Understanding Grief and Loss
When a person loses someone close to them, it is natural to grieve. This process takes time and involves many different emotions and behaviors. People with cancer and their families may also grieve other cancer-related losses. These may include the loss of a breast, the loss of fertility, or the loss of independence.
The terms “grief,” “mourning,” and “bereavement” have slightly different meanings:
- Grief is a person’s emotional response to the experience of loss.
- Mourning is the process of adapting to life after a loss. It is influenced by each person’s society, culture, and religion.
- Bereavement is the state of having experienced a loss.
Common grief reactions
Reactions to loss are called grief reactions. They vary widely from person to person and within the same person over time. Common grief reactions include difficult feelings, thoughts, physical sensations, and behaviors.
- Feelings. People who have experienced loss may have a range of feelings. This could include shock, numbness, sadness, denial, despair, anxiety, anger, guilt, loneliness, depression, helplessness, relief, and yearning. A grieving person may start crying after hearing a song or comment that makes them think of the person who died. Or that person may not know what triggered his or her crying.
- Thoughts. Common thought patterns include disbelief, confusion, difficulty concentrating, preoccupation, and hallucinations.
- Physical sensations. Grief can cause physical sensations. These include tightness or heaviness in the chest or throat, nausea or an upset stomach, dizziness, headaches, physical numbness, muscle weakness or tension, and fatigue. It may also make you vulnerable to illness.
- Behaviors. A person who is grieving may struggle to fall asleep or stay asleep. He or she may also lose energy for enjoyable activities. The person may lose interest in eating or being social. A grieving person may also become more irritable or aggressive. Other common behaviors include restlessness and excessive activity.
Religion and spirituality
Grief and loss may also cause a person to question his or her faith or view of the world. Or it may strengthen the person’s faith by providing a new understanding of the meaning of life.
Each person experiences grief in a different way. Often, a person feels grief in waves or cycles. This means there are periods of intense and painful feelings that come and go. People may feel they are making progress with their grief when they are temporarily feeling less grief. But then, after some time, they may face the grief again. Such changes in grief may occur around significant dates, such as holidays or birthdays. Over time, some people experience these grief cycles less frequently as they adjust to their loss.
Tasks of mourning
There are different theories about how a person adjusts to loss. One widely accepted model describes 4 tasks of mourning:
- Accept the reality of the loss.
- Experience the pain of grief.
- Adjust to life without the person being physically present.
- Find new ways to remain connected to the person who has died.
Factors affecting grief
The following factors may affect the nature, intensity, and duration of grief:
- The relationship a grieving person had with the person who died.
- The cause of death. For example, the grieving process may differ depending on whether the person died suddenly or was ill for a long time.
- The grieving person’s age and gender.
- The life history of the person who is grieving, including past experiences with loss.
- The grieving person’s personality and coping style.
- The support available from friends and family.
- The grieving person’s customs and religious or spiritual beliefs.
The grieving process is often harder when the person has unresolved feelings towards or conflicts with the person who has died. People who are struggling with complicated grief may find it helpful to talk with a counselor. This may include a clinical social worker, psychologist, or spiritual counselor.
Grief in different cultures
Although each person’s grief is unique, the experience is shaped by his or her society and culture. Each culture has its own set of beliefs and rituals for death and bereavement. This affects how people experience and express grief.
The way a person experiences and expresses grief may be at odds with his or her own culture. For example, someone who feels numbness or disbelief may not cry as he or she might be expected to at a funeral. Another person may experience a level of despair that challenges his or her cultural values or beliefs. It is important for each person to grieve in ways that feel right to them. It is also important to consider how someone’s culture may be affecting their grief. Learn more about grief within a cultural context.
Grieving the Loss of a Sibling
Grief is a normal response to the loss of a brother or sister. But adult siblings are sometimes called “forgotten mourners” because their grief is often overshadowed by the grief of other family members, such as the person’s parents, spouse, or children.
Regardless of the type of relationship you had with your sibling, you have the right to grieve. Family members and friends may not understand the role your sibling played in your life. So it is important to communicate to them that you need their support.
A sibling’s death can have many effects on a person, such as:
- The loss of a long-term relationship. Siblings are often deeply connected with each other. They have been present in each other’s lives through all of their ups and downs. So their death may represent the loss of a friend, protector, and confidant with whom you share many memories. You may grieve the loss of your past relationship and the role you pictured your brother or sister playing in your future.
- Guilt. Sibling relationships can be complicated. They may involve love and affection as well as rivalry, jealousy, and arguments. You may feel guilty about things you once said or did. Or you may regret that you did not maintain a closer relationship. You may also replay “what if” and “if only” scenarios in your mind. Or you may experience “survivor guilt,” questioning why you were not the one who died. Learn more about coping with guilt.
- The redefinition of your role in the family. Family members have different, sometimes unspoken, roles and responsibilities that may change when a sibling dies. You may take on new responsibilities, such as becoming the oldest child or an only child to whom family members look for leadership. This change can cause you to feel more stress or resentment during the grieving process.
- A fear of developing cancer. Because you and your siblings share many of the same genes, it is normal to worry that you could develop cancer as well. You may also be concerned that other family members will be diagnosed with the disease. Although cancer can run in families, most cancers are sporadic, meaning they occur by chance. Learn more about collecting and sharing your family cancer history.
Tips for coping with the loss of a sibling
Everyone copes differently with the loss of a sibling. There is no right way to work through your feelings of grief. And there is no specific amount of time that it takes to recover from those feelings. The following tips may help you throughout the grieving process:
- Share your grief with other family members. Your entire family is grieving the loss of your brother or sister. But each person grieves in his or her own way. Talking about your shared grief can help you work through your pain and sadness together.
- Find support outside your family. It can be helpful to seek support from your family. But it can also be hard for some family members to provide consolation while coping with their own grief. Consider talking about your loss with people outside your family, such as a close friend, a clergy member, or a grief counselor. Support groups can also provide a setting to talk with others who share and understand your experiences and feelings.
- Forgive yourself. Siblings compete, argue, and challenge each other. Forgive yourself for any unkind things you did or said or for things you wish you had done or said but did not. Forgive yourself for not maintaining a close enough relationship with your sibling. It does not mean you did not love him or her.
- Take care of your physical health. Help ease some of your fear about your personal cancer risk by focusing on developing and maintaining a healthy lifestyle. Have regular checkups and get medical tests as recommended by your doctor. Compile your family’s cancer history and share it with your doctor and other family members.
- Take care of your mental health. Feeling extremely sad or numb are normal reactions to the loss of a sibling. But sometimes these and other symptoms of depression do not lessen over time, and feelings of hopelessness, anxiety, or anger can begin to affect your daily life. If you feel this way about your grief, ask your doctor about grief therapy. Medication may also help manage depression related to grief.
- Find ways to remember your sibling. As the pain of grief begins to ease, it may feel like you are beginning to forget your sibling. Finding ways to memorialize your brother or sister can help keep his or her memory alive and maintain a feeling of connection. You may decide to make a family memory book with pictures, stories, or other mementoes contributed by different family members. Or consider volunteering with a cancer-related charity or one that was important to your sibling. Read more about ways to cope with grief.
Parenting a child who has lost a sibling
The death of a sibling is a tremendous loss for a child. But parents are often overwhelmed with their own grief and may need help addressing the needs of grieving siblings. A surviving child may feel the need to “fill in” for the deceased child or may worry that the parents would have preferred if he or she had died rather than the sibling. It is important for parents to recognize the grief of surviving siblings and to support them.