Note: Names have been changed to protect the privacy of those mentioned.
My cousin Micah recently contacted me to let me know his 84-year-old father Harry was in the hospital again. Harry was hospitalized several months ago with bronchitis a few weeks following his youngest brother’s death. Last week, an older brother died and within days Harry was in the hospital emergency room complaining of chest pain he was sure was a heart attack. After a flurry of tests the emergency room doctor sent Harry home with assurances that “everything is fine."
But everything isn’t fine: Harry is suffering. He is experiencing overwhelming physical manifestations of grief due to the loss of his brothers. Grief is an all-systems experience and as we mourn, the physical, emotional, mental and spiritual aspects of ourselves cannot be neatly separated out. Harry’s emotional distress is being experienced as pain and dysfunction in his chest area indicating that greater resiliency through greater self-care is needed in order to process his grief.
Physical Resilience and Grief
Physical resilience refers to the body's ability to adapt or be flexible, maintain stamina and strength, and recover quickly and efficiently in the face of stress, challenge and adversity. Physical grief resilience can be defined in the same way.
The loss of a loved one is one of the most stressful events most of us ever experience. The process of mourning can greatly compromise our physiology, negatively affecting brain processing, and also adversely affecting the way in which the immune, hormonal, and nervous systems function. I once had a client say, “I hate all this grieving. It makes my whole body feel awful – just terrible - like I’m living in someone else’s body!” The awful and terrible she described was the overall effect grief and trying to process that grief were having on her physiology.
Age, Loss History and Layered Grief Affect Physical Resiliency
Grief is an individual experience, different for everyone – and every BODY. No matter your age, we all come to a loss event with a body molded by time and what we have experienced.
Because the aging process itself depletes the body’s immune and hormonal reserves as well as brain and nervous system activity, older adults (people over 60) are more adversely affected physically by the stress and challenges inherent in a profound loss event such as the death of a loved one. Yes a lifetime of learned coping skills in the emotional, mental and spiritual domains of resilience can make the grief journey less physiologically impactful but those skills do not totally mitigate the effect mourning has on an aging body, making good physical self-care imperative when loss occurs.
The general state of one’s health prior to a loss event is also a key factor regarding how grief affects the body; no matter one’s age, if a loss event occurs when a significant or underlying health issue is already present, it can contribute to further immune, hormonal, nervous system and higher brain functioning deficits when traversing the hills and valleys of grief processing.
Additionally, if a loss occurs when another loss is already being processed, a person’s resilience capacity – their capacity to recover from and adapt after loss – can be lessened. This is certainly true for Harry, but is can also be true for children and adults of all ages as well.
Signs of Grief-related Physical Energy Drain and Stress Depletion
Feeling “awful” when in mourning (as my client phrased it) is due to what is referred to in the field of stress resilience training as “depletion” or the effects of “energy drain”. Thinking in terms of energy and a need for energy management when processing grief can be helpful in understanding the myriad ways in which grief emotions are expressed as physical symptoms; thinking in terms of energy management can also guide you toward what self-care behaviors and routines are now needed and work best for you.
Some common signs and symptoms of physical grief-related manifestations include:
- Deep fatigue
- Problems sleeping, including insomnia or sleeping too much
- General body aches, tightness or pain
- Backaches
- Headaches
- Stomach pains or a periodic flip flop sensation in the stomach
- Intestinal distress (diarrhea, constipation, pain, discomfort)
- Chest pressure or pain
- Heart palpitations
- Anxiety or panic attacks
- Heightened anxiety
- Difficulty regulating emotions
- Sudden - and sometimes - significant weight gain or loss
In a very real sense your body is always talking to you, trying to tell you something you need to know. The above signs and symptoms arise as an indication greater self-care is needed; self-care that optimally includes doing energy management practices and tools that help you avoid or mitigate the effects of energy drain and physiological depletion.
Some of these physical complaints are potentially serious and require a medical evaluation to exclude underlying health conditions before determining that the symptoms are due to grief; for that reason it was wise of Harry to go to the emergency room when experiencing chest pain after the death of his older brother.
Short-term Physical and Emotional Self-soothing Behaviors Aren't the Answer
I once had a woman tell me, “For some reason my husband’s death hasn’t affected me at all.” And yet in the six months following her husband’s death the woman had gained 60 pounds. In other words, without awareness, she was feeding her sorrow by eating (it turned out) lots of cake.
Sometimes we turn to what are called “short-term energy relieving behaviors” when in mourning. We engage in these behaviors as a way of trying to either numb out or, conversely, physically feed the pain of loss; we engage in these behaviors as a way to soothe overwhelming or uncomfortable emotions in a concrete physical way. Such self-soothing behaviors can negatively impact the grieving process and include:
- Food: eating when distressing, stressful or uncomfortable emotions arise
- Food: not eating to control your emotions when distressing, stressful or uncomfortable emotions arise
- Excessive or more than normal consumption of alcohol
- Drug-taking
- Working to excess to avoid feelings of loss
- Excessive shopping or going on buying sprees to avoid feelings of loss
- Isolating yourself to avoid having to share your feelings with others
If you become aware that you are engaging in these behaviors as a way to momentarily ease or relieve the pain of loss, it is an indication that healthier alternatives need to be explored and engaged in – perhaps with a grief professional or therapist.
Essential Physical Self-care Tips for Grief
Here are some basic – but essential – self-care tips for maintaining or improving physical resiliency when grieving:
Connect with others. The latest health and well-being research maintains that physical resilience is positively affected by the environment and social support. Arrange to spend time with supportive family and friends when possible. And stay connected to your faith community, social organizations or any other organizations or groups that give you a sense of belonging. If you need extra support, explore support group options and other resources or seek professional grief support.
