Grief and Grieving, Step-by-Step (a DBT-Informed Approach)
As you’ll see from the quotes, this post is heavily informed by what I have learned from Alan Fruzzetti and his approach to teaching about grief and grieving.
What is grief?
“Grief is a particular kind of sadness.” -Alan Fruzzetti
Anytime there’s a loss, there’s grief.
Why bother experiencing grief?
If you don't experience the grief of a loss, it builds up and will eventually overtake you. If you avoid your grief enough, it often results in the experience of guilt and shame, and ultimately, a crisis. Experiencing and moving through the grief in small doses is the best way to prevent the crisis and reduce your suffering. The goal is to experience and move through the sadness in manageable doses so you don’t get stuck.
“Emotions are like the delivery person from federal express. If you avoid it, they’re going to come back and try to deliver it again. And they’ll come back and try to deliver it again. But if you receive it, it’ll stop coming. And you can open it later if you want.” -Alan Fruzzetti
Examples of losses:
Someone passes away
Someone moves away/you move to a new place
You leave a community
You face a major transition
Things don't turn out as you hoped or expected (i.e., There is a loss of what you wanted or imagined)
You get something you didn’t want
You don’t get something you did want
We often underestimate the impact of different kinds of losses. Most major changes – even positive changes – involve some amount of loss. For example, you can be very excited to finally be done with school, while at the same time experiencing some sadness to move on from the school community. You can be relieved to end an ineffective relationship, and still experience enormous sadness at its loss.
Why do we have to deal with grief?
Grief is, arguably, one of the most painful human experiences. And, the flip side of grief is love. We don’t have grief without having something important to us (i.e., something we love). The more we love someone or something, the harder it if/when we lose it. Refusing to experience loss and grief would mean shutting yourself off from love and meaningful connection.
So, how do you actually grieve?
Humans have found a lot of useful approaches to supporting us through our grief:
Engage in rituals (religious or otherwise): Funerals, visiting gravesites, scattering ashes, signing yearbooks, saying the Mourner’s Kaddish, sitting shiva, holding a wake, reading names, and lighting candles are just a few examples of rituals that help us experience and process grief. Often, rituals contain other rituals (e.g., lighting candles during a service).
Connect with reminders of the person/thing we’ve lost (e.g., pictures, shared memories, physical things/smells/sounds/sensations that remind us of the things/person)
Talk about the loss with others who “get it” (e.g., who are experiencing the same loss or have experienced a similar loss)
Make a memento of the person/situation
Let’s break it down:
Choose your exit strategy: Ideally, before you experience the grief, you have a plan for how you will move on from the emotion and re-direct your attention. Entering into the grief is a lot less scary if you know what you will do to move on afterwards (i.e., how you will manage it if it becomes overwhelming). This is generally as simple as choosing an activity to do afterwards. Often, it’s just the next thing you’d usually be doing (e.g., washing the dishes, walking the dog, or doing the laundry). If the grief is really big, you will need to add in some additional distress tolerance skills (e.g., self-soothe or a bigger distraction). You can think of this as your post-grief skills plan. The bigger the grief, the more thorough a plan you will need. Ideally, we avoid things like TIPP skills, which may cut off the natural experience of the emotion. But, if you need a TIPP skill, you need a TIPP skill (and that’s okay)!
“Bump into the emotion”: This step isn’t something you have to do on purpose (though of course, you can) – it just happens as we move through the world during/after a loss. For example, when the first holiday comes up after someone’s passing, we “bump into” the grief when we realize they won’t be there. If you want to do it on purpose, you can pay attention to something (a memory, an object, or a photo) or talk with someone about the loss.
Choose something small and specific to grieve: Don’t try to grieve the whole loss at once. For example, instead of trying to experience the sadness of a loved one’s loss, or the fact that they’re not here for the first Thanksgiving since their passing, notice that you’ll never have the special recipe they made, the exact way they made it, again. Experience the loss of your loved one in that dish and the experience of sharing it with them. If you start getting overwhelmed by the whole experience, gently notice and validate that, and then do your best to bring your attention to a smaller part of the loss (e.g., what you remember the person doing, or what they would have said in a particular scenario).
Notice the emotions: notice sadness, disappointment, loss
Notice it in your body:
Do a body scan
Observe the sensations in a small part of your body (e.g., your left big toe)
Do a STUN wave. Notice:
Sensations
Thoughts
Urges
Name the emotion
Experience the emotion coming and going, (like a wave), for 30 seconds to 2 minutes
Talk about it, write about it, make art about it, or observe it
Breathe: Take a deep breath and let the emotion be. Notice where it sits in your body.
Validate: Add in a little, “of course I feel this way. This is not what I want[ed].” -Alan Fruzzetti
Remember, it’s healthy to notice you’re getting something you don’t want or not getting something you did want
Seek validation/support from others, as needed
Self-soothe: listen to music, stretch, make your favorite warm drink, snuggle with your dog, listen to a song that brings you comfort, paint your nails, go for a walk, take a bath
Follow your post-grief skills plan (see above), as needed
Re-engage with your life: Move on to another activity and “bring your mind with you” -Alan Fruzzetti.
The mindfulness part of this is key. Managing grief requires strong mindfulness skills (i.e., the ability to direct your attention where you want it to be). If you move on with your life, but keep thinking about the loss and your grief, you’ll keep “re-firing” the emotion and you will likely feel “stuck” in it. Notice your mind wandering back to the loss and grief, validate (“of course”), and gently steer it back to whatever you’re doing next. Be persistent and gentle about steering your attention where you want it to go.
Fully participate: Really throw yourself into whatever you are doing in the present.
Repeat: For significant losses, we never really stop bumping into the grief. A loss never stops being a loss. This makes it really easy to get stuck in or overwhelmed by a loss for a very long time. However, time and practice help us get better both at experiencing it and redirecting our minds into what’s going on in the present, and even to seeking joy in your life now. The more you experience and move through the grief, the more feasible this gets.