The Other Side of Sadness

One

THE WORST THING THAT COULD EVER HAPPEN

HEATHER LINDQUIST WAS in the kitchen cleaning up after lunch when she heard a dull thud. It sounded as if it came from the hallway, and it was just a little too loud to ignore. “Boys!” she yelled. “What are you up to?” There was no answer. She found her two boys playing quietly on the couch in the living room. They giggled. “You jokers,” she said with a smile. “What was that sound?” They shrugged. “Where is your father?” Without waiting for an answer, she ran toward the hallway. She cried out in fear when she found her husband, John, writhing on the floor. John had severe asthma. He was taking a new medication, and it had seemed to be working, but suddenly he had collapsed in the worst attack he’d ever had. Heather tried everything she could think of to save her husband’s life. Then she called an ambulance. The rest was a blur. John died of cardiac arrest on the way to the hospital.

Heather was thirty-four years old. Her boys were five and seven. At that moment, John’s death felt like the worst thing that could ever have happened to her.

Most of us are so fearful of harm coming to those we love that we find it difficult even to think about. With time, though, we have no choice. Surveys on stressful life events put the death of a loved one right at the top of the list.¹ We imagine grief to be a relentless shadow that can lock onto us and follow us everywhere. Grief, as we imagine it, turns light into dark and steals the joy out of everything it touches. It is overwhelming and unremitting.

Grief is undeniably difficult. But is it really always overwhelming?

Heather Lindquist had lived her entire life in the same quiet suburban community in northern New Jersey. She and John had been high school sweethearts. They married and purchased a small ranch-style house. They had children. They got a dog. The schools were good and the community was stable. Heather thought that the television was on more than it should be, but other than that, everything seemed in order.

Then John died and she had to rethink it all.

Now she was a single parent. She had to find new ways to earn money and also find extra time to be with her boys. And somehow she had to contain everyone’s anguish. She found strength she didn’t know she had. It was lonely and painful at times. But Heather found meaning and vigor and even joy in the idea that she was going to make it.

“I expected to collapse. I really did. That’s what I wanted to do. That would have been the easiest thing to do,” Heather explained. “But . . . I couldn’t. Each day I got up and did what I had to. The days passed and somehow it was OK. The boys were great. They were upset in the beginning, of course. We all were. They hung in there. And we stayed together. I love those boys so much. John would have been proud of them.”

HEATHER’S STORY ILLUSTRATES a curious irony in the way we think about grief and mourning. We can’t help but know that the pain of loss is inevitable. Death and taxes, as the saying goes. Eventually, grief confronts everyone, and probably more than once in a lifetime. Yet, despite its ubiquity, most people know next to nothing about what to expect. Even people who have already suffered a major loss often do not know whether the grief they experienced was normal or whether they will experience anything remotely similar if they have to go through it again.

The questions we might ask are endless: What does it really mean to lose someone? Does grief feel the same each time? Is it the same for everyone? Is it always dominated by pain and anguish? How long does it last? How long should it last? What if someone doesn’t appear to grieve enough? What if someone talks about having an ongoing connection to the person who died? Is that normal? These are big and important questions. If we understand the different ways people react to loss, we understand something about what it means to be human, something about the way we experience life and death, love and meaning, sadness and joy.

There is no shortage of books on grief and bereavement. Most take a surprisingly narrow perspective, avoiding the bigger questions. One reason is that many of the books on grief are written by medical practitioners or therapists. This is not surprising, but it does create a bit of a problem when we try to understand grief in broader terms. Grief therapists are apt to see only those bereaved people whose lives have already been consumed by suffering, people for whom professional help is the only chance of survival. These human dramas may be compelling, but they do not tell us much about what grief is like for most people.

Self-help books tend toward the same end of the spectrum. They portray grief as a paralyzing sadness, an anguish that removes us from the normal path of life and makes it difficult to function as we once did. The bereaved, in these books, can hope only to gradually wrench themselves from half-conscious despair. Self-help books embody this dramatic representation in titles like Returning to Life or Awakening from Grief.²

Overwhelming grief experiences are not trivial, to be sure, especially for the people who suffer them. But they are not the experiences most people have when they lose a loved one. While researching bereavement, my colleagues and I have interviewed thousands of people. As part of our research, we ask people to explain their personal story, how they have experienced loss, and what their grief was like. Many who volunteer for our studies make the point that they tried to read up on bereavement. They quickly add, however, that they couldn’t seem to find anything in their reading that matched their own experience. They often tell us, in fact, that they wanted to participate in our research just to have the chance to show the so-called experts what grief looks like on the inside.

NOT LONG AFTER obtaining my PhD in clinical psychology in 1991, I received a curious job offer: a chance to direct a research study on grieving at the University of California in San Francisco. I say it was curious because at the time I knew almost nothing about bereavement, either professionally or personally. I had experienced only one major loss: My father had died a few years earlier, and I had explored our relationship as part of my training to become a therapist. But since then, I hadn’t given much thought to my own grief reactions. I confess that I found the idea of studying bereavement a bit unsettling. I wondered if it might be too depressing a topic to study. I wondered if I might become depressed.

