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What Is Normal Grieving, and What Are the Stages of Grief?

[G]rief is a natural response to losing someone or something that’s important to you. You may feel a variety of emotions, like sadness or loneliness. And you might experience it for a number of different reasons. Maybe a loved one died, a relationship ended, or you lost your job. Other life changes, like chronic illness or a move to a new home, can also lead to grief.

Everyone grieves differently. But if you understand your emotions, take care of yourself, and seek support, you can heal.

What Are the Stages of Grief?

Your feelings may happen in phases as you come to terms with your loss. You can’t control the process, but it’s helpful to know the reasons behind your feelings. Doctors have identified five common stages of grief:

  • Denial: When you first learn of a loss, it’s normal to think, “This isn’t happening.” You may feel shocked or numb. This is a temporary way to deal with the rush of overwhelming emotion. It’s a defense mechanism.
  • Anger: As reality sets in, you’re faced with the pain of your loss. You may feel frustrated and helpless. These feelings later turn into anger. You might direct it toward other people, a higher power, or life in general. To be angry with a loved one who died and left you alone is natural, too.
  • Bargaining: During this stage, you dwell on what you could’ve done to prevent the loss. Common thoughts are “If only…” and “What if…” You may also try to strike a deal with a higher power.
  • Depression: Sadness sets in as you begin to understand the loss and its effect on your life. Signs of depression include crying, sleep issues, and a decreased appetite. You may feel overwhelmed, regretful, and lonely.
  • Acceptance: In this final stage of grief, you accept the reality of your loss. It can’t be changed. Although you still feel sad, you’re able to start moving forward with your life.

Every person goes through these phases in his or her own way. You may go back and forth between them, or skip one or more stages altogether. Reminders of your loss, like the anniversary of a death or a familiar song, can trigger the return of grief.

How Long Is Too Long to Mourn?

There’s no “normal” amount of time to grieve. Your grieving process depends on a number of things, like your personality, age, beliefs, and support network. The type of loss is also a factor. For example, chances are you’ll grieve longer and harder over the sudden death of a loved one than, say, the end of a romantic relationship.

With time, the sadness eases. You’ll be able to feel happiness and joy along with grief. You’ll be able to return to your daily life.

Do I Need Professional Help?

In some cases, grief doesn’t get better. You may not be able to accept the loss. Doctors call this “complicated grief.” Talk to your doctor if you have any of the following:

  • Trouble keeping up your normal routine, like going to work and cleaning the house
  • Feelings of depression
  • Thoughts that life isn’t worth living, or of harming yourself
  • Any inability to stop blaming yourself

A therapist can help you explore your emotions. She can also teach you coping skills and help you manage your grief. If you’re depressed, a doctor may be able to prescribe medicines to help you feel better.

When you’re in deep, emotional pain, it can be tempting to try to numb your feelings with drugs, alcohol, food, or even work. But be careful. These are temporary escapes that won’t make you heal faster or feel better in the long run. In fact, they can lead to addiction, depression, anxiety, or even an emotional breakdown.

Instead, try these things to help you come to terms with your loss and begin to heal:

  • Give yourself time. Accept your feelings and know that grieving is a process.
  • Talk to others. Spend time with friends and family. Don’t isolate yourself.
  • Take care of yourself. Exercise regularly, eat well, and get enough sleep to stay healthy and energized.
  • Return to your hobbies. Get back to the activities that bring you joy.
  • Join a support group. Speak with others who are also grieving. It can help you feel more connected.

Complete Article ↪HERE↩!

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A Burial Practice That Nourishes The Planet

Here’s a question we all have to answer sooner or later: What do you want to happen to your body when you die? Funeral director Caitlin Doughty explores new ways to prepare us for inevitable mortality. In this thoughtful talk, learn more about ideas for burial (like “recomposting” and “conservation burial”) that return our bodies back to the earth in an eco-friendly, humble and self-aware way.

 

 

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How Death Positivity Helps Me Mourn The Living

By: Lola Phoenix

[T]here are many ways that death has followed me throughout my life. I was born with my umbilical cord wrapped around my throat and a disability nearly caused my death several times as an infant. When I was three and I stopped growing, my growth hormone, before it was made in a lab, was taken from cadavers.

