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Author Topic: Complicated grief
katharina
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http://www.cnn.com/2006/HEALTH/06/21/complicated.grief.reut/index.html

There is a discussion about addding complicated grief to the DSM as a diagnosis, and the crux seems to be how to distinguish it from the normal grief, which is also devastating and life-changing.

The greatest symptom appears to be persistence, when it continues for months or years after the death that began it.

This is interesting to me because I grieved after the death of my mother for a very, very long time - years longer than my siblings. I finally did go to therapy to deal with it, and was very much helped by it. I wish I had gone five years earlier. I like that it is being considered seriously.

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kmbboots
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A book that addressed this from a very personal perspective is Joan Didion's "The Year of Magical Thinking". It might be helpful/enriching for you to read it. I should warn you, though, it is pretty heart-breaking.
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katharina
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I have read the reviews of that book. [Smile]

I'm really okay. I have recovered from my own grief, but I am interested in what happens for other people. It's also entirely likely that at some point in my life, I'll have it again. However, this really isn't a cry for help thread - I'm fine.

I'd love to discuss grief as a clinical diagnosis, though. Grief is a part of life - I can see the potential for classifying all of life as a devastating experience. How can we responsibly distinguish the normal slings and arrows of outrageous fortune from the truly egregious vicissitudes?

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kmbboots
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You didn't strike me as crying for help. I think the book might be interesting to you because she outlines how complicated grief (and names it as such) effected her during the first year after the sudden death of her husband. Being who she is she resesarched different kinds of grief in order to bring some understanding to what she was experiencing. She relates that to her own experience.

It is also (of course) very moving and beautifully written.

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Kwea
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Tough subject. I will have to think about this before I post, as it raises many issues for me.
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Tatiana
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When my friend committed suicide in high school, I went through this. Other people in our group of friends seemed able to get over it in just a few days.

I'm not sure it's a pathology. I think some things are supposed to change your whole life and leave you a different person forever.

Even the merry joy of the elves is predicated on deep deep sadness from ages hence, from the kinslaying, and from the grief that can never be forgotten, the death of the trees, and the loss of so much that was beautiful and pristine and new.

I'm not at all sure that a deep and lasting grief is something to be cured of.

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IndigoKnight1
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I've always felt that the deep abiding grief that we feel over the loss of someone very close is a type of insanity. Which might explain why I feel that most people are insane.

Personally, I feel. One day, when I figure out what it is, I might come to grips with it. Until then, I'll just let it be. When I do come to grips over it, the odds of me talking about it are practically nil. Not the way I was raised.

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JennaDean
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It's so hard to compare one's grief to someone else's. You know what you feel and compare it to what you see in someone else. If they can laugh, you think, "They've gotten over it and why can't I?" or, "How could they stop grieving so soon?"

But losing someone close changes the rest of your life. It's supposed to. We all show our grief differently, and if some don't cry or if some can laugh sooner than others, that doesn't mean they don't feel it as strongly or they're "over it". No one gets "over it" in a few days, if they were close to the person. We don't know how it's changed them.

I do recognize that some people cannot seem to go on and live after a death. I don't expect that life will ever be "back to normal", but everyone needs to be able to begin to function again, even though it may be functioning differently than before. For those who can't, I don't know that their grief is any different, but their coping skills - their ability to begin to function again - could be impaired for a long time, and that could need treating.

I just hate the thought of trying to "compare" grief - "My grief is more complicated than yours." I just see potential for hurt feelings there, since grief is so personal.

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kmbboots
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"Complicated grief" is an actual clinical definition rather than just a description. Here is an article that helps explain it.

http://www.apa.org/monitor/nov04/grief.html
quote:
Of particular concern, says Neimeyer, is the finding by Yale University psychologist Holly Prigerson, PhD, that roughly 15 percent of people who've lost a loved one might be susceptible to "complicated grief," a condition more severe than the average loss-related life transition, depression and anxiety. Distinguishable from depression and anxiety, it is marked by broad changes to all personal relationships, a sense of meaninglessness, a prolonged yearning or searching for the deceased and a sense of rupture in personal beliefs.