Eat well. Eating nutritious foods and a well-balanced diet is always important, but particularly while grieving when the body is vulnerable to immune, hormonal and nervous system stress and depletion.
Sleep well. A good night’s sleep helps to renew the body’s daily energy supply (resting not only the body, but mind, emotions and spirit) and can help to counteract energy drain and the effects of depletion. Good sleep is one of the best things you can do for your total well-being after the loss of a loved one. If you find you’re not getting enough quality sleep or sleeping too much, consider speaking to a medical professional.
Exercise. Loss can leave you feeling temporarily unmoored or ungrounded. Staying connected to the physical body and the physical world through exercise is vital to maintaining a sense of aliveness that often feels lacking when in the midst of mourning. Even a short walk or several short walks inside or outside taken throughout the day can prove beneficial. Walks in nature are particularly renewing, offering the solace of quiet, fresh air, beauty and sunshine. Healthy grieving requires flow – emotionally, mentally, spiritually and physically – movement is essential self-care to avoid feeling stagnant or stuck.
Easy-to-do Tools for Improving Physical Grief Resilience
The relaxation response is a physical state of deep relaxation in which your body releases chemicals that slow down your breathing and heart rate**. Learning to purposefully access the relaxation response 1 – 2 times a day for 15 – 20 minutes at a time can help mitigate the depleting effects and energy drain caused by grief. The inner ease and greater inner comfort offered by the relaxation response can help you deal more skillfully with the physical and emotional aspects of the grieving process. Physiological benefits of the relaxation response include:
- Less muscle tension and tightness
- A greater feeling of relaxation or inner ease
- Better digestion
- Improved mood
- Greater emotional self-regulation
- Better sleep
- Greater mental clarity
- Improved long-term resiliency
Here are two easy-to-do relaxation response exercises that can be helpful as part of a grief resilience self-care routine:
Simple Breath Awareness and Belly Breathing
When under stress or when in distress, we tend to breathe faster and more shallowly than normal, increasing feelings of chest constriction and limiting the amount of oxygen circulating throughout the body, symptoms of which can include: light headedness; a feeling of cold in the body; increased muscle tension; and more. Taking time everyday throughout the day to stop and consciously breathe slower and deeper than usual to comfort or deeply into the belly can help to lessen grief-related physical symptoms. To breathe with awareness and belly breathe:
- Sit upright in a comfortable position or lay down flat on your back on a comfortable surface.
- Close your eyes. Begin by breathing normally and noticing how the breath feels on each inhalation and exhalation. Note: Is your breath long or short? Warm or cool? Are the inhalations and exhalations the same length? Try to let go of judgment - there is no good or bad, right or wrong answer. Simply notice how you are breathing.
- After several rounds of noticing your inhalations and exhalations, begin to breathe a bit slower and deeper than normal. Place one hand on your belly and the other hand on your ribcage or chest. On each inhale see if you can feel the belly area and ribcage expand with air; on each exhale see if you can feel the belly and ribcage contract, releasing all air. Continue to breathe slowly, decreasing the pace and increasing the depth of the breath as it feels right to you. Focus on noticing how your belly rises and falls with each breath. If it is helpful, count to four on each inhalation and four on each exhalation, gradually increasing over time the length of each inhalation and exhalation to a count of eight for each in and out breathe.
- Continue to focus on your breathing. If you notice your mind wandering away from your breathing, gently return your attention back to your breath.
- When you feel ready, open your eyes, letting your focus return to your surroundings.
Progressive Muscle Relaxation
Progressive muscle relaxation (sometimes called progressive muscle body scanning) involves purposefully tensing and then relaxing different muscle groups in your body until your body learns, over time, to find and maintain a state of physical relaxation. When we are under stress, including the stress of the pain of loss, the body can become habitually tense. A tense body then becomes the norm and a sense of inner relaxation or ease is lost. Purposefully tensing and relaxing different muscle groups can gently guide the body back to remembering what inner ease feels like.
To do progressive muscle relaxation, begin with the feet, hold tension for 10 – 20 seconds and then release. Work your way up the body: lower legs; thighs; hips and buttocks; back; torso; arms; hands; neck head; face. If it feels right to you, reverse the process, ending at your feet.
Related Remembering A Life Blog Posts
Yoga, visualization and guided (self-guided or guided by someone else) imagery are additional practices that induce the relaxation response. To explore these options check out these blog posts:
A Healing Place Meditation
Yoga – a Helpful Practice for Navigating the Grief Journey
Other related blogs include:
The Four Tasks of Mourning
The 5 Stages of the Soul and Grief Processing
Journeying Through Grief: Death, Memories & Healing
The 5 Things We Cannot Change
From Death Denial to Death Acceptance
Grieving and Healing After a Loved One Dies by Suicide
Faith & Grief
The Process of Accepting Difficult Grief Emotions
Grief and the Language of Emotions
A Related Remembering A Life Podcast Episode
Grief Re-imagined: 50 Creative Strategies to Build Resilience
Other Resources
The Grief Recovery Handbook by John W. James and Russell Friedman
Grief and God by Dr. Terri Daniel
The Language of Emotions by Karla McLaren
10 Helpful Tips for Resilient Grieving by Claire Bidwell Smith
Living Through Loss by Nancy R. Hooyman and Betty J. Kramer
**www.massgeneral.org
www.self-compassion.org
*www.heartmath.org
www.heartmath.com