COVID-19 and the Invisible Veil of Grief
While it is certainly true that there is no “good time” for a loved one to die, losing someone in the midst of the COVID-19 pandemic is arguably one of the worst (if not the worst) possible times to experience grief.
Sometimes I have to remind myself that it is January, 2021, and we have been dealing with the ramifications of this pandemic for almost a year now (and even longer in some other countries). The days, weeks, and months blend together in such a way that makes it difficult to track time… Is it Tuesday? We know that this pandemic has disproportionately impacted people of color and widened an already unequal distribution of income, access to medical care, and allocation of federal resources. The degree to which you have been affected by COVID-19 may differ from your neighbor, however the thread that links us all is the sense that much has been lost. While there has been a universal, public experience of loss during the COVID-19 pandemic -- in particular yearning for “life as we knew it” -- there has been another pandemic rippling behind an invisible veil, the silent, private suffering of the bereaved.
Over the course of our lives we deal with loss in many ways: a pet dies, a friend moves away, a relationship ends, a beloved item breaks, a job ends, etc. All of these losses provide opportunities to practice saying goodbye and to tolerate intense feelings (perhaps sadness, anger, guilt), which can serve as small preparations for coping with death. If you are someone who has experienced grief before, you know that no amount of preparation can prepare you for the moment when someone dies and your life changes forever. Grieving people often feel that they are in uncharted territory and do not know what the path ahead looks like. This combined with the uncertainty of the pandemic creates a recipe for feeling anxious and untethered, without the support you might typically count on.
What is grief exactly and how long does it last? Grief is your response to death, and is experienced and expressed through physical sensations (the way grief manifests in the body), feelings (typically mixed feelings), thoughts or cognitions (the story created about the death and how you make sense of things), behaviors (may be different than you are used to behaving), social difficulties, and spiritual searching. And while friends and family might anticipate you will “bounce back” quickly, it is well documented that grief persists longer than many imagine and can reverberate throughout the rest of your life. You must adapt to the reality that the person is no longer alive, contend with the deep missing of the person, and learn to move forward in your life, both without the person and with the person (although existing in a different way). The death of a loved one can challenge the beliefs you hold about the world as being a safe, orderly, and predictable place, and can cause you to feel deeply vulnerable.
The COVID-19 pandemic has complicated what is an already complex and painful time for people in a number of significant ways. One of these ways is the lack of normal social support. Typically, you are surrounded by your community after someone dies. People come to pay their respects, give hugs and hold hands, bring food, and provide much needed love and company. Friends are likely to encourage you to get out of the house as a distraction and try something new, and usually offer a (albeit tiny) break from the grief. Quarantining, physical distancing, restrictions on public gatherings, and mask wearing all result in a loss of contact and meaningful connection with others. And while there is something to be said about the incredible way that technology has created connection at this time, there truly is no substitute for in person support. This makes people grieving during COVID feel particularly isolated and lonely.
Secondly, people are dying alone in a way we have not had to contend with before. Hospitals, nursing homes, and other care facilities have rules in place that may prohibit visiting patients, even those who are at end-of-life. Even if the person was declining and the death was expected, the moment the death occurs can still feel sudden and shocking. Not having the option to be present and say goodbye in person is leaving some people feeling guilty and distressed, despite knowing intellectually that they did not have a choice. In my practice, I have also seen this issue impact medical decision-making, with people weighing the need for much needed medical intervention with the personal need to be surrounded by family at home. In some circumstances, this choice might hasten someone’s death, but the desire to be with loved ones felt like a worthy trade-off. These are very real decisions that people are having to make for themselves.
Another complication is the loss of tradition and ritual that usually follow someone’s death, including the inability to have a funeral, religious service, memorial or reception. These events can serve the very important functions of underscoring the reality of the situation, offering opportunities for storytelling and honoring the person, and bringing together people to share in their grief. Without them, people can feel as though they don’t know what to do to adequately memorialize the person who has died. Additionally, grief can be isolating under normal circumstances, but grieving people who are COVID-19 positive or have been exposed and need to quarantine for a period of time are at risk of being totally alone at a time they most need to be with others. Some creative work arounds have included Zoom funerals, having something right away with immediate family and scheduling a memorial when people can gather in person again, and holding “drive through” hours where friends can show love from their cars.
A phenomenon talked about less frequently is the disenfranchised grief experienced by people whose loved one died during the time of COVID-19 but not from COVID-19. When someone dies during the pandemic, the first question people either think of or ask is, “Did they die from COVID?” There’s a curiosity and a sense of horror about the virus, which can translate into a feeling that people are not as interested in death from other causes or expected deaths. We know that the pain the bereaved person feels is equally great no matter how someone dies, and the presence of this question can inadvertently minimize other kinds of losses. The same phenomenon was documented around September 11, 2001, where other losses were more invisible in comparison to what was labeled as a more profound loss.
Lastly, there is the presence of ambiguity. It is unknown what is going to happen next, how quickly our country and the world can regain some sense of normalcy, and what “normal” even looks like going forward. When you are in the position of rebuilding your life after someone dies, it is important to have dates on the calendar to work towards. If you are grieving you may wonder, “What do I have to look forward to, and when?” You may have been looking forward to something in the future (a wedding, family vacation, etc.) that will likely not happen or will have to be postponed, which can bring an additional sense of sadness and loss. Also people who were bereaved prior to COVID may have just started to get life back on track, for example going back to work in the office, planning to move, engaging in hobbies, or starting to date again. Stay at home orders and other necessary aspects of preventing virus spread are keeping people in an unanticipated holding pattern.
So how do you lift this invisible veil and get additional support as a grieving person? As I remind my clients often, people are not mind readers, as much as we want them to be. You may have to educate those around you about the added challenges of trying to grieve at this particular time. They may need some guidance on how they can support you. Also, know that you are the expert on your own self, and that you already possess many skills to heal your hurt.
Much of the anxiety and loss you are experiencing at this time is felt and held in your body, which activates the sympathetic nervous system, or the “fight or flight” response. In order to release the stored tension in the body, it is particularly important to turn to things that make you feel soothed and comfortable. For some people that might be a guided progressive muscle relaxation, gratitude or grounding practices, or connecting with the earth (e.g., gardening). For others that might mean exercising or scheduling additional time to connect with friends. You may need to brainstorm with a friend to figure out how to practice self-care at a time when your go-to self-care strategies may not be available to you. For example, if your break from grief was going to the gym, how can you promote creating space for exercise at home? If the break from grief was going to get a massage, would you feel relaxed by taking a bath?
Know that this is a very challenging time and that you are seen. If you are not getting the support you feel you need, please make sure to reach out.
Side note: Going forward, I encourage you to only use the word “grief” when it refers to the death or anticipated death of a person, and use the word “loss” to refer to the many changes that are a result of COVID-19. The reason for this is that people who are actually bereaved due to death are feeling as though the word “grief” is being used too freely. While it’s upsetting for a high schooler to miss out on the tradition of prom, using the word “grief” in relation to this loss is very invalidating for people who are grieving the death of a loved one, which is permanent. So please be thoughtful with your choice of words—it does matter!