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raventh1
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Death is a rather strange thing. It can change your complete outlook on life in a matter of a few moments.

The people closest to you seem to affect you the most, and people that are not as closely associated to you can still affect you in ways you didn't think.

For me, it made me not want to have any close associations because they could just 'dissapear' from life, and change everything.

It's hard to lose your sense of meaning if you hadn't quite developed it yet. But apparently it is possible.

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Belle
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I definitely experienced complicated grief when my grandfather died.

It wasn't just about missing him or feeling sad that he was gone, I felt like my whole life was changed and that I could never feel safe again. I ignored my children, stayed curled up on the couch for hours just letting them fend for themselves. I withdrew from my husband, I was not a functioning adult.

Therapy helped me get through it, but I definitely believe what I went through was more than just grief. It changed my whole life, for more than a year I was locked into the grief and not able to see a way out.

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raventh1
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I think I have just recently been seeing less darker days. Too bad it's taken about 10 years to get this far.
But now it has just turned into a loss complex where I don't get attached or close to things because I will lose them.

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Tatiana
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Raventh and Belle, I hope you find your way through the darkness to some sort of light that lives inside there.
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Kwea
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I experienced this, and still do, with the death of my grandparents. Particularily of my Grandma Fullerton.

Years later I still think of them often, and get sudden tears in my eyes thinking of them. I had a series of friends die right before I left the Army as well, and I changed my entire life because of it.

It isn't all bad, I remember the joy as well, but I doubt that feeling of grief will ever completely leave me. I have learned to deal with it, but it was very hard.


It still is, sometimes.


I was an EMT, and the first serious accident I saw after becoming certified (although not in my home state of MA, oddly) involved friends of mine, who all died in my arms. I couldn't save them, no one could have....I know this.

I took some time off (emergency leave) and came back....

To find a friend of mine on post had just been in a car accident and died while I was away, and that his funeral was that day.

I never finished nursing school, because I couldn't deal with it. I had no problem with blood and gore before that, although I didn't like it of course, but I lost all confidence in my abilities, even though I was the soldier hand picked to deal with teaching the others proper procedures. I was one of the 3 best in my class (over 500) at Ft. Sam, and of the three of us I was the best at hands on training.


I left the Army in part because of this as well. I always handled my patients well, and even saved a few lives...even got to deliver a baby, once...but after I would break down and be a mess.

I changed my entire life to avoid being in that situation again....but the weird part is that I still jump in right away to help when I see something like that happen to this very day. I am good at it.


And no one else knows that after, once I am alone, I still lose it. Not to the same extent, but I can't help it. I get the shakes, and that is the least of it.


My Grandma Fullerton died about 12 years ago. My friends 3 years before that.


I had always thought I would be a priest growing up, but after my Grandma died (Grandma Brill, 20 years ago) I lost my faith completely. I found it years later, but it has never been the same, nor will it ever be.


I don't know why I feel this way when someone close to me dies, but there is no doubt I do. I know a lot of it is normal too.


But not all of it. I can't explain why, or how it is different, I just know it is.

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Elizabeth
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I am sorry, Rob.
I think faith helps many people through grief, and other times, people abandon their faith because of it.
Both of my grandmothers have been very strong pillars in my life. If I had lost my grandmother twelve years ago, I know I would have had a much, much harder time getting over it, ever. When she did die, she was frail and experiencing dementia, and she was ready to go.
Still, I miss her every day.

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Kwea
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Well, I eventually had to admit that I believed in God even though I was angry and hurt. I just am not sure any specific religion fits what my beliefs are, so I have just come to a truce with myself regarding that.

I believe what I want, and have tried to find a religious framework that feels comfortable.


Since I was raised RC, Episcopalian fits the closest to my beliefs. It is still a lot of the forms and structures that I am used to seeing and that I am comfortable with, but they have fixed most of the problems I had with the RC church. Priests can marry and have children; women can be priests....