Fearing death dominated my childhood so much that I became extremely paranoid. Growing up with a gay parent and hearing about Matthew Shepard, I had to trust the friends I brought home into my life. Already having been bullied in school for supposedly being a lesbian, I didn’t want to give them any reason to escalate the harassment physically. While I know I’m not personally going to be targeted, the spectre of death is ever present.

But so much of death is about mourning people who have died, when, for LGBTQ people especially, there is a kind of death that is not really discussed, explored or acknowledged—the death and mourning of the living. Estrangement grief is a thing, and it’s complicated to mourn a person who is not dead.

“Death positivity” is about coming face to face with mortality and, instead of fearing and ignoring it, embracing it. I came across this movement through the “Ask A Mortician” channel on YouTube run by Caitlin Doughty, who is also behind the death positivity movement Order of The Good Death. Fundamentally, death positivity is about challenging the way our society views death and creating a culture that allows people to be more prepared and ready to make the difficult choices around death that they may be avoiding.

All around the globe, people have signed up to be part of The Order of The Good Death, and this may mean something as simple as taking an active interest in making end of life wishes to educating people locally about burial options to campaigning in local government for options such as water cremation, which aren’t available in all areas.

The process of becoming death positive is about embracing the realities that lie at the end of my life, it also has helped me embrace several lessons that have helped me live my life.

I am estranged from both of my parents: one of them disowned me and the other has mental health problems that make a relationship between us difficult. Other family members either don’t show very much interest in me or, when I have attempted to reach out for support, have either not responded or told me they were tired of “weird.” As someone who has always felt quite strongly about family ties, these losses were difficult to endure. But the lessons I have learned through death positivity have made them much easier to cope with.

1. Sadness is not shameful.

This seems obvious, but it isn’t. Part of death positivity encourages people to think about what choices they want for their bodies after death. That got me thinking about the complex way I’ve felt about funerals I’ve been to—how cold and incredibly formal they’ve felt and how awkward it was to express strong emotions in austere settings. I decided I didn’t want the people I left behind to feel how I felt. I wanted them to feel like being sad was okay. And in doing so, I had to tell myself that it was okay not only for the people who lost me to mourn, but for myself to mourn the people I have lost.

Estrangement isn’t always permanent, but holding on to the hope of change in many instances can end up causing more pain than it’s worth. It may seem on the outside that your estranged relative has more of a chance of coming back into your life than a dead relative, but that isn’t true for everyone.

Giving others the space to grieve helped me understand that it was okay for me to grieve. At least now when I mourn the loss of people in my life, I can accept that I have these feelings and not fight against them.

2. Grief and recovery aren’t linear.

In thinking about how I wanted to prepare as much as possible for my loved ones before I die so that they don’t have to stumble around in the process of grief, I had to come to understand it more. Despite the presence of death and loss in my life, there have been few family members I have actually felt sadness at losing. My mother was 18 when she had me and her mother was 18 when she had her, so I have a relatively young family. I lost my grandfather and step-grandfather when I was in high school, but I knew both of these men as abusers of my mother.

When they passed, I wasn’t even remotely sad. Many of my great uncles and aunts had passed, and I lost a second cousin to a tragic accident, but I didn’t have very close relationships with these people. It was when my great grandmother died in 2013 and I didn’t have the money to fly home and attend her funeral that I came face to face with my biggest loss.

One of Caitlin’s videos talks about the reasons people fear death, and one of them is the impact it will have on their loved ones. Much of what I suspected from both Caitlin’s videos and the crowdfunders I’ve contributed to for funeral costs spelled out the reality of the impact “traditional” funeral homes and their soaring prices can have on families. I had to understand that grief is expressed in so many different ways and it’s not as simple as “letting it go.”

In the case of my great grandmother, losing her felt so odd and numb that I had almost no emotion when I heard the news that she had passed away. She was 98 years old and the morning I got the news, I’d had a funny feeling that she was gone. Without having ever experienced a massive loss, I didn’t at the time know what was normal. And I secretly felt ashamed that I hadn’t shed many tears, though I told nobody.

