Counseling Today, Online Exclusives

Grief and the COVID-19 pandemic

By Sophia Caudle December 21, 2020

The COVID-19 pandemic has triggered everyone around the world at the same time. The most common feelings people are reporting are fear, anxiety and loneliness, often with no clear pathway to feeling grounded again because of the uncertain nature of the pandemic’s timeline.

Unacknowledged grief is also being triggered for people during the pandemic. For example, a 22-year-old male client has been experiencing flare-ups with his obsessive-compulsive disorder, and his generalized anxiety and sex addiction have been triggered since the beginning of the pandemic. However, after guiding his therapeutic work into his deep, original grief, which he describes as not feeling connected or nurtured by his parents, he is now more effectively understanding and processing his grief, and his symptoms referenced above have drastically reduced. I have seen this pattern with many clients who experience reduced daily triggers after digging deep into their original grief work.

When grief is triggered (especially when we are unaware of our grief being triggered), it can create an intensity attached to the feeling we are currently identifying, because it traces back to our original grief. What I have termed “original grief” is the perceived awareness of our earliest emotional woundings, and when this gets tapped into, whatever we are currently dealing with seems exponentially more severe.

Original grief typically is formed during the first five years of life, when we are most vulnerable to being shaped by life’s circumstances. The foundational emotion attached to the pandemic is grief, and grief — if not acknowledged, felt and addressed — will continue to trigger more easily identifiable emotions such as fear, anxiety, depression, and whatever other feelings and reactions typically present for people in a crisis.

The COVID-19 pandemic is a perfect example of how understanding the different types of grief, especially original grief, can be helpful to us when we experience current daily triggers, because our deep grief awareness can better inform the tools we implement to ground ourselves.

Traditional grief

The most easily identifiable grief that the pandemic is creating for people is traditional grief. Traditional grief is the grief we feel when someone dies. For many of us, traditional grief is the only type of grief of which we are aware. Most of us are aware of acknowledging grief for ourselves or others only in the event of death and dying, and the biggest fear related to COVID-19 is the possibility of getting sick and that either we or a loved one will die.

According to the tracking website Worldometer, as of Dec. 13, more than 305,000 Americans had died from COVID-19, and there have been approximately 1.6 million deaths around the world. When we see the numbers of deaths related to COVID-19 around the globe, it is easy to become overwhelmed by fear and anxiety. It is also easy to think that if we or a loved one contracts COVID-19, death is inevitable.

Ambiguous grief

Another type of grief that is widely prevalent during the time of COVID-19 is what I term “ambiguous grief.” Ambiguous grief is the grief felt when a relationship ends or when we lose a loved one in our life who is still living. Ambiguous grief is also felt when we lose something important to us or when we have the awareness of something important that we never had. According to Pauline Boss, the principal theorist of the concept of ambiguous loss, the grief experienced during ambiguous grief can be ongoing because there is no closure as there is with traditional grief.

During the pandemic, ambiguous grief has certainly been ongoing for many of us. Most of us have lost relationships, lost in-person connections and lost our ability to move around our communities. Most people do not realize that the primary emotion being triggered in them is ambiguous grief, and typically, if we do not know what we are feeling and where it comes from, then we cannot effectively address it. People may believe that they are feeling anxious, scared or lonely when, in reality, their deep grief is being triggered and the felt awareness is anxiety and fear. Also, because there is no real sense of when the pandemic will be over and no sense of a projected closure date, ambiguous grief is constantly present and creating ongoing insecurities for many people.

The pandemic is triggering many types of ambiguous grief. The ambiguous grief I am seeing most often is the grief felt from the loss of daily interactions with others because of physical distancing. This has created a sense of feeling isolated and lonely for so many people. The interactions we are missing can involve either significant relationships or random interactions with people we do not know well at all. For instance, a simple conversation with the checkout person at the grocery store or a simple chat with a stranger in a park can serve as a type of spontaneous connection. For many of us, these interactions are no longer occurring or occurring much less frequently.

