The other day we posted on the blog about different types of grief and we got a great comment pointing out a grief type we hadn't mentioned, cumulative grief. The commenter said “I read something a little while ago on cumulative grief, where people have experienced loss after loss. Do you have any info on that?” I started typing a response to the comment and it quickly went well beyond the length for an appropriate comment reply. Brevity is not always my strong suit.
There are several expressions in English that reflect the idea that when one tragic thing happens other tragic things sometimes follow:“When it rains it pours” (or in British English, “it never rains but it pours”) and some people believe “bad things come in threes”. I started wondering if this idea (and corresponding idioms) existed in other languages. Luckily a quick “phone a friend” to Google provided some quick answers. Turns out those in the English-speaking world are not alone.
In Hebrew, the phrase is “Bad things come in packages”.
In Swedish, German, Spanish, French and a bunch of others, “misfortune seldom comes alone”.
In Latin, “troubles are followed by troubles” and “the abyss attracts the abyss”.
In Polish, “misfortunes walk in pairs”.
In Japanese, “when crying, stung by a bee”.
In Chinese, “good fortune never comes in two; bad luck never comes alone”.
In Russian, “when troubles come, leave the gate open”.
Kind of a downer to see all these expressions for such a painful phenomenon, but I guess on the bright side it shows we are not the first to be overwhelmed by multiple losses (I know I know, a tough sell to find the bright side there, but I figured I’d give it a try).
As wonderful as it would be to pretend that every time we suffer a loss we have time to process that loss and integrate it into our lives before we suffer another loss, these idioms found in languages around the world point to the sad fact that it is simply not the case. It is all too common that a death is followed by another death. Pain is piled on pain; fear on fear; the abyss on the abyss. This experience of suffering a second loss before one has grieved the initial loss is sometimes known as “cumulative grief”, “bereavement overload” or “grief overload”.
I can hear your question already: when another loss arises, how can you possibly know if you have “grieved the initial loss”? This is a tough question because grief is so individual for all of us. There is no checklist or timeline that works for everyone, as we have said time and time again. But one thing that is common to the many different grief theories out there and to the personal experiences of so many grievers is that grief requires time. Be it stages, tasks, or processes, we need time to attend to each loss. If we don’t have the time we need before another loss occurs we end up overwhelmed by these multiple losses and unable to give them the attention they need.
When we become overwhelmed by anything our mind kicks into an incredibly powerful defense mechanism, which is avoidance. There can be an inclination toward avoidance when experiencing just one loss, so it is not surprising that this inclination grows when losses are compiled on one another. Though avoidance, denial, and shock may seem like a really bad thing (and it can be if it is never resolved), it can be our body’s way of keeping us functioning in the short term. When we are overloaded with multiple losses, this avoidance allows us to maintain our day to day activities. What becomes important when losses have become cumulative is an awareness that we may need to make a concerted effort to begin the work of facing the reality of the loss, as this avoidance can’t continue indefinitely.
Unfortunately, there is no magic answer for how to cope with cumulative grief. If you have suffered multiple losses, either all at once or before integrating the previous loss, some important things to remember are:
1) Be aware of the risk of cumulative loss/grief overload. Knowing is half the battle! Just being aware that multiple losses in a short period poses unique challenges and can put you at risk for a grief process that is especially complicated is important. Cumulative losses do put us at higher risk for prolonged grief. If you are worried your grief is no longer ‘normal’ check out our post on normal vs not-so-normal grief. And don’t panic – even if your grief is more complex, there is help out there!
2) Be sensitive to other friends or family members who have suffered multiple losses and are at risk for cumulative grief. When we lose someone we become absorbed in our own way of grieving. We can find it difficult to deal with people who are grieving differently. Being sensitive to the differences between all grievers is important. This sensitivity can be especially important when someone faces the unique challenges of cumulative grief.
