HERMIONE Davis, a retired social worker with two grown children, knew for more than a year that her husband, not yet 50, was likely to die of a brain tumor. But that didn't make the reality of losing him any easier. "You can know intellectually that someone you love is going to die," she says, "but when it actually happens, it's still a shock."
Although grief is one of the most common of human emotions, most people who haven't gone through it themselves don't understand it very well.
"I don't think most people are aware of the extent of the trauma," says Anne Rosberger, executive director of the Bereavement and Loss Center of New York. "It's mental, it's emotional, it's physical, and it takes your whole being."
Psychotherapists say there is no way to prepare for the full impact of the death of a loved one or for the ensuing tremors of anger, sadness and longing that will be felt for years. But there is a growing body of advice on ways to work through grief once it hits.
Grieving is now most often described as a succession of stages, first outlined by Elisabeth Kubler-Ross in her pioneering work "On Death and Dying." But while the stages of grief may be somewhat predictable, our passage through them isn't. Most psychologists agree that grief proceeds at an individual pace.
The first stage is usually numbness and denial, when it seems as if the death just can't be real and the world feels distorted. "I felt like I was walking through pea soup," says Massachusetts psychologist Judith Souweine, whose mother died suddenly of a brain aneurysm three years ago at age 63. "I remember not wanting to get up in the morning, not wanting to remember that this had happened."
After the initial shock and denial, mourners may pass in and out of phases of anger, helplessness, depression, guilt and fear. "I felt absolute rage," remembers Hermione Davis. "It wasn't fair. Why me? Why him?" Bouts of these emotions may last for a year or two or even longer before the person left behind finally comes to a stage of adjustment and acceptance.
"People are often afraid that they're losing control because these feelings are so strong and foreign to them," says John Stephenson, a family therapist in Portland, Maine, and author of "Death, Grief, and Mourning."
Survivors may feel intense guilt for things they failed to do or say to the person who died, or somehow blame themselves for the death, endlessly running over the "what ifs." Hallucinations of the loved one, or even suicidal thoughts, are not uncommon. Those who have lost a mate often feel helpless, unable to take on the smallest tasks, or can feel that life isn't worth living.
Perhaps the most difficult kind of death for someone to overcome is the death of a child.
"We expect our grandparents, and eventually our parents, to die, but we don't expect to outlive our children," says Therese Goodrich, executive director of The Compassionate Friends, a nationwide organization of support groups for bereaved parents and siblings. "The death of a child is out of sync, and it often takes up to five years for parents to start feeling normal again."
Children who lose parents also require special understanding and help, say people who specialize in working with youngsters. Clear communication is the first step. If, for example, children hear that a parent has been "lost," they may wonder when the parent will be "found." Youngsters often believe, magically, that they've caused the death by something they've done or not done, and adults need to explain that they aren't at fault. Children usually heal well from grief, say psychologists, as long as parents and adults don't get in the way and tell them how they ought to do it.
For young and old alike, grief can be physical as well as emotional. Peter Niland, an executive assistant for San Francisco's Shanti Project, which works with people with AIDS and their companions, remembers how sick he felt after his lover of 13 years died. "The depression affected me physically, through exhaustion, aches and pains, and an inability to sleep." Appetite loss, headaches, shakiness, indigestion and heart palpitations are normal. Occasionally, more serious ailments crop during bereavement.
Studies of widows and widowers have found an increased death rate from cardiovascular disease; those who lose their spouses, it seems, are more likely literally to die of a "broken heart."
Most mourners adjust, but the adjustment may come slowly. "I finally came to some accommodation of my husband's death," says Hermione Davis. "I realized this is the way it is, and I'd better work on building a life for myself that doesn't include him. You accept that it's never going to be great, but you discover resources in yourself that you never knew were there." Davis took trips with friends to help her get a sense that her life was continuing afresh without her husband, and she now helps others who've faced such loss by conducting bereavement support groups.