Delving into books and papers on grief, however, quickly piqued my interest. Although bereavement is part of the fabric of life, something almost everyone must deal with, it had received surprisingly little systematic study or attention.

At the time I got interested, though, that lack of attention was just beginning to change.

The Vietnam War had generated a great deal of interest in the idea of psychological trauma. Initially, most of the research had been limited to war trauma. Then, gradually, the scope widened to other types of adversity, like natural disasters, rape or physical assault, and, eventually, bereavement.

Surprisingly, those early bereavement studies provided only modest support for the traditional picture of mourning. Some of the research even seemed to suggest that the accepted ideas about bereavement were actually wrong. Even more intriguing, two prominent scholars, Camille Wortman and Roxanne Silver, published a paper in 1989 with the bold title “The Myths of Coping with Loss.”³ They argued that many of the core assumptions about bereavement were, in fact, wrong. The more I looked into the subject, the more I tended to agree. The “state-of-the-art knowledge” about bereavement, it seemed, was woefully outdated. How interesting, and how inviting, for a new researcher! In spite of my reluctance because it seemed a capricious thing to do, I decided to take the job offer. I moved to San Francisco.

I assumed I would study bereavement for only a few years at most, moving on eventually to bigger and better things. To my surprise almost three decades later, bereavement is still a major focus of my career. The reason is simple: So little was known about bereavement that every new study and every new question seemed to unearth something. Often the discoveries that my colleagues and I made were unexpected, simply because we had asked questions about bereavement that had not been asked before.

Our approach was straightforward. The originality, if there was any, was that we simply applied standard methods from other areas of psychology to the topic of bereavement. Grief experts had assumed, for example, that it was essential to express one’s pain after a loss. Yet they had never actually tested this idea. Mainstream psychology offered us myriad possible tests. We used experimental paradigms, for example, in which we asked recently bereaved people to tell us about their loss and about other important events in their life, and then we compared the two. As our subjects talked, we recorded their facial expressions and their autonomic nervous system activity as a way of measuring their emotional responses. We also transcribed what our subjects said so that we could measure how often they talked about the loss and how much they described their emotional reactions when they did so. None of these techniques was innovative in itself, but none of them had ever been used before to study the grieving process.

The fact that I knew so little about bereavement turned out to be a big advantage. Although my naïveté could have been a problem, and sometimes it was, for the most part it gave me a fresh perspective. I had few preconceived notions about what we should expect to find, and for that reason I tended to ask simple questions that had not yet been addressed.

I wondered, for example, what the typical course of grief looked like.

Until recently, most theories about grief and bereavement viewed grief as a kind of progressive work that takes a long time to complete. Bereavement experts have, in fact, used the phrase grief work to describe the extensive process that they assume all bereaved people must go through before they can successfully resolve a loss. They have fleshed out this idea in elaborate detail. Books and journals on bereavement often include charts and lists showing the various tasks and stages that comprise the normal mourning process. “Successful” grieving, it is often argued, depends on these tasks and stages, and failure to complete them will lead to more pain.

Inherent in the lists and charts is also the assumption that grief is more or less the same for everybody and that there is something wrong when people overcome their grief quickly or when they appear to have skipped some of the “stages” of mourning. Armed with these ideas, it is easy to become suspicious when a bereaved person seems too happy or at ease. “Is this some sort of denial?” we might wonder. Or worse, maybe the person never really cared about the loved one in the first place? Or maybe, without help to get in touch with the grief, she or he will suffer some sort of delayed reaction years from now.

Remarkably, though, after many years of studying bereavement, I’ve found no evidence to support any of these ideas. A good deal of what my colleagues and I have found, in fact, suggests a completely different picture of grieving.

One of the most consistent findings we’ve seen across the years is that bereavement is not a one-dimensional experience. It’s not the same for everyone and there do not appear to be specific stages that everyone must go through. Rather, bereaved people show different patterns or trajectories of grief reactions across time.⁴ I’ve depicted the three most common patterns in Figure 1. Some bereaved people suffer a trajectory of chronic grief. The pain of loss simply overwhelms them, and they find it all but impossible to return to their normal daily routine. Unfortunately, for some, this kind of struggle can endure for years. Others experience a more gradual trajectory of recovery. They suffer acutely but then slowly pick up the pieces and begin putting their lives back together.

The good news is that for most of us, grief is not overwhelming or unending. As frightening as the pain of loss can be, the most common trajectory we’ve seen among bereaved people is the trajectory of resilience. Some cope so effectively, in fact, that they hardly seem to miss a beat in their day-to-day lives. They may be shocked, even wounded, by a loss, but they still manage to regain their equilibrium and move on. That there is anguish and sadness during bereavement cannot be denied. But there is much more. Above all, it is a human experience. It is something we seem to be wired for, and it is certainly not meant to overwhelm us. Rather, our reactions to grief seem designed to help us accept and accommodate losses, usually relatively quickly, so that we can continue to live productive lives. Resilience doesn’t mean, of course, that everyone fully resolves a loss, or finds a state of “closure.” Even the most resilient seem to hold onto at least a bit of wistful sadness. But we are able to keep on living our lives and loving those still present around us.

