We are experts who study grief, doctors who help the grieving, and people who lived through it. Ask Us Anything.

What advice do you have for dealing with the complicated grief that comes from estrangement? No one brings over a casserole when you’ve voluntarily removed a toxic person from your life. People find it awkward to discuss and don’t check up with you over time, I’ve noticed. The grief is of course nothing like loss through death, but it’s painful all the same. I find myself wishing for and missing a loving parent who never really existed. It’s hard.

It’s so hard, isn’t it? It’s not recognized as a “real” form of grief, but can be so painful because the possibility exists for a loving relationship that you don’t have. Sometimes people even blame a person who’s grieving estrangement from a loved one. So I think the first step is to consistently acknowledge for yourself that it’s hard. It just is—even if others don’t get it. Many people find therapy helpful in this regard, to process the mix of feelings about the relationship. It can be especially important, too, to surround yourself as much as possible with people who love you and bring out the best in you. Those relationships can’t take the place of the one you’re missing, but they can ease the pain. - Seth Gillihan, PhD

I’m so sorry you’re experiencing this kind of loss. For me, when I’m feeling grief and pain I tend to isolate - it’s not even a conscious thing, it just doesn’t even occur to me to verbalize my feelings and needs to the people around me. If you have people in your life that you feel comfortable sharing with, maybe you could let them know how you’re feeling and ask them for support (maybe even in specific ways - let them know what feels supportive to you - like, what’s your support “love language”)? I think our culture puts such a high value on being self-sufficient, that asking for help and verbalizing our needs can be really hard (at least, it is for me!). My heart goes out to you and I wish you the best as you come to terms with this loss (and PS - I think you are very brave) - Kim Richardson

It’s been 5 years since I’ve lost my friend, and sometimes the weather is exactly the way it was when she sent her last message to me, and everything inside me screams but I just can’t cry. Does grief ever end?

When someone we love and care about dies, there are often physical sensations that can be tied to that time...smells, sounds, sights...so it is not unusual that you might connect with your friend’s death when the weather is the way it was when she sent her last message to you. It’s okay to not cry, just as it’s okay to cry. I would encourage you to not place expectations on yourself about that, and rather, just...notice... As to whether grief ever ends, I offer this: does love end when someone dies? The love doesn’t end...only the ability to express it in the physical realm. - Donna Shuurman, Ed.D, F.T.

I see grief as a way to express love- so, does love ever end? No, and probably our grief won’t either. - Patty Holliday

I work in emergency services, we often deal with family of the deceased immediately after or on the scene of death. What are some important things to consider at that time, some dos and don'ts, etc?

I’ve been thinking a lot more about this recently. During my residency, our team would be running from patient to patient, not really thinking clearly about the actual people we were working to help (and that includes the family members). Having been on the other side now and seeing how we were treated as family members of someone who was in the process of dying (both of my grandparents passed in the hospital in the last few years), it definitely makes me realize some of the things we can be more aware of as medical professionals. Having just one member of the medical team be a point person to talk to, to ask questions, to know that they are actually aware of the whole story would have been so much easier on our family. It’s definitely different in the emergency setting, but I think just 1 person on the team making a real effort during the time of loss can make such a difference for families.- Neha Pathak, MD

So hard. And thank you for being there in those incredibly tough moments. Don’t try to empathize or make it about something you’ve experienced and seen before- though I’m sure that’s an easy “don’t” to already know. Do be present with them, make sure they know you see them as a person, not just a victim, and that the loved one they lost was a person. Which I’m sure is hard considering the job and need for compartmentalizing, but that would be helpful in the moment to the grieving family. - Patty Holliday

My partner wants me to open up about losing a close family member, but it makes me angry because he’s never lost anyone and he won’t understand. How can I tell him this and what should I do?

It sounds like your partner is caring, and wanting to listen to you about your loss of a close family member. I can assure you that a lot of people do not want to hear about another’s losses, so this is a positive sign that your partner wants to try to understand and support you. While none of us can completely understand another’s experience, he does not have to have lost anyone in order to care and support you. You might share with him that you’re afraid, or angry, or whatever you feel that in sharing he might not understand...follow your heart, and...let him know what you’re feeling, whatever that is...it sounds like he’s listening. - Donna Schuurman, Ed.D, F.T.

I’m a doctor, unfortunately, a reasonable part of my job is breaking bad news in the high stress of the emergency department in the wee hours of the morning.

Last wk, I had to tell an entire family member their 27 year old family member daughter had died suddenly and unexpectedly, and we had to stop working on her. About 2 hours later, we had a 47 year old also die suddenly after being brought in by ambulance, and we had to call it after about 45 mins.

The two families took the news completely differently: one was hysterical, the other seemed amazingly calm.

My strategy is to not bullshit, not use euphemisms, and to get to the point as quickly as reasonably possible, whilst trying to be as sensitive as possible.

What advice to you give to bad news breakers? How can I tell when it’s going to go well, or completely tits up?

I’ve always been amazed by how my ER doc friends can handle the daily (really minute by minute) change in pace of ER care. I’m a primary care doc so the pace is much slower and allows for time to build a relationship with people. I agree with you though, when it comes to breaking bad news I’ve found it’s best done in a straightforward way with a tremendous amount of empathy - because like you say, reactions can be so different that I always try to take my cues on what the family member wants to hear (or say). I’ve found it’s so important to be keyed in to the family member’s eye contact, body language, to figure out how I should say something... before I even think about what I should say. - Neha Pathak MD

Many see grief as a purely emotional state, but is it exclusively emotional/mental?

