Grief is a physical, mental and emotional experience. And while grief itself is universal — all human beings experience loss — it’s also individual, as each person’s grief will manifest in ways unique to them.
“Grief is a wiggly, squirrelly, messy, complex thing,” said Jenny Tran, PhD, a psychology fellow with the Simms/Mann-UCLA Center for Integrative Oncology and co-leader of its recent online workshop “The Art and Science of Grieving.”
“Grief is an inherent part of a cancer diagnosis,” Dr. Tran said. “There is lost time, lost sense of safety, changed sense of self, changed relationships, changes to one’s body, the list goes on. Caregivers and loved ones also experience grief and a range of changes and losses in their lives.”
The hourlong workshop, held in August, is one of many free, publicly accessible events offered by the Simms/Mann Center, which provides multifaceted psychosocial support for people receiving cancer treatment at UCLA Health and their families.
“The Art and Science of Grieving” offered definitions of various types of loss, explanations of how grief affects us physically, mentally and emotionally, and strategies for managing and assimilating grief.
Defining loss
“One of the most powerful things we can do with our grief is give language to it, to voice it, to share it,” Dr. Tran said.
She outlined the following terms around grief and loss:
- Loss: Any event resulting in a change in one’s relationships, daily life, sense of self or sense of the world.
- Grief: The reaction to a loss or change, recognized to have emotional, cognitive and physical elements.
- Anticipatory loss: Feelings of grief experienced in the days, months or years in advance of loss or death.
- Ambiguous loss: When someone is physically present but psychologically absent — emotionally, cognitively or physically altered, as in cases involving dementia, addiction, traumatic brain injury, severe depression or other mental health conditions; or when there’s a physical absence but a psychological or emotional presence, as when a loved one is missing, estranged, incarcerated or otherwise away.
- Disenfranchised loss: Grief that’s often minimized or invalidated by societal norms, including loss of a pet, loss of friends, loss of a client or patient, job loss, loss of someone you’ve never met, loss through abortion and losses with stigma, including incarceration or death by suicide.
All of these types of losses can bring about grief, which can manifest physically as fatigue, changes in sleep or appetite, low energy and pain or discomfort in the body, Dr. Tran said. Emotional manifestations of grief can include sadness, crying, longing, anger, irritability, guilt, anxiety, as well as relief, enjoyment, unreality and intrusive thoughts or images.
“Understanding what grief can look like and what impacts our grief process allows us to tend to it and have more self-compassion,” she said, “instead of ignore it or judge ourself for it.”
Dealing with grief
Dr. Tran and workshop co-facilitator Elizabeth Cleary, PhD, a clinical psychologist with the Simms/Mann Center, also shared strategies for “holding” grief. These include:
- Recognize and name grief: Label feelings (such as sadness, anger, worry, frustration) as they arise. “Research has demonstrated that if we can name what we’re feeling, we are less likely to experience the feelings as overwhelming, less likely to try to avoid the feelings and to build an ability to tolerate the feelings and experience how they naturally subside,” Dr. Tran said.
- Make space for feeling and processing: “It may feel safest or necessary to schedule that time, whether that’s in therapy or writing and journaling, which can be a way to sort through your feelings and thoughts,” Dr. Tran said. Other ways to make space for feelings might be through movement, meditation or in conversation.
- Ask grief-specific questions: Dr. Tran offered a list of questions that may aid in processing or reflecting on feelings, including: When you think of the loss, what feelings are most pressing? When do you feel most alone with your grief? What are your tears for today?
- Practice mindfulness: “Mindfulness is a stance that embodies a non-judgmental awareness of the present moment,” Dr. Cleary said. “We recognize that much of our suffering can come from either imagining things in the future, or reliving things from the past. We lose out on opportunities to savor or enjoy things in the present if our minds are elsewhere.” She offered the strategy of using the senses to feel grounded in the present moment — what can you see, hear, smell, touch and taste?
- Allow for physical, cognitive and emotional rest: Acknowledge that grief can cause fatigue and make it difficult to concentrate, prioritize rest and convey limits to others, Dr. Cleary suggested.
- Tend to your physical self: Sleep, nutrition, movement and routine medical care are well-being essentials. “Pay attention to any physical issues you may be experiencing and seek support for that,” said Dr. Cleary. The Simms/Mann Center hosts a regular Breathwork group and offers a workshop on getting better sleep.
- Get support: “Therapy for grief can have many benefits … and there are several empirically supported forms of grief therapy,” Dr. Cleary said, adding that “therapy is really much more than kind listening.” The Simms/Mann Center offers various group therapy options as well as one-on-one counseling.
“The Art and Science of Grieving” will be repeated Nov. 1, she said. The Simms/Mann Center’s next workshop, about sleep, is scheduled for Sept. 6.
