STAGES OF GRIEF

Overview

In your personal and professional life you may meet people who are grieving as a result of a traumatic incident. Or, you may experience the loss of a loved one. Because you may face death and loss, it is important to understand the grieving process.

Reminder

The stages of grief do not occur in a specific order and may repeat. Grieving people are likely to experience all the stages in a way that is unique to them. Also, cultural differences may affect how each stage is expressed.

Shock/Denial

Immediately after learning of a traumatic incident, one may feel an emotional numbing. The traumatic reality is likely to be absorbed very slowly. Feelings of disbelief may be articulated in expressions such as:

This cant be true!

It must be a bad dream!

Anger

Once the realization of loss begins to set in, the feeling of anger may be overwhelming, particularly if death was unexpected or sudden. It may be unfocused and an individual may find himself/herself verbally lashing out at anyone. Strong desires to blame someone for the loss are not uncommon.

Depression/Sadness

Emotions displayed during this stage include agony, depression, anguish, grief and despair. Performing normal, everyday tasks suddenly becomes difficult and even unbearable. One may have a preoccupation with learning every detail of the incident.

Guilt

When one begins to have a full awareness and understanding of the loss, he/she may have strong feelings of guilt. These feelings may be expressed as:

If only I had gotten home earlier, maybe this wouldnt have happened, or

I should have told her more often that I loved her.

Feelings of guilt usually subside with time. Individuals begin to acknowledge their loss and to accept that they did the best they could to let loved ones know they cared.

Integration

At this stage, individuals are able to remember the good times, look at photographs, and talk about loved ones without a feeling of overwhelming pain. Being able to integrate the loss into one's life so that there are more good days than bad will allow one to move forward.

Do

Dont

Convey sympathy

Say I can only imagine/I understand how distressing this is for you, and

Refer to the victim by name or as your son/daughter, etc.

Offer your assistance and a listening ear if they have not asked for help

Reassure them they are safe

Tell them that you are sorry such an event has occurred and you want to understand and assist them

Share personal experiences

SayI know how you feel.

Be cold or distant

Be too clinical

Use terms such as deceased, the late, remains etc.

Tell them they are lucky it wasnt worse or that the deceased is better off traumatized people are not consoled by those statements

Do

Dont

Remain composed

Argue, NEVER argue

Act professional

Be defensive

Respect religious or personal beliefs

Question the personal or religious beliefs of others

Take the persons anger personally

Listen

Give advice on how to handle bereavement

Do

Dont

Show your understanding or appreciation for the extreme pressure the person is under

Convey impatience or time constraints to get off the phone

Only in the most urgent scenarios (i.e., the body will be cremated tomorrow unless you say otherwise today) should the citizens be given time constraints

In most scenarios, consular officials should consider the deadlines to be for themselves rather than for the mourners and should raise items that need timely decisions in a timely fashion (and perhaps repeatedly) rather than giving the citizens the added (and often paralyzing) pressure of a deadline

Assist the family to make necessary decisions

Show impatience to move on to the next call or case. Dont Expect immediate decisions from the family

Do

Dont

Repeat information

Reiterate all principal points discussed verbally in writing (e.g. standard notification/sympathy correspondence and correspondence describing burial options)

Conversations may not be fully absorbed by someone under stress, whereas information in writing can be referred to and absorbed gradually

Convey bureaucratic obstacles

Speak slowly

Use short sentences

Try to respond to specific questions

Use abbreviations or acronyms

If you dont have the answers to the questions raised, advise the person that you will do your best to get the answer, and then be sure to follow up

Give your opinions

Stress the positive actions you can take

Give bad news in a compassionate and straightforward way

Give false hopes or pass on unconfirmed rumors regarding a person's well-being, although you may convey preliminary reports from local authorities, citing the source

Avoid or sugar-coat the bad news once it is confirmed

Set a time when you will call again and do it.

Make promises and not follow through

Note: This is most easily done when you have the resources to use a case-worker approach (where one consular officer is the sole point of contact for the family) and ensure that a victim/family becomes used to and comfortable with a particular member of your staff

Medline Plus Bereavement

National Center for Post Traumatic Stress Disorder Managing Grief After Disaster

Yale Hospital Common Reactions to Grief and Bereavement