Dealing With Grief in the Age of COVID-19

Many parts of the country, including Philadelphia, are slowly reopening businesses and lifting restrictions on stay-at-home orders, as the urge to return to some sense of normalcy intensifies. But for hundreds of thousands in the U.S., and millions across the globe, some scars will remain forever.

The pandemic has forced us to reckon with an unprecedented scale and nature of grief. The disruptions of our daily routines, not being able to interact with our communities, the loss of income and stability, and the indelible loss of our loved ones – there are so many layers of “normal” that have been stripped away, leaving a significant toll on our mental health and life, as we once knew it, hard to recognize.

Mourning our individual and collective losses is overwhelming. We sat down with Rachael Rosenfeld, LCSW, a behavioral health consultant at Abington - Jefferson Health who provides mental health support to patients in a primary care setting. Here she offers tips for how to cope with grief, and support someone who has lost a loved one to this pandemic.

What is so unique about the grief we’re experiencing during these uncharted times?

Three major points stand out and characterize our current grief: the cause of the grief, how long it’s lasting, and that we’re all experiencing this collectively.

A lot of us have experienced the loss of a loved one or anticipate that one day we will. But perhaps we did not anticipate also grieving the loss of normalcy, safety in the community, physical contact with our friends, the ability to send your kids off to school. This was a major curveball and our lives were really turned upside down very quickly.

The recent incidents of police brutality against Black people have exacerbated the grief of these communities, who have also been disproportionately impacted by COVID-19. The intersection of these public health crises is a huge burden to bear.

What are the different kinds of grief and emotions that people may experience right now?

There is no “normal” when it comes to grief. While there are typical stages that we move through in the process, we all experience grief differently and on our own timelines—that’s OK! Anticipatory grief is when we begin grieving before the loss has occurred. This is common when we have a loved one who is sick. We know they will die and so it is understandable that we mourn the loss of their health as well as anticipate the grief we will feel after they pass. Right now, we may be experiencing anticipatory grief thinking about the cumulative loss of life, the economic toll and everything that was normal and comfortable to us before this health crisis began.

It is possible to experience a range of emotions during grief – anger, anxiety, profound sadness, denial, acceptance, guilt – and there is no linear path between these emotions. One day, you might find yourself thinking ‘I can do this’ and the next day you might feel the complete opposite. It is normal to experience the back and forth’s – be kind to and patient with yourself.

What would you say to someone who is overwhelmed by grief?

Grief is so tough. I often remind patients who are grieving that the pain they are experiencing mirrors their loss. If you lost someone you were very close to and that individual played a big role in your life, then you can anticipate feeling some pretty significant grief.

It is important to remember that grief is a normal and healthy human experience. While it should not be skipped, it’s OK to pause grieving if you feel like it’s not yet safe to process these emotions in light of the current situation. This is compartmentalizing, and it is an understandable coping mechanism given the magnitude of this health crisis.

If you need to talk to a someone, many mental health professionals are offering virtual appointments. Consider finding someone who specializes in grief and loss.

Many people aren’t even able to say goodbye to their loved ones. How can people grieve, when so many of the ways to mark loss are no longer possible?

This is certainly one of the most challenging aspects of grief and loss during this crisis. Many of our traditions around death aren’t available to us right now—a typical funeral, a mass, or sitting shiva at home. It is painful to have to put off memorializing in a traditional way, but consider ways to remember your loved one from the safety of your home, such as creating a photo album of memories, writing in a journal or wearing something special that was theirs, like a sweater or a watch.

Grief can be isolating even under normal circumstances. With social distancing, the risk of isolation is even greater. Use FaceTime, schedule phone dates with friends and family and connect virtually for support. Many religious communities are running support groups right now, and it’s a great way to connect.

How can one help someone who has experienced a loss?

The best thing you can do for someone who has lost a loved one to COVID-19, or their job, or even place of residence, is listen and be available. We all need a safe person to hear us out when we are sad, scared and angry. Know that all of these feelings are to be expected and you can provide space for these emotions by being a listening ear. Don’t wait for your friend or family member to reach out, instead schedule a time every few days to check in. Consider saying “I’m going to call you after dinnertime on Monday, Wednesday and Saturday- don’t feel pressured to talk but know that I am going to check on you then and I’ll be there for you.” Try not to offer advice or feel like you need to fix the situation.

What can someone who has been dealing with an existing loss or trauma and is triggered by this crisis do to support themselves?

The lack of human contact, the images of hospitals and sick patients, and headlines in the news can certainly be re-traumatizing for someone who has experienced a loss of a loved one, has been a caregiver, or experienced trauma that reflects the current social isolation, like incarceration. It’s important to fall back on coping mechanisms that have helped you in the past, and remind yourself of the resilience that those previous adversities built. Think about ‘How did I survive that?’ And while it is important to recognize the collective loss that we are facing as a society, it does not diminish your loss or grief in anyway, and it is not selfish to tend to that internal process. We can’t take care of others if we don’t take care of ourselves.

How can we all support the individual, and collective grieving process?

• Stay connected: Your community has changed but it has not disappeared. Talk openly with your friends and family about your emotional health and ask them about theirs. You can be a role model by getting the conversation started. Remember to do so within appropriate boundaries with children.
• Acknowledge anxiety: A big, but often unspoken part of grief is anxiety. The two really go hand in hand, and especially right now, the fear of losing someone we love is anxiety-provoking and scary. Now more than ever it’s important to utilize good coping mechanisms. If you are feeling anxious, try to engage in an activity that is both distracting and relaxing. For example, go on a long walk while listening to your favorite music, start a big puzzle with your family or put something funny on the TV.
• Be informed but not overwhelmed: It is important to be informed about the numbers coming out every day on the loss of life and economic toll, but there is the danger of being overwhelmed to the point of being desensitized. We must remember there are names and faces behind these numbers, but at the same time, it is important to conserve our emotional energy when it comes to consuming difficult news. Consider limiting the amount of time you are on social media, watching and reading the news and then be strict about those parameters. You can also take a “media cleanse” and delegate your news alerts to a friend, family member or significant other. After a long day at work, sometimes I know that the last thing I should do is turn on the news so I turn to my husband for the highlights and that’s OK.

Resources at Jefferson:

• Visit myJeffHub for resources for wellbeing during COVID19
• Student Personal Counseling Center or call 215-955-HELP to make an appointment
• Emotional Health & Wellness Program for House Staff or call 215-955-HELP to make an appointment
• First Call Employee Assistance Program for all Jefferson employees
• Taking Care of Your Mental Wellbeing During a Pandemic
• A History of Injustice – Coping with Racial Trauma

General Resources:

• National Suicide Prevention Lifeline; 1-800-273-8255 (TALK); suicidepreventionlifeline.org
• NAMI (National Alliance of Mental Illness) Helpline 800-950-NAMI. Or in a crisis, text "NAMI" to 741-741. NAMI.org/Covid19
• www.crisistextline.org
• National Behavioral Health Treatment Services Locator
• Substance Abuse and Mental Health Services Administration. SAMHSA National Helpline: 1-800-662-HELP (4357) Treatment referral and information, 24/7.