A loss is the disappearance of something that is important and valued.
Grief is the normal response to a loss. Mourning is the outward expression of that grief. Grief occurs not just when someone dies, but whenever a person experiences significant loss which ranges from loss of business, home, pet, possessions to security, trust, safety, or a family member. Grief affects the person physically, emotionally, socially, and spiritually. Life is irrevocably altered, and the process of grief includes stages of coming to accept that reality.
Mourning is a different process from grief. Grief is the emotional response. However, mourning is the actions or behaviors that express that grief. Examples are having a memorial service for someone, wearing dark clothes, withdrawing from social activities. Mourning usually includes ceremonial rituals to honor what was loss. Although there is no "acceptable" mourning period, it tends to be approximately two years. This varies from culture to culture. Depending on the loss, a "normal" period of
intense symptoms (e.g., loss of appetite, weight loss, insomnia, morbid thoughts, major depression) is thought to occur for approximately two months. However, the
disclosure of a child's
sexual abuse is not a discrete, one-time event but continues over time, often with more disclosures and increased
distress. It is important that anyone experiencing prolonged losses and significant and painful symptoms, talk with their physician and/or
therapist.
Coping with personal loss can be overwhelming and all-consuming. It is important to mourn in a manner that honors and accepts the reality of the loss and also preserves the emotional stability of the person and maintains awareness of the effect of the mourning process on other members of the family. It is important that individuals have emotional
support as they mourn their losses. Talking to others, friends, family, professionals, is important for mental and emotional health. Joining a
support group , either online or in person results in opportunities to relate to other people in the same situation. Crying and release of emotions is critical. Holding in emotions and not processing through them, and denial of these feelings and not acting upon them, demonstrating through word or action the meaning of the loss, can result in being "stuck" in the loss and grief for much longer.
The
disclosure of a child's
sexual abuse initiates a pervasive sense of loss in
mothers. They grieve the loss of their child's innocence. They grieve the loss of childhood and adolescence without the
damaging effects of sexual abuse. In the case of
incest, they grieve the loss of
family as it has been experienced in the past and family members whose role and place in the family change. If the
perpetrator is a
partner, the mother experiences loss of an intimate relationship and loss of
trust. This loss compares to the loss of a spouse due to death or divorce. The loss may come without warning and initiate a
traumatic experience similar to hearing a spouse has been killed in an automobile accident. Mothers may experience significant loss of
self-esteem.
Elizabeth Kubler-Ross (1969) identified stages of grief, and these stages coincide with the experience of mothers following the sexual abuse of a child. The stages of grief include:
- Denial or emotional numbness - This is a natural defense to protect the person from reality.
- Anger - Anger can be directed at everyone involved in a situation. Grief is an emotional state, and a person is vulnerable to illogical thought processes and a lack of objectivity and clarity of thought.
- Guilt - Guilt is inevitable with any grief. In this case, mothers are vulnerable to intense and long-term guilt as they blame themselves for not protecting their children. Guilt can change to depression or despair unless processed through.
- Depression - Depression is a normal grief reaction and may feel like a heavy cloud hanging over your life. Depression is paralyzing and can sap energy, motivation, and hope. When depressed, mothers may seek unhealthy solutions, such as alcohol or drugs, or isolate from supportive people.
- Acceptance - Eventually acceptance of the loss occurs. However, this does not mean that life goes back to what it was before.
A recent study by Maciejewski, Zhang, Block, and Prigerson (2007) showed that, although the five stages of grief were present, each peaked during the grief process. Results of the study show that:
- Disbelief peaks at one month.
- Yearning peaks at four months. Yearning is the missing of the way things were. In the case of losing a loved one, it is missing that person.
- Anger peaks at five months.
- Depression peaks at six months.
- Acceptance is the strongest response to loss. It is present at the first and grows stronger with time.
The researchers concluded that sadness is not the predominant emotion in the grieving process. Yearning or what they characterized as pining increases steadily until the fourth month after a loss. The study showed that the first four stages gradually reduce in intensity after peaking; however, acceptance continues growing after a two-year period.
Parkes (1998) in his study of the grief process reports that about a third of people who lose a child or spouse will experience negative effects to both physical and mental health. Heart disease and other medical and psychological disorders increase following loss. The normal course of grief is outlined as:
- Numbness - The initial response of disbelief and inability to comprehend and process the loss. May last for hours or days and may result in impaired judgment and difficulty concentrating.
- Pining - Intense longing for the person accompanied by anxiety. Inability to accept the reality of the loss and yearning and searching for what was. Includes restlessness, anger, and guilt, and may include withdrawal.
- Disorganization and despair - Going over the events leading up to the loss and trying to find out what went wrong and make it right. Includes depression and lack of familiarity with present life; however, acceptance of reality has increased.
- Reorganization - Normal life functions, such as eating, sleeping, and short term memory, return to normal. Includes increased energy, decision-making, and self-confidence. Recovery often occurs in the second year after loss.
The tasks of the grief process include:
- Using healthy coping skills and accessing support in order to process past the denial and accept the loss.
- Experiencing the pain and the feelings associated with the losses. Allowing the process of "feeling the pain" to occur, rather than avoiding it.
- Adjusting to life in the here and now and to new roles, new ways of being, and a new sense of self and the world.
Mothers who experience the sexual abuse of a child process through grief and experience stages and tasks as in other types of losses. These are unique to the individual and situation and not predictable. As mothers process through the grief stages and symptoms, they must also perform critical roles in supporting the victim and remaining engaged and functional with the rest of the family. Because of this, the grief process can be aborted. If mothers do not experience the grief process, they are more likely to demonstrate physical or emotional consequences at a later time.
See Grief.
See Symptoms of Grief.
See Complicated Grief.