Years after her death, I was trying to recall how she made biscuits every Sunday morning for breakfast. My mind walked through the process of her pouring flour and lard on her biscuit pan, but there was a lot I couldn’t remember. When it occurred to me that I couldn’t ask her anymore, something broke in me and I finally cried. After being active in Death Positive communities, I knew and understood that grief wasn’t linear and that sometimes the sadness comes and goes when it wants.

Likewise, I stopped telling myself to “let it go” when I was grieving estrangement from my parents. When you experience a loss, you have good days and you have bad days. Thinking about my own death and preparing for it meant thinking about what my loved ones would go through in their grief. I would never expect them to just stop feeling their feelings, so why should I expect my feelings to suddenly go away?

3. Celebrate the time you have.

The Order of the Good Death may sound very morbid and odd to some. But in her videos, Doughty points out that “the good death” is not about failure if you don’t plan, but about the idea that avoiding conversations about death ultimately means much more hardship than addressing it at all.

Facing my own mortality in a healthy way encourages me to actually take advantage of the time I have. When death becomes something that moves from being in the unknown, terrifying and looming but never addressed to being looked at, planned for, and understood, that also means that you’re more likely to take advantage of life.

Loss and grief become part of the process of death and equally part of the process of life. When I learned to address the fact that all life will end including my own, it felt easier to for me to cope with the idea that several of the relationships I once valued and held dear in my life were also at an end—and that’s okay. And what’s more, it’s helped me appreciate what time I do have and know not to waste it on people who hurt me or don’t respect me for who I am.

Death positivity may sound like a bizarre notion, especially as a queer person and a disabled person fighting in many instances to stay alive. It’s not about wanting to be dead. It’s not about being happy about dying. But it’s about facing the reality of death in a way that isn’t the paranoia and fear I’ve had sit heavy on my shoulders.

And doing so has helped me cope with what a lot of other people like me go through when we lose a family member either because of our own identities or because of their inability to accept and see us for who we are in a loving and positive way. Reckoning with the face of grief and mourning has given me tools to use to cope with a different but also painful kind of loss.

Because I embrace the fact that I will die, I live better.

Complete Article ↪HERE↩!

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Green funerals help planet, wallet

For years, Dr. David Wong has questioned why religious people, who say their souls go to heaven, would go to such extremes to protect their dead body by embalming, select expensive wooden caskets and then even protect the casket. Perhaps green funerals are the alternative?

By Dr. W. Gifford-Jones

[H]ow would you react if you saw people dumping 800,000 gallons of formaldehyde, a carcinogenic substance, into the earth every year?

Then witness them cutting down four million acres of forests annually? I suspect the environmentalists who fight underground oil pipes would be raising holy hell about formaldehyde and rampant destruction of trees. Yet this is what it takes to bury the U.S. dead every year. So why are environmentalists so silent?

Now, a film called “Echo Death Takeover: Changing the Funeral Industry” has been produced by The Order of Good Death, founded by funeral owner Catlin Doughty who advocates green funerals.

Some readers may wonder why I’m writing about death when I’m trained to keep people alive. But pollution of many types is currently causing serious respiratory and other health problems. Moreover, for years I’ve questioned why religious people, who say their souls go to heaven, would go to such extremes to protect their dead body by embalming, select expensive wooden caskets and then even protect the casket. And although I’m not a religious authority, don’t they always say at funerals, “Ashes to ashes and dust to dust?”

So, what to do about the current burial procedure? Formaldehyde was discovered by a chemist, August Wilhelm von Hofmann, in 1867 and it quickly replaced arsenic as the prime way to embalm bodies. Now we know that formaldehyde is a hazardous substance, highly toxic to humans. It is linked to cancer and irritates the eyes, nose and throat.

Some readers would reply, “But what about cremation? Is this more eco –friendly?” Unfortunately, where there’s fire there’s smoke. Cremation also produces harmful substances such as carbon dioxide, hydrochloric acid, sulphur dioxide, dioxin, mercury from amalgam dental fillings and carcinogens.

