The Mindfulness Response: Grief and Loss

Kubler-Ross and the Five Stages of Grief and Loss

            Grief and loss have stages associated with them. Kubler-Ross (1969) identifies five stages. People can go back and forth among them over time. As you talk about the issue, the intensity decreases.

Denial: It is a shock to realize that someone died, or the loss occurred.

Anger: It is upsetting to accept the loss, creating anger.

Bargaining:  People might ask why a person died or did not die. People may hope the loss occurred to someone else or they believe “if I had only done… or said, “

Depression:  This is felt in the physical body with fatigue, low energy, and low motivation.

Acceptance:  Take time to realize that someone is gone from your life. The loss created a change, and it affected daily routines.

Questions that are common in group therapy:

Why am I here and my loved one is gone or dead?

Why do I have this illness?

Where is God? God has abandoned me.

            The grief and loss issues will stay with you for your lifetime. You learn to work with it differently over time and resolve the grief gradually. To transform grief and loss, try volunteering or helping others who have similar issues, saying prayers, having a church, synagogue, mosque, or temple service or ceremony said for the loved one, join a grief and loss support group, be open to listening to others and helping them through the process of grief and loss, and allow yourself to cry.

            Do not use alcohol as a coping mechanism street drugs, or gummy marijuana. These are other substances or medications that will affect your body. Alcohol is a depressant and will make you more depressed. Use of THC or marijuana over longer periods can interfere with concentration and create more depression, as observed in outpatient mental health (Lund, 2021).

Hopelessness

            Hopelessness is associated with depression and recurring mental illness. Sometimes, it feels easier to give up, than to proceed with a difficult situation. Discouragement, desperation, gloom, misery, and sorrow are other words to describe hopelessness. Seligman (1967) wrote of “learned helplessness, “a state where people or animals gave up, due to uncertain situations. They believe that they have no control over what happens to them.” They begin to think, feel, and act as if they are helpless.

            When faced with ambiguous situations, hope and courage are beneficial. Ambiguous loss is a grief and loss situation that keeps a person wondering where the missing person is. It keeps the person alive in their mind and their heart. People may not accept that the person died and may not return (Boss 1999).

            Recurring symptoms of serious mental illness is a grief and loss issue. The group therapy members talk about losing their independence and their functioning. They feel helpless and are reminded that it is a disease, just as cancer or multiple sclerosis are diseases and can return. This discussion helped them understand the situation differently. They lost hope for the future. The recurrent mental health symptoms caused so much distress and depression that they felt stuck or that they were in a deep hole.

            When a person experiences mental illness, values are questioned. These types of questions affect spirituality, purpose, and our communities. What is their worth in a capitalistic society if they are not working? Muller (1999) wrote about national well-being and how it needs to consider those who care for others, those who volunteer to instruct children who cannot read, and care for those who are disabled. “What society needs is a broad, comprehensive indicator, a Common Wealth Index.” The figure would somehow manage to calculate the true value of common work. This would measure more thoroughly the depth and breadth of our national well-being.

            When a person with mental illness is faced with stigma and shame, it affects their sense of belonging in a community and creates depression. People express that they feel alienated from others. They do not feel a connection to the community, to religion, faith, or spirituality.

I was told that God was punishing me.

My family does not believe that mental illness is real.

_____________________________________________________________________

            People who return to the program more than once are familiar with anhedonia. It is a term that describes the loss of pleasure. They are so upset and frustrated with returning to the program that they turn on themselves. Talking openly in the group was helpful for others to understand and develop self-kindness or develop self-kindness by being non-judgmental with themselves.

            I expected the anhedonia to be there for those who returned to the program. When it was discussed, they acknowledged the issue with a heavy sigh. It is not easy to confront this symptom when it is present. It takes endless amounts of different skills combined to manage the anhedonia.

            Some group members knew the skills and had practiced them over the years.  The return of mental illness symptoms was disappointing, just as a recurring disease. The anhedonia became more of a grief and loss issue where they were once again facing difficulties and felt hopeless to stop it. They felt powerless over the strong negative feeling that appeared each morning upon waking.

            The group therapy process helped them learn and grow from the therapy’s social environment. Part of this process is having other participants hear and understand your story and validate your sorrow. The group operated like a pressure cooker valve that could release the pressure from the pain and suffering.

ANHEDONIA: Loss of pleasure, loss of desire

Describe the anhedonia that you feel: _____________________________________________________________

Object: It is like a person, like an animal, like a foggy-shaped blob

_____________________________________________________________

Sounds:  What would it make: negative thoughts, yelling, moaning, howling, squeaks, other animal sounds, singing songs,

_____________________________________________________________

What it does: Does it sit on your shoulder, weigh heavy on your heart? Does it follow you around like a raincloud?

_____________________________________________________________

ANHEDONIA

The loss of pleasure

The loss of the ability to experience pleasure

Feeling isolated

Feeling self-hate

Feeling as if your opinion does not matter

Feeling like crap

Feeling trapped

Feeling angry about everything you do

Feeling like every action is difficult to do

Feeling alienated from others

Feeling as if you do not belong

Feeling like you fell into a pit

Feeling stuck on the bottom of a deep pit

Feeling overwhelmed, and having multiple emotions all at once

Unable to focus

Unable to express happiness

Unable to feel love

Unable to feel joy

Unable to change rotten behaviors or thoughts

Unable to concentrate, and having thoughts that race

Wanting to smash things

Wanting to harm things or self

Hearing - Negative thoughts:

I should have done__________________________________________________________

I could have done _____________________________________________________________

If I would have done ____________________________________________________________

I am not deserving of____________________________________________________________

            One participant talked about childhood trauma and how they became invisible. The group participant did not need to go into detail about the trauma, everyone understood how it can be destructive to a young child. They talked openly with the group about what invisible meant. Other participants agreed with the descriptions and said that they had felt that way in the past.

Being Invisible

Wanting to disappear, due to:

Feeling too much embarrassment,

Feeling too much shame,

Too many traumatic memories

Too many chaotic home/family situations

Feeling as if you are a burden to others

Feeling no love from anybody

Feeling numb,

Feeling nothing, 

Feeling like you are in a cloud or fog

Feeling overwhelmed for so long

Feeling emotional pain

Thoughts are distant,

Thoughts are unfocused,

People seem to be distant,

People seem aloof

Unable to move

Unable to express your thoughts or opinions

Unable to find the motivation to do things

Unable to stay grounded

Unable to stay present

Starting to dissociate

Negative Thoughts:

I do not matter, because_______________________________________________________

I am not important, because _____________________________________________________________

My opinions are not right, because _____________________________________________________________

My actions are not good enough, because________________________________