[Big Grin]

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Elizabeth
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My grandmother lost her faith entirely when my mother died, and she has never recovered from that loss.

I doubt my grief would ever be uncomplicated if I lost one of my children or my husband.

The more I think about it, the more I dislike the term "complicated grief." Grief is complicated, period. I say, pick another word.

And, like you, I am in for the comfortable rituals.(forms and structures)I found myself back in the Protestant world. I was raised Methodist by my grandmother, but I had been baptised Catholic, and was confirmed Catholic when my dad remarried. I loved it, and I was always able to distance myself from the dogma that I disagreed with.

In fact, if my kids weren't in the Congregational church, I would probably go back.

Edit: Both children christened Catholic, but I got mad when they kept sending what amounted to debt collector letters demanding we give money to the church or no longer be a part of the parish.

Why? Uncomplicated. At mass, I can free myself to meditate(pray) and know that I have no decision to make about any church policy. Sometimes, the other church seems way too much like a middle school, with the old guard standing firm against change, and the changers not respecting the need for the old guard to have their stability.

I am probably more Unitarian if I really had to define my beliefs, but to be honest, I am still not quite sure what they are!

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Belle
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My faith didn't suffer during my time of depression and grief but my fellow believers did nothing to help me. All they did was make me feel worse.

I kept getting told that I knew where my grandfather was and that he was happy and reunited with my grandmother so I should be rejoicing for him. So, on top of my grief, I had guilt that I wasn't happy for him and the uncertainty that on top of my pain I was now also a bad Christian.

It has really changed how I react to grieving people. My best friend from childhood lost her dad about two months ago, and I went to the viewing and heard much of what I had heard before. All I did was put my arms around her and tell her I was sorry and that I loved her. It seemed the safest thing to say and do at the time, because no matter what else she was feeling, I knew she needed to be told that she was loved, and that I recognized her pain. Those were the two things I needed the most, but unfortunately didn't get from my family or from my community of friends and church members. I distinctly remember being told by one person that I needed to take care of my mother. There was this sense that it wasn't okay for me to be in pain, he was after all, just my grandfather.

In fact, he was the most important person in my life before I met my husband, and with my tumultuous family life growing up, he was the one person that I knew I was always safe around. When he died I lost my refuge, my sense of security in the world and I was completely devastated. No one around me seemed to recognize that and I felt like I didn't have the world's permission to grieve.

I really feel like my grief became complicated because of the response to it. Had the people around me reacted more appropriately or had I recognized that I didn't need anyone else's permission to feel what I felt it would have been better, I think. Not that I blame other people, I've come to the point where I can now look back and see no one tried to hurt me or marginalize my feelings on purpose. In fact, while I'm not exactly grateful I went through those approximately two years of hell, I can appreciate that they've certainly contributed to make me the person I am today.

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Elizabeth
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Isn't it strange that we tend to discount the feelings of loss for a grandparent? I think that happens a lot, Belle, now that you describe your situation.

No one has ever been closer to either of my grandmothers than I have been. No one, other than my dad, helped me through my early life more. As I said, if I had lost either of them as a child, I would have been a wreck. Yet, when my grandmother died, I had to listen to my aunt say how sad she was, how she was the saddest of all, how no one in the world had ever been as sad as she.

And, I think it is a similar thing when someone's pet dies. I am always sure to say something, because so many people think, "Oh, it is just a dog or cat." Well, to that person, the pet might be closer than a person. I guess that is a whole other discussion, but not for me. Losing my grandmother felt similar to when I lost my dogs. The grief was pure. It was unsullied by guilt, or by thinking I shoudl have been or done something different. It was "clean" grief, for lack of a better description.