If not, what are the physical effects of grief? Do they change depending on the type or grief or its intensity?

This is a great question. I think we sometimes artificially separate mental from physical, even though we are learning more and more about how intertwined they both are when it comes to health and wellbeing. Emotional turmoil can set off a cascade of hormonal and chemical changes that can change how you feel “physically.” People are also at higher risk for blood pressure problems and heart disease depending on how long the stress remains. One thing a lot of people are talking more about is “broken heart syndrome” which can happen with intense emotional strain. It can feel like a heart attack and change the way your heart pumps… thankfully most people recover from it.

But you are right, there can be a lot of physical effects from mental health problems and vice versa. So we really want to make sure we are treating the “whole person” and not just a single condition….- Neha Pathak, MD

Many of the bereaved children, youth, and adults I have listened to over the last 33 years report all kinds of physical aspects of grieving ~ changes in sleep and appetite, pulsing, uncontrollable shaking, waking dreams, you name it. This shouldn’t be a surprise to us since we are beings whose minds and bodies are connected. Sometimes our bodies tell us things our minds don’t, and the reverse...grieving is a full human experience. - Donna Shuurman, Ed.D, F.T.

What is the best way to describe the pain of losing a child becoming more bearable with time without minimizing the significance of the loss? Even as a mother who knows this pain, I do not know what the right thing is to say to help someone else. I'm at a loss every time and end up saying nothing because I don't want to give the impression that you just get over it with time but in the immediate I want them to know this intense overwhelming pain will get better and that they will find some joy again.

Grieving mom here. And this is not my analogy, but one I think sums it up for me. I say grief is like a box with a ball and a pain sensor inside the box. The ball is HUGE at first- and rolls around and hits that pain sensor repeatedly and easily, triggering the feelings and waves of hurt. But over time, the ball gets smaller. As the smaller ball moves around the box during life’s events, it still hits that pain sensor. But less often. At first because the ball is so big, it hits it all.the.time. But as the months & years go on… the ball gets smaller. It still rolls around and hits the pain sensor- and the pain is still the same level of pain (at least for me)- but it just comes less often. The pain sensor is triggered less frequently. It’s almost harder, in a way, because early in grief I expected the pain and so did everyone around me. As time goes on, the ball hits the sensor at random, unexpected moments, and takes everyone by surprise. It’s been 14 years and I still sob at times, just like in the beginning. But I’m not sobbing all the time, so, improvement? - Patty Holliday

So beautifully expressed, Patty, and thank you for sharing this. One of the mothers in a grief support group related that after her son’s unexpected death at the age of 4, which was about 12 years ago, she felt like she was carrying a boulder of pain around with her...over time, and not just time alone (as time alone does not heal all wounds!), but through the loving support of friends and family, the boulder wasn’t always as heavy...now she says that most of the time she feels like she’s carrying a rock, sometimes a pebble, and then occasionally the boulder is back. The idea that we should someone “get over” the death of someone we loved is not consistent with what love is...and those (as Alan Wolfelt coined the term) “memory embraces” will happen throughout life. My 91 year old mother lost her first child, my sister Lynne, 5 days after Lynne’s birth. Three of us followed, and at 91, my mother is mourning the death of her baby...as it should be… - Donna Schuurman, Ed.D, F.T

I wonder how a series of grieving experiences accumulates in a person over a lifetime ? I think about how I lost a sibling when I was six, and between then and now in my 40's, I have grieved over the deaths of various others - friends, grandparents etc. Are aspects of grieving partly learned ? Does each consecutive grieving experience change or inform the nature of the grieving experiences that follow ? Do we develop grieving habits? Can we become better, more mindful grievers ?

Though this is not a particularly comforting thought, I believe that life is a process of accumulating losses: the longer we live, the more loss we will accumulate...the losses of friends, sometimes hope or faith, health, beloved pets, possessions, etc. We can become numb and closed off; we can allow ourselves to feel the full range of the depth of love and the depth of pain, and everything in between. I think it’s important to not put pressure on ourselves to react in A Certain Way. Rather, be as gentle with yourself as you would be with a close friend... - Donna Shuurman, Ed.D, F.T.

I’m answering solely from personal experience. My dad died when I was nine, and though of course there was initial emotion, I was so eager to get back to normal and be “fine” and support my mom and younger brother that I denied the depth of my pain. Years of denial created a numbness in me of sorts, and so when my brother died 27 years later, I really was unable to feel the loss. There was, again, initial emotion -- but after the funeral was over, it was hard to really access much emotion about his death. I felt very ashamed that I wasn’t more affected by his death until I understood that I had never really dealt with my father’s death all those years before. Since then, I’ve dug deep into my grief issues and have slowly been able to un-numb myself; it feels good to finally truly miss my brother -- though it’s painful, of course, it feels good to feel. - Kim Richardson

I lost my husband last year to a stroke. It has irked me whenever someone asks me what stage I am in. As if I will be 100% fine after I get through the last stage. Frankly, I can't abide that idea.

I wake at night often, at the time he fell ill, panicking. Is this common?

It is common to hear, “But it’s been X-many years, I’m surprised you still get sad?” So yes, you might run into this frequently. I wish more people understood that grief doesn’t have an end date or expiration. - Patty Holliday

There are no set or specific “stages” and you could say you are in the “I am grieving all the changes that have come about since my husband’s stroke and death” stage...that is, there is not a “finish line” and a time all will be fine. His stroke and death have changed your life forever. As far as waking up at night, at the time he fell ill, and panicking...yes, this is common. Not pleasant, but common… - Donna Shuurman, Ed.D, F.T.

