Having returned from an international conference on grief and bereavement I received strange looks from friends when I said the conference was excellent. For those of us who work daily with issues around loss, it is nice to be able to have an open forum for discussion of such a difficult area with over seven hundred colleagues from around the world. After all, bring up the topic of death with your family and friends and they bolt. No one wants to talk about serious illness, let alone death. Here with experts in the field we talked about, ambiguous loss, complicated or prolonged bereavement, disenfranchised grief, sudden, traumatic, anticipated, unanticipated, violent and just about any other kind of death and loss imaginable. Suicide, homicide, assisted death, and last but not least palliative and hospice care along with advanced directives and end of life decisions. We spoke of various aspects of death in every age group from fetal to geriatric, in a parent, newborn, child, adolescent, sibling, partner, caregiver, peer, pet and more, in peacetime and war.

Whether a care provider or recipient, all of us deal with loss at various times of our life. Some are more significant than others. Some losses may be socially acknowledged whereas others such as suicide, death of a pet, a miscarriage or abortion or loss of a childhood home may not be. Whether relocation, aliyah, infertility, divorce, declining memory, a physical handicap, serious illness, declining health or death, you grieve for what you've given up, what you have left behind and what you no longer have.

Each person grieves differently- in their own way and in their own time. The nature of the relationship will determine the impact and meaning of the loss and there is no right way to grieve. The depth of one person's loss and pain can't be compared to another's. I once worked with a 6 year old girl who was far more upset about her beloved dog dying than she was over her Dad's death. This little girl had spent her lifetime confiding in her dog and had rarely seen her dad who was away in the army.

Saying you know just how someone feels is seldom helpful. Being there for someone if and when they are ready to talk is however a gift. Don't just ask how you can help; try to anticipate what may be needed and do it. Grief's journey is time consuming and exhausting. You may become impatient with someone who you feel should "get over it already" and "move on". If only it were that simple. Unrealistic expectations, whether self-imposed or from others sadly add to the already heavy burden of loss. How for example, do you "return to normal" one week, month or even a year after a sudden unexpected loss? Loss impacts you in every way possible. You develop physical, emotional, cognitive, and behavioral signs of distress as you grieve with your entire body and being. Spiritual, economic and social challenges cause you to question who you are and reevaluate how you live your life. So one doesn't get over a death but rather eventually moves on in spite of it. Life cycle events, holidays or anniversaries, make loss more acute. While some you might anticipate, others will catch you by surprise and bring renewed sadness.  

Children grieve differently than adults. Play and laughter are not an indication that they don't feel the loss and if your needs are all consuming, your children definitely need someone who can be there for them in their pain.

Death is a normal part of the life cycle but it often brings up unresolved issues and fears. For many, the fear of death is the fear of the unknown, dying alone or being in pain. Open discussion can alleviate much concern, and enable you to face death with dignity and respect when especially as caregivers, we give our loved ones "permission" to go.

What can you do if you are grieving? Go easy on yourself for starters. Take it a moment, an hour and one day at a time if you have too. Maintain regular routine as much as possible, albeit acknowledging that nothing is normal. Try and eat a balanced diet, sleep or rest, and exercise (nature's antidepressant), meditate and relax with a hobby or book when possible. Keep a journal if you like to write. Spend time with loved ones who care, share and are supportive. Get outside help if you feel you are not coping as you think you should or if grief becomes complicated. While a therapist can't take away your pain, she can listen nonjudgementally and be there as you face the many challenges that lay ahead.

Don't make any major decisions in the first year after a loss. You may think that a move, for example, will ease your pain, but you may discover that at first nothing feels good. The depth and extent of your grief may surprise you. With time, you'll know just what to do.

Death and loss brings sadness but is also accompanied by love, laughter and wonderful memories. While living in the present and enjoying what you have to the fullest, you can grow in unexpected ways, begin to heal, make meaning out of your life and find pleasure once again.

Dr. Batya L. Ludman is a licensed clinical psychologist in private practice in Ra'anana.  Send correspondence to [email protected] or visit her website at www.drbatyaludman.com. Her book,  Life's Journey. Exploring Relationships Resolving Conflicts, has just been published and has a whole section devoted to bereavement and loss.