How Grief and Mourning Change During a Pandemic

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Six experts explain how to recognize the many new faces of grief during a pandemic. As of this writing, the coronavirus pandemic has killed more than 50,000 people in the United States and more than 200,000 people worldwide. These deaths inevitable companion is grief, but the turmoil of the pandemic is altering and interrupting the normal course of mourning. People are experiencing many different kinds of loss simultaneouslysome of them unique to or changed by this moment in history. Because of the risk of viral transmission, many people are dying apart from their loved ones, and many others are mourning apart from theirs. Meanwhile, those who havent lost someone personally are surrounded by daily reminders of death, and are mourning their lost routines, jobs, and plans for the future, all while fearing for their health and that of their friends and family. I think that this situation is very, very difficult for people, says George Bonanno, a researcher who studies grief. But by the same token, people will get through it, probably the same way that people have gotten through other kinds of losses. Theyll just need to be a little more creative about it. Based on decades of research, Bonanno calls grief a natural adaptive reactiona painful but necessary mental recalibration to accommodate a new absence. Bonanno was one of half a dozen experts I consulted in an attempt to catalog how mourning is changing in the coronavirus era. These six, whose fields span academic research and clinical psychology, were not in conversation with one another, but they addressed many of the same themes. Their comments below have been edited for length and clarity. The pandemic has made the usual gatherings that follow a death dangerous, depriving mourners of a traditional funeral as well as the comfort of friends and loved ones physical presence. Megan Devine, a psychotherapist and the author of Its OK That Youre Not OK: Meeting Grief and Loss in a Culture That Doesnt Understand : Grief can be a really isolating experience, and that has been very much magnified during the pandemic. The things we do to support people who are grievingcoming over to someones house with a casserole, attending a wakeare not options in the way that we usually think of them. On top of that, everybody is struggling with their own stuff, so the available emotional bandwidth is very much reduced. George Bonanno, a clinical-psychology professor at Columbia Universitys Teachers College and the author of The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After Loss : Cultures all over the world have these rituals where people take care of a bereaved person, and one thing these rituals do is connect the people who are presentthe person theyre mourning may be gone, but they see that others are still here. People who come to your wedding are in your life forever, in a strange way, and its sort of the same thing with funerals. These people came together around a death in your life, which is really a powerful thing. Thats the way it works normally. Ramtin Arablouei: The coronavirus is stealing our ability to grieve Joshua Coleman, a psychologist and a senior fellow at the nonpartisan Council on Contemporary Families: Humans are wired to reassure and to comfort . In my practice, Ive seen that it is not only distressing to be deprived of receiving comfort, but similarly to be deprived of the ability to provide comfort. Not being able to directly comfort loved ones who are grieving right now is also painful. Kami Fletcher, a history professor at Albright College and the president of the Collective for Radical Death Studies : One of the things about mourning and grief in African American communities is that weve been stereotyped so many times in life, but in death we are able to have our humanity: You have people in the community who are able to show who this person was by getting up at the podium to talk about someone or playing a slideshow of their life. The fact that we cannot gather and grieve is a really big blow. Unable to be physically together, many people have conducted memorial services on group video calls. Virtual funerals are not inherently worse than in-person eventsbut they are very different. Bonanno: When we gather to mourn, we tell stories about the person who died and make little speeches about them, which helps build an image of the person that you take with you: They may be gone, but this is who they were . I think people have to do their best to find ways to do that while apart. You can create Facebook pages or email people or send letters and ask people if they have stories to share. Ive participated in a few of those kinds of things with friends of mine who have lost loved ones, and I think theyre quite powerful. Not everyone is as comfortable doing that as [they would be doing] a memorial service, but thats what we have right now. Devine: One thing Ive heard from people recently is that the virtual funeralor memorial, or wake, or shivawas more moving to them than an in-person one. In-person funerals are familiar: You dress up, you go, you pay respects, you do the receiving line, and then everybody gathers for food afterward. Having to come together in a virtual space is new, and that act of novelty can break us out of things and make us feel and connect in different ways, though certainly thats not true for everybody. Read: Notes from a videochat memorial The thing to remember is that theres no time limit on when you could hold an in-person funeral. You can do that at a later date, so a virtual service doesnt have to be a flat-out replacement. There are some really creative ways to plan a virtual service. Maybe you could send out a recipe that the person used to make and have