To what extent is there a recognised link between grief and nostalgia?

I'm nearly 40 and for a long time have suffered from painful nostalgia for my life as a child - to the extent that trips back to my childhood home can be upsetting because it makes me dwell on the the time I spent there as a child and I can never have it again.

My father died rather suddenly when I was 20, which was shortly before I moved permanently away from home. It's only in the last few months that I've realised what I'm actually yearning for is a time when he was still alive as opposed to the places and things for which I thought I was feeling nostalgic.

20 years feels like quite a long time for this to have persisted, but at least in the shorter term is what I have experienced something that is recognised more widely?

That’s very poignantly described. Yes, what you describe is certainly familiar. Nostalgia is a bittersweet experience, and the bitterness seems to be the feeling of loss and grief for a time/place/person that is in the past. I would actually say that it’s not that surprising that those feelings could persist for 20 years or more, especially upon returning to your childhood home. Most likely the smells of home are especially triggering of those memories, since smell is so closely linked to memory and emotion, and the resulting feelings of missing your father. Hopefully you also feel some of the sweetness of the nostalgia, too. - Seth Gillihan, PhD

I can understand how these feelings can be confusing. My dad died suddenly when I was nine; it was about thirty years later that I realized that I still had a deep well of unresolved grief in my heart. And there was a part of me that felt a little bananas, thinking to myself “it’s been thirty years! You should be over this by now!”, but grief doesn’t have timelines. It seems to me that it is very patient -- it runs in the background - sometimes quietly, sometimes wreaking havoc (as it did in my life) - until we’re ready to deal with it. For me, it took about 30 years to get to the place where I could really go back to that night in 1979 and sit with my child-self and comfort her and really hear her grief. Only speaking from my own experience, as a fellow griever, I hope that you’ll go down this path with curiosity - reaching out for support from friends or a therapist as needed. For me, once I decided to explore my grief, it took me to places I never would have expected and taught me things about myself and about life that I don’t think I could have learned any other way. It was a painful journey, but worth it. I’m wishing you all the best. - Kim

It feels true that stunting the process of grief via drugs/alcohol or other types of destruct behavior seems to compound the pain involved involved in the process of grieving, like it compounds due to avoidance. Is that a false assessment or am I on the right track?

While I’m no psychologist, my own personal experience (having had lost my dad at age nine, and repressing that grief until my 30’s) has been that my efforts to numb my grief with sex or alcohol compounded the problem in two ways -- one, it put more time and experiences between me and the source of my grief which made some of my grief feelings harder to spot and identify; and two, the sex and alcohol almost always had painful consequences which just added new pain on top of my grief pain (and again, made my grief-related pain harder to spot). - Kim Richardson

It’s a great assessment. Yes, generally it seems that efforts to avoid feelings just makes them stick around for longer. Even if the behavior isn’t obviously destructive, it can have the same effect (things like overworking or constant social media use come to mind). When we allow ourselves to feel what we feel, we can process our emotions and move through them. That’s not to say the feelings “go away,” but they shift and evolve over time. - Seth Gillihan, PhD

Have we seen anything different about grief based on the way that the deceased passed away? Anything clinically or scientifically unique if they died from suicide or homicide, as opposed to a disease or other more natural causes?

Absolutely. It can make a big difference. The DSM even distinguishes the type of loss for loved ones in terms of whether they might develop PTSD, with more traumatic types of losses associated with this condition. Suicide can be particularly painful because of the tendency to blame oneself—If only I had done more…. Thinking of my own friend who died by suicide, I still wonder every day what led him there. Sudden deaths also don’t allow us to have end-of-life conversations with our loved ones, which can be so meaningful. Also, we can suffer knowing that our loved ones died in a particular way, such as by homicide, and of course it doesn’t tend to help our view of humanity. So the short answer is yes—while no loss is easy, there are more painful ways to lose someone we love. - Seth Gillihan, PhD

At The Dougy Center in Portland where we serve over 500 youth and 350 of their parents/adult caregivers each month, all of whom have had a family member die from accidents, disease, illnesses, suicide, or homicide, I will offer this: no death is better than or worse than another. Every person will experience the death of someone in their life in different ways, because the person was unique, we are unique, and our relationship with that person was unique. Every mode of death brings its own complications: seeing someone waste away from disease is not “better than” or “worse than” having someone die after falling off a roof. There are frequently additional complicating factors when someone is murdered or died of suicide, including that generally speaking, families often do not receive the same level of support because of stigma and other issues. - Donna Schuurman, Ed.D, F.T

It’s true that there is no death that is “better than” or “worse than,” just like there is no “right way” or “wrong way” to grieve. On the whole, it does appear that people who lose loved ones suddenly - or violently like through homicide or by suicide- may experience a different type of grief. Some people can develop more symptoms of PTSD as well. - Neha Pathak, MD

What can I do about anticipatory grief? I'm an adult with my own family and at an age where my parents are getting older. For some reason, I'm extremely emotional about what life will be like when my parents die. It's as if I get overwhelmed by how much I know I'll miss them.

