Kristin Heinz, a licensed social worker who specializes in grief, explains the grieving process, its emotional effects and how to find hope during trying times.
In the midst of a global pandemic, loss is inevitable. The loss of a daily routine, the loss of a job, the unfortunate loss of a loved one, the loss of a sense of normalcy in any shape or form. If you are feeling the weight of a collective, solemn sadness, you are not alone.
We spoke with Rosslyn-based Kristin Heinz, MBA, MSW, LCSW, LICSW, a licensed social worker who specializes in grief counseling, to discuss the forms of grief many are feeling. Whether or not you’ve lost a loved one, you may still be experiencing signs or symptoms of grief, and that’s OK. It’s important to know how to identify the emotional signs in your own life, and what you can do to work through them at this time, and beyond.
Below, find highlights from our conversation about how you or someone you know can work through grief in effective, healthy ways, and continue to find hope during this trying time.
For those who might not have experienced grief before, or are trying to identify the emotion behind their own behaviors, what are the signs of grieving?
Obviously when we think of grief, we think of loss and sadness and, very often, death. But grief can present itself in many ways from many different types of loss. Loss of a job, loss of a relationship, loss of a pet and loss for us all right now and the way things used to be. I mean, there’s a loss of our normal routine. Kids are even having to figure out how to do online schooling. Then there are parents that are having to help kids do the schooling and take care of them when having full-time jobs. So there is a lot of stress out there.
To start, grief doesn’t always present sadness. For some, sadness and grief is an emotion that comes easy to them. For others, anger is a more accessible emotion. So there are some people that have trouble actually grieving, crying, feeling sad, talking about their sad feelings, and instead they may act out. Grief can also present as frustration or irritability, or restlessness.
This can be acting out through behavior in dysfunctional ways, or it can even be isolating, and losing interest in the things that you once loved. Right now, we’re being told to isolate but even hobbies at home, I think some people are struggling with their free time to actually enjoy the things they used to enjoy. Those are signs of depression and grief. Other behavior things to keep an eye out for are changes in sleep and appetite. Either eating more or less, as well as sleeping more or less. These are often signs of emotional struggle against signs of depression, and signs that one is grieving.
It’s also important to look out for any increase in addictive habits. Sometimes when we’re grieving, it’s a painful feeling, and we don’t want to feel pain, so we look for ways to numb it. For example, excessive drinking, or turning to things that numb what we’re feeling.
In addition to emotional and behavioral symptoms you can have cognitive symptoms like difficulty concentrating, difficulty making decisions or trouble remembering things. Other cognitive symptoms might be just a general negativity. It may feel like one big, bad mood and it may actually be grief.
The last thing I would take notice of is any kind of physiological symptoms. I believe that emotional and physical are intertwined and that when we may not actually feel grief, we may realize we’re having daily headaches or gastrointestinal programs. A lot of people will also start to feel emotional pain in their back, as it can present as back pain too.
What are some healthy ways to work through grief, sadness and otherwise overwhelming emotions?
Definitely the mental health field of professionals, which is available. Reaching out to a mental health provider, looking into some psychotherapy or counseling can be helpful. I have also been encouraging all of my clients to make sure, to the extent that they can, that they can go outside and get some fresh air and some exercise. Then, trying to do whatever we can to stay connected to our friends, our support systems. Our community connection is key to our emotional health. And in a time where we can’t be physically connected, whatever we can do to stay emotionally connected is really important.
If you’re feeling a lot of anxiety at this time, find things that can ground you and can give you a sense of peace. That might be exercise, but it also might just be being with your pets or engaging in some hobbies that you love. Find something that makes you feel a little more grounded in a time where everything just seems out of sorts.
If someone has recently lost a loved one, what should they know about the grieving process, and how can they best approach it during COVID-19?
Start by knowing all of the phases of grief. Know the symptoms that can come up and just allow yourself to feel whatever it is that you’re feeling. Very often we feel like crazy people because one moment we’re fine and the next we’re a mess. I stress to my clients that is OK too. You may have a really high-functioning day followed by one where you just can’t get out of bed, and there doesn’t need to be a reason and you don’t need to hold yourself together.
The first phase is really the hardest phase: the first 12 to 14 months when we’re dealing with a death. That allows time to go through all of the seasons, all of the anniversaries and birthdays, all of the holidays. Then to get past the anniversary of the death. That’s why they really say 14 months. But everybody’s process is going to be different. Everybody’s grief is going to show up in different ways, there is no one way. But I think we need to know how it’s showing up in our lives and we need to honor that and allow space for those feelings to be there. Allow enough of a pause to work through those feelings.
Once you get through that first phase of grief, where you feel a little bit more in control of your emotions, then we can start to work on making meaning from the loss. We can focus on finding meaning in life after the loss. But that is not work that we can do right away, especially when the loss is unexpected. We need to give time and space to actually feel what we need to feel, and to feel all of these emotions whenever we’re feeling them. And then later, we do the work that says, OK, now we need to find a way to move forward. How do we honor our lost loved one? How do we fill that void that’s left in our life? How do we make something good out of something tragic, and how do we just move forward and continue living our lives? That can be some pretty hard work that I encourage people not to tackle upfront. It comes later.