FIGURE 1—The three most common patterns of grief reactions. Adapted from G. A. Bonanno, “Loss, Trauma, and Human Resilience: Have We Underestimated the Human Capacity to Thrive After Extremely Adverse Events?” American Psychologist 59: 20–28.

Another thing my research has shown is that bereavement is not all Sturm und Drang. Sadness is, of course, a big part of grief. I’ll explore sadness in some detail in Chapter 3. For example, I’ll explain why we may experience it so profoundly during bereavement and what purpose it may serve in helping us deal with loss. I will also show that bereaved people are able to have genuinely pleasurable experiences, to laugh or indulge in moments of joy, even in the earliest days and weeks after loss. Most of the early literature about bereavement tended to gloss over these kinds of positive experience, which were often dismissed as examples of avoidance or denial. My research has suggested the opposite. Not only are positive experiences common, but they also tend to have an affirmative impact on other people and may actually help the bereaved recover more quickly after the loss.

I will focus most of this book on the natural resilience of bereaved people, but I don’t want to minimize the great suffering some people experience after a loss. Actually, by taking a perspective that includes both severe pain and healthy resilience, we see these extreme reactions in even starker contrast, and we are better able to examine why some people suffer more than others and what, if anything, can be done about it.

When we put the full range of grief reactions on the table, we also see that there is usually more to grief than simply getting over it and moving on. Bereavement is a powerful experience, even for the most resilient among us, and it sometimes dramatically shifts our perspective on life. Under normal circumstances, most of us cruise through our busy days without the slightest thought of life and death and those other annoying existential questions, like where we came from and where we stand in the grand scheme of the universe. The death of a loved one tends to peel back the curtain on those existential questions, at least temporarily, and begs us to take a larger view of the world and our place in it.

Bereaved people often find themselves wondering where their deceased loved ones have gone. Have they simply vanished, or is it possible that they still exist elsewhere in a different form? Many bereaved people actually experience a strong, perceptible connection with deceased loved ones, something like an enduring bond, as if the person were still alive and communicating from an alternative reality. Such experiences can be comforting, even wondrous, but Western cultural norms about scientific objectivity may also make them deeply unsettling.

We don’t see this kind of confusion in parts of the world where an ongoing relationship with a deceased loved one is commonplace, if not part of the very fabric of the culture itself. In some parts of Africa and in Mexico, for example, bereaved people participate in centuries-old rituals through which dead loved ones are allowed to return and walk among the living. In Chinese and other Asian cultures, ceremonies based on ritual communication with dead ancestors have endured for millennia and persist even to this day despite the wear of political upheaval and economic and cultural globalization.

What happens if we try to mix some of these cultural elements? Add a bit of the old in with the new? In Chapters 10 and 11, I ask the reader to accompany me in a bit of globe-trotting to explore these kinds of questions.

IT’S BEEN A decade since the original edition of this book appeared. A lot has happened since. My colleagues and I have conducted a great deal more research and have probed the original ideas further. Other researchers have studied bereavement as well, and other new ideas have emerged. In a way, we could say that the study of bereavement has come of age. The question of how bereaved people might endure the pain of loss was once viewed as a specialty topic, marginalized to some extent and relegated to the domain of a relatively small group of experts, mostly therapists. But it’s a huge question. Almost everyone must deal with loss at some point in her or his life. It was only a matter of time before the study of bereavement would catch the attention of a wider range of scholars, researchers, and practitioners.

In this the revised edition, I’ve updated many of the chapters to incorporate the most relevant of this new work. Many of the observations and conclusions I made in the original edition, I am pleased to say, have held up well over time. But in some cases, because of the new research, I’ve been able to expand on the original, broaden it, and push a bit further toward an even larger understanding. In the revised edition, for example, I’ve probed deeper into new ideas about the emotional side of grieving. I’ve also delved further into the different ways people grieve and in particular the different trajectories of grief reactions over time. Our original trajectory findings have now been replicated several times over. But we’ve also expanded this approach to encompass other areas, traumatic events more broadly defined, and other types of adversities, like divorce or acute medical conditions. We’ve also come to a greater understanding of why most bereaved people manage to cope so well but also of why others do not and how we might better help them. We’ve also begun to look for further insights into what the brain does while people are experiencing grief. With all this new research behind us, I think it’s fair to say that we are closer now than ever before to achieving a scientifically informed picture of the grief process, one that more realistically captures what people actually go through during bereavement.

Before we get into all of this, though, we need to start at the beginning. We need first to take a closer look at what happens in Western culture when someone important to us dies.