If the body is embalmed, smoke also contains vaporized formaldehyde which remains in the atmosphere. That is, until it bonds with water. Then we are rained on with formaldehyde. So be sure to take a good raincoat and hat if attending a rainy funeral. Besides, cremation requires heat that could be used for other purposes.

So, what is a green funeral? It’s a process called alkaline hydrolysis, also called flameless cremation or water cremation. The body is placed in a pressurized steel container filled with 95 per cent water and five per cent potassium. For the next three hours the body undergoes chemical decomposition, reducing it to soft bone fragments. This mixture of amino acids, peptides, sugar and salt can then be used for fertilizer.

Water cremation is not an illogical proposition for the next century. It’s now legal for human disposal in four U.S. states and in 14 for pets.

Are there negatives to water cremation? I imagine some would be disgusted at the dissolving of a loved one in a warm alkaline bath. But, surely, it’s less psychologically shocking than having Grandpa inserted into a fiery inferno.

Another alternative is to wrap the body in a biodegradable shroud made of cotton or unbleached bamboo, place it in a biodegradable casket in a shallow grave and let bacteria break down all these ingredients.

So, what’s going to happen? I hope that good sense will one day finally prevail and the days of spending thousands of dollars on today’s burial rites will finally end.

Shakespeare, in his play “Hamlet,” describes the scenario of life and death so well. He wrote: “Worms are the emperor of all diets. We fatten up all creatures to feed ourselves and we fatten ourselves for the maggots when we are dead. A man may fish with the worm that hath eat of a king and eat of the fish that hath fed of that worm.”

This is not a pleasant thought or the best bedtime reading. But regardless of how expensive the casket is the worms finally win. So, isn’t there a better way to protect the planet and return all the minerals and other elements to the earth?

So, what is my wish on death? My family knows I want a simple bench along the waterfront in Toronto where people can relax and enjoy the view. My ashes beneath can help the trees grow.

Complete Article ↪HERE↩!

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Will your life end well? An Oscar nominee and palliative care advocate on what’s new in death

Shoshana Ungerleider, founder of the End Well symposium and the Ungerleider Palliative Care Education Fund

By

Shoshana Ungerleider is a leading palliative care advocate as well as a practicing physician at California Pacific Medical Center in San Francisco. In her work as an activist and educator on end-of-life issues, she’s been focused on creating a more human-centered approach to how we die. To this end, Ungerleider has started a philanthropic organization dedicated to education about end-of-life issues, launched an annual symposium on the end-of-life experience called End Well, and helped produce documentary films on the subject, including the Oscar-nominated Extremis and End Game, which was released on Netflix earlier this month. The Business Times spoke to her about what’s behind her passion for palliative care and how a better understanding of death is essential to a better health care experience.

As an internist who works in a hospital, how did you first get interested in palliative care?

Sort of the weird thing is that I never set out to be any kind of advocate for end-of-life issues. But really early on in my residency, I experienced so many patients in the ICU who were dying of lung cancer, of liver disease, of end-stage something and I realized that nothing that we were going to do was really going to reverse their age or their underlying medical problems. But nonetheless we were still kind of doing things to them because we could and not because we necessarily should. It turns out that far too many people spend their last moments of life suffering. They’re in pain. They’re hidden away from their loved ones. And to me it’s coming down to the fact that we’re not doing as a job both as health-care providers but also society at large of having honest conversations early and often about what matters most to us.


 
Are there generational differences in terms of people being open and comfortable about conversations around death?

Millennials are, for whatever reason, really open and honest about mortality and making sure that they get what they want and have some autonomy. There’s a similar thing with baby boomers interestingly, really wanting to have a say and maintain control. There are organizations like Death over Dinner in Seattle, where they kind of helped you curate and facilitate a conversation around the dinner table with friends, family or loved ones. Also, The Dinner Party, which is another group founded by some young women who lost their parents which is more focused on grief, and loss, and creating an open conversation around their table. So it’s fascinating to me just how much innovation is happening around this seemingly very taboo topic.

Many doctors feel that death is ultimately a treatment failure. But have you seen an evolution from the physician and provider side when it comes to end-of-life care?