Honor your own paths of grief, honor what you’re feeling and allow there to be space to feel that, which can be hard. For people that have full-time jobs, I always say that grief is 24/7. You can’t be actively grieving while also doing a job or engaging in life. To the extent your circumstances allow, you need to put some flexibility in your life and have some space where if it’s a hard day, you just pull back and you do the grief work. The other stuff can get done when it gets done, but you can’t actively grieve while you’re also trying to show up in a professional way to others. That requires you to really hide and repress the grief.
What ways would you suggest readers continue to check in with their mental health during COVID-19, whether with a professional or on their own?
I’m encouraging all of my clients to find ways to stay connected with me and others, even if that’s not our traditional, weekly in-office appointment. If somebody is working with a mental health professional, I would encourage you to stay connected to them during that time. Also, stay connected to your loved ones and to your community.
Some people have more self-awareness than others and some have that ability to what I call “play the observer,” and they can step outside of themselves and they can notice an odd thought or behavior they might have, or a strong emotional reaction or severe behavior. When they notice it, that’s when it can indicate to them that maybe they need to pay more attention to their mental health. Others have more difficulty doing that. That’s where we rely on our community, our loved ones, our family or our support system to “play the mirror” for us. Someone to look at us and say, “Hey, I’m noticing that you’re carrying some sort of frustration or some sort of fear, and I get a sense that it’s coming out in other ways.” Like we mentioned before, it can come out in physiological ways or behavioral ways, and if you have others that can play observer for you, that can be really helpful.
When should readers reach out to a mental health professional for help with grief? What other resources are there if they have limited access to a professional or mental health support?
I would say any time is a good time to get professional help. But as for when you might be feeling like it’s required, if you are feeling that you’re lacking the emotional support that you normally get from others. That could be either for whatever you’re going through right now, say you’re just not as connected with friends and family, or that maybe what you’re struggling with is more than your family and friends can help you hold and handle. That’s when you go see a professional, and definitely if the grief is beginning to impact your everyday functioning in destructive ways. If you start to notice that you’re not showing up for your job, or that you’re not present in the way you would like to be for your friends, your family, your children or your partner; if you start to notice a move toward more addictive habits that are destructive, these are times that you would definitely want to reach out. If the coping mechanisms for what we’re dealing with aren’t feeling healthy, then that would be a time to reach out for some help too.
As for resources, there is a crisis hotline, Crisislink, that you can call at 703-527-4077. There is also the Suicide Prevention Hotline at 1-800-273-8255, and there is also a text crisis hotline, where you can text CONNECT to 85511.
What continues to give you hope for yourself, your family, your patients and everyone during COVID-19?
I think individually, it’s really a chance to pause and do some of that internal work that we’re often too busy to do, especially when we’re constantly interacting with others. When we’re being stimulated externally, it can be a lot easier to distract and repress, and this is a chance to do some of the inner work and slow down.
For those that have a family, it’s a chance to be with their families. A lot of my clients are working from home and they’ve actually returned home to their family of origin. So rather than being alone, they’re going to help their parents or reconnect with family.
For what really gives me hope for community, it’s seeing everybody come together to help one another. The amazing things that the medical community is doing. Where everybody else might be bored, these are people that are really putting their lives at risk, and I hear so much being done just for the patients in their care, but for the people taking care of the front line workers as well. Even for people that have lost jobs and how this has impacted the economy for local businesses. People are supporting local businesses in a way that I’ve never seen before. That gives me hope.
I do believe we’re going to get out of this and we’re going to be better in many ways for it. You know, I can’t say that everyone’s going to experience that, especially for those that have lost people to this disease. But I think there is opportunity here to turn inward and connect with family and to connect with the community.
Is there anything else readers should know about grief during COVID-19, taking care of their mental health or continuing to find hope in everyday life?
From my own experience, I know that grieving during COVID-19 is hard because we do have to isolate, and so many people find the support of others to be helpful. We’re even in a time now where you can’t have the typical funerals or services to provide some closure. These are really hard times for those that are grieving because everything is so isolated and without a funeral, there’s no formal ceremony to honor the loss of a loved one’s life.
In some ways, it almost feels like it didn’t happen. Make sure you understand that you are not just in a state of bereavement right now. If you’ve lost somebody to this disease or some other reason during this pandemic, you’re in an unusual, unprecedented time. Not only are you grieving the loss of a loved love, you’re also just grieving everything else that goes with these strange times, with the loss of structure, the loss of routine, the loss of connectedness, the loss of being able to go to a yoga class if that’s what brings you joy. This has really limited the way that we can handle our grief. We just have to honor that and reach out to others as needed. Recognize that everything you’re feeling is normal. All of these uncomfortable situations and emotions are normal, so allow yourself to be human and allow yourself to have human emotions. Don’t be afraid to ask for help.
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