One very positive thing to do is to have the conversations with them that you wouldn’t want to have missed, before they pass out of this life. Things like letting them know how much you love them, what you’re sorry for, what you’re grateful for. It can also be helpful to talk with a therapist about these issues, to better identify and understand the strong emotions you feel in anticipation—things like what it will mean to you to lose your parents. - Seth Gillihan, PhD

My son was ill from the moment he was born and I had this kind of feeling we might not have a full lifetime with him. So I get the anticipatory grief idea. I made sure to take video, take pictures, and write down the funny things he did and said, just because I didn’t want him to fade if he should pass. That is something I could also see doing with my parents as they age and we worry about losing them. Just like Seth is suggesting- maybe even record those conversations so you have their laugh, their voice, a little bit of them for always. - Patty Holliday

Other than people, what else do people grieve that is not widely known?

Change! Or expectations. When one of my children was diagnosed with something I didn’t expect, I needed (and still do on a daily basis, to be honest) to grieve over the challenge they now face -- that we didn’t expect or see coming. It’s a shift for what I saw as the future and I totally feel I’m grieving that knowledge and loss of what I expected. - Patty Holliday

Health and career are big ones I see, too, which follows what Patty shared about change and expectations. Loss is hard, and there’s an additional challenge when the cause of our grief isn’t seen by others, or isn’t recognized as grief by those who know about it. - Seth Gillihan, PhD

Big “ditto” to what Patty said! Once I started learning about grief and loss, I started recognizing that I had feelings of loss in areas that I had never thought to examine before (and unmet expectations is a big one for me - especially since I can be a perfectionist). For me, it’s become an important part of my ongoing emotional wellness to do a regular inventory for feelings of loss that I might be repressing -- even seemingly small things. - Kim Richardson

In the past few years, I've lost a very high amount of friends through both suicide and accidental overdoses. (7, by my counting.)

I'm fairly young, so to lose this many people is a little out of the ordinary. I've started to honestly become a little numb to it.

That being said, my question is:

What effect can sustained, regular grief have on a person? It's been non stop, every few months, someone dies.

It’s hard losing so many people you care about, isn’t it? I agree that it’s out of the ordinary. There can be many effects of repeated losses, and the one you mentioned is not surprising (feeling numb). A person might start to feel like they’re constantly waiting for the other shoe to drop, or could start to have a harder time getting close to people emotionally because of the fear of losing them. Those are just some examples—I always encourage a person to make room for their experience, whatever it is. Grief has some common themes, but it’s also such a personal response. Being aware of your own feelings and responses and taking care of your needs is so important. I’m wishing you well as you work through these losses. - Seth Gillihan, PhD

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I’ll certainly let Seth handle the false memories part of your question, but just wanted to chime in as someone who experienced childhood loss (my dad died suddenly when I was nine). I did not really experience the weight of my grief and loss until many years later (like, thirty years). When I was a child, I didn’t know how to feel those weighty feelings - they scared me too much (I think I feared I would I get stuck in them) and I didn’t want to feel them, I didn’t want them to even exist - I wanted to be normal, I wanted to be fine. So I went into survival mode and turned into a good little soldier and powered through and acted responsible and strong and fine. I did a good job being fine -- I made straight A’s, had lots of friends, went to a great college, etc. I did such a good job that I even fooled myself -- I truly thought that I was “over” my dad’s death (I could talk about it as easily and nonchalantly as if I were describing the ham sandwich I had for lunch). Inside, I was deeply unhappy and felt lost - but because I had convinced myself that I was “fine” about my dad, I didn’t even realize that my nagging, profound unhappiness was related to unresolved grief. All of that to say, yes, in my experience, it can take a really long time for pain from childhood trauma to surface and it may surface in ways that you wouldn’t expect. My heart goes out to you for the depth of the loss that you have experienced; I’m so glad that you came here and asked your question, that you are exploring these feelings. I’m hoping that you’ll continue digging (I found therapy very helpful) -- though the effort can be really hard, you are worth it. I am wishing you all the best. - Kim Richardson

This may have been asked, but I just lost my Grandma last week. We were close. I've been still going, but it's hard. I find myself trying to shut down my thoughts about her to make it through the day. If I think about her I non stop cry. Today is her funeral and I'm trying to make it through.

Also her death was a hard one. It came because of elder abuse/neglect in the care facility she was at. It's even harder to deal with because she was only 67. She went in for rehab and never came back out.

What would you suggest to healthily deal with her death?

Thank you for writing, and for sharing about your Grandma and how hard it is to cope with her death, made even more difficult by the tragic elder abuse/neglect she experienced. Please be gentle with yourself... you were close, it was only last week, today is her funeral: this is a lot! Right now you may be coping by shutting down thoughts about her to make it through the day...that’s okay...it may help you right now to make it through your day...to deal healthily with her death...you will find your path, to remembering and honoring her. Perhaps ~ and this is certainly not a requirement or even a directive, just something for you to possibly consider if and when the time is right ~ you may find a way to take action such that no other person suffers from elder abuse...you will know if that’s a path for you to follow, but for now: be kind to yourself and gentle, as kind and gentle as you would be to a friend. - Donna Schuurman, Ed.D, F.T.

If you were standing here in front of me, I would give you a hug and tell you that I hope that you’ll be gentle with yourself, that you’ll continue to be really honest with yourself about your feelings, that you’ll ask for support, and that you’ll resist any pressure you might feel to “be strong” or to “hurry up and get over it.” The elder abuse circumstance adds another painful layer to your feelings of loss, I’m no professional, but it seems like that could make grieving more complicated - I imagine that the guidance of a therapist could be really helpful. - Kim Richardson

If you are in a position to know that a loved one will pass in the near/coming future, are there any ways to cope with that knowledge and maybe prepare for it somehow, so that it might help ease the grieving process later on? How would you support someone in this position?