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Tatiana
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Yes, Elizabeth! Some people might think it's odd, but losing Drive By was like losing my child. It's like a physical wound that takes time to heal. She was so much a part of my daily life that not having her here is like an amputation, in some ways. A pure grief, just like you said. I am coping just fine, but I know it's true that losing a pet can be as grievous as the loss of any other family member.
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JennaDean
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quote:
The more I think about it, the more I dislike the term "complicated grief." Grief is complicated, period. I say, pick another word.
Thank you, Elizabeth, this is what I was trying to say. Everyone's grief is real and hard and complicated and takes a long time to get over. If someone's reaction to grief keeps them from functioning at all, or really long-term, pick another word for that. It just feels like "complicated grief" belittles those who had, by comparison, "ordinary grief". You know, grief that's easy to get over. </sarcasm>

About the grandparents,
quote:
I kept getting told that I knew where my grandfather was and that he was happy and reunited with my grandmother so I should be rejoicing for him.
... this sounds like what King of Men said when some of us were expressing compassion when someone died. 'Why are you sad if you're so sure they're in heaven?' Or something similar.

Just because someone has faith that their loved one who died is not gone forever and is in a "better place", doesn't make it easy for the ones who are left behind. We still miss them terribly and have to live in this world without them. I've never mourned for my family members; I don't worry about what's happened to them, because of my faith; but I mourn for me, for being left in this world without the one I love. Even though I have faith that I'll see them again, it seems like such a long time. That's what's so sad. I think my faith has made it slightly less sad, though, because I have hope that the separation is not forever.

But it's taken me a lot of years to understand better what to say to someone in that situation ... mostly I just tell them I'm sorry, and that there's really nothing good for me to say, but I'm thinking about them. I'd hate to make it worse by saying the wrong thing, but I found that what hurt me the most was the people who avoided me because they didn't know what to say; so I try to at least let them know I'm mourning with them.

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Elizabeth
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So true, Jenna.
Sometimes, we are sad when we know we will se someone again, but we know that it will never be the same when we do. Plus, they won't be with us.

I feel an intense sadness every spring when the school year ends. I know I will see the kids the following year, but they will be transformed into sixth graders, they will not be "mine" anymore. They will move on. As much as this is good for them, it is still sad for me.

Lame analogy, but I think we have a constant parade of losses in our lives. They hurt.

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Kwea
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It isn't just about faith though, that was one example.


I remember that things even tasted different for months. Nothing seemed appetizing. I had to force myself to eat.


It was hard to care about anything at all, really. even other people I loved. I knew that wasn't right, that I could care for them even more, and that made me feel guilty....which only re-enforced my other feelings of guilt and complicity.


It is hard to put into words, oddly enough.

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Elizabeth
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I think you are doing a lovely job of explaining it, Kwea.
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katharina
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I think my grief was complicated because of circumstances as well - because I didn't start griveing until long after the rest of my family was doing better. Since I left for a year and a half immediately after Mom died, I didn't really begin to grieve her until I got back. By then, my dad had remarried and everyone else had mostly moved on. That's fine - good, even. After a year and a half, I wouldn't expect everyone to be in the same place. Since it was all fresh for me, though, I was a reminder of an awful time. It meant I had to grieve by myself. I remember the first Christmas after I was home - it was my first Christmas without my mother, but my brothers' third, and my dad's second Christmas with his second wife. I cried most of the day, and my dad told me to stop being maudlin - I was making my stepmother feel bad. Good hell.
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kmbboots
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quote:
quote:
--------------------------------------------------------------------------------
The more I think about it, the more I dislike the term "complicated grief." Grief is complicated, period. I say, pick another word.
--------------------------------------------------------------------------------

Thank you, Elizabeth, this is what I was trying to say. Everyone's grief is real and hard and complicated and takes a long time to get over. If someone's reaction to grief keeps them from functioning at all, or really long-term, pick another word for that. It just feels like "complicated grief" belittles those who had, by comparison, "ordinary grief". You know, grief that's easy to get over. </sarcasm>

Thibnk of it like a medical term. Like having pneumonia with "complications" or a heart attack with "complications". You can still die from really bad pneumonia or a heart attack witour complications - nobody is saying that anyone's grief is less. It doesn't address the severity of the diagnosis. It is just a way to describe a certain set of symptoms.
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katharina
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I can see the problems with complicated grief, but can anyone think of a term that's better? Medically, it does describe the phenomonon.
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dkw
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I think what I don't like about it is that it implies that "normal" grief has a time limit.

