By Dr. Natasha Josefowitz

Everyone deals with pain differently. What helps me is trying to understand it. When my husband died, the pain was so intense that I wondered whether I would survive it. I did survive and decided to learn and write about the pain of loss and the process of healing. I used my own experience after the death of my husband four years ago, my cousin and my brother two years ago, and my son last year. I also researched the literature. As an expert, empowering yourself by understanding what you are experiencing is important. But it is equally important to allow yourself to experience the states of loss as well. As each state is discussed below, I have incorporated poems that reflect and perhaps engender the feelings associated with the various states of loss.

In order to better understand the grieving process and to discover if my experiences were universal, I talked informally to about 50 people experiencing loss and then interviewed in-depth 12 widows and 12 widowers. I used a questionnaire as a starting point, but I left it open-ended to capture more of their experiences. My criteria was that the death of the spouse should have occurred recently enough so that the memories were still fresh, and often still raw. The ages I chose were between 60 and 90 because this group tended to have had a long-term marriage and had parents who were no longer living and grown children — who had their own lives and were often living far away and therefore not available on a ongoing basis. This group lived alone with fewer resources than those who experience the death of a spouse in an earlier part of life. (Younger people dealing with loss have very different issues — they usually have children at home, parents that are supportive, friends and relatives, and often a job or regular activities that involve a community of like-minded people.) In the older group, issues such as health and isolation were more prevalent, many friends and relatives had died or were not available due to problems with transportation.

Even though people grieve in many individual ways and need different types of support — to wit, the activities that helped some were exactly what distressed others — there are common feelings and behaviors that most people exhibit in a continuum. I found that emotional states after the loss of a spouse had enough similarities that they were worth examining further.

Although I have attempted to categorize these in some sort of sequence, not all people went through these emotional states nor did they all encounter them in the order I propose. At times, many reverted to a previously experienced state before moving on. These emotional states, painful as they feel, are the steppingstones to healing.

PRE-GRIEF

What I call “Pre-Grief” only concerns those whose spouses had been ill for weeks, months, or even years. Those who are caregivers often reduce or drop out of their usual activities and stopped going out with friends. After the spouse dies, it is very difficult for them to reenter the social scene. They are grieving — even if relieved after a long illness — and initiating contact feels daunting. They feel disconnected and may need to ask trusted friends to help by organizing outings and events for them to participate in as a way to start reconnecting.

Still at Hospice

We’re still here because
his back is still hurting
he has prostate cancer
metastasized to his bones
so we’re here to get some relief
but the relief comes at a cost
opiates put you to sleep
so he lies there, only half-conscious
and as the hours become days
and the pain is only relieved
by increasing the medications
the days are turning into weeks
we came here, believing he would get better
and come home
but instead
he only came home to die
in a different hospital bed
the one in our continuing care unit
two floors up from our apartment
in our retirement community
he can see the ocean from his window
and hear the waves
hospice people come here, too
adjusting the pumps
the nurses are at his bedside
day and night
at first he has trouble talking
then swallowing
then moving
then breathing
and finally
living

SHOCK

The first state right after the wife or husband dies is “Shock.” Even if the death has been anticipated, the end of a life is jarring. During shock you fluctuate between unbearable emotional pain and the need to be rational and logical in order to deal with practical concerns such as funeral arrangements. Facing the reality of what needs to be taken care of pulls you away from the flow of tears and acts as a respite until a hug or display of sympathy causes you to break down again.

I strongly suggest you have everything in place before there is even an illness. My husband and I had picked our grave sites, written each other’s obituaries, and made lists of the newspapers, schools, and organizations to be notified. We had even chosen the music to be played and the caterer for the meal after the service. Everything was paid for, all I had to do was show up.

Where Are You?

Give me a sign
blow out the candle
rustle the curtain
make a sound in the wind
touch my cheek
with a breath of air
give me a sign
so I will know
you are here
somewhere with me
please let me feel you
in the room
in the air
in the energy
pulsating in the universe
my love
where are you?

NUMBNESS

After shock comes the second state: “Numbness.” People say, “I feel nothing,” “I feel like a ghost,” “I walk around like a zombie.” I suspect this lack of affect is the brain’s way of protecting against intense and disabling pain, waiting for things to get settled a bit. What often makes this such a difficult time is that it is also the period when there are papers to fill out and sign, decisions to be made, transfers of titles, financial questions, etc. Friends and relatives who were there for the funeral are still around. For some the company is a solace, for others a burden. This is a time when you need a trusted lawyer, accountant, and someone to deal with the paperwork.