This has become a very real thought for me personally. I have parents that are both in their 80’s and my father was recently hospitalized after years “staying away from doctors,” as he puts it. I have young children and I have spent a lot of time thinking about whether or not they will remember my parents, which elevates the feelings of anticipatory grief.

My best ways of coping have been to spend as much time with my parents as I can. I also have my daughters spend time with them (without me) because it seems like they all prefer it that way on occasion. :) I think that this has helped me accept the idea that at some point there will be loss, and that I will grieve, but we are trying to be as mindful about spending time with each other as we can be. - Neha Pathak, MD

Thank you for your response, Neha. My mother is 91 (and a half, she tells me), and is declining with dementia as well as physical frailty, and I live on the west coast and she’s on the east coast. I call her and it’s lovely when we talk, though she doesn’t remember in a half hour that we have spoken. I have had to come to terms with that and recognize that the moments we do talk are special and joyful. I know her death is close, and I do wonder how I will feel when I get that news ~~ the before and after news ~~ and truthfully, even after being a “grief professional” for several decades, I can’t really predict how that finality will impact me. I can imagine, but I can’t fully know until it’s here. - Donna Shuurman, Ed.D, F.T.

Sometimes I think and get preemptively sad about how it’s going to feel when I lose the people I love. Normally I try to get my mind off it as fast as I can. Is this something that could help the grieving process when it actually happens? Should I be embracing it?

I think there’s a place for this kind of thinking, but it’s not someplace you want to “live” in for long. But I do think those feelings are coming to you for a reason or a purpose and might be worth exploring. If it’s overwhelming, then seeking a counselor (or even having discussions with a trusted friend) would be the next step to help discuss these feelings. - Patty Holliday

My partner lost his Brother last Year and he needs (by his own admission) grief counselling. Problem is, he got referred to a place where the woman handed him a bunch of crystals and told him 'the dead don't speak to me but they speak through my art' and now he feels dejected and gunshy because he can't get any normal one on one grief counselling.

What other options are there for someone who needs 1 on 1 counselling and No airy-fairy garbage?

This is so unfortunate, but the reality is that many people who call themselves healers or helpers or even “grief counselors” or “grief therapists” have no training. In fact, the majority of graduate level programs in the U.S. in counseling, psychology, and even psychiatry don’t even offer a single course in “grief and loss.” I would refer you to the Association for Death Education and Counseling (ADEC.org), a professional association which can help you locate a trained and competent grief counselor or therapist in your area. - Donna Schuurman, Ed.D, F.T.

Oh my. Keep looking! Keep looking! Keep looking! There’s not one way to seek counseling or one path during counseling. It can take different forms. But it’s also a beat down on top of the beating you feel when grieving to try to find the right fit. I just encourage you to stay on that journey because the right counselor or therapy will make a world of difference for you. And there is no single path that might work. Where crystals might be good for your neighbor, that was rubbish for your partner. But I hope he is encouraged to keep trying to find the right help for him. - Patty Holliday

My mother’s father passed away in October and my fathers father pasted away in February. I lost both of my grandfathers in under 6 months. There are times when my grief just comes out of no where and I get very upset for the day. Is this normal?

Yes, that is definitely normal. That is a lot of loss. It can raise feelings not only of sadness but of anxiety, as we realize that those we love will pass on. There’s no right or wrong way to grieve, and feeling those losses, acutely at times, is very understandable. - Seth Gillihan, PHD

Have you ever collected data on disease following a period of grief? I’m thinking autoimmune diseases.

Researchers have definitely looked at the question of diseases (and chronic diseases) after a period of grief. Grieving can affect your sleep, increase the amount of cortisol in your body, increase inflammation, and decrease your immune system’s ability to fight infection. I don’t have the evidence around autoimmune diseases, but a lot of the physical changes that can happen with grief can play a role in chronic diseases like high blood pressure and heart disease. - Neha Pathak, MD

What's the best way to help someone cope with the loss of their father? She skipped the first three steps and went straight to depression. No amount of support on my side seems to work, and the only solution I can offer is time. (Only reason I say time, is because she ignores nearly every sense of conversation or fun activity that could help her get this situation off her mind)

I've lost my father a few months ago, and just coped 100% differently: Thinking that time will keep moving and just keep moving forward. No grief or sense of sadness. She's going through the exact opposite and I feel there's no right answer in this situation. :(

It’s hard when you can’t make the person feel better. That might be exactly the case—that there’s no right answer that will make your friend move through her grief more quickly. It sounds like you and your friend have very different ways of grieving. It’s good that you’re there for your friend, as your presence is the most important thing (more than words or fun activities). Unfortunately our efforts to move someone along through the stages of grief often have the opposite effect of what we intend. I encourage people as much as possible simply to be present for those who are grieving, making space for the other person’s grief, however it is and however long it takes. Also, trust the wisdom of your friend’s heart and mind to grieve in a way that is right for her. - Seth Gillihan, PhD

I have a family member that is grieving. She has been diagnosed with PTSD from the experience. It's been 3 years, just to add some context, not that there are rules for grieving. Every conversation with her leads to the experience, the loss and trauma. Every song, tv show, situation, etc. brings up memories for her. 'm struggling to maintain distance for my own emotional health while still supporting her. In fact I'm trying hard to keep my focus on the empathy I have for her suffering vs. the resentment I feel about the grief being forced on me every time we are together. It's really exhausting. I don't know how to, or if I even should, set boundaries for myself. She's trying to share her pain, and my pain caused by her constant reminders is just a tiny fraction of what she is going through. Does this situation come up in your experiences helping people with grief?