Grieving a death for months or years is not abnormal. It's not even unusual.

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Elizabeth
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I agree, Dana.
My grief for my mother has lasted my whole life, and I didn;t even know her. It coincided with various stages. The hardest was when I realized I was older than she was when she died. That was mind-blowing. But when I had my daughter, it was the weirdest thing. I felt her. I have described this elsewhere, and can't right now, but it was very overpowering.

Kate, you might have sort of similar stuff when you get married, and when you have kids. It never ends, it just changes, and matures. Maybe that is the term: immature grief? Something like that? for grief that stays young beyond its time. Stunted grief? I don't know.

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katharina
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I think it is hard to give a name to something like that without insulting either the people with it or the people without. I don't like immature or stunted grief as names because the names imply that there's something wrong with the person who has it.
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Theaca
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There are many medical terms that might sound offensive to patients, who don't understand that it isn't personal, and it doesn't mean what they think it means. It startles me sometimes now, when someone gets upset, I am so used to the terms.

Complicated grief sounds like a pretty good medical term to me. And I agree, any term we come up with for something as personal as grief could and will probably be misinterpreted by some patients.

Is there a latin word for grief? That might sound more medical to people.

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dkw
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I think if we as a society did a better job of supporting grieving people in general we wouldn't need a medical diagnosis for it.
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Kwea
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I just had a very personal post written out, and this stupid computer just ate it again.

I lack the energy to write it out again, at least now.

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Elizabeth
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quote:
Originally posted by dkw:
I think if we as a society did a better job of supporting grieving people in general we wouldn't need a medical diagnosis for it.

Oh, I agree.
And, Dana, I really believe a lot of that has to do with the way we tend to exclude children from funerals. By "we," I mean the society in general.

I was raised to believe that funerals were a celebration. There was really good food, you got to see aunts and uncles and cousins you hadn't seen in ages, it was a time to come together. I feel sad when kids don't get to see the happy part of the sadness. People were sad, but they could share their grief with others, and it was safe to laugh and play.

Edit: SOmehow, though, it was not the "be happy or you must not have faith" message.

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dkw
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I consider a good funeral one where the closest family members cry at some point and laugh at some point.

There is a marvelous book called The Grieving Child written for parents/educators/clergy about supporting children through grief. It has a fascinating section on having a children’s funeral – not a funeral for a child who has died, but a ritual designed and conducted by children when a parent, grandparent, or sibling dies. The author suggests it take place a few hours before the “real” funeral. The important part was that the kids get to plan it (with adult assistance), so whatever happens is meaningful to them.

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breyerchic04
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When my great uncle died two years ago, his son in law who was a brethern minister had a small service with the grandkids (and I got included because I was there and almost the same age as the oldest), It was beautiful. He read a few quotes, and let them say things. He knew it was the best way for his kids to get through it, so it would work for his nieces and nephews too.
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katharina
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That's a really great idea.
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breyerchic04
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The whole memorial service was organized perfectly. There was a speaker to explain why he had donated his body to science, and what would happen, music, stories, food, pictures.
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Elizabeth
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I just love that idea. Thanks, Dana. I want to get that book.

After my grandmother's funeral, the kids both told us how scared they had been to go, but how happy they were that they had gone.

Back at the house, my dad dragged out these old song sheets from when he and my aunt had taken piano lessons. He did a "Name thet tune" with my great aunt. He and my aunt sang the songs, beeped out the title, and she had to guess the songs. It was incredible.

They also loved hearing me read about my grandmother, and in general, felt very good, though they miss her terribly.

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dkw
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Amazon link to The Grieving Child, by Helen Fitzgerald
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Elizabeth
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Thanks.
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