As Passover approaches, coping with grief over the death of a loved one can be particularly acute, especially when annual traditions are continued in the friend’s or relative’s absence.
“During a holiday, memories and gatherings of people close to you are repeated,” said Mona Strassburger, a trained volunteer at the Good Grief Center for Bereavement Support in Squirrel Hill, a nonprofit organization that provides resources and referrals for those coping with loss. “For this holiday — Passover — for example, people have a seder. Someone might be missing from the table. Maybe it’s the person who was the leader of the seder, or maybe it’s the person who asked The Four Questions last year, or maybe it’s someone whom you cooked with. Their absence may be more focal than during a typical day.”
In order to get through such a difficult time, Strassburger said it is important to first face the fact that one is grieving.
“One of the most important things to do is to acknowledge that you are going to be sad, and that you are okay with that,” she said.
Some people may find it too difficult to attend seders or services. In such cases, they should not feel obligated to participate.
“You may need to sit out some activities,” Strassburger said. “You may not be able to go to a seder. You need to check in with yourself to see what you are feeling, and give yourself a wide berth.”
Strassburger, who runs an open support group at the Good Grief Center, and also counsels individuals, advises people dealing with those who are grieving to be respectful of their needs, and not to push them into participating in activities in which they are not ready to engage.
“You need to allow a person who is grieving to do what they need to do,” she said. “You need to be respectful of how people need to grieve. You need to take the cue from the person who is grieving. They may need some quiet time. They may be able to come to the seder, but need to leave early. The important thing is not to judge them, to be willing to listen, and to give them some space.”
Grief is a personal process, she said, and not everyone deals with it in the same way.
“For the seder, someone might get an enormous amount of pleasure cooking dishes that were cooked by a person who is now gone,” she said, “but there may be someone else in the family who can’t do that.”
Because holidays can be particularly difficult to navigate when dealing with grief, it can be helpful to be proactive when dealing with those who are coping with loss, according to Dr. Mark Miller, a geriatric psychiatrist and the medical director of the Late-Life Depression Prevention Clinic at the Western Psychiatric Institute and Clinic.
“Holidays are a very common time to remember those who have passed
before,” Miller said. “It can be more painful and obvious when a family member is missing. People need to anticipate that fact and be proactive, and encourage someone who is grieving to talk more about his loved one.”
“There is a myth that you don’t bring up the death of, say, a husband, because it could upset his wife,” Miller continued. “In fact, what better time to talk about someone we cared about and to reminisce than the holidays? It helps a person to process the meaning of his loss. He might shed a tear, but that’s what he needs to do.”
While most people begin to move on with life after about six months following the loss of a loved one, about 10 percent of people experience what is called “complicated grief,” which is prolonged over time, and which does not lessen in intensity, Miller said.
“These are people who are stuck in grief,” he said. “These are folks who have difficulty accepting the loss. They think they don’t have anything to look forward to. It is sometimes accompanied by depression.”
Miller, along with Dr. Charles Reynolds III, Dr. Kathy Shear of Columbia University, and colleagues in Boston and San Diego, have devised a treatment study for people suffering from complicated grief.
The study, called HEAL, aims to determine whether medicine, as compared with a placebo, helps those with complicated grief, and whether complicated grief therapy is more beneficial than standard support.
The 16-week study will randomly assign some of its 300 participants to complicated grief therapy, which employs “specialized techniques to help people get at the root of their complicated grief suffering, hearing out the story of a person’s perception of the death in great detail,” Miller said. “It involves revisiting memories of what happened right before the death and subsequent to the death, and helping them to process the memories in a way they can better live with.”
The study, which is ongoing, and is currently enrolling participants over the age of 18, is a “great opportunity for people in the Pittsburgh area to take advantage of a novel treatment,” Miller said.
People interacting with those who are grieving during a holiday need to realize that people grieve in different ways, and on different timetables, said Mike Lockovich, the senior clinician for the HEAL study.
“Where some people may be able to approach the holiday and think of good memories [of a loved one], another may only feel the loss,” Lockovich said. “There needs to be some awareness and sensitivity that the holidays may be very difficult for people who are only feeling the loss, and not the wonderful memories that came before the loss.”
As a holiday, anniversary, or other important day approaches, Lockovich recommends that someone who is grieving “deliberately” do three things:
• Think of a specific way to commemorate or honor the person who is not there;
• Do something that is personally fun or enjoyable; and
• Have a plan to take care of oneself if one becomes overwhelmed.
“You want to have a way of taking care of yourself, and you don’t want it dependant on what other people do,” he said. “It may be pulling yourself apart from the group and spending some time alone. It should be something specific within your power to enact, a way of taking care of yourself if you get overwhelmed.”
The holidays are an “ideal time” for family members to offer support and “gentle encouragement to work toward restorative activities in life,” said Miller.
“But be patient as well,” he cautioned. “It takes time.”
(Toby Tabachnick can be reached at email@example.com.)