everybody make it so that you can all join in a meal together. Because of the risk of viral transmission, many people whose loved ones die in the hospital are unable to be with them in their final days. Those people lose an opportunity for last words and closure. Bonanno: When we lose a loved one, we struggle a lot more if we imagine them in pain at the end of their lives. Its harder to grieve those kinds of losses, because you picture your loved one suffering, and in the case of a death in a hospital, theres a sense of fear and loneliness that you can imagine them having experienced. Devine: Not being at your persons bedside at the end of their life adds extra layers of suffering. It might add guilt: Even though you werent allowed to be there, theres a sense that you should have been anyway, or that you should have realized that they were sick sooner. Theres also a lot of survivors guilt around the coronavirus because the virus is transmitted by close contactsomeone might think, I just saw my dad three weeks ago. Maybe I gave this to him . That survivors guilt is uncomfortable, and adds extra layers of suffering on top of grief itself, but its very normal. Pauline Boss, a professor emeritus of family social science at the University of Minnesota and the author of Ambiguous Loss: Learning to Live With Unresolved Grief : When people dont have a body to bury, its quite natural for them to hope that the person who died is still alive somewhere. As human beings, we need to see the body of our loved one, to have remains, in order to know that our loved one has been transformed into another state. Thats missing now for many people because the body is whisked away and they dont get to see it for a certain amount of time. So even many clear-cut losses have become ambiguousunclear and lacking resolution. Death is more present than it usually is in daily lifepeople are surrounded by reminders of it in the news, in stories from friends and loved ones, and in the sirens of ambulances. Devine: When I hear a siren go by, my habitand it has been for yearsis to wish them luck. Right now, we cant get away from the overwhelming volume of loss, and thats forcing us to really let in how fragile life is and how easily that siren could be for us or someone we care about. To deal with that, it might help to come up with a ritual, a habit, that you do after you hear a siren or read a news story. One of the things thats happened during the pandemic is we dont have the usual protections that keep the idea of death at a distance. Often, we say things to ourselves like, I always wear my seatbelt or I do X, Y, and Zso I dont have to think about that too much . But right now, we cant say, Oh, that would never happen to me . With this virus, its so uncertainbeing outside can kill you. So theres grief, yes, and theres also a lot of anxiety mixed in with that. Boss: I think it's triggering anxiety about our own mortality. I mean, why wouldnt it? Were all in danger. Science is coming, but it isnt ahead of the game yet, and there are conflicting messages from leaders about what to do and what not to do. The anxiety were all feeling right now is collective and understandable. Carmen Inoa Vazquez, a clinical psychologist and a co-author of Grief Therapy With Latinos : Right now, a lot of people are experiencing a sense of communal griefthey may feel like this could happen to any one of us, and they may know people who have died. Some people who have lost loved ones in the past will tell you that eventuallyand the amount of time variesthey started to take a different approach to life and find meaning in the loss and in their future. So during and after the pandemic, maybe people will try to pay more attention to their unfulfilled wishes, or have conversations with loved ones that they may not usually have and affirm their love for those people. In this way, the pandemic can bring unity and connection, and help us deal with our mortality. On top of its death toll, the pandemic has also stripped away many aspects of life that give it joy and meaningcanceling graduation ceremonies, causing layoffs, unraveling visions of the future. These losses are more abstract than deaths, but grieving them is no less valid. Boss: The loss of having answers to questions, the loss of a routine, the loss of freedom to go out and do what we please, the loss of being able to hug our loved ones and be with our friendsthose are all major losses, and they have to do with the relationship between ourselves and the changing world. These losses are not the ones we have sympathy cards or rituals to deal with, and grief for these losses often gets stuck because there are no supports for it. When nobody notices or acknowledges it, that makes it so much harder for the people who are experiencing it. What we need to do now is name these losses. You cant cope with something until you have a name for it. Read: On top of everything else, my dog died Bonanno: One former student of mine showed that you can actually have a grief reaction for anything thats really a part of your identity. And people are losing their identities right now: Someone opened a bookstore a couple months ago and now the bookstore is going to go under. That was their dream, and its gone. All the seniors graduating from college, theyre not going to have a ceremony, and theyre finishing online classes. People can grieve for that. If they feel grief, they should let themselves feel it. Devine: The people who are wrestling with grief because they lost their jobthats a very valid loss, and it deserves to be honored and acknowledged, just as we should acknowledge the grief of somebody whose sibling died of the virus. Those losses are not the same, but they are equally valid. And thats a really important distinction: If we say something like, My 30-year-old sister