There is a reason common wisdom dictates that we should not make major decisions too quickly after a loss. In this state, judgment can be impaired, and we may even be making choices by refusing to choose. Behavioral symptoms can include lethargy and exhaustion, but also anxiety and agitation, not crying at all or sobbing uncontrollably. The immune system may be weakened after loss — so taking care of yourself by getting enough sleep and eating regularly becomes even more important.

Tired!

Ever since he died
I have felt tired
I wake up tired
I may have a bit of energy
during the day
but then I’m exhausted
afterward
I have become a person
who drags her feet
pushes herself out of an armchair
with a sigh
I walk slower,
think slower,
and everything matters less —
the way I look,
what clothes I wear,
whether I need a haircut,
I am also more forgetful
I have to keep checking
my calendar
lest I forget to go somewhere
or do something I’ve promised to do
I forget who just asked me a question
or what that question was
I walk into a room
and wonder why I’m there
I mix up names and faces
and worry whether
I’m losing my mind
I wonder whether I have MCI
“mild cognitive impairment”
but maybe it’s not even
“mild” anymore
yes, I’m more tired and forgetful
than I was a year ago

DISBELIEF

“Disbelief” is the third state. Slowly numbness becomes cognitive dissonance. The phone rings, you think it’s him — it isn’t, he’s dead. You get some news you want to share with her, for a split second you plan on doing so, then you realize you cannot, because she is gone. Even though you know your husband has passed, you keep expecting to see him sitting on the sofa reading the newspaper when you come home or to hear him making coffee when you get up in the morning; you shop for two; you say “us” instead of “me.” Your unconscious has not yet caught up with the new reality of your life, and it will take time to reprogram your reflexes and habits.

Maybe

Maybe it’s all a mistake
maybe it wasn’t real
maybe it was a bad dream
maybe it didn’t happen
maybe when
I come home tonight
he’ll be there, saying
“Hi, how was it?”
and I’ll tell him
all about it
except
he wasn’t there
and he didn’t ask

REALITY

Finally you are emotionally able to accept “Reality,” the fourth state. You get in touch with the finality of death, with the permanent absence of the beloved spouse, with having to live without the one you cannot live without. It is a period of intense grief for most people. You may be plagued with guilt, the urge to blame someone, and unanswerable questions. “How could this have happened?” “Maybe we could have done more to save him.” All the “could have,” “should have,” “why did I?” “why didn’t I?” come surging into our consciousness.

You are left alone; there is no one to share the minutia of daily life. You have lost the witness to your life — no one knows what you had for breakfast, what you just read, where you went, what you thought, and, worst of all, no one really cares. The feeling of isolation is pervasive. You are no longer the center of anyone’s life, nor is anyone the center of yours.

Pain

The pain comes on suddenly
while I drive
or eat dinner
or talk to a friend
the pain is terrible
it starts somewhere
in the center of my body
and radiates out
everywhere
it’s the pain of being aware
of how I miss him
in that moment
the overpowering awareness
of his forever absence
and there is no one to turn to
no where to go
no getting away
no possible refuge
no stopping the pain
it sits there
enveloping me
and I am helpless in its grip
contemplating with awe
the immensity
of how much pain one can bear
without dying from it

ALIENATION

Getting out of your comfort zone to meet the world is both difficult and imperative. When you first begin to make that effort, you experience the fifth emotional state, “Alienation.” We tend to identify ourselves in relationship to other people — daughter, son, mother, father, wife, husband, friend... So if you are no longer a wife, what are you? You are single in a couple’s world: You market for one, cook for one, walk alone, go to a party and stand in the corner with a glass in your hand watching happy couples. You’re not a whole person; you are half a couple.

I became grateful when couples invited me to join them for dinner or a movie, but I found the odd number uncomfortable (“three’s a crowd,” “the fifth wheel”). Unless they are old friends, there is a level of discomfort that is felt by your companions too. This uneasiness is probably why many recent widows are dropped by some couples. It is also my experience. The way to keep up with the relationship is to reciprocate: Treat the couple to dinner or lunch or get tickets to the theater or a concert. You must become creative to maintain friendships.

Alone at a Party

Going alone to a party
will the people there be friendly?
will someone talk to me?
or will I stand in a corner
glass in hand
scanning the room
for a familiar face
not finding one
looking for a smile or nod
approaching close-knit groups
unable to enter?
I am a stranger among the natives
an alien in a foreign land
I will go home early tonight

It’s Good for Me

Everything is an effort
I make myself
go out with friends
go to cultural events
because I know
it’s good for me
but I must make myself do it
it’s a conscious effort
I used to look forward
to all kinds of things
I don’t look forward
to anything anymore
I just do it
because it’s good for me

REINVENTION

You cannot live happily in your new, single life without changing your identity from half a couple to a whole person. You will need to reinvent yourself in order to move on, stand on your own two feet, and forge a satisfying future. Reinvention is the purposeful transformation of your perceptions about yourself and the world. It is normal to feel awkward at first; navigating in this new way may be uncomfortable for awhile. Ask friends to include you in their activities and help you get engaged again in your community. If you refuse invitations too often, chances are you won’t be asked again. If you go to an event or a party, it is helpful to go with someone so that you don’t feel stranded by yourself.