What you’re describing is difficult for sure ~ trying to find that balance of empathy and caring, while still being able to find and experience joy. And yes, you should set boundaries for yourself... there’s a reason we’re instructed by flight attendants to put on our own oxygen masks first: if we don’t take care of ourselves, we can’t be available to others. Also, no one person, no matter how close they are to us, can fully meet the needs of another. My suggestion is that you find a good therapist for her who is skilled in working with people experiencing trauma, loss, grief, PTSD, and that you also specifically attend to the needs you have to be healthy and vibrant. Trauma and PTSD reside in, and sometimes “take over” our bodies, and there are skilled clinicians out there who can help. - Donna Schuurman, Ed.D, F.T.

My parent got divorced when I was toddler and thus growing up I never grieved him leaving the house because my normal was me and my mom only. He kept in contact throught my entire childhood and adolescence and he's still a part of my life but I wouldn't say we are father-daughter close. While growing up he was never really there (only child support and mandatory visits). I guess my questions are: How do you deal with the grief of the absence of someone who is still somehow part of your life (If that can be considered a grieving process)? Are there any effects of this process in the long run?

And also, related: are there any effects of this situation in the long run for children whose parents got divorced when they were older (so they remember the process)? And what about children's whose parents split up but then get back together?

That ended up being longer that I expected. I apologise.

Those are great questions, and it is certainly a form of grief when a parent or other caregiver was absent. Not having that relationship is a real loss, even though the person was still alive. The effects will vary from person to person, naturally, and as you suggested, might be different depending on how old the kids were when the parents split up and whether the parents get back together. In terms of dealing with the grief, it would seem to be similar to other forms of grief. As we acknowledge our thoughts and feelings and let ourselves feel what we feel, we can trust our inherent wisdom to grieve. It’s a built-in healing process, like our physical healing. And like physical healing, it can be necessary sometimes to get additional help to support ourselves and our process. - Seth Gillihan, PhD

My aunt is fighting a really awful form of cancer right now. I can’t help but feel like I’m already grieving her and she’s still alive and fighting. Is there any explanation or potential solution for this?

There’s for sure an explanation for you “already grieving her” because...you are watching her fight a really awful form of cancer right now, and she’s alive and fighting, and...you are grieving that someone you care about is having to cope with all of this. As for a potential solution...keep caring...and find ways to also keep yourself healthy, whatever those are: being in nature, writing, listening to music, massage, whatever feeds your soul. Grieving the real-time hard stuff is taxing, and it’s the price we pay for love. - Donna Schuurman, Ed.D, F.T.

I have lost almost every close family member (mom, dad, brother, favorite aunt and uncle, and now my only remaining uncle has cancer). I started losing them at 16 and I’m 31 now. I lead a mostly happy life, but I know I have serious issues with letting people in emotionally.

Sometimes during holidays or anniversaries of their deaths I break down and weep uncontrollably. But then I suddenly stop after only a minute or two of crying. I don’t have control over my grief. Is there a way for me to process it and “get it out”? It seems like most days I can’t really process it, but I know it’s there.

I’m sorry to hear about your many losses, and starting relatively early in your life. I wouldn’t necessarily expect occasional bouts of sadness and crying to disappear even after a person has worked through the most intense parts of the grief, but when a person describes having a hard time processing and connecting with grief, then talking it through with someone might be really useful. It sounds like it could be valuable to talk with a therapist who specializes in the grieving process. Addressing bound-up emotions and the trauma of multiple losses can also be helpful in other relationships, and allowing oneself to open up to others. - Seth Gillihan, PhD

I’m not entirely sure if answering personal questions was the intended outcome of this AMA, but here it goes.

My dad died last year (senior year of HS) after battling cancer and heart issues for most of my life. Other than his physical health, he had some pretty serious mental health issues as well as drug addiction problems. Consequently, I lost out on a lot of your average “father son” moments and the things he could have taught me. I am often slammed by these thoughts, realizing how much I have missed and how I so desperately wish he could have been healthy in order to be like all the dads of my friends. I try not to dwell in these thoughts and think to myself, “well shit, this really sucks but there’s nothing anyone will ever be able to do to change this, and no matter how much I think about it, it will never feel better”, so I lock that up until something triggers more of those feelings. I often feel that I would be in a much better place, both mentally and just generally in life if I had a healthy father for at least some memorable part of my childhood.

I understand that this is not a substitute for counseling and I still see a therapist, but I tend to focus on different issues because once again, what’s the point in dwelling on these things if nothing will ever be able to change the past? My question to you, is this a healthy way of dealing with loss? Is it progressive in any manor, or am I just complicating the process by trying to ignore these thoughts?

Thank you for all that you do!

Thank you for sharing your personal experience. Those are great questions. People often ask me that in my work as a therapist—What’s the point in talking about things I can’t change? While we can’t change the facts about what happened, we can change what they mean to us, and create a new storyline about them. This is often called writing a new narrative of your life, or how you explain the things you’ve gone through. And as Donna said, ignoring the thoughts and trying to avoid the feelings generally isn’t a helpful way to go in the long run, as understandable as it is. As we let ourselves feel what we feel and don’t try to push away our experiences, we give our minds and hearts the opportunity to process our grief. - Seth Gillihan, PhD

I’m of the opinion that ignoring thoughts is generally not a helpful way of coping, because those thoughts don’t just go away, they tend to do tricky things like fester and haunt us...your experience with your father, the father who could not meet your needs as his son because of struggles with substances and all his issues, is shaping you, like all of our life experiences shape us. It is not just okay, but helpful, I believe, to recognize that your longing for that father who nurtured you and with whom you could share a father/son bond is part of making you who you are. The fact that you are just a year out of high school and addressing this is amazing to me, and hopeful...and that you’re getting help, well...many people don’t realize how much they’re ignoring or fighting or coping with until they’ve strewn a path of experiences they regret. I don’t know, I just sense, young man...that you are going to ultimately transform your pain into something very good for this world. - Donna Schuurman, Ed.D, F.T.

