Loss and Grieving

Question: I find that I often am sad, lonely, or angry, for a bunch of things that happened in my life. I do not know how to deal with my feelings other than to use drugs. Can you help?

Answer: Unresolved grief is a very common problem many addicts and their families need to work through. We all suffer little loses all of the time, and most of the time we can cope; but what happens when we lose people or things that are important to us? We generally have a harder time coping when loss happens suddenly or unexpectedly?

Big loses can be losing friends, boyfriend / girlfriend, husband / wife, possessions, money, home, apartment, place to stay, sense of security, or even the feeling of constantly failing at something - like trying to stay clean.

My own stats show that about 80% of the substance users that I work with are suffering deeply from loss and grieving issues. If you throw in trust issues caused by past abuse (mental, physical, emotional, and sexual) you have the other twenty percent easily. So how do we work through loss and grief issues?

I will try to explain the Stages of loss and grieving here briefly.

1. SHOCK: The person is mentally, emotionally and physically stunned. This is most common with sudden death or sudden tragedy.

2. PANIC: The person is unable to think clearly, they cannot make decisions on their own, and have difficulty organizing their thoughts or choosing a course of action. Some people may need to be guided through this phase.

3. DENIAL: This is a natural response and a form of self-protection to give the person time to absorb the facts of the tragedy. "No, it can't be!"

4. NUMBNESS: The person's ability to respond emotionally is overloaded. They are dazed and just barely able to focus on doing what needs to be done. People may even feel numb physically, arms, legs, hands, feet. Their ability to show a normal range of emotions shrinks down to the most primitive. Generally extreme mood swings, that may be attributed to other disorders when really it is unfinished grieving.

5. RAGE: When a person becomes so angry about the incident and just keeps on getting angrier, because they do not know how to deal with the situation or how to direct their feelings.

6. ANGUISH / DESPAIR: At this stage the person feels the full force of their pain and sense of loss. Sometimes this can be "too much to bear" and they need to seek medical or psychiatric / psychological help.

7. BARGAINING: The person is wrestling internally with accepting the loss. "I could accept losing him, if I only really knew how he died, or I knew that the people responsible were going to go to jail." or "I could accept my divorce if only I knew why my wife really left." Generally, people who get stuck at this stage do so because they are missing information that might help then put the issue to rest. "Have I done all that I can?" The Serenity prayer can be very helpful at this stage (see below).

8. FORGIVENESS: The person learns or chooses to forgive the person(s) they have been blaming for the tragedy, including themselves. Refusing to forgive and hanging onto resentments, bitterness, anger and rage, can be very damaging and destructive to the person, and can lead to even more mental health concerns.

9. ACCEPTANCE: This will follow naturally from forgiveness, and the realization that no amount of grieving will bring back the deceased, or restore the loss. Life begins to return to normal. Many cultures have an established period of time for grieving - this is in part to show proper respect for the loss suffered, but to also give mourners "social permission" to carry on. Sometimes the person needs to give them self permission to "get better." Not to forget - just to slowly let go of the pain and sorrow.

10. GROWTH & MATURATION: Once grieving starts personal growth and development stops, and it stays that way until the grieving process is completed. The final stages of grieving are generally marked by the person getting to a point where they can talk about their loss (with out it hurting too much), and they can reach out to and support others who are going through a similar process. Lastly, they are once again able to re-establish or put energy into strengthening meaningful relationships.

Not all people go through these stages in the exact order, and we can all bounce back and forth, and get stuck at different stages. However, this is the generally understood process of grief and healing. It is all a part of being human, the good and the bad.

The Serenity Prayer

God grant me the serenity
to accept the things I cannot change
courage to change the things I can
and wisdom to know the difference.