How Do You Mend A Broken Heart?
Tools For The Grieving Process

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

Sheri’s husband of eighteen years passed away unexpectedly four years ago. During a presentation, he gestured towards the screen and dropped to the ground. Coworkers who attended the services were visibly shaken. “He just reached up and fell over,” said one fellow.

Sheri was devastated. “There was so much we were going to do,” she cried. “We were going to take dancing lessons.” The pain in her voice was tangible. Her tears became your tears as you listened to her speak.

I saw Sheri last summer. Her demeanor was cheerful and her smile genuine. She embraced me warmly, but when we pulled apart, I noted an inconsistency across her face. Her mouth and cheeks were turned up into a cheerful smile, but her eyes were dark and vacant. The visible sadness took me aback. The vacancy in Sheri’s eyes illuminated the vacancy present in Sheri’s heart. I had believed Sheri was doing well, and had moved forward providing a stable life for herself and her children. But this disharmony between her features made me wonder if she needed additional help.

When someone suffers a devastating loss, it can take years to recover. “The standard grieving period is one to three years in an uncomplicated event such as a death or divorce,” says Susanne Slay-Westbrook, licensed professional counselor and marriage and family therapist. “However, if there were extenuating circumstances such as a violent murder, suicide, or other trauma, the grieving period can last much longer.”

“Should I suggest that she see a counselor? Should she consider anti-depressants?” I asked.

“Grieving is a natural process and there are specific stages through which every grieving person must go,” Slay-Westbrook explained. “Sedatives or anti-depressants are not usually indicated because the emotions the person is displaying are normal. They’ve experienced a loss. Drugs, prescription or illegal, and alcohol block the progression through the grief stages, delaying healing. Individuals should be sad and cry and perhaps not want to eat. But if these symptoms become dangerous to the person’s health or if the individual becomes suicidal, then intervention may be necessary.”

Elisabeth Kübler Ross, MD, first defined the five stages of grief in her book, On Death and Dying, as follows:

Denial: Inability to accept that illness, loss or death has occurred. This is a normal reaction, a defense mechanism to buffer against the shock.
Anger: Denial gives way to anger. The person begins to face the reality of the loss (or impending loss) and may direct anger at doctors, other family members, God, circumstances or the ill or deceased individual.
Bargaining: Once the loss becomes real, the person may try to bargain with God for more time or a different outcome.
Depression: The loss is acknowledged. Many people withdraw, feeling helpless and hopeless. This depression is normal and usually short term.
Acceptance: The reality has set in and the grieving person is ready to begin looking forward. They begin to evaluate how they will continue, what changes need to be made, and take steps to move on with life.

A sudden loss takes longer to grieve as people cope not only with the loss but also with the circumstances surrounding the loss. They may feel guilty, especially if there were unresolved conflicts, and frustration because there was no formal good-bye. However, if loss follows a period of illness, the grieving period may be shortened because loved ones had time to grieve during the illness, to give love and affection during the caregiving, to resolve old issues and to say good-bye.

Grief is not an easy or an organized process. People may go through any of the stages at any time during the grieving process. They may repeat stages or stay in a stage for a prolonged time. The only sure thing about grief is that people will go through all of the stages before moving forward with their lives.

“How can I help someone through the grieving process?” I asked.

Slay-Westbrook replied, “Be present when they need you, absent when they don’t, and listen. Everyone rallies around the grieving person immediately following the diagnosis of an illness or right when the loss occurs. A month later, much of the initial support is gone. People go back to their lives and assume the grieving individual is “getting on with life”. But grief lasts much longer. Grieving people need to talk and sort out their feelings. Counseling and support groups are invaluable during this time.”

Counselors are impartial sounding boards upon which the grieving person can unload without feeling burdensome. They help people sort out their feelings and decide what they need to do to move forward. Support groups are also excellent resources for the grieving person. In groups they can share their feelings and frustrations with others who have experienced similar events and can offer feedback, support and resources.

We’ll all experience grief. Supportive loved ones and our own resiliency may not be enough to get us through the grieving process. Most insurance policies include counseling. Many hospitals, funeral homes, churches and hospices offer free support groups.

Grieving may endure for a time, but joy will come again.