young relative passed, family devastated, grieving...thoughts?

Shveitta Sethi Sharma and
old what's his name in Hong Kong

Shveitta Sharma.  My friend...just lost his 24 year old nephew and everyone in the family is devastated.  We understand the fallibility of the mortal body but how does one cope with sheer grief?  I have said many things to grieving people but I know it hurts.  Do you have any thoughts?


(Shveitta, shown at the right w/owhn, and her wonderful husband, Rahul, were kind enough to host me during the Asia Consciousness Festival (ACF) held in Hong Kong, where they live, in Nov 2010.  i gave several talks, etc. @ the ACF and Shveitta played a major role in the conference.  Her blog is http://www.happinessisaskill.blogspot.com/; she describes herself as Chief Happiness Officer @ Self Employed and Loving It!)




G.  First, let's look at what is "grief" is.  Grief, the emotional suffering one feels when something or someone the individual loves is taken away, is a natural response to loss.  Grief associated with death is familiar to most, but folk grieve in connection with a variety of losses including relationships, health, jobs, financial stability, traumas, divorce, relocation and pets.


One of the most common psychological models has four general sequential stages in the grieving process:

     Shock and Denial

Our emotional protection from being suddenly overwhelmed by the loss. we may not yet be willing or able to believe what we know is true. This normally lasts 2 - 3 months.

     Intense Concern

Not being able to think of anything else, even during daily tasks.  Conversations always turn to the loss. This may last 6 months to a year.

     Despair and Depression

A long period and the most painful and protracted, but during which folk gradually come to terms with the reality of the loss.  Typically involves a wide range of feelings, thoughts, and behaviors, some of which may be irrational; may include anger, guilt, sadness, and anxiety.

     Recovery

This is not the elimination of all the pain or the memories of the loss.  There is a new interest in daily activities and one begins to function normally on a day to day basis.  one's life is reorganized so that the loss is an important part, rather than the center, of one’s life.

George Bonanno
Columbia University

A well known researcher in this area is George Bonanno, a professor of clinical psychology at Columbia University, who has conducted decades of research on grief and trauma.  His work has included thousands of folk in places such as Israel, Bosnia, and China as well as the U.S. and every imaginable category of loss.  

Professor Bonanno described "Four Trajectories of Grief" in his 2004 paper, "Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Aversive Events?". American Psychologist 59(1): 20–8.  

Bonanno's four different "trajectories" (not sequential stages) are:

Resilience: we "maintain relatively stable, healthy levels of psychological and physical functioning" as well as "the capacity for generative experiences and positive emotions."

        Recovery:  "After normal functioning gives way to symptoms of depression or PostTraumatic Stress Disorder (PTSD), usually for at least several months, and then gradually returns to pre-event levels."

        Chronic dysfunction: Prolonged suffering and inability to function, usually lasting several years or longer.

         Delayed grief or trauma: When adjustment seems normal but then distress and symptoms increase months later. 

Bonanno's research, including his book "The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After a Loss", was the first to use "pre-loss" data and has some surprising conclusions:

     a) absence of grief or trauma symptoms is a healthy outcome, rather than something to be feared as has been the "conventional wisdom".  Bonanno states, "the vast majority of people who have experienced a loss do not grieve, but are resilient."

     b)  grief responses can include laughter, celebration, and "bawdiness", in addition to sadness, leading to his coining "coping ugly" to describe forms of coping that may seem counter intuitive.

  

     c)  resilience is natural to humans, and does not need to be "taught" through specialized programs.  There is virtually no existing research to support major investment in such programs.

Elisabeth Kubler-Ross

There is, of course, also the famous " Kübler-Ross model, commonly known as the Five Stages of Grief, introduced by Elisabeth Kübler-Ross in her 1969 book, On Death and Dying.  This is a popular but largely untested theory that describes the stages as a) denial, b) anger, c) bargaining, d) depression, and e) acceptance.

It is worth noting that the Kubler-Ross model was based  on observations of folk who are dying, not those who are grieving at the loss of a loved one.  There was an study done to validate this model by Maciejewski et al. in 2007 "MacIejewski, P. K.; Zhang, B.; Block, S. D.; Prigerson, H. G. (2007). "An Empirical Examination of the Stage Theory of Grief" in JAMA: the Journal of the American Medical Association 297 (7): 716.   

As far as cognitive neuroscience studies, fMRI scans of women grieving over the death of a mother or sister in the past five years revealed an inflammation response correlated with activation in the anterior cingulate and orbitrofrontal cortices which causes stress linked to emotional processing centers in the frontal lobe.  These areas as well as the vagus nerve are similarly implicated in "heartbreak" whether due to social rejection or bereavement. 

Freed, et. al, in their 2009 paper "Neural Mechanisms of Grief Regulation" in Biological Psychiatry 66, (1) 33-40, showed that those suffering loss of someone close and who report a greater intensity of sadness show amygdala and anterior cingulate cortex hyperactivity and lower functional connectivity.  In those folk who do not have such thoughts, there is an opposite pattern in which high functional connectivity and deactivation of the amydala and the dorsolateral prefrontal cortex activation is observed.  

Previously it was believed that grief was only a human emotion, but studies have shown that many other animals, including primates, elephants, big cats, etc. have shown grief or grief-like states during the death of another. 

From a spiritual perspective, here is my teacher,  Ramana Maharshi's, answer:  

Ramana Maharshi

<sup>Mr. Jharka..from the University of Benares, holding the M.A. and the M.Sc. degrees, said that he was stricken with grief due to the loss of his wife and children. He sought peace of mind and asked how to get it.

Ramana Maharshi :</sup> 

It is in the mind that birth and death, pleasure and pain, in short the world and ego exist. If the mind is destroyed all these are destroyed too. Note that it should be annihilated, not just made latent. For the mind is dormant in sleep. It does not know anything.  Still, on waking up, you are as you were before. There is no end of grief. But if the mind be destroyed the grief will have no background and will disappear along with the mind.

^{Question : How to destroy the mind?}

<sup>Ramana Maharshi : Seek the mind. On being sought, it will disappear.

Question : I do not understand.</sup>

<sup>Ramana Maharshi : The mind is only a bundle of thoughts. The thoughts arise because there is the thinker. The thinker is the ego. The ego, if sought, will vanish automatically. The ego and the mind are the same. The ego is the root-thought from which all other thoughts arise.

Question : How to seek the mind?</sup>

^{Ramana Maharshi : Dive within. You are now aware that the mind rises up from within. So sink within and seek.}