Knowing the Symptoms and Signs of Grief

We were promised sufferings. They were part of the program. We were even told, ‘Blessed are they that mourn,’ and I accept it. I’ve got nothing that I hadn’t bargained for. Of course it is different when the thing happens to oneself, not to others, and in reality, not imagination.” ― C.S. Lewis, A Grief Observed

Intellectually, we all realize that eventually we will lose our loved ones. We try not to think about that too much as if guarding it as a remote notion in our minds staves off this inevitability. After all, as Saint Gregory of Nyssa observes, “There is an instinctive and deep-seated abhorrence of death in everyone!” (On the Soul and the Resurrection). When death does come to a loved one, however, we feel as though we’ve been struck by a thunderbolt and don’t know quite how to react or if our reactions are normal. We experience strange emotions welling up from what seems like nowhere. We are consumed with thoughts about the beloved as if recalling that person in the imagination will bring him or her back to life. We may even experience physical symptoms such as an inability to sleep, a susceptibility to illness, a racing heartbeat, headaches, and stomach disturbances.

Why do I mention all of this? When you are in the throes of grief, it’s quite common to have thoughts like “What’s wrong with me?” “I shouldn’t be sick,” or “I should be able to control my emotions in front of strangers or co-workers.” In the midst of grief and anguish, it is helpful to know that grief is normally accompanied by cognitive, behavioral, and even physical symptoms, usually associated with a myriad of other difficult situations and conditions. If you’re grieving and experiencing such symptoms, know that you are not alone. It is quite normal and part of the grief process. Just knowing what those symptoms are and that others have had them can reassure us that even in the loneliness of grief, we are “compassed about with so great a cloud of witnesses” (Hebrews 12:1) on earth and in heaven.

C.S. Lewis is especially adept at describing the cognitive symptoms related to grief. His A Grief Observed is recommended reading for those who’ve experienced loss, because the grieving can identify with his poignant description of his own journey in the dark woods of grief. Hence, they can more easily name their experience, which makes it more manageable. For example, when the grieving read about Lewis’s hopelessness, despair, preoccupation with thoughts of the deceased, his own sense of being in a dreamy/unreal state, and his own self-reproach, they can see themselves and tacitly receive the quiet, unspoken assurance that even as Lewis came through that stage and was able to write a book about it, so they will come through their initial grief and be able to do something constructive with the suffering they experience.

While the cognitive symptoms of grief are perhaps the most private and possibly the most painful, there are also behavioral symptoms associated with experiencing loss. In their paper, “The Nature of Grief”, R.O. Hansson and M.S. Stroebe list some behavioral changes that may be associated with grief: agitation, tenseness, restlessness, fatigue, over activity, searching, weeping, crying, sobbing, and social withdrawal. In the same paper, the authors list some physical symptoms of grief, which include loss of appetite, sleep disturbances, energy loss/exhaustion, physical complaints similar to those of the deceased, and a susceptibility to illness and disease. None of these symptoms are pleasant, but they show that love for the departed expresses itself through one’s entire being. Our muscles tightening with anxiety, our body weary with fatigue, our mind clouded from lack of sleep, all bear witness to love and in the richness of that love the varied forms of suffering and symptoms of grief take on new meaning. Like one of the speakers in the Song of Songs, the soul of the bereaved may say, “By night on my bed I sought him whom my soul loveth: I sought him, but I found him not” (3:1), “I opened to my beloved; but my beloved had withdrawn himself, and was gone: my soul failed when he spake: I sought him, but I could not find him; I called him, but he gave me no answer” (5:6).

Patristic literature also shows a deep awareness of the many symptoms associated with grief. For example, Saint Jerome once wrote about the physical symptoms of his grief in a letter to his friend Heliodorus: “my mind is dazed, my hand trembles, a mist covers my eyes, stammering seizes my tongue. Whatever my words, they seem as good as unspoken seeing that he no longer hears them. My very pen seems to feel his loss, my very wax tablet looks dull and sad; the one is covered with rust, the other with mold. As often as I try to express myself in words and to scatter the flowers of this encomium upon his tomb, my eyes fill with tears, my grief returns, and I can think of nothing but his death” (Letter 60). The saint clearly grieved and, what we should underline, his grief was no hindrance to his sanctity. The mind that thinks, the hands the work, the eyes that see, and the tongue that speaks, the very members that enable one to perceive the world and interact with others, are all deeply and negatively influenced by grief. And that is not abnormal. Speaking seems pointless, writing holds no interest, and death comes to the mind again and again. And yet the Saint does not stop there, to these involuntary reactions and responses, he would use his freedom of choice to add new behaviors. In the face of His physical reactions, He turned to the Lord with faith saying, “I will not beat my breast with Jacob and with David for sons dying in the Law, but I will receive them rising again with Christ in the Gospel.” In spite of his ruminations on death, he chose to tell himself, “Do not grieve that you have lost such a good example: rejoice rather that he has once been yours.” And so he accepted his suffering, but also allowed his faith to begin to heal his wounds and enable him to explore other behaviors and thoughts.

Other fathers also refer to the many symptoms of grief. For example, Saint Cyprian writes, “If you had lost any dear one of your friends by the death incident to mortality, you would groan grievously, and weep with disordered countenance, with changed dress, with neglected hair, with clouded face, with dejected appearance, you would show the signs of grief (dejecto indicia)” (On the Lapsed, PL 4.049A)). These behaviors are the indicia, the signs, tokens, or proof that point out the loss and make it know in every sort of way, demonstrating the deep connection between the living and the now departed.  In his Confessions, Saint Augustine describes the signs of his grief as follows: “I fretted, sighed, wept, tormented myself, and took neither rest nor advice, for I was impatient with my torn and bleeding soul that found rest nowhere, not in pleasant groves, not in sport or song, not in fragrant spots, nor in magnificent feasting, nor in the pleasures of the bed and the couch, nor, finally, in books and songs did it find repose. All things looked terrible, even the very light itself; and whatsoever was not what he was, was repulsive and hateful, except groans and tears, for in those alone found I a little repose. But when my soul was withdrawn from them, a heavy burden of misery weighed me down. To Thee, O Lord, should it have been raised, for Thee to lighten and avert it. This I knew, but was neither willing nor able” (Confessions, Book 4, chapter 7, PL 32.698). Among the physical symptoms of grief that can be noticed elsewhere, Saint Augustine also refers to a spiritual symptom, his inability or unwillingness to turn to God. Why wasn’t he able to do so? He suggests that it was because his understanding of God was not correct. This is why searching the Scriptures and reading the Gospels, especially the Gospel of Saint John, can help one again find one’s spiritual vision in order to see one’s way through the labyrinth of grief.

Grief has many signs and many symptoms. Psychologists know this and so do the church fathers. Our Lord Himself foretold, “In the world ye shall have tribulation,” “ye shall weep and lament, but the world shall rejoice: and ye shall be sorrowful.” Although speaking of the reaction of the apostles to His death, it can also include our reaction to the death of our loved ones. And for a season, those reactions can consume all our being, all our behaving, all of our very selves. At such times, we need to be understanding and gentle with ourselves, patiently recognizing the many signs and symptoms of our love. And then, all that is left to do is to turn to the rest of what our Lord said: “These things I have spoken unto you, that in me ye might have peace” and “your sorrow shall be turned into joy.” Trusting that in time so it shall be.

About Father Alexios