There’s been, over the last 15 years, a shift in medical education. So people are realizing that teaching doctors how to have hard conversations is really critical. We need to be doing more of it and there needs to be sort of core academic competence models coming out of our national accrediting bodies that haven’t happened yet. But the field of palliative care is brand new. It’s only been a specialty that’s been board certified since 2008. There has been a radical shift in the last 10 years to now being a very much more popular field. They talk about it often and medical students and residents are much more open to the idea that doctors still have a place in healing, even when a cure is no longer an option.

One of your stated goals is to make the end-of-life process more human-centered and less clinical, cold and impersonal. What role is technology playing in that shift?

There’s a few apps out there that are really helping to facilitate advanced care planning, meaning the kinds of documentation and discussion that need to take place to make people’s end of life care preferences known, like Cake out of Boston. There are also a few entities researching the use of virtual reality in terms of both therapeutically helping to treat pain and anxiety, but also for recreational use. So some places in Canada and the UK are specifically using it for patients who are in hospice and want to mark things off their bucket list. So while they can’t travel but they might be able to experience Niagara Falls or go climb Everest virtually.

Are there things that American culture regarding death can learn from other places around the world?

It’s really interesting because everybody always asks if there are countries or societies that do this well, and the answer to that is no. Nobody has figured out the best way to support patients, to support families, to think about caregiving from a civic perspective. The one really interesting case study that I always point to when I talk about this is La Crosse, Wisconsin. It’s a town of about 50,000 people where one leader in the community decided that he was going to make his hometown just like a great place to die. How he went about this was in the mid-2000s he figured out a way to really encourage people to do a lot of advanced directives, so that it became just a commonplace thing. In 2009, something like 95 percent of the people that died (in La Crosse) had filled out an advanced directive. In the United States we have 10,000 baby boomers turning 65 every day. Never in the history of our country will so many people die in such a short time span, so it behooves all of us to start thinking about innovative solutions to caregiving.

So you’re probably the person I’ve talked to who’s thought about these issues the most, how has your perception of your death had changed?

Something sacred is happening. You get to see a very intimate window into someone’s life and really the mystery of what binds us together as human beings. For me, being reminded of my mortality makes my life sweeter. It’s more rich when you know that one day it will end.

Complete Article ↪HERE↩!

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Everything You Need to Know about Thanatophobia- The Fear of Death

By Nancy Walker

[D]eath anxiety is not a distinct disorder but might be connected to problems of anxiety and depression such as:

  • Panic disorders
  • Panic attacks
  • Post-traumatic stress disorder PTSD
  • Hypochondriasis

Thanatophobia is quite different from necrophobia, which refers to a general fear of the dead or dying things, or anything that is linked with death.

In this article, we will discuss thanatophobia or death anxiety, explore the signs and symptom, reasons, and treatments for this problem.

What is Thanatophobia?

The word thanatophobia has been derived from two Greek words, Thanatos meaning death, and Phobos meaning fear. Hence, thanatophobia means the fear of death.

Being anxious about death is quite normal and a part of human behavior. However, in some cases, people may suffer from an intense form of fear or anxiety when they think about their own death or the process of dying in general.

A person may feel extreme fear and anxiety when they think that their death is inevitable. Other than this, they are also likely to experience the following symptoms:

  • Fear of separation
  • Worry about leaving the dear ones behind
  • Fear of suffering from a loss

When these fears and disruptive thoughts become so intense that they stop the sufferer from performing his daily activities, this condition is known as thanatophobia.

In the most severe forms, these feelings can hinder the patients from living their lives and performing daily activities. Their fears tend to center on things that may cause death such dangerous objects or contamination.

Diagnosing Thanatophobia

Doctors do not consider thanatophobia as a separate condition, however, it can be considered as a specific phobia.

As per the Diagnostic and Statistical Manual of Mental Disorders, a phobia refers to an anxiety disorder that relates to a specific situation or an object.

