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Dr. Kenneth J. Doka On Grief

Dr. Kenneth J. Doka, Senior Consultant to the Hospice Foundation of America, lends his renowned expertise to Crossroads Hospice Charitable Foundation and brings his professional insight and experience to principle questions from those in grief. Most will experience the grieving process at some point in life and ask these simple questions.

There are always moments where we revisit our grief...

When does grief end?

Well I’m not sure that grief really ever comes to an end. I describe it as a roller coaster. Over time, I think for most people, in the beginning you experience lots of highs and lows – times that you’re doing well, times that you’re not doing so well – it’s very intense in the beginning; the lows often are long lasting and troubling in the beginning. And I think over time the roller coaster modulates where most people say: “Every once in a while, I have a low. It doesn’t happen often; it doesn’t last as long; it’s not as intense.” But even years later, it’s not unusual to have surges of grief. It may be that your husband died when your daughter was twelve, and fifteen years later, your daughter is walking down the aisle, and at that moment you feel: “Gee, I wish he were here with this, ” and the daughter feels that. There arealways moments where we revisit our grief and have these, what I call, “surges of grief,” and that’s very normal and natural.

What is the difference between grief and mourning?

Depends who you ask. I think in many ways we look at grief as the reaction to a loss, which can be manifested physically, emotionally, spiritually, affect the ways we think and affect the ways we behave, so grief is a reaction to a loss. Mourning has traditionally been used in two ways: One, as an internal process, as an intrapsychic process, where one sort of begins to cope with and adapt to one’s loss. I prefer the term “grieving” there. The other way it’s been used is to describe the rituals and customs around death, and I think that’s a nice differentiation. So, when I go to a funeral or I wear black, I’m mourning. I think that reminds us then that if we use that external definition of mourning, we can mourn without grief. Many times we go to funerals of people where we may feel sympathy for the person we knew and maybe their mother who we met maybe once in our life, so we’re not feeling grief, but we’re engaging in mourning.

Is this reaction different from other reactions you had at various times in your life when you’ve dealt with loss?

After my loved one died, I felt numb and didn't react strongly. Is this wrong? What's behind that?

Well I think there can be a couple of things behind it. Certainly, for instance, it’s not unusual, particularly when a death is shocking and unexpected and traumatic, that we do feel a period of numbness. In other cases, people may be fairly resilient toward the loss, and it’s not unusual that some people say: “I didn’t really have profound reactions of grief.” Some of it may be that the loss was expected. Some of it may be their own spirituality, or their own psychological health, but people respond to grief in all kinds of ways. The question that I would ask is one of consistency: Is this reaction different from other reactions you had at various times in your life when you’ve dealt with loss? And if it is so different, let’s explore what might be going on here.

Do men and women grieve differently?

Terry Martin and I have done some work on that and we have a book called Grieving Beyond Gender. What we do is discuss a continuum of grieving styles. On one end, there are people who often experience grief as waves of emotion. Their expression of grief is very much a mirror of that: they cry, they scream, they’re angry and they often say that discussing and working through these feelings is very helpful. On the other end of the continuum are people whose grieving style is more, what we call, “instrumental.” When they describe grief, they describe it more in terms of cognition: “I thought about the person a lot.” Their experience tends to involve doing their grief and that’s what they tend to find very helpful. Now we often think that more women are on the intuitive end of that continuum and more men are on the instrumental end of that continuum. But again, individuals grieve differently certainly, and certainly gender is one of the factors that affect how individuals grieve, but obviously not the only one.’re always going to have memories of the person and that connection is never going to be lost...

Should I continue to talk about my loved one while grieving?

It depends on the person and it depends on what they’re talking about and what they’re saying. Certainly, sometimes we can be so obsessed with our loss that continued talking about it can maybe drive others away, or make others feel uncomfortable. But normally, I would say, in most cases, yes – it is important to process your grief, and you’re always going to have memories of the person and that connection is never going to be lost, so there’s nothing wrong with talking about what you’re experiencing and how you’re experiencing it.


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