Everyone grieves differently. We’re all individuals. No two people are exactly the same biologically or psychologically. Even your “identical” twin is different­–if you have one. You both came from the same set of genes, but when that set divided into the two of you, accidents may have happen: little accidents that don’t prevent a good life, or big ones that end life. You may have had a twin that you never met. And, everyone’s course of growth and development follows a different path from conception to death. The fall of every raindrop follows a different route from cloud to ground.

Your genes guide your body’s growth a little like house plans guide the construction of your house. But no house is finished exactly as the plans dictated. Did you notice that? If you build a hundred tract houses from the same plans, they’ll all be different. Some carpenters drive nails with a left-handed stroke. When your lumber runs low the next batch may come from a forest on the other side of the world. You may order Maytag dishwashers, but the last houses may get different brands. And did your plans show all the houses the same color? How did that work out?

Wait a minute! What’s all this got to do with grief? Well, your brain, which supports the mind that carries out psychological processes, is a physical part of your body. The brain is subject to all the accidents of genetics, missteps of development, and physical injuries and illnesses that can happen in this physical world. Some of these interfere with mental function generally and others only certain processes; and may be so subtle that no one notices–or totally disabling.

Your physical health, psychological health, personality and cultural predispositions all modify your grief experiences. With so many variables it’s hard to imagine that two grief experiences are as nearly alike as the feel of two different tract houses you might walk through–but sometimes maybe they are. Do you see a problem here? How do we know what’s normal, how do we know when to get help? Well, that’s two different questions. Always get help if you can. If you don’t know what kind you need that may be a sign your situation isn’t normal.

What’s normal for one person may not be normal for another. The idea that normal grief is an inherent five-stage process to be worked through by everyone, comes from observing a small subculture and assuming a pattern common to it applied to everyone. Actually, “everyone” includes many cultures and subcultures, and we all have our own individual brain and personality, so grief is different for each one of us.

Grief is an adjustment process. To be alive means to grow and change, and all of nature continually changes around us; and we’re forced to adjust. We do that by thinking about what changed and what’s best to do about it. But being forced to do it usually provokes emotion. Unfortunately, thought and emotion are incompatible. Our brains aren’t built to multitask. With little changes, like when it rains, our disappointment usually subsides fast enough to figure out to take our picnic into the barn. When you win that big lottery and are forced to take all that money, you should have already planned to put it in the bank, and then do nothing until your excitement fades and you have time give careful thought to your next step. When a big change is tragic, like a death in your family, the emotion is usually big and bad. Arrange the funeral, then do nothing more until you can deal with the emotion well enough to sustain periods of clear thought. As a real world adult we’re forced change our plans to account for some new reality nearly every day, fortunately most are small and we get good at it. A healthy adjustment improves our attitude, and works toward the benefit of our self and family, to the degree possible.

However, poor mental health often interferes with healthy adjustments. Schizophrenia is our worst mental health problem and is very common. It’s due to inborn brain defects, probably partially genetic and partially developmental. Symptoms are also influenced by life events and come in all degrees of severity, from unnoticeable, to life long institutionalized disability. It often decreases a person’s ability to feel emotions, especially affection, to form emotional bonds, and to care about others. This internal apathy may go unnoticed when wrote learning teaches appropriate respect for others. But if you don’t care about people, emotional adjustment to their loss isn’t needed, and no grief is stimulated. Alternatively, the disease may cause exaggerated emotions, and the worst possible form of “grief,” sometimes called pathological grief, in which intense anguish continues life long, without leading to an adjustment.

Stimulant drugs, like cocaine and amphetamines (“speed,”) can also cause exaggerated emotions, and sedatives like tranquilizers, pain medicines, and sleeping pills can suppress emotions, and both types can distort psychological processes. The traditional remedy of a stiff drink is probably safer. It usually wears off in a few hours and mental function returns to whatever is your normal. And let’s be clear about what you’re doing with these drugs. To produce their effects they cause physical changes in your brain that nature did not plan your brain to experience.

Two anomalies commonly first noticed in childhood, Autism and Attention Deficit Hyperactive Disorder, cause individuals to be preoccupied with things or themselves and perceive others more as objects than as real and animated. They aren’t as effected by loss as most of us, but they tend to grow more normal with age. Obsessive-Compulsive Disorder sometimes produces a similar outlook.

Dementias, like Alzheimer’s gradually reduce a person’s awareness of everything. As the meaning of their relationships is forgotten their understanding of, and reaction to loss is diminished. Traumatic brain injuries may do the same, and focused traumas cause a whole spectrum of variations in both perception and responses.

Well, with all these potential distortions of the process, what is grief? It’s whatever you experience in response to loss. It could be anything depending on who you are and how interpret your loss. So, if you notice that someone doesn’t cry at a funeral, don’t think that they don’t care, or aren’t grieving. They came to the funeral. They’re having their own experience. Wish them well with it, and work on your own experience in your own way.

And, if that’s not enough, how many more shadows are cast over our experiences by our cultural memberships and unique personalities?

C W Patterson, MD

Copyright © 2017

Tehachapi, California


Charles Patterson

I was born in Santa Monica, California, earned a BS degree in biochemistry at California State Polytechnic University in San Luis Obispo in 1962, and an MD at the University of Louisville School of Medicine in 1966. I completed a psychiatry residency at Rollman Psychiatric Institute in Cincinnati in 1970. My working career consisted of private practice in five locations, six fulltime employed positions, and included eighteen hospital staff memberships, sixteen professional titles, and membership in twelve professional organizations; and unintentionally grew into a nomadic life style. My career goal was to learn as much as possible about normal human nature, in addition to make a living. Now my goal has extended to understanding as much as possible, especially life and death. I wrote a newsletter about psychiatry for the general reader to support my practice in Arizona, and consolidated it into my first book in 1984. From that my interest in writing grew along with interest in horse care that was stimulated by my wife’s interest in endurance riding. We enjoyed the sport together during our thirty years of marriage, until we retired in 2008 to an equestrian community near Tehachapi, California, with three horses, two dogs and four cats, and a plan to rejoin the sport, but without realizing they all had become too old. The subsequent loss of my wife to ovarian cancer in 2010, and much of the animal herd, reawakened my interest in the process of death and the potential for “life after death,” that continues to motivate my writing and study.

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