The fear of death may be considered as a phobia if it:

  • Arises every time the person wonders about dying
  • Continues to persist for a period of more than 6 months
  • Interferes with the life and relationships of the patients

Some of the key symptoms that a person is suffering from a phobia of dying include:

  • Immediate anxiety or fear when thinking about the process of dying
  • Panic attacks that may lead to hot flushes, dizziness, sweating, and increased heart rate
  • Avoiding situations where the concept of death or dying is discussed
  • Feeling pain in stomach or general sickness when thinking about dying
  • A general feeling of anxiety or depression

Phobias may lead to a person feeling extremely isolated and avoiding any contact with family and friends for long periods of time.

The symptoms may come and go throughout the entire life of an individual. Someone suffering from a mild form of death anxiety can feel their anxiety heightening when they think about their own death or the death of a loved one, particularly when he himself or any family member is seriously sick.

If the death anxiety is connected to another depressive condition, the patient is likely to suffer from the symptoms related to that particular disorder as well.

Types and Causes of Thanatophobia

While thanatophobia refers to the general fear of death, there are a lot of types of this disorder which depends on what the patient is focusing on.

Phobias are often experienced by a specific event occurred in the patient’s past, even though the person does not always remember it. Some particular triggers that lead to thanatophobia include a traumatic event related to the near death of self or a loved one.

A person who is suffering from a severe illness has a high risk of developing thanatophobia. This is because chronic patients are always anxious about dying, however, ill health is not necessary for someone to experience death anxiety.

Most of the time, thanatophobia is related to psychological illness.

The experience of thanatophobia may differ from person to person and mainly depends upon individual factors like:

  • Age: A study performed in 2017 suggested that older adults are more likely to experience the process of dying as compared to the younger ones who fear death itself.
  • Sex: As per a 2012 research, women are more likely to suffer from the fear of death, which may be their own or that of a loved one.

It is common for the medical professionals to connect anxiety near death to a range of different mental illnesses such as PTSD, depressive disorders, and anxiety.

How to Treat Thanatophobia

Social support networks can help protect a person from thanatophobia. Some people are likely to come to terms with their deaths with the help of their religious beliefs but this may perpetuate the anxiety related to death in others.

People enjoying a good health, high self-esteem, and a belief that they have spent a fulfilling life are less likely to fear their death as compared to others.

A doctor usually recommends a person suffering from thanatophobia to receive a treatment for phobia, anxiety, or any other problem that may be triggering this fear. The treatment involves a talking or behavioral therapy. These therapies teach the individuals to focus on their fears and work through them by expressing their concerns.

The treatment options for thanatophobia usually include:

Cognitive Behavioral Therapy

Cognitive behavioral therapy or CBT includes working with the patient in order to alter his behavioral patterns in such a way that he adopts newer ways of thinking.

In this therapy, the doctor works in collaboration with the patient to come up with practical solutions in order to overcome the anxiety and depression. This eventually leads to the development of strategies that make the patient unafraid and relatively calm when he talks or thinks about death.

Exposure Therapy

Exposure therapy works by helping someone face their fears. Instead of suppressing the feelings of death in a person, this therapy encourages the patients to expose them and acknowledge them.

A therapist will work very carefully in order to expose a person to his fears but ensuring that he is in a safe environment. This is repeated until the response of a person towards the factor causing anxiety reduces.

The person is able to confront his own thoughts and feelings without any fear.

Medicines

If a patient has been diagnosed to have a certain mental disorder such as PTSD or generalized anxiety disorder (GAD), he may be prescribed to take anti-anxiety medications such as antidepressants or beta-blockers.

Using these medications together with other psychotherapies can be extremely effective.

Relaxation Therapies

Practicing self-care can boost the overall mental health of a person. It can also help a person to cope with his fears and anxieties. Avoiding caffeine and alcohol, sleeping well, and eating a healthy diet are some of the easiest ways to practice self-care.

When a person suffers from anxiety, specific relaxation techniques can reduce the stress on their minds and reduce the fears. They may include:

  • Performing deep breathing exercises
  • Focusing on certain objects in a room, like counting the tiles on the floor, or meditation

Outlook

While it is completely natural to express concerns about your future and the future of your loved ones, if the death anxiety persists in your behavior or more than 6 months, it indicates that you require medical help.

The fear of death can be overcome by different ways and your mental health professional can guide you through them in a better way.

Complete Article ↪HERE↩!