I’m so sorry for your loss - my heart goes out to you. Please resist the urge to minimize your pain or to reason it away. You’ve suffered a significant loss - not just your dad’s death but the relationship with him when he was alive. My dad died when I was nine and I minimized my grief for 30 years before I fully acknowledged the very deep and profound ways that his loss impacted me (the feeling of being different, the fact that the other kids had their dad, the feeling of being “the girl who lost her father” - all shaped how I saw myself). I reasoned it and rationalized the pain away, and frankly, the pain was a freakin bummer. I wanted, more than anything, to be NORMAL, so I tried to rationalize my grief down into a small box that would make that possible. I’m no therapist, but having lived through repressed grief, I would urge you to own the depth of this loss -- the loss is significant, and YOU are significant. YOU are worth the pain and difficulty of really facing this. I would urge you to let yourself fall apart - don’t try to keep pace with your peers, don’t compare yourself with them - your path is and will be different than theirs. With the help of your therapist, lean into the pain - not away from it - so that you can find healing and find freedom from the pain - that, I believe, is how you will truly find yourself. Just the fact that you are here asking questions signals that you are brave and self-aware -- you’ve got this. Keep going. I’m wishing you all of the best - Kim Richardson

What is a normal grief period and process for when an adult's/child's pet dies?

I am not an advocate of putting timelines on grief after any loss, and I believe our mainstream society is way off-base in what is considered “normal” when a person or a pet dies. I had a hair stylist I saw for years who knew I was a “grief professional” and one day she asked if she could share something with me that she didn’t feel she could share with anyone else. It was that her cat died recently that she’d adopted at birth and lived with for 19 years...and she felt more pain about her cat’s death than she did when her mother, with whom she’d had a troubled relationship, died. I would never compare deaths of any kind, and I don’t mean to suggest that a pet’s death is more painful than a person’s, but my point is: every death is individually experienced, whether a beloved pet’s or a relative’s, and I don’t believe we are helped by placing “normal” or set periods for how we should or shouldn’t grieve. - Donna Schuurman, Ed.D, F.T.

My late mother-in-law died 30 years ago. She died as a result of injuries sustained in an auto accident. The suddenness and the fact that she was a vibrant, heathy, lovely being destroyed any remaining faith we had. My ex and I had young children at the time so we focused on them during the chaos that followed. There were tears, but restained. To this day, when I think of her, I break down. I can still see her, hear her and even remember her scent. Really? My children are adults and my ex left the marriages 19 years ago. So why is she so real to me? I don't feel this way about my late parents. They died old and sick. This can't be good. Yet, if I think of her or someone mentions her, I can't stop crying.

What you’re describing sounds like the symptoms of unresolved grief, likely related to the factors you described (like the suddenness and shock of it). It’s not at all uncommon for traumatic losses like yours to sit “unprocessed,” just like a soldier might have combat memories from, say, Vietnam that still feel fresh today. It might be really helpful to talk with a grief specialist. - Seth Gillihan, PhD

How can I become involved? I'm an RN. I understand grief in ways I wish I didn't. I lost both my husband to suicide and father to cancer 6 months apart.

I am not sure what you mean by “how can I become involved?” so forgive me if I am not answering what you’re asking...because you share that you’re an RN, and that you understand grief in ways you wish you didn’t after the death of your husband to suicide and your father to cancer just 6 months apart, it may be that you are asking how you might be able to be involved in helping others. As an RN you are interacting with people who are grieving their own illnesses and other losses, and when medical professionals truly see their patients as people with hurts and fears and pain they can make a tremendous difference in just being...present. A friend of mine who is an oncologist told me of the first child’s death he experienced as his patient. He was in the room with her and her mother when the child died, and he said he was wracking his brain trying to think of the “right” thing to say. He couldn’t think of anything, so he just sat there with her in silence, gently holding her hand. When he left the room he felt like a failure. A few years later he ran into the mother in a grocery store, and she asked him if he remembered her...he was afraid to hear what she had to say, but it was this: “You sitting with me in silence after my daughter’s death was one of the kindest and most helpful things anyone did at that time. I can’t thank you enough.” So...as an RN, you too can be that loving presence… - Donna Schuurman, Ed.D, F.T.

We lost my grandfather about 6 years ago and it was very hard on my family. While most of us have been able to pull ourselves together and come to terms with the situation, my mother has not. She is still very much in pain from losing him. Is there something that can be done to help her? I don’t want her to have to carry this sadness forever..

It’s not easy seeing a family member continue to suffer through grief. There are definitely things that can be done to help your mother, but helping her might not mean making the sadness go away. We can offer our loving presence and support, and a listening ear, and room for all of the person’s experience (even if it’s different from everyone else’s). Even validating the person’s ongoing pain can be really helpful, so they don’t feel like their grief is a problem for others. I’m sending you and your family my best. - Seth Gillihan, PhD

I lost someone really close last year, she had cancer for 14 years with ups and downs. The whole process of dying was a very long and scary time. Sometimes I really want to tell someone every cruel detail because I have regularly flashbacks. But I don't want to burden people with this story. Will it stop over the coming time? Would it stop quicker when I tell someone? Or would it just bring back even more memories of those last months?

