The death of a spouse can be one of the most stressful experiences of adulthood. This is due partly to the multiple losses widowhood causes. A marital partner commonly provides companionship, advise, financial support, friendship, emotional and physical intimacy. At exactly the time when these qualities are most needed, the widow or widower finds himself or herself without the person to whom they have normally turned. Marriage often plays a large part in defining one's identity. Losing your spouse suddenly means the end of your status or role as husband, wife or married person. This shift in identity is particularly apparent to widows who find themselves excluded from social activities by couples with whom they and their husbands were previously active. Again, this "fifth wheel" phenomenon is especially painful just when the support of friends could be most helpful.

As with any grieving person, the widow or widower can expect to experience a number of emotional reactions. Knowing and understanding these can help. Some of these reactions can be so intense and unusual that the person as well as the family and friends may fear they are 'going crazy.' It is reassuring to remember that this is a typical part of grief and is a temporary condition. If you are not mentally ill before the death, you are likely to eventually recover from the 'craziness' during bereavement. Due to this major disruption in emotions, thinking and judgement during early widowhood, it is advisable not to make any major life changes during the first year. Some examples include not selling your house, quitting a job, moving or remarrying.

Often the initial reaction to a spouse's death is shock or disbelief. Some people in this stage appear somewhat emotionless or numb. They may describe a sense that the death doesn't seem real. In time, the next phase, sometimes known as bargaining may emerge. In this phase, the bereaved begins to feel the reality of the loss but is full of thoughts designed to 'undo' or mitigate the death. One example of this thinking is, "God, if you just let him be alive I'll devote myself to helping others." This thinking is characteristically a combination of irrational, wishful thinking with painful realizations of the irreversible loss of the spouse. As one progresses through the grief process, with its gradually emerging realization of the death, the spouse may experience and exhibit the emotions of anger and depression. Anger may be felt directly toward the death, sometimes even toward the deceased for leaving. However, it is also often expressed indirectly through its manifestations of impatience, irritability and hostility. These are commonly displaced toward physicians and medical personnel, family, friends, or anyone who is perceived by the grieved to have been irresponsible or insensitive to themselves or their deceased.

The intense depression that some equate with the grieving process, or think of as true grief, is a result of the full realization of the loss. It is characterized by sadness, longing, despair, loneliness and suffering over the knowledge that the death is, in fact, real and permanent. Physical symptoms such as sleep disturbance, appetite changes as well as anxiety, guilt and isolation are not uncommon. A wish to die is order to join the deceased sometimes also occurs. Or at least, widows and widowers, even when not suicidal, can lose interest in their own lives and activities as though life without their spouse has little purpose or meaning. Fortunately, with enough time and support and willingness to experience and express these feeling, the bereaved eventually moves into a place of acceptance. As this is achieved the intensity of emotional suffering diminishes, both the anxiety and the depression, and although the bereaved never stops missing their spouse, their thoughts and feelings become more manageable. Thinking of the deceased may now bring a pleasant memory. There may still be some tears, but the person can feel more involved in and able to participate in their current life as well. Although an uninvited one, the new identity and life style of the widowed may bring opportunities for activities, relationships and challenges that encourage the person to grow and develop beyond their previous self.

Although grief is a normal necessary response to the death of a loved one, some people find that the very necessary support of family, friends or clergy is either unavailable or inadequate. Most areas offer some sort of widowed support group that can be very beneficial at this time. A psychotherapist trained in loss and bereavement can also be instrumental in offering not only support and understanding but also education and assistance with working through the grief process. Permission and encouragement to feel the emotions is essential because postponement or denial of grief and mourning only delays or compounds the grief reaction.

Dr. Stoll is a psychotherapist in practice in Redondo Beach and Glendale. She is a member of the Independent Psychotherapy Network. He can be reached at (818) 265-4052.

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