During the stay-at-home-order, I was able to interview my wife Victoria, who is a grief counselor and who continues to provide support to clients during this crisis. Victoria Goebel, LMSW, is a Bereavement Counselor at Crossroads Hospice of Atlanta. She is a graduate of the Masters in Social Work program at the University of Georgia. 

What is grief?

Grief is the thoughts and feelings related to a loss, such as the death of a loved one, and includes anything we experience inside in response to a loss.

Mourning is the outward expression of our grief and has been called, “grief gone public.” Mourning involves talking to people about our experience. It also includes rituals such as attending funerals, donating to a charity in honor of our loved one, planting a tree, or writing a letter to a deceased loved one.

Anticipatory grief occurs when we anticipate a loss and feel grief before the event happens. For example, we may grieve the initial diagnosis of a loved one’s serious illness as we imagine how it impacts us and them. We may anticipate the loss of our loved one’s functional abilities, changes in daily structure and routines, financial strain, role shifts, or disrupted plans for the future. Many of us are experiencing anticipatory grief as we weather COVID-19.  We understand that life will not be the same and we feel that loss and vulnerability now.

How does grief affect us and how do we heal?

How grief affects us depends on the individual and their unique relationship to the person or thing they lost as well as the circumstances surrounding the loss, their own personal and biological history, and their support system. Though people share common grief experiences there are vast differences among individuals. We would be amiss to assume that the way we grieve is the same as someone else even if the circumstances are similar.

Bereaved people feel a range of emotions. Some clients describe feeling empty, lost, unmotivated, surreal, and profoundly sad. Often grievers experience anger, guilt and regret, frustration as well as mixed emotions. They may feel relieved that their role of primary caregiver has ended and shame for feeling relief. The feelings really vary depending on the person.

Grief affects us physically, emotionally, cognitively behaviorally, and spiritually. The important thing to remember is that what we feel is legitimate and so we can give ourselves permission to let it move in and through us. We do not need to be the gatekeeper of our thoughts and feelings by ignoring or rejecting those we think are unacceptable. When we give up trying to respond the “right” way and instead allow our true thoughts and feelings, self-compassion arises and grief can be more easily felt and released. We become softened.

As we allow grief the pain will eventually become less intense and our anxiety will decrease. We can breathe into the discomfort and know it isn’t forever even though it may feel entirely permanent. We can go for a walk with a friend or listen to beautiful music or pray or do whatever helps us cope. We may notice we start to have a good day here and there and that the pain did not destroy us after all. We begin to accept the unacceptable and can imagine ourselves being a part of life again. Some grievers have transformational growth experiences and become more compassionate toward themselves and others. Others seem to be unable to accept the changes and may become withdrawn and isolated. It is so important that we take very special care of ourselves during this process. If we feel stuck there are people who can help.

How is the loss of community during COVID affecting the bereaved?

I just spoke with a heartbroken client whose father died. She was not able to have the traditional funeral they had planned. Her father was cremated without a funeral due to travel restrictions and social distancing guidelines. Cremation meant no open casket to view the body or say goodbye in a way that felt meaningful to her. For many people to see and touch their loved one’s body helps them begin to accept the finality of the death. The funeral home did not allow gatherings of more than ten people and so her large extended family was not able to comfort each other in person. They did not meet in one another’s homes to share meals, hugs, tears, and memories. Besides feeling disoriented and lost from the death itself, my client said she felt stalled and alone. She said, “I don’t know what to do.”

Funerals, as well as other non-traditional ceremonial gatherings, help us know what to do after someone we love dies. They provide structure and support when we often feel directionless, heartbroken, and bereft. Groups like churches and their pastors and leaders also provide comfort and support as well as spiritual guidance. If ever there was a time that we need the physical presence of familiar people, this is it.

Bereaved children are also impacted by COVID-19. In addition to the collective anxiety felt around the pandemic, kids are not able to play with friends, attend their schools, see extended family, and may not be able to see an ill grandparent or loved one before death occurs. They may or may not be able to attend a funeral. We can help children grieve by involving them in what is going on. They may want to draw a picture for grandma with a note to say goodbye or sing a song or tell stories about their loved one. Above all we can help by encouraging them to ask questions and by being open about our own grief with them (appropriate to their age and development).