3) Be aware of the increased possibility of avoidance or denial in instances of cumulative grief. To make it through, one day at a time, you may find yourself more prone to avoidance than you have ever been in the past. This can also increase your risk of alcohol or drug use, as these substances can be tempting to numb pain. Maintain an awareness that you must ultimately grieve both (all) of the losses. Professional support may be a good idea if attending to the grief of these losses is feeling impossible.
4) Keep in mind that time is not the only factor in cumulative grief. Though it may be tempting to assume that bereavement overload only occurs when deaths occur in immediate succession, this is not the case. A loss that was never fully attended to years before can be brought back up by a new loss and can be overwhelming.
5) Substance abuse can increase the risk for cumulative grief. When abusing drugs or alcohol, people are prone to avoid grieving. Using drugs or alcohol to numb grief can result in never fully grieving losses. This means that when a person stops using drugs or alcohol they may face multiple losses that they failed to grieve over the course of years or even decades. Once someone stops using drugs or alcohol they may find themselves facing multiple losses from the past that they avoided with substances, and hence experiencing grief overload.
6) Age can increase the risk for cumulative grief. As individuals progress into their 70s, 80s, and 90s they may find themselves experiencing the deaths of friends and family members more regularly than earlier in life. This can put them at a higher risk for cumulative grief. This is without even considering the other losses they are prone to, like loss of home, independence, and identity, as well as the fact that their grief may be minimized by society if those they lose are elderly (read about disenfranchised grief here). Due to a stigma around seeking professional support, some people in this age group may still have a strong aversion to seeking counseling. A little therapy never hurt anyone, but if therapy doesn’t seem like the right fit, seeking other types of grief expression and exploration is important for people in this age group.
7) Grief is as unique as each person we lose, so we cannot rush grieving multiple losses. Though it can be tempting to think that grief is grief, and we can lump our grief work together if we have multiple losses in a short period, the reality is that we must grieve ever loss individually. Grief is not generic to any loss but is specific to each person we lose, our relationship with that person, and the circumstances of that loss. Attention must be spent on each loss in order to integrate them into our lives.'
8) Cumulative grief can put a greater strain on our faith. One devastating loss can be difficult enough and can cause us to question our faith in a higher power. When someone suffers multiple losses, this feeling can increase. People can begin to feel they are being punished (remember Job?), have a harder time resolving a benevolent God with all the pain they have seen and felt, or struggle with repeatedly experiencing ‘bad things happening to good people’. This is certainly not true in every case of grief overload. Many will continue to find strength in their faith (again, remember Job?), but it is important to know it is normal if your faith shakes as a result of grief overload.
9) It is important for hospital, hospice, and other healthcare professionals to be aware of cumulative grief. Like compassion fatigue and vicarious trauma, the experience of building relationships (even professional relationships with appropriate boundaries) with patients and repeatedly experiencing the death of those patients can take a toll on healthcare providers. Though the grief of professionals may take a different form than friends and family, it is important for professionals to grieve these losses to avoid developing an unhealthy avoidance or detachment. Check out some info on self-care that isn't totally unrealistic.
If you have had multiple losses, pretty pretty please consider some professional support. Just give it a try. You may be surprised by how much it helps. When you are already emotionally and physically exhausted from the pain of one loss, it can only help to seek support when more losses pile on. If that truly doesn’t feel right for you, consider other ways to attend to each of your losses. Learn about grief. Find a friend or family member to talk to. Write or journal. Find a creative outlet, like art or photography. Join a support group. Just make it something that works for you and that will allow you the opportunity to deal with each of these losses. And remember, even if the abyss attracts the abyss, tomorrow is a new day and hope springs eternal.
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We wrote a book!
After writing online articles for What’s Your Grief
for over a decade, we finally wrote a tangible,
What’s Your Grief? Lists to Help you Through Any Loss is for people experiencing any type of loss. This book discusses some of the most common grief experiences and breaks down psychological concepts to help you understand your thoughts and emotions. It also shares useful coping tools, and helps the reader reflect on their unique relationship with grief and loss.
You can find What’s Your Grief? Lists to Help you Through Any Loss wherever you buy books: