Poorly resolved grief has many causes. Its origins are often in childhood. We may have had parents who were unable to grieve normally, and were unable to be good models for healthy grieving. We may have received explicit or covert messages from our families or culture that expressions of grief were unacceptable. If adults did not talk to us after a loss, we were left with the message, “Grieve alone.�?We may have suffered traumatic events that made it impossible for us to have normal emotional functioning. Not only are we then left with unresolved feelings about the losses of childhood and adolescence, but we carry poor grieving patterns with us into adulthood.

Many of us suffered the loss of a loved one in a way that was traumatic, stigmatized, or unexpected. We may have been present when these deaths occurred. Perhaps we suffered several losses in a short period of time. Important facts concerning the cause and circumstances of the loss may be unknown to us. These factors make the mourning process much more difficult.

Some of us suffered for years from depression, chemical addiction, or patterns of compulsive behavior. These illnesses made it impossible for us to grieve losses we suffered during these periods. Moreover, chronic mental illness or addiction themselves cause enormous losses - loss of years of our lives, loss of personality and self-respect.

We did not choose the conditions that made it more difficult for us to grieve. Although grievers are often negatively judged - “What’s wrong with you? Why can’t you snap out of it and get on with your life?�?- these judgments are invalid and abusive. As children and as adults, our culture and most of our families bombard us with the message, “Don’t grieve.�?

Within a support group we create a place where it is safe to grieve. We maintain confidentiality, and we are not competitive about our losses or about our recovery. As we listen to others struggle with their grief, we see that we are not alone. We can begin to identify the factors that cause us to suffer unresolved grief.

An important step in recovery from accumulated grief is to prepare a chronological list, with approximate dates, of our loss histories. There are no rules about what to put on the list; it may include the births and deaths of important people in our lives, changes of schools and residences, divorces and separations, physical and mental illnesses suffered by ourselves or family members, traumatic events, losses of occupations or activities, loss of childhood, youth, innocence, or trust, periods of addictive or compulsive behaviors, periods of institutionalization, and changes in social or economic status. You may wish to revisit places from your past, or make efforts to obtain photographs or information. There are no rules about when to prepare this list; you can do it when you feel you are ready to do it. (The recently bereaved are not in delayed grief or unresolved grief. It is normal to suffer pain after a severe loss. There are no rules for how long “normal�?grief lasts, since it varies by individual, type of loss, and relationship to the deceased. The griefwork program described here is designed for the not-recently bereaved.)

Preparing the loss history is apt to stir up strong feelings and memories. Many of us regarded the past as something awful, and preferred not to think about it. We may have large memory gaps and be confused about the chronology of events. The loss (and, below, relationship) history charts will enable us to revive some of our memories and to place them in more accurate order. Although no one else need see our loss history charts, it is important not to do this alone. We should discuss these issues with someone we trust or with the group.

The second step is to identify the emotionally incomplete losses. The losses that still hurt or are hard to talk about should be written down in a list.

The third step is to take each item on that list and prepare a chronological list of the significant events in your relationship to the person or thing lost. If you lost a family through divorce, you list the significant events in the family history from the beginning of the family to the present. Again, there are no rules about what goes into the history. For example, many of us can remember seemingly offhand remarks by relatives that vividly defined personal attitudes. If something feels significant, it probably is. There are no rules on how much time to spend working on grief. You may choose to spend a week or more on each incomplete loss, and give yourself a break in between.

After the relationship history is prepared, you may in some cases have a surge of warm feelings and memories about the person or thing that was lost. That is a good time to write out a detailed list of the positive qualities in the person or relationship.

You may then wish to write out or talk out responses to various questions. What kinds of feelings do I have about this loss? At the time of the loss, was I told by others, or did I tell myself, to not grieve, or to grieve alone? What kinds of other losses were part of this major loss? (For example, extended depression, as a loss of mental health, may bring with it loss of ambition, loss of interest in life, loss of ability to sleep normally, deterioration of relationships with family members, loss of self-confidence, loss of capacity for enjoyment of life, loss of money due to reduced earnings and cost of treatment, loss of social acceptability due to the stigma of mental illness, etc.)

The major question to ask about each incompletely grieved loss is, “How do I wish the relationship had been different?�?This is tremendously painful. This is the pain we have to address if we are to make progress in resolving our grief. Simply articulating our regrets and our disappointed hopes can be a great release.

We can then ask ourselves a series of further questions. Do we want to continue with the kinds of feelings we have had, or have now? Given what happened in the relationship, are these feelings accurate or rational? Do we want to reassess our feelings about the extent to which we and the other person (or group) were responsible for things that happened in the relationship? To what extent were we and the other person powerless over what happened? To what extent do we wish to make amends for things we feel guilty about, or offer forgiveness for ways in which we were harmed? Are there messages we would like to have communicated to the person we lost? Have we, consciously or unconsciously, been trying to replace something that cannot be replaced?

Soon after beginning work on the relationship histories we will begin to enjoy the benefits of delayed grieving. These are

• Improved memory, and a new appreciation for the value of our memories.
• A strong feeling that these losses are real, that these losses impoverished our lives. The strong feeling of sadness means that what was lost had unique value. A sense that the life we have is precious.
• A sense that my life is important. Because of stigma, trauma, and illness, many of us led lives that were devalued by society and our families. Griefwork helps to undo the effects of this devaluation.
• Improved self-esteem.
• A stronger sense of being alive, a new vitality. A new sense of being able to live in the present.
• Feeling less weighed down, that the burdens of the past take up less “rent�?in one’s mind.
• The griefwork reduces the extent to which we have negative thoughts and feelings about the past. We have a sense that our beliefs and judgments about the past are more accurate.
• While the periods of early recovery in programs for addiction and trauma are often unrelentingly painful, delayed griefwork has been described as a “passionate�?experience. The release of blocked pain is often accompanied by the release of blocked positive feelings and memories. These are feelings that at an earlier time we were unable to have, now they can be experienced and appreciated.
• Persons in recovery from mental illness, substance abuse, or compulsive behaviors are prone to relapse. The progress we make in bereavement recovery invariably remains with us.

All of us will experience more losses in the future. Members of bereavement support groups learn how to become better grievers. When possible we do preparatory grieving. We do what we can to learn all the facts and to encourage the distribution of the facts to other grievers. We make extra efforts to participate in memorial activities. We communicate more and learn how to be good listeners. We recognize grief related problems and take appropriate action. We lead lives that are healthier for ourselves and those around us.