Navigating ambiguous loss, grief, and mourning during COVID-19

Do you feel frazzled, irritable, preoccupied, angry, reactive, or just plain tired?

Christine Ruth, M.Div., MS, LMFT, owner of Niwot Counseling Center says you are not alone. In her over 20-years of experience as a social worker, hospice grief counselor, spouse, and marriage and family therapist, Ruth has specialized in helping people work through loss and grief.

And while you might not know it, these feelings are a normal response to what Ruth calls the “confusing emotional roller-coaster” of COVID-19.

According to Ruth, there are some complex grief responses we, as a society and as individuals, are working through in response to the pandemic.

When faced with stressful situations, Ruth said the body will often have a traumatic stress response. Though we often think of this type of stress response as a result of immediate life-threatening situations, this cortisol and adrenaline pumping fight or flight response can also come from low-level sustained trauma, like the ongoing uncertainty of a global pandemic. And this stress response can result in a strange mix of emotions.

Part of the challenge we are faced with is working through ambiguous loss. According to Ruth, this term, coined by Dr. Pauline Boss, refers to a loss that’s unacknowledged or unquantifiable or is a loss that’s not supported by the cultural rituals we have for managing grief.

“I’m realizing that so much of what we’re going through is ambiguous loss—meaning we are going through the stages of grief—many people are having all of those emotions and are cycling through the stages of grief—but aren’t recognizing that,” Ruth said.

The stages of grief, as identified by the Swiss-American psychiatrist Elisabeth Kübler-Ross, are denial, anger, bargaining, depression, and acceptance.

Ruth noted that these stages are a cycle, not a line. And because they are not linear, we can cycle through all the stages in an hour, a day, a week, or a month. And to complicate the cycle, most of the people around us, including our family, friends, and neighbors, likely aren’t in the same place in their grief cycle as we are.

One thing Ruth said that can help but may feel counterintuitive is to respect each other’s privacy and to be gentle with yourself and others. This is a time when respecting limits and boundaries is important.

Ruth also noted that there is a difference between grieving and mourning, with grief being the personal experience of loss, and mourning being the outward expression of loss or the ways we find to verbally or emotionally express loss.

“In our culture, we’re all grieving, but we’re not doing a great job of mourning which is finding helpful ways to express our losses,” said Ruth.

She related this to losing a loved one. With this type of loss, we have helpful cultural rituals and structures to support our grief. However, in times of an unprecedented crisis like a global pandemic, we aren’t necessarily equipped to know how to properly mourn the losses we are facing. And these losses, according to Ruth, range from loss of identities, roles, relationships, and security.

“I’m seeing a lot of the anger and a lot of the despair of people just feeling helpless or hopeless. Anxiety is spiking for everyone because these are huge events over which we have no control,” said Ruth.

Her recommendation is to work on what can you control. And part of this, said Ruth, is identifying your needs and creating a routine to help you meet them.

“We all have a deep need for novelty and change in our lives. Ironically, we also have a need for stability. Right now COVID is assaulting both those needs. So it’s important to create stability by creating routines in your house,” said Ruth.

And routines don’t have to be elaborate to be helpful. One that Ruth recommended was going to bed at the same time and waking up at the same time. Without our normal schedule of work and school, we might be tempted to shift our routines, but Ruth said that sticking to a sleep schedule is one way to help with the need for routine.

In terms of our need for novelty, Ruth recommending finding new but simple ways to vary your quarantine routine. “If you’re able to walk, find one new way to be novel,” she said. This can be as simple as taking a walk in a new place, heading out on a short road trip or drive, going on a new hike, or dining out at a new restaurant. “Finding ways to integrate physical activity and being outside are both really important things,” said Ruth.

On her most recent blog, Ruth offered five strategies for managing relationships during COVID-19:

1. Recognize that you are grieving and will likely grieve differently than your partner or family members

2. Embrace your differing strategies for distraction

3. Notice and name the parts of you that are becoming reactive

4. Be gentle with yourself and your family members

5. Mourn your losses

And don’t be afraid to reach out for help if you feel you can’t manage these emotions on your own. Ruth recommends Psychology Today as a great resource to connect with a medical health professional.

“Make room for the whole repertoire of emotions, and know that you’re not alone,” said Ruth.