I believe it is important and helpful to share our experience with at least one caring “other,” whether that is a beloved friend or a competent counselor. As far as telling “someone every cruel detail,” not everyone is able to hold the pain of another in a caring response, so you are wise to be discerning about whom you confide in. But confide you must, or it will (I believe, strongly) continue to rattle around inside you with...I can’t say if your story and the flashbacks will stop over time, or stop “quicker” but I believe sharing it with someone you trust will be a step in the right direction... Donna Schuurman, Ed.D, F.T

Hello. How feasible it is for us to really prepare ourselves, mentally or emotionally, to any drastic events that may afflict us during our lives? More specifically, do you think that changing the conceptions that we have regarding all the different aspects of our lives may be effective to minimize or even neutralize the outcomes of those events?

The following excerpt from Montaigne's book (The Essays) is something that comes to my mind when discussing about this issue:

"Neither do the Stoics pretend that the soul of their philosopher need be proof against the first visions and fantasies that surprise him; but, as to a natural subjection, consent that he should tremble at the terrible noise of thunder, or the sudden clatter of some falling ruin, and be affrighted even to paleness and convulsion; and so in other passions, provided his judgment remain sound and entire, and that the seat of his reason suffer no concussion nor alteration, and that he yield no consent to his fright and discomposure. To him who is not a philosopher, a fright is the same thing in the first part of it, but quite another thing in the second; for the impression of passions does not remain superficially in him, but penetrates farther, even to the very seat of reason, infecting and corrupting it, so that he judges according to his fear, and conforms his behaviour to it. In this verse you may see the true state of the wise Stoic learnedly and plainly expressed:—

“Though tears flow, the mind remains unmoved.” — Virgil,

The Peripatetic sage does not exempt himself totally from perturbations of mind, but he moderates them."

​

Thanks a lot in advance!

I am reminded of something a bereaved mother told me years ago: “Most of the things I have worried about never happened. And what did happen, the death of my daughter, is something I could not have imagined in my wildest dreams. So…(as the saying goes) worrying robs us of today, of now.” That stuck with me. I don’t know that we can truly prepare for how we’ll feel prior to events we know will happen, but we certainly can engage in practices that help us stay healthy through inevitable change and loss: meditation, intentional love, choosing to do things with people who bring us joy, for example. Sixteen years ago I was diagnosed with Stage 3 cancer, and went through grueling surgeries and chemotherapy. As strange as it might sound, I was at that time, and ever since, grateful to have been shaken in such a way that I am acutely aware of the fragility of life, and of the brevity of mine in particular, and that intense knowledge informs my life and path in positive ways. - Donna Schuurman, Ed.D, F.T.

I can’t speak to whether there’s any way to prepare for bad events, but as someone who spent most of her life trying to do just that, I’d say please don’t try - it’s been so life-robbing for me. I watched my dad have a heart attack when I was nine -- watched him gasping for breath, panic on his face; watched my mom frantically try to stop the disaster that was unfolding in front of her. But the disaster came. And it was horrible - yet it was. But you know what, before that night I was so freaking happy and free and alive - the world was such a carefree place - and in the almost 40 years since that night, my mind often goes back to that pre-disaster world and I linger there and just freaking enjoy it. Thank goodness I have those wonderful memories, free from anticipation of what was to come. And, opposite to that experience, after the death of my dad, after having experienced what it feels like when life pulls the rug out from under you, I subconsciously resolved that I would never let that happen again. The world that had once been carefree and beautiful now looked to me like the French battlefields in “Saving Private Ryan” -- that’s the image I had in my head -- like I was walking out into a deceptively beautiful field where hidden snipers might blow my guts out. So I became very very careful, always looking ahead and assessing risk, always avoiding danger -- the world becomes very small when you do that. And all of that risk avoidance means that, yes, you are keeping yourself safe but you are also keeping yourself from experiencing great joy and love and greatness. Life is full of risk -- the good and the bad all have risk. Do not miss life because you are scared of risk -- please - it’s just too beautiful to miss. And one bonus that happened when I decided to try to stop seeing life as a battlefield -- I started realizing that when painful things do happen to me, I have people in my life who can and will help me put my guts back in, help me get patched up and help me find the strength and the hope to keep exploring that beautiful field with curiosity instead of fear. I know that none of this is easy (and I’m always a fan of reaching out for support from a therapist) - my sincere best wishes go with you. - Kim Richardson

Is there anything I can do to move past the pain I have due to not beeing able to spend more time with my grandparents even tho I was like 7 years old when they died?

I don't really know why it hurts so much but I guess it's my mother's "fault" since she's still suffering from it after 11 years.

Don't understand. I mean, I didn't know them very well but I guess I just remember them through my mom's eyes.

Now I fear that I would loose everyone and that I'll regret not spending time with them, resulting in me crying if I don't see my family in a month and being afraid they'll die in that moment

From what you described, it sounds like it could be really valuable to talk with a grief counselor about these things. I hear a lot of confusion and uncertainty in your words, as you said you don’t understand and don’t really know why it hurts so much. It’s not surprising that you would feel that pain, and you seem to really want to understand what it’s about. Wishing you well as you discover more about yourself and this process you’re experiencing. - Seth Gillihan, PhD