Another consequence of COVID-19 are the restrictions that have been placed on visitations in hospitals and other healthcare facilities. It is heartbreaking to see primary caregivers separated from their dying love ones. Imagine being a parent unable to visit and comfort your dying child. One mother was not able to visit her young dying child in a pediatric hospital. These are the types of heart-rending situations that put people at an increased risk for complicated grief. Many grievers have shared with me how difficult it is for them to accept that they were not present when their loved one died. They often feel guilt that their loved one died alone. Not all grievers feel this way but it is not uncommon based on my observation.

These are just a few examples of people groups whose grief is impacted by COVID-19, and is focused on those who have lost a loved one. Grief also encompasses other losses such as employment, freedom of movement, limited opportunities, and feeling unsafe in an unpredictable situation. The homeless, elderly, high-risk individuals, LGBTQIA community, and others are also grieving and are impacted in unique ways.

Those who are in the helping fields are doing our best to adapt and will need to be creative about learning to help in new ways. We may need to overcome learning curves, such as the use of new technology, in order to be of optimal service.

What are some alternate ideas for traditional funerals given the current COVID guidelines?

Grief cannot be put on hold without complicating the grieving/mourning process. We need to find ways to help grievers during this crisis. The following are suggestions in a changing situation, so please follow all CDC and local/state guidelines.

  • Have a small funeral or graveside service and postpone the larger funeral (people will be likely to attend due to the unique circumstance of COVID)
  • Provide multiple back to back services in order to accommodate more people
  • Livestream a small service (use technology to have guest books, video tributes, readings, sermons, prayers, shared memories, etc)
  • Those who do not have access to a live-streamed service may choose to have their own intimate gathering where they read, display photos, light candles, play music, share memories
  • Call a local hospice to see if the chaplains and bereavement counselors might provide a Ceremony of Remembrance (while following COVID precautions)
  • When it is safe to do so according to medical authorities, hold a memorial eucharist for all who have died during the pandemic, or for each person individually.

Visitations and funerals are, in many states, still permitted but the number of participants is limited. Regulations may vary so contact local funeral homes for updated information on the laws. For more information visit the National Funeral Directors Association and the Hospice Foundation of America.

What are some things that Anglican pastors and lay ministers can say to support people who grieve?

I am convinced that our ability to truly listen and care is more valuable than the majority of what we say. When we resist the temptation to say the “right” thing or to try and make them feel better we provide a safe place for grievers to express themselves honestly. National Grief Specialist, Dr Alan Wolfelt, calls this model of grief counseling “companioning” meaning the helper is there to be present to their pain, not try to take it away. I think the approach is so beautiful because it demonstrates the utmost respect for the person and their process.

Before I see clients I ask God to help me hold back the impulse to speak too fast or offer solutions. The simple act of listening and showing empathy can provide tremendous relief. Many of us, though well-intended, start to talk before we are conscious of what we are saying or what we just heard. We may be nervous because we care and don’t want to cause harm. However, talking without presence shuts most grievers down. I have learned this the hard way time and time again! God helps me slow down and put my ego in check.

When I pay attention, I can really look the person in the eye, take in their words, and observe their body language. What are they saying underneath the words? It is necessary to ask if we understand them correctly. This way we can establish enough trust to ask them how they are coping. Most people really want to be heard and they want to know we care. Maya Angelou said it best, “I’ve learned that people will forget what you said. People will forget what you did. But people will never forget how you made them feel.”

What are some things not to say?

Do not say, “give me a call if you need anything.” Either do not offer help or be specific about how you can help. When you ask them to call you, you are putting an additional burden on them.

Do not say anything that starts with, “at least” which minimizes their pain. For example, “at least he is no longer suffering or at least she led a long life.” That may be true but it takes the focus off the griever and may lead them to feel shame for feeling sad when their loved one is “no longer suffering.” Timing is everything. Follow their lead.

You might say, “I am heartbroken for you” or “I can’t imagine what it must be like to lose someone you love so much” or just tell them you love them and give them a hug (if you know they are a hugger).

Grief can be a wild and uncomfortable journey, a rabbit hole that changes us forever, and it is no easy task for most of us.  It is also vital to have trustworthy friends or family members, pastors, and church members who come along side us for support. They can make all the difference. If professional help is needed, many hospices provide bereavement counseling for free or and pastors can recommend trusted counsellors.