By Rev. Joseph Kellerman, Executive Director of the Charlotte (North Carolina) Council on Alcoholism.
Grief is the real or imaginary loss of a cherished person or thing. Depression, by contrast, exists despite all evidence to the contrary. It may be a psychotic condition and does not respond to reason or counseling but may respond to drugs, and is usually self-limiting.
Grief is usually a normal loss reaction but does not require the loss of a loved one by death. Any basic loss may produce grief.
Dr. Hans Lowenbach, formerly with the Duke Medical Center, defines the contrast between grief and depression as indicated above. He also states that 90% of those persons thought to be suffering depression are experiencing acute grief and deserve the dignity of knowing they are not mentally ill.
This is also true in the field of alcoholism. Whether in individual counseling, group therapy, lectures to recovered alcoholics in AA and family members in Al-Anon, there is an immediate and tremendous response when this long-term pain is identified as grief and not depression.
Unfortunately grief is rarely mentioned in alcoholism literature while depression has become a blanket term used to cover a multitude of bad feelings and conditions and in a sense not used in its primary meaning as a serious mental illness.
Each person, in the course of life, experiences acute grief. Life is filled with painful losses of loved ones by death and the acute pain of gri9ef is accepted as normal. There are ways and means of working through such grief and most persons use them. Time also permits healing.
As grief is a normal condition, medication is contraindicated. Grieving persons should never be given medication other than one pill for one night’s sleep before a funeral, states Dr. Lowenbach.
Every religion, every culture, every society has its own custom and means of working through grief. Each person must be permitted to work through grief and using medication prevents this healing process. This is clearly seen in the repeated drinking by the alcoholic and prescription drugs given to the spouse all too often.
The symptoms of grief are easy to recognize.
- Fatigue and loss of energy. Also no zest for doing anything not essential.
- For many, the loss of appetite.
- May look 10-15 years older, no smile or laughter and an overall appearance of sadness.
- Initially, acute grief comes in waves of severe pain which almost choke the person. In times, waves lessen in intensity and the calm between gets longer.
- The grieving person focuses on the lost object and talks about nothing else.
- Acute grief entails such intense pain it prevents the person from doing anything that might add to the pain by additional loss. This is why the spouse of the alcoholic finds it so hard to seek help and enter a recovery program.
The grief of the alcoholic is matched by similar losses and grief on the part of spouse other family members. Alcoholism is a progressive illness which may be charted in most cases by a series of losses
- Loss of the ability to drink and remain sober.
- Loss of memory of drinking experiences, alcoholic amnesia.
- Loss of ability to predetermine not to drink and stick with it.
- Loss of responsible social behavior including work performance and financial responsibility.
- Loss of the ability to regain sobriety once intoxicated-addiction.
- Loss of the ability to support self and family due to unemployment.
- The loss of life at a median age in the early fifties.
An overall loss is the loss encountered as the self-realization fails to reach the self-idealization which is always high.
Finally, there is the long-term acute grief if the alcoholic abstains and gives up the best friend and source of comfort – the bottle.
Families also suffer grief. The more the alcoholic looses, the greater the loss for those primary persons, spouse, children and others.
- Loss of social life due to inability to stop the drinking.
- Loss of order as related to antisocial symptoms of alcoholism.
- Loss of normal role and responsibility in the home. The sober spouse takes over the alcoholic’s responsibility and thereby becomes irresponsible.
- A loss of the sense of reality and an attempt to escape from it. One symptom of this is a “divorce within the home.”
- Separation or divorce which always brings grief for all parties, including children. If it results in sobriety and a quick reunion without both parties entering a recovery program the result is a return to drinking and added grief. Reconciliation without a recovery program spells grief.
The overall loss of what was expected in marriage is a constant source of grief. Some marriages are like living death as long as drinking continues so grief can be a constant cause for all parites.
Children also suffer intense grief. They loose the drinking parent to alcoholism and the sober parent becomes so involved with the drinking parent this becomes a loss of both parents. This sense of grief may be very real years later and should not be confused with depression.
All in all, the family members need help in understanding and overcoming grief which is inescapable in an alcoholic marriage.
There are no steps in overcoming grief, although other things may be done in addition to these fundamentals.
- One must make a sacrifice to learn that all has not been lost.
- Repeated questions that begin with “why” must be abandoned. Why did I, why did he/she, why did we are asked over and over. There is no basic answer to why as revealed by the poet who created the Book of Job. When Job stopped asking “why” and said “Do though teach me” he began to heal.
- The final step is sanctification or the ability to release in love and give back to God that which has been lost, remembering the joy and happiness, not focusing on the lost person or thing.
The spouse who can work through these three steps not only heals from grief but creates a condition which has tremendous potential in setting the alcoholic free and permitting a voluntary choice to enter a recovery program.
It creates a sense of freedom for the spouse and the removal of a great burden of guilt and shame. People can discuss grief and work through it but not so with depression.
Helping a grieving person is not difficult. Your presence and your love is essential. Lending an ear and not a mouth is the essence of such a visit. You do not have to say “I understand,” for your presence says it all. Remember that healing is also a part of life and with time and love the grieving person recovers.
AA and Al-Anon are very helpful. One essential is that neither ask why, both provide a means of sacrifice and in the long run their spiritual program can result in sanctification.
Steps one, two and three are acts of surrender and sacrifice.
Steps four and five eliminate “why” completely. The Ten Commandments, the Beatitudes, the Creed, the Lord’s Prayer and especially the Confessional never contain the word “why.”
Having worked through steps four and five, the alcoholic can no longer alibi for the drinking and the spouse is also free of guilt in relation to the illness of the mate.
The remaining steps work toward sanctification, and of course the 12th prepares one to take this message of comfort to others who need and want it.
Working through grief as tremendous power in recovery, not only for the alcoholic but for the whole family which is where recovery should begin with the restoration of dignity by accepting grief as the most normal and intense of the human pain but one which heals with time, love and understanding.