out now can help prepare teens for future losses.

Barriers to effective communication

• Our discomfort with death and grief
• Our fear of intense feelings
• Our desire to protect teens from the reality of death
• Our desire to “fix” things
• Our fear of “saying the wrong thing” or “making things worse”
• Our own grief

Techniques for successful communication

• Create a safe, non-judgmental environment, free of interruptions.
• Listen, listen, listen. Don’t interrupt, interpret their feelings, or offer advice.
• Do provide accurate information as needed. Identify and counter misconceptions about the death itself. Be honest and factual and use age-appropriate language.
• Use the name of the person who has died.
• General, simple words of condolence are always appropriate:
  •  I am sorry for your pain.
  • I really miss (name of the deceased).
  • He (or she) was a special person.
  • I’m here if you need to talk, or cry, or just have quiet company.
  •  I’ve never experienced this before, and I just don’t know what to say.
• Ask open questions to get them talking:
  • What was your relationship with (the deceased) like?
  • Can you tell me what this has been like for you?
  • How are you doing?
  • How is your family doing?
  • Is there anything you can think of that I can do to help you?
• Accept and validate whatever feelings are expressed – do not argue with or
  minimize their feelings. If appropriate, suggest constructive outlets for strong
  feelings.
• Normalize their feelings and thoughts. Reassure the teen that difficulty
  concentrating, lack of enjoyment, anger, decreased energy, and so on are all
  normal parts of the grief process and will abate over time.
• Leave room for a conflicted or ambiguous relationship with the deceased – do
  not idealize the dead.

What Not to Do:

• Don’t avoid the issue. Avoidance causes the issues to go “underground,” resurfacing later in potentially harmful ways
• Don’t try to “rescue” the teen from his or her feelings. Grief involves feelings that make us uncomfortable, but successfully resolving grief requires that we work through these feelings in our own way and at our own pace. Witness their pain without trying to change it, hurry it, make it better, or minimize it.
• Don’t use euphemisms. It suggests to the teen that you can’t handle the reality of death, and may cause them to worry that they have to protect you. Use the “d” words instead: dying, death, dead.
• Avoid clichés. Try to imagine what they would sound like to you if you were the one grieving.
• Don’t lie to protect the family or community image. When the teen finds out the truth, they will have another loss to grieve for – their trust in you.
• Don’t impose your own religious beliefs. Teens often go through spiritual  crisis or existential questioning after a death. Be supportive, but let them find their own way.

Other Things Adults Can Do To Help Grieving Teens

• Respect the teen’s privacy.
• Model positive coping behaviors.
• Maintain regular routines and structure as much as possible – minimize disruptions.
• Maintain normal expectations of behavior and appropriate consequences for negative behavior –this helps teens maintain or regain a sense of consistency.
• Encourage the teen to eat healthy foods, to drink plenty of water, and to sleep – physical health effects emotional well-being.
• Encourage and facilitate age-appropriate activities:
  • Memory book
  • Journaling, letter writing
  • Artistic or musical expression
  • Physical outlets such as sports or other active recreation
  • Memorial rituals
• Give teens choices and options to help counter feelings of helplessness.
• Introduce grieving teens to others who have also been through difficult losses – peer support can be a powerful resource for adolescents.
• Reassure the teen that love for the deceased can be expressed through other emotions than sadness. Feeling joy and happiness about life events is often experienced by the teen as being somehow disloyal to the person who has died. Reassure the teen that it is okay for them to continue to enjoy their lives.
• Explore if school assignments can be modified to allow grieving teens to channel their emotions and energy into writing, drawing, or other expressive outlets – this may allow students to keep up with school while they work through their grief. Have a buddy who will help the teen with homework, or
  assign a tutor who can help the student. Step in if needed to advocate for the teen at school.
• Teens often benefit from having a safe way to physically express anger. You can give grieving teens appropriate things for them to unleash their anger on, such as telephone books or magazines to rip up, pillowcases full of clean cloths to wrestle with and hit, paper cups to smash, paper bags to blow up and pop, golf tees to hammer into thick Styrofoam, or clay to manipulate, pound, and smash.
• Be available over time. Many grieving people report that their support system rallies well at the time of the death but then vanishes two or three months later – long before their grieving is over.
• Be aware of “anniversary dates” which can reactivate grief;  acknowledge these special days and assist the teen in making the connection between approaching “anniversary dates” and their renewed feelings of grief.
• Be patient. Grief takes time.

What Does Grief Feel Like?

Grieving is the natural response to loss, a gradual process of healing. Grieving is not about “getting over” the death. It is about expressing your sorrow, sharing your memories, and learning how to go forward with your life. Grief is not a mental illness, but it can sometimes feel like depression or anxiety.

