Note: Client names have been changed to protect their privacy.
What do I do now?
What do I do with this sadness? This anxiety? This fear? This regret?
What do I do with all of these uncomfortable thoughts?
What do I do now with my time – time I used to spend with my loved one?
How do I go on – how do I live in a world without my loved one in it?
Once a loved one has been memorialized and we turn our attention back to daily life routines such questions arise spontaneously seeking to be answered. When I present workshops on grief- healing most people attend the workshops prompted by a need to explore and answer such questions. As one elderly workshop participant recently said to me: “Even with all my life experience, I feel like I don’t really know what I’m doing since my husband died. Isn’t there a map or something you can follow for getting through grief?”
Every grief and every griever are different so there is no one size fits all map for processing grief. But there is a framework called the four tasks of mourning that can help us understand how people who experience profound loss journey through the mourning period in a way that allows grief to flow and heal.
Worden's Four Tasks of Mourning
The four tasks model for mourning was developed by psychologist J. William Worden. Mourning is the process of adapting to loss. Healing happens gradually. The four tasks provide a structure that supports the mourning process and allows for the gradual process of healing. The four tasks are done in no specific order - grievers often find themselves going back and forth from one task to another over time until they feel ready or able to move forward with life.
Task 1: Accept the reality of loss.
If you weren’t present at your loved one’s deathbed, the communal gathering of friends and family at a funeral or life celebration is a ritualistic event that can help you begin to accept the reality of loss – at least intellectually. However, taking-in the full emotional and day-to-day impact of loss with your whole being is a gradual process that unfolds over many weeks, months - and even years. Allowing yourself the time, space, pace and support for this unfolding is key to adapting to the pain of loss and moving forward with life.
Task 2: Process the pain of grief.
A client once said to me, “Can’t I just be on the other side of all this pain without having to feel it?” The answer to that question is a compassionate “no.” The painful and often messy emotions and thoughts accompanying grief helps connect you in understanding to the important role your loved one played in your life and what now will be missed or absent. While it can be tempting to avoid sadness, anger, guilt, regret and other uncomfortable loss emotions, grief-processing requires that you confront, name, and make sense of such emotions in order to heal; doing this may require the learning of techniques and practices aimed at helping you to be with and release uncomfortable emotions as they arise.
Task 3: Adjust to a world without the deceased.
Worden identified external and internal changes that need to be made as part of the process of adjusting to a world without your loved one in it.
External adjustments include taking on new roles and developing new skills. For example, my 42-year-old client, Trisha, lost her husband after a short-term illness leaving Trisha to figure out how to be “both mother and father to my son and daughter.”
Trisha said, “I’m so worried about helping my son learn how to be a man. I don’t really care about how to throw a baseball and things like that, and now I have to care because my son cares. And there is so much other scary stuff. My husband did all of our finances. Now I have to learn that and I don’t want to.”
Adjusting to the world meant that Trisha had to work through resistance to the changes that came with her husband’s death, as well opening to asking for help from her parents and in-laws when she wanted to prove that “I can do this alone.”
Internal adjustments can include coming to terms with changes in your identify (If I am no longer a wife or father or son then what/who am I?). And it can mean making adjustments to your spiritual beliefs, values and the way you view the world.
Prior to her husband’s death, Trisha was secure in her religious faith; after her husband’s death she “had to have a lot of private talks with God before I felt like trusting him again or going back to church. I just couldn’t get past why God would take my husband away from me. I still don’t get it, but I now accept it.”
Task 4: To find an enduring connection with the deceased in the midst of embarking on a new life.
Finding an enduring connection with your loved one is sometimes called establishing a “continuing bond”; it can also mean engaging in a process of “relocation.” The process of relocation entails acknowledging and accepting that your loved one is no longer here on earth but still remains alive – is now forever located - in your heart , in memory, in heaven – or any place else that brings you comfort and peace. Establishing a continuing bond means engaging in activities and rituals that honor the bond you once shared with your loved one that hold significance for you (for example, listening to music your loved one liked, lighting a candle for your loved one at Thanksgiving etc.)
Completing task 4 signifies that you have found a healthy balance between treasuring your loved one’s memory and embarking on a new life.
