Despite the intense roller-coaster emotions and feeling out of control experienced by many bereaved persons, most grief is a normal albeit painful reaction to the loss of a loved one. Each individual expresses grief in his or her own way. Although grief is not time bound, the intensity of normal grief does ameliorate over time as the bereaved adjusts to the loss.

Grief can affect people emotionally, physically, cognitively and behaviorally.

Emotional
Sadness, anger, guilt, self-reproach, anxiety, loneliness, fatigue, helplessness, shock, yearning, emancipation, relief, numbness

Physical
Hollowness of the stomach, tightness of the chest, tightness of the throat, over-sensitivity to noise, sense of depersonalization, breathlessness and shortness of breath, weakness of the muscles, lack of energy, dry mouth

Cognitive
Disbelief, confusion, preoccupation, sense of presence, hallucinations, lack of focus

Behavioral
Sleep disturbances, appetite disturbances, absent-mindedness, social withdrawal, dreams of the deceased, searching and calling out, sighing, restless over-activity, crying, visiting places or carrying objects, treasuring objects.

Many grievers express their grief with emotional and behavioral grief reactions. Others, who express their grief cognitively and with physical manifestations, may appear on the surface to not be grieving, and their grief can go unrecognized and unacknowledged.

Extramarital lovers, mentally handicapped individuals, children, ex-spouses, step-parents, and women who have had miscarriages and abortions are examples of others whose grief often goes unrecognized and unacknowledged. These individuals may carry their burdens alone and are often denied participation in funerals and other rites.

The grief journey involves accomplishing tasks and making choices. These tasks include: accepting the reality of the loss; working through the pain of the grief; adjusting to an environment in which the deceased is missing; relocating the deceased and moving on; and readjusting spiritual and philosophical systems.

The manner and timing in which these tasks are met will vary, and each individual will find his or her own special way. Again, it is important to be kind and patient with oneself. Bereavement support groups can be helpful. On occasion, a person will become stuck at some point in their grief journey and their grief becomes complicated. Seeking the services of a grief counselor may be warranted.

For counseling and bereavement support group referrals, please contact the patient services manager at your local chapter of The Leukemia & Lymphoma Society. To find your chapter, go to our Web site's homepage and type in your ZIP code in the upper right hand corner and click on "go". The chapter name and number will come up.

Although children are not able to fully comprehend death until they are about 10 years of ages, they are nevertheless capable of experiencing grief from a very young age, once they are able to sense separation from caregivers. Children's grief is different from adults and is very much dependent on their developmental level. Children's grief may also be cyclical, in that children will grieve within the confines of their developmental stage, and then re-grieve the same loss again when they are older in a more developmentally advanced manner.

Over time, with successful grief work, the ups and downs of grief will become less intense, as the wounds of loss heal. However, what remains is often not an ending but a new beginning, as new and different, but continuing bonds with a loved one are established and personal growth and transformation are discovered.

The select reading list available through our Web site has listings of books for bereaved children, teens, and adults. Please click here for details.