Gray Matter: It’s vital to understand grief, support those mourning

In light of the recent deaths on campus, many students are grieving the loss of loved ones or are supporting friends who are grieving. To mourn in a healthy way and effectively support our peers, it’s important to make an effort to understand how people experience grief and address some common misconceptions.

To empathize with those in mourning, it’s key to understand the various emotions one may be experiencing. Perhaps the most well-known conceptualization of grief comes from Dr. Elisabeth Kübler-Ross’ five stages of grief: denial, anger, bargaining, depression and acceptance. 

While this systematic progression through grief may be helpful to some people, modern research has shown that there is actually no “standard” way to grieve. In fact, Kübler-Ross’ theory referred to patients who were grappling with their own terminal illnesses rather than the loss of loved ones.

In reality, there are many differences in the ways people grieve the loss of loved ones, and most people don’t progress through each of the five stages methodically, if at all. These differences depend on a variety of factors, including cultural background, personality type and the nature of the loss. Additionally, grief varies not only by the person, but also by the loss within each individual.

Simply put, there is no right or wrong way to grieve. The five stages of grief should not be used as a step-by-step guide to properly mourn. In fact, adhering too firmly to this framework can be harmful — it can induce feelings of pressure or guilt within those who are not experiencing grief in the proposed five stages. The best thing one can do to support a friend in mourning is to listen. Although it may feel helpful to tell them about our own or other people’s experiences with a loss to help them understand their own feelings, this can be counterproductive because you could be setting them up with false expectations. For example, telling someone that it took you three months to get over the worst of the pain can make them feel panicked if their pain has not lessened at the three-month mark, or even guilty if those feelings faded far earlier.

Another misconception about bereavement is that pain and sadness should consume your emotions. Actually, positive emotions are both normal and healthy and should not elicit feelings of shame or disloyalty as they often do. According to George Bonanno, a clinical psychology professor at Columbia University, positive emotions in the months following a loss can indicate resilience and healthy long-term outcomes. 

Finally, it is important to make a distinction between uncomplicated and complicated grief. In the initial stages of uncomplicated grief, it is common for individuals to experience intense sadness, difficulty concentrating and disengagement from daily activities. In a study by clinical psychologist Mary-Frances O’Connor that looked at brain scans of grieving people, women who had lost a loved one in the past five years showed activation in the same parts of the brain that process physical pain when reminded of their loss. 

Given these symptoms, it is crucial for professors to be understanding and lenient to support any bereaved students during this period. Furthermore, a review by Catriona McDaid, a senior research fellow at the University of York, found that group therapy can be an effective intervention for people mourning suicide-related deaths.

Even though this initial acute grief may feel unbearable, it is a healthy, normal part of uncomplicated bereavement. Eventually, uncomplicated grief will progress from acute to integrated, meaning the pain will fade as the grieving come to terms with their loss and find new ways to maintain the presence of the deceased in their lives.

On the other hand, complicated grief occurs when an individual does not make that transition, meaning the symptoms of acute grief persist over a prolonged period of time. These symptoms include difficulty accepting death, avoiding things that remind them of their loss, recurring pain, intense yearning and feelings of bitterness or anger. 

In the same study conducted by O’Connor and her colleagues, patients who were diagnosed with complicated grief also showed brain activation in the part of the brain involved with the feelings of pleasure and reward that come from social attachment. This implies that they are still holding onto their relationship with their loved ones as if they were still alive rather than coming to terms with the loss.  Due to interactivity in that part of the brain, patients have a harder time regulating the anger, bitterness and sadness characteristic of acute grief.

For all of these reasons, assessing whether someone is experiencing complicated grief requires a certified clinician. In these difficult times, it is more important than ever for USC to have enough mental health professionals to not have to turn any students away or refer them out.

Jessica He is a senior writing about neuroscience. Her column, “Gray Matter,” runs every other Wednesday.