died of the virus and thats way worse than your 97-year-old father dying of the virus, because at least he got to live to 97, thats a competition for compassionthats treating compassion as a scarce resource. But really all loss is valid, all grief is valid. Every loss should be heard and acknowledged, because its important to the person experiencing it. Inoa Vazquez: If you lose a loved one, these other losses can make the grieving process much harder. For instance, if someone in your household is having financial issues right now and they are grieving over a death as well, they might be less resilient and empathic. Sometimes families that come to my practice are in different places with their grief: Somebody might think that you should not dismantle Moms bedroom; some people think you should wait X amount of time after the death to dress in a certain way. Now, during the pandemic, people are very stressed, which could result in people having less patience, less understanding, less self-control when theyre dealing with a loss together. And if a family loses a financial provider right now, that could add even more stress and again complicate the normal resolution of their grief. One grim pattern that has emerged from the early data on deaths from COVID-19 in the United States is that black and Hispanic Americans appear to be more likely than white Americans to die from it . Grief in each of those communities carries unique and specific resonances. Fletcher: This is definitely shining a light on these systemic inadequacies of being medically underserved, which is an added layer of grief. In the black community, weve always had to depend on ourselvesthe government doesnt necessarily see us as folks who need immediate help in the way that they see white America. As a result, the things that will help us cope and memorialize now are things that weve already put in place. For example, part of my research is on RIP T-shirts . Theyre a memorial that anybody can access, and black Americans with those T-shirts are tying deaths to systematic oppression and refusing to be silent. Read: The pandemic will cleave America in two Inoa Vazquez: This situation can intensify the grieving experience for many people who are immigrants. The immigration experience brings a lot of losses, and in moments of grief, in moments like this, these losses can be reignited and brought to the surface. You lose your culture, you lose those connections that you had, and you have to readjust. The Latino population has lost a lot of people to the virus, and those previous experiences can delay the process of finding closure. During the pandemic, health-care workers will experience more deaths firsthand than perhaps any other segment of society. Their grief will be destabilizing and overwhelming. Devine: What Im hearing from health-care providers is that this is brutal. Theyre seeing people die not only without their friends and family, but sometimes in great distress because of the nature of this disease. Under normal circumstances, these workers know how to make the end-of-life process more gentle both for the person dying and for their friends and family, and yet right now theyre not allowed to do those things or dont have the resources to do them. So theyre heartbroken. They also have the added challenge of making decisions about separating themselves from their own friends and family to keep those people safe. Were asking people to go into these very challenging situations at work, but without having any off switch at home at the end of the day. In normal times, palliative-care, hospice, and ER teams can go home to a sense of normalcy and lean on their loved ones after a long day. They cant do that right now, which means theyre having to lean on each other, and they only have so much emotional bandwidth to do that. When someone dies of COVID-19, their death occurs against the backdrop of a historic event, instead of being a self-contained story all its own. That fact could shape the grieving process. Bonanno: I did research about 9/11, and one way a national tragedy makes grieving even harder is theres so much pain right now. Theres this amplified sadness. But I think in the long run, it may actually be helpful is not the right wordbut it may give people something to hold on to in a strange way. After 9/11, I interviewed a lot of people who were in the towers but got out and survived. Some of them were traumatized by it, but there was a sense that you had this story that you could tell people and they immediately knew some of what you went through without knowing your particular story. People reference your story to this historical event, and this might help you reach a shared understanding. Fletcher: Theres a concern that the experiences of people of color, folks from marginalized communities, will get swallowed up in this grander narrative of the pandemic, with a homogenous story about the large group of people who are dying of COVID-19. There may even be acknowledgments that people with certain diseases died at higher rates. But Im worried that the racial patterns will get overlooked, and that there will be a real throwing-away of the black community as the story of the pandemic is recorded and remembered. Devine: Ive heard that after 9/11, many people felt that their personal losses were overshadowed by the national disaster, and this is something were seeing right now, in a way. People who are losing people to non-virus-related causes are sort of being erased because the spotlight is on this other thing. Boss: In a way, it might be easier on the families left behind if they know that their loved one left because of such a great power outside of their control, and that others shared in the same kind of loss. Theyre not alone, and its pretty clear to them that theyre not alone.