Each person grieves in their own way and at their own pace. Not everyone will experience all of what is discussed here, but these are some of the most common reactions. There is no timetable for grieving, no exact moment when you should “feel better.” However, grieving is about healing, and most of the intense feelings of grief do become less frequent and less intense over time. With time, you will find that your memories bring more pleasure than pain.

Emotional Reactions

Many people describe grief as an emotional roller coaster – some days are good, some are bad, and some days you just feel numb. The key to getting through it is to allow yourself to feel the feelings as they come. Because the grief experience is uncomfortable, many people try to avoid these feelings, shutting them down or pushing them aside. Unfortunately, this tactic rarely works for long – buried grief feelings can emerge later as emotional difficulties or relationship problems. Unacknowledged grief can also lead to problems with alcohol, drug use, or other destructive behaviors.

Many feelings accompany grief, not just sadness. Some of the most common include numbness, shock, disbelief, sense of unreality, helplessness, anger, worry, fear, anxiety, panic, loneliness, isolation, frustration, shame, irritability, relief that deceased’s suffering has ended or that a bad relationship is over, and guilt. Many grievers feel as if they have lost control of their emotions, or as if they are “going crazy,” never knowing how they will feel from one moment to the next. Painful as these feelings can be, they are all part of the natural response to the death of someone loved. Expect ups and downs, and be patient with yourself.

Physical Reactions

Since our emotions affect our bodies, it is reasonable to expect some physical symptoms during grief. It is normal to have changes in sleep patterns – difficulty getting to sleep, waking up in the middle of the night, or wanting to sleep all the time. Changes in appetite are also common, as is exhaustion – grief takes a lot of energy. Headaches, muscle stiffness, and stomach upsets are experienced by many grievers. Some people find themselves jumpy and restless, or overly sensitive to loud noises or other people. A pounding or racing heartbeat, dizziness, or chest tightness may also occur.

Some grievers become afraid that they may have a serious illness, or find themselves experiencing symptoms similar to those of the deceased.

Take care of yourself. Getting regular exercise can help you sleep better, lowers your risk of depression, and can boost your immune system. Try to eat regular, nutritious meals. As best you can, try to get enough sleep – take naps during the day if you find you can’t sleep at night, and rest as much as you need to. Lighten your schedule as much as possible, and don’t be too hard on yourself when you can’t get as much done as you’re used to. While physical symptoms are often a part of normal grief, any physical conditions that are worrisome should be evaluated by a doctor.

Thoughts and Behaviors

Frequent and unexpected bouts of crying are common in grief, and most people expect such reactions. However, there are other, less well-known but equally common thoughts and behaviors that accompany grief.

It is normal to have difficulty concentrating, remembering things, or making decisions. Many grieving people describe themselves as “going around in a fog.”

Some grieving persons may have little energy for or interest in others or for activities which formerly provided pleasure. Others may feel a need to be with other people, to talk a lot and retell stories of the deceased over and over.

Vivid dreams or nightmares about the person who has died are common, especially in the early weeks after the death. Many grievers may also experience the sense that they are hearing or seeing the deceased. These experiences can feel comforting, or they may be frightening. In either case, they are common and quite normal.

Some grievers experience a vague longing to join their loved one or to escape from the pain of the loss. Many people find such thoughts and feelings frightening. It may be comforting to know that they are not uncommon and do not mean that the grieving person truly wishes to die. It is important to realize that these feelings are different from suicidal thoughts, which involve active plans about when and how to take one’s own life. If at any point you are worried about such thoughts, seek help from your doctor or a qualified mental health provider.

Spiritual issues and questions are also common after a death. Some people find themselves questioning their beliefs and faith, while others may have a discovery or rediscovery of faith or spiritual understanding. Many people find themselves thinking more about the meaning of life, or about what follows this life.

Give yourself time. As much as possible, postpone making major decisions; if circumstances allow, don’t change jobs, move, or make any large changes to your life until the intensity of your grieving subsides.

Remember that personal faith does not make one immune to grief, or to the spiritual doubts grief can raise. Find safe avenues to explore your feelings, thoughts, and questions, and take spiritual comfort where you can.

Coping with Grief

Sometimes grief feels so overwhelming you wonder if you can survive it. It is important to remember there are some things you can do to make your grief more bearable. These include taking care of your body; exploring healing ways to express your thoughts and feelings; sharing memories of your loved; and finding safe sources of support.

Be patient with yourself as you get used to all the changes your loss brings. Remember, healing doesn’t mean forgetting the person who died. That person, and your relationship with them, will always be a part of you, kept alive in your memories.