After losing a loved one, the holidays can be hard

Anniversaries and especially the holidays can be a difficult time for family grieving the loss of a loved one. There are types of grief that are "stuck" and unhealthy, and need therapy. However, it is important not to pathologize normal, healthy grief just because it hurts, or because others think it's "time to move on." Research shows that anniversaries of a death or a special time can bring up grief-related memories for up to 10 years. It's normal.

But what makes grief healthy or unhealthy? There are four basic tasks to address after losing a loved one, which represent healthy grieving:

1. Actualize the death (recognize that the loved one is truly gone)

2. Express emotions regarding the loved one (including negative or conflicting emotions)

3. Readjust to daily life without the loved one (especially in the loss of a spouse), internally, externally, and spiritually

4. Be able to remember the loved one while reinvesting in life (the future)

(from Worden, 2002, Grief Counseling, 3rd. Ed.)

These are not tasks that are taken in this order, necessarily, and can overlap. Everyone's experience is different, and regardless of taking three months or three years to move through these tasks, the act of moving through them represents healthy grieving. And healthy grieving does not exclude the importance of seeking support from family members, a faith community, a therapist, or all of the above.

Unhealthy grieving is defined by getting stuck on one of the tasks, just as healthy grieving means moving through the tasks (again, at a natural pace). I find that many of my clients, for instance, are stuck on Task 2, which is expressing emotions. This is often because they have emotions that they feel are unacceptable, such as anger toward the deceased. Perhaps a teenage boy promised his mother to be safe in his new car but died because he did not wear a seat belt. It would be normal to have conflicting emotions, including anger, and it is healthy to express that. But it can feel unfair or socially inappropriate. The mother might hide such emotions even from herself, and instead project her anger onto others, such as doctors, or feel guilt by turning the anger on herself. A therapist is especially valuable in helping "stuck" clients discover emotions they did not know they had (such as anger), and to help find healthy ways to express all emotions.

Traumatic grief is another thing altogether, and often occurs when there is a sudden or horrifying death, such as seeing a loved one die in a car accident, or watching a parent have a prolonged and disturbing experience of a degenerative disease like Alzheimer's. In these cases, trauma therapy such as EMDR can be very helpful, in untangling the trauma so that all memories of the deceased fit into a life story, rather than the only accessible memories being terrible and intrusive. Even so, grief is so unique that it is best, even in the case of using EMDR, to choose a therapist with a knowledge of grief therapy.

I have recently made a study of traumatic loss as an event unlike other traumas. You see, not everyone is physically abused, and not everyone was told they were worthless since birth, but everyone dies. And deep inside, we know that this is not supposed to be the way things are. Traumatic loss, when I use EMDR, has required special techniques that I didn't learn in my EMDR training even at the higher levels. It should be noted, however, that for normal grief, in one study, EMDR without any "extras" was shown to be as effective as any mainstream grief therapy

Finally, it is important not to assume that there is anything wrong with you for feeling sad, even for an extended period, as long as the stages of grief are being navigated. Therapy can provide useful support. But, when things seem completely stuck in the past, however, it is definitely time to seek help, especially if the loss was traumatic.