Losing a loved one is one of the few truly universal life experiences. Despite its universality, however, grieving can feel totally unpredictable — and totally isolating.
Some bereaved people might already have mental health care providers or be able to rely on community resources like a school counseling office. But for many others, finding help means conducting a deep dive on Google or sifting through provider listings in Psychology Today, all while enduring the throes of grief. That scenario, says Katherine Hyde Hensley, a psychotherapist and perinatal loss doula in Asheville, is “a nightmare for the grieving person to try to find help.”
Compounding those difficulties in recent months has been the coronavirus, which has caused 347 deaths in Buncombe County as of Sept. 2, according to N.C. Department of Health and Human Services data. COVID-19 has upended the grieving process in ways society may not yet comprehend, suggests Brett McVey.
“The pandemic has increased many people’s sense of isolation, fracturing support systems and disrupting collective grief rituals like funerals,” says McVey, a bereavement counselor for CarePartners Hospice. “Some bereaved clients have experienced a profound sense of alienation when their grief is not acknowledged. While grief is universally painful, the pandemic has made it significantly more difficult for many.”
Measures to slow the spread of COVID-19 have also prevented people from being able to spend time with loved ones near the end of life, and, in some cases, from being able to say goodbye.
“Some people find great comfort in being present when the person dies, and that has not always been able to happen,” says Dan Yearick, grief services team leader at Four Seasons — The Care You Trust, a hospice serving 13 counties in Western North Carolina. He says the hospice staff have witnessed anger and “a greater sense of disbelief” surrounding coronavirus deaths.
Numerous resources, both individual counseling and group support, exist throughout Western North Carolina. Though the coronavirus has led to many providers transitioning their services online, they still support the grieving as compassionately as possible. While many services require payment or health insurance, others are available at no cost.
The new normal
Disbelief, fear, guilt, anger and sadness are symptoms of grief, which present as the bereaved is “adjusting to life without the person that’s been in their life before,” says Yearick. If a death was tragic in nature, the bereaved may “have symptoms of trauma, difficulty sleeping and fears that they never had before,” he says.
Grief can present differently in children. “Sometimes they revert to behaviors such as bedwetting or thumbsucking,” Yearick explains. Children’s emotions may be different as well; death can bring confusion, as well as difficulty articulating feelings like anger.
For many people, even acknowledging a struggle with grief can be hard. “There’s stigma around saying, ‘I need help; someone died, and I’m not doing so well,’” Hensley says. They might fear appearing weak or mentally unstable. It doesn’t help, she continues, that society often puts pressure on the bereaved to move on in the early stages of grief, when many are still in shock.
In some cases, Hensley notes, grief can evolve into complex bereavement, also called persistent complex bereavement disorder. The condition refers to prolonged emotional suffering, lasting for at least six months, that becomes debilitating to a person’s life. (Although the American Psychiatric Association has not officially recognized the disorder, the group lists it as a “condition for further study.”)
“You’re irritable, you’re crying, you’re not functioning in your day-to-day life skills, you’re ruminating over thoughts or longing for the person,” Hensley explains. She calls the condition “basically being stuck.”
Individual grief support can come from private practices, as well as school systems and community outreach centers. People with Medicaid coverage can seek services through Vaya Health, a managed care organization that serves 22 counties in WNC. Compass, a program at Four Seasons, works with children and teens to develop strategies to cope with grief.
But working one-on-one with a mental health care provider isn’t the only way to find help with grieving. Grief support groups in Asheville offer communities for sibling loss and pet loss, substance-related passing and perinatal loss, among others. Most support groups at Four Seasons aren’t targeted to a specific type of loss; someone who lost a parent may sit side by side with someone who lost a best friend. The hospice also provides some specialized support groups. A pet loss support group meets the first Wednesday of every month, while on Thursday, Oct. 28, a Widow’s Breakfast Club takes place at the Dandelion Restaurant in Hendersonville. (Donations allow the hospice to provide grief support services at no cost to anyone in their coverage area.)
Some support services are affiliated with medical providers. Mission Health offers bereavement support in Buncombe, Macon, McDowell and Transylvania counties through its CarePartners HomeCare & Hospice. Although some services have been paused in response to COVID-19, JC Luckey Sadler, a Mission spokesperson, saysc “Each local office has been making some services available.”
Mission Health also offers “perinatal navigator support for high-risk pregnancies and partners with a licensed clinical social worker who refers clients to external local agencies, based on the needs and location of the patient,” says Phillip Fritts, a spokesperson for CarePartners. Until 2014, the system also offered a perinatal support group called A Love Not Forgotten, he says.
Hensley, who lost a child during pregnancy in 2005, says she has benefited greatly from grieving with other bereaved parents. In her own practice working with perinatal loss, her clients feel validation and normalization from seeing others’ experiences similar to their own. She works with clients on deciding how to describe their family after an infant loss, as well as learning what she calls “exit strategies” for baby showers or holidays.
Grief support services also exist for people whose loved ones are still alive. The nonprofit MountainCare is considering offering grief support groups for loved ones of those experiencing dementia and Alzheimer’s disease.
“There’s a lot of grief in that slow loss,” says Executive Director Elizabeth Williams. (MountainCare paused its four grief support groups at the start of the pandemic; Williams says the nonprofit is looking to restart those groups in 2022.)
Support groups, whether paid or at no cost, can be a complement to individual counseling. Hensley offers sliding scale fees in her practice for clients with high health insurance deductibles, no insurance or Medicaid coverage.
There is no straight path through grief. But the healing journey does not have to happen alone. In fact, experts say it shouldn’t.
“One of the most effective ways of dealing with grief is being able to share experiences with people who have had similar experiences,” says Yearick.