The Grief FAQ- Anniversaries

In the first article of this series we discussed the differences between adaptive and maladaptive grieving, remembering being one of several areas we covered. We are going to get into remembering a bit more today paying particular attention to anniversaries. I’m using the term anniversary to refer to a range of events – holidays, birthdays, the date of the actual loss – as each of these may present with its own unique set of challenges for individuals and family systems. Some of these challenges can include,

– The obligation the individual who is grieving may feel to the family to remain “active” in the festivities of the holiday.

– The anticipatory distress of an upcoming anniversary and how an individual is going to “be”.

– Feeling an obligation to comply with cultural, familial or individual expectations surrounding ritual or formal remembrances and being unsure about the capacity to “perform” appropriately.

– Fear of being or feeling alone.

– Fear of losing control and engaging in maladaptive behaviors.

Planning can be helpful in tolerating and working through the distress of anniversaries. Prior to developing strategies, it’s important to consider where you’re at in the grieving process. If safety issues exist and/or memories or triggers relating to the loss leave you vulnerable to relapse (addiction/mental health) then strategies could center on safety, distraction and structured, purposeful and time limited exposure to memories or events surrounding the loss. If you feel you are in a position to honor the loss willingly, safely and feel closer to a position of acceptance; strategies could be more assertive in honoring the loss and celebrating memory. photo_29849_20131130

Since I tend to work with folks who have complicated grief reaction or struggle with a co-existing condition in addition to a grief reaction; I’m going to focus more on conservative planning. Denial and avoidance get beat up pretty bad in the public discourse surrounding how folks should deal with problems and this can creep into people’s thinking about what they need to do in order to deal with the loss. I think it’s important to consider that denial and avoidance behaviors exist for many reasons; not all of them are bad. Sometimes, denial and avoidance can be protective and may work to increase resiliency while helping an individual maintain functioning. Like anything else, it comes down to the degree and length a person resides in these states or strategies that will determine whether they are ineffective.

I’m not saying folks should be encouraged in maintaining denial or avoidance strategies only to be aware of the purpose that they serve in helping individuals through the grieving process. With that in mind let’s go through some strategies that can help mitigate the impact of anniversaries in ways that nudge us closer to acceptance.

Timing
Many times the anniversary date isn’t the only thing we need to plan for; some individuals require support a week or so in advance. The fall and winter can be really difficult because of the seemingly back to back reminders that pop up. Parents who have lost a child, as an example, have to deal with back to school in September, Thanksgiving in November, Christmas in December and New Years in January. The point here is that the development of an anniversary plan should account for the anticipation of the event, the event itself and, perhaps, the time after the event.

Available Supports
Anniversary plans should include trusted and helpful loved ones who are willing to provide the individual with support by phone, by engaging in activities with the individual or as a resource an individual can go to during an event that is expected to be difficult. The more supports an individual has the better, as a larger pool can help prevent individuals who have agreed to take on this role from being “burned out”. To the extent possible, responsibilities should be delegated according to the strengths and resources each support has.

Scheduled Activities
Structure and activity can be key to safety as distraction can act to mitigate difficult emotions and thoughts.  Use of supports can be very helpful in developing structured activities.  Having a full schedule during the anniversary period allows supports to plan ahead which works to make their role easier. A schedule can also help to hold the individual who is grieving to their plan. Not all activities can be planned so creating a list of activities that can be done on the fly (short to long term) can help individuals who are grieving through difficult periods when informal supports are not available or not necessary.  If you’re having difficulty with creating a list, the DBT folks have developed a list that may be helpful.

Make Some Activities Meaningful but  Safe
Activities can also help folks honor the loss in safe and indirect ways that they are able to tolerate; I’ve written before about how contribution, ritual and structured remembrance can play a significant role in providing folks with a variety of opportunities along these lines.  Family members can play a significant role helping the system and individual members remain connected to each other while creating opportunities for adaptive grieving (Masses/Services in honor of the deceased, family Reunions during the anniversary period to specifically honor the member, etc.)

Strong anniversary plans can help individuals and families safely grieve a loss while  creating opportunities for stronger relationships within a family system. Just by virtue of their existence, plans can reduce the anticipatory distress of an anniversary because it answers the “what am I going to do?” question.

By the way, if you missed the first post of this series you can check it out in the related articles section below. Thanks for checking in.

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