Looking at Men

I caught myself
looking at men
I have not done that
in seventy years
then it used to be boys
now it’s older men
in my age group
I look and wonder
whether they’re married
I would like to go out
with a male companion
for a quiet dinner
perhaps a movie
that we can talk about later
I have women friends
why isn’t it the same?
I’m somehow not sure
I am allowed
to feel this way
he died just over two years ago
is it too soon
for me to wish for couplehood?
am I being disloyal
to him and his memory?
I feel guilty
for catching myself
looking at men

Caring about Not Caring

The things I used to care about
I no longer do
but I really do care
that I don’t care
about the things
I used to care about

THE NEW NORMAL

Through reinvention, you have morphed into an okay single person. You have arrived at the next and final state: “the New Normal.” You are not half of a couple, but a whole woman or man — less needy and able to experience life with all its pleasures and pitfalls. I am not saying that you don’t miss your spouse, but you are really living again instead of just surviving.

Now life can be good again, and new adventures are not only possible, but also enjoyable. In this state you are able to form new friendships which are meaningful and enduring — friends to go out with, share a meal or travel with. You may be alone, but you are not lonely. Home is a refuge, not solitary confinement. You feel like a complete person, grounded, and secure in your ability to manage your life.

Because of the particular age group I interviewed (60 to 90), romance is a very remote possibility, and the large majority said they would not be interested in sharing life again with someone — companionship yes, love affair no. This is more true of widows than of widowers, who frequently find companionship and marriage with a younger woman. Single men in this age group are at a premium, and we joke about the casserole brigade: women who come bearing food and end up with the man.

Amazing

Today I have decided
that I am not half a couple
mourning the one that’s gone
for I have integrated him within me
and so I am a whole person
standing on my own two feet
independent and strong
there is nothing I cannot do
for there is nothing I can’t imagine
I have no fears
not of living nor of dying
I am doing the first
the best I know how
until the second stops me
hopefully in my tracks
I feel the wisdom of my years
a learning that I can use well
to make it easier for others’ 
journeys
as mine draws to an end
I savor the moments
in ways new to me
a quietness has taken hold
like a new distance, a perspective
an understanding
I know not exactly of what
a comfort in my place
a knowing of my time
the word may be “serenity”
it exists
even in new adventures
in willingness for risks
in shoulder shrugs at failures
in smiles at foibles
and secret laughter
at the amazingness of it all

POST-GRIEF

For years after the death of a spouse, you may regress into earlier emotional states. A song, a scent, or a photo triggers an instant of sharp pain, and this may impact your mood for a few hours or days. Anniversaries and holidays can exact an additional toll — others in a celebratory mood make the widow or widower even more aware of the loss, pain, and separation. If it comes on suddenly and gets resolved, it is a normal occurrence. On the other hand, if after seeming to have come to terms with being alone, there is a long period of renewed pain and of feeling alienated in a world of non-grieving people, it is called “complicated grief,” and the help of a professional may be needed if it continues unabated.

Missing Him Again

He has been gone
for several years
and I’m OK
he does not live
in my head anymore
he lives in my heart
and yet sometimes
unexpectedly
I feel I am back
to just after
he died
I’m missing him
I’m hurting
I feel disoriented
desperately wishing him back
I remember
all that I have lost
that I will never have again
it has been years since he died
but it feels like yesterday

Conclusion

Grieving can be long or short. The emotional states I described are not immutable: Some may never be experienced; others may exist that I have not encountered. They may not be sequential and may be repeated. I often felt like I took two steps forward and one step back, but grief does soften over time.

The important thing to remember is that it is normal to feel abnormal. In other words, when you feel a bit crazy, it is good to know that it is a prevalent experience and a typical part of grieving; it too shall pass. Life is made up of steppingstones, no matter how awful it feels at the moment, there is a step waiting for us to place one foot on, perhaps gingerly. Add the second foot, and there you are, standing solidly on a new step that is waiting to be explored and to be lived.

Healing

When one is in the middle
of pain
it is impossible to envisage
a time without it
yet that time comes
unexpectedly
surprising me
by its suddenness
from an agonizingly
slow healing
to a world of brighter colors
to a lighter step
to being whole again
there is an old saying that
when someone you love dies,
the main difference is
that he is no longer
outside of you,
he is inside
I have incorporated him
I am poorer for the lack
of his physical presence
but I have become richer
by his continuing to exist
in me