Another Perspective: Tom Attig's Relearning the World
In How to Grieve: Relearning the World, author Tom Attig uses Worden’s four tasks as a starting point for his own systematic approach to relief from grief. I have used this approach often with clients like Jeff who request “grief homework.” Over an 18 month period of time, Jeff found this approach helpful in dealing with the “shock, disbelief, sadness and pain” that came in the wake of the death of his wife Ann. Experience has shown me that Attig’s approach is most helpful after a client has first learned strategies and techniques for dealing with uncomfortable grief-related thoughts and emotions; additionally, I have found that clients move through Attig’s steps at their own pace rather than the pace set by Attig.
Attig’s systematic tasks of grieving can be outlined as:
Step One: Accepting the Reality of the Loss
List 4- 8 roles your deceased loved one filled for you, roles that belonged exclusively or almost exclusively to your loved one.
- In this step, Jeff identified his wife as “the person I share my bed with,” “my travel companion,” “my dinner partner,” “my do-nothing-with person” as roles that belonged exclusively or almost exclusively to his wife.
- Write a paragraph to your loved one using his/her name. In each paragraph acknowledge your remembrance and appreciation of him/her and also acknowledge your sense of loss that the role is now no longer being filled. Regarding “the person I share my bed with,” Jeff wrote: “Ann, I’m remembering you as the person who always came to bed with cold feet no matter the weather. I miss warming your feet between my thighs and how you always laughed when I did this.”
- Sit across from an empty chair and read the paragraphs you’ve written aloud to the chair. Do this on three separate occasions in the upcoming weeks. Only after you’ve finished this activity can you continue with the next step.
Step Two: Working through the Pain
- Review the paragraphs from step one and identify 4 - 8 emotional, physical, and/ or spiritual pains you are experiencing due to your losses. In this step, Jeff identified a sense of abandonment, fear, a tight stomach, and anger for no longer having Ann in his life.
- With each identified pain, take a separate sheet of paper and write two strategies you can follow to alleviate that pain. As part of our work together, Jeff had learned mindful breathing and body relaxation techniques to help ride waves of grief when they arose. So on one sheet of paper Jeff wrote “When my stomach becomes tight thinking about Ann, I will do square breathing;” and on another sheet of paper he wrote “when my stomach becomes tight thinking about Ann I will imagine my breath going into and out of my stomach relaxing it as I listen to relaxing music.”
- Post these sheets of paper throughout your home and read what you’ve written at least three times in the next week.
- After that week, begin implementing at least one strategy for each pain. After you’ve started implementing the strategies you can continue with the next step.
Step 3: Filling Some of the Gaps
- From the first activity, choose 2-3 of the roles that you or someone else can now – or in the future - fill. Remember not all of these roles can or ought to be filled.
- In the next several weeks find a way of filling each of these roles that you have identified and begin to have them filled. At this point Jeff said to me: “I’m not going to share my bed with someone else! At least not now! But I can think about the other stuff.” Over the next month, Jeff looked into ways he might be comfortable traveling without Ann. He eventually participated in a group walking tour of Scotland sponsored by a learning tours travel company. To fill the role of dinner partner, Jeff made a weekly dinner date with a recently widowed former work colleague.
- Do not proceed with the next activity until you feel some degree of comfort in how these roles are now being filled.
Step 4: Moving on with Life
Develop 2 – 4 rituals for saying goodbye to your loved one. Each ritual should in some way acknowledge how you benefited from having had your loved one in your life. Each ritual should also end with some form of goodbye, acknowledging that your loved one is no longer physically with you.
Jeff engaged in several goodbye rituals. One ritual involved Jeff writing a letter to his wife recalling fond memories; then together we engaged in a burning ritual where we lit and then watched the letter burn, at the end of which Jeff said aloud “Goodbye my Ann.” In another ritual Jeff went through Ann’s personal belongings, deciding what to keep and what to give away. He then invited some of Ann’s girlfriends to his home for a remembrance dinner party and asked them to choose a keepsake from Ann’s belongings. 18 months after Ann died Jeff bought all new bed linens and a new bed spread and relegated the old linens and bed spread to the guest bedroom. Jeff said it was his way of “saying goodbye to my bedroom Ann and also letting our history be there in another room.”
Grief Counseling and Grief Therapy: A handbook for the Mental Health Practitioner by J. William Worden
How to Grieve: Relearning the World by Tom Attig