Live human interaction is sorely missed during this time, and our brains are noticing the loss of connection. As John Bowlby, the renowned attachment theorist, acknowledged, humans are hard-wired to connect, and the pandemic has removed person-to-person connection for many people. Some people who live alone or who are in other isolating living circumstances have not had a face-to-face conversation or felt a hug from another person in months, and this is tapping into their deepest sense of original grief aloneness.

For instance, my client “Charles” has not left his apartment in over eight months because of his fear of COVID-19 and his other health concerns. Charles lives alone and has not attended in-person Alcoholics Anonymous meetings since the pandemic began. Charles has also not experienced human touch in over eight months, and he describes feeling the effects of that unfortunate reality as “constant loneliness and depression.” Charles is experiencing deep grief around the loss of the ways he used to connect with others in a face-to-face manner.

Another type of ambiguous grief most of us are feeling is sadness around the loss of our “normal” way of living life. We used to be able to leave our homes and grocery shop, go to work, attend school, attend spiritual gatherings and socialize without thinking that our health could be in jeopardy. Now, these ways of living have either been stripped from us, or we must take extra safety precautions to do them at all. So many regular activities have been lost to us since the onset of the pandemic: marriage ceremonies, funerals, graduations, birthday parties, going away celebrations, sporting events, competitions of most kinds, and many types of intimacy.

Most of us took many of life’s daily activities for granted before the pandemic. Now, we are feeling ambiguous grief because much of what we used to do is not possible at this time. We are feeling a loss of our freedom to connect and move about in society.

Physical distancing during COVID-19 has forced us to set up intentional connections with others rather than relying on spontaneous connections if we want to feel emotionally healthy and maintain healthy relationships. Intentional connections during COVID-19 are exactly what they sound like — ways of meeting with others that we discuss and agree upon ahead of time. So, rather than communicating and deciding what fun activity we are going to do, we are actually planning with whom, as well as how, we want to connect in a safe manner.

COVID-19 has forced many people to make decisions about who they want in their inner circle of social connections. People who are being responsible and observing Centers for Disease Control and Prevention recommendations have chosen a short list of friends they can trust to socialize with during this time. Some relationships are blossoming, and some are deteriorating.

Living in isolation is difficult for many people, and not everyone can handle conscious connection for safety purposes. The removal of spontaneous interactions has required many of us to pivot and create new ways of connecting. Zoom, FaceTime, Skype and many other platforms have been used frequently during the pandemic in efforts to connect. Among those who have been able to transition into intentional connection during COVID-19, most are doing fine, but among those who are stuck in their original grief and not knowing how to create intentional connections, many are not doing well. In March, a commentary in QJM: An International Journal of Medicine predicted heightened isolation-related mental health impacts such as depression, anxiety and posttraumatic stress, which have already been identified during the pandemic in China. Furthermore, literature from Jiang Du and colleagues with the Drug Abuse Treatment Department at the Shanghai Mental Health Center suggests that those with substance use disorders and addictions are particularly sensitive to stress and have increased potential for maladaptive coping styles during periods of isolation related to the pandemic. Finally, according to research published by Brad Boserup, Mark McKenney and Adel Elkbuli in The American Journal of Emergency Medicine, relationship issues and domestic violence are trending upward globally following stay-at-home orders, quarantines and social isolation.

As noted, people in addiction recovery may be especially triggered during the pandemic because shelter-in-place regulations require disconnection, and addiction recovery is about learning how to connect. One of the main components of addiction recovery is learning how to have healthy relationships and connect deeply with others. When in-person therapy sessions, in-person group therapy, in-person 12-step meetings, etc., are removed from the recovery plan, it can be difficult for people to pivot and learn connection via teletherapy or video meetings, particularly when connecting was a challenge before the pandemic. Some people in recovery have transitioned nicely to video meetings, but for those who have not, recovery may be at a standstill, or they may be at greater risk of relapse.

Fortunately, some people in addiction recovery have used the extra time to do more recovery work and more self-care while acknowledging their grief, and this has provided an opportunity for further growth. Grief awareness and the use of recovery tools to intentionally connect are critical to sobriety and recovery. I facilitate two meetings on the global addiction recovery website In The Rooms. One meeting is for codependency, grief and relationships, and attendance at this meeting has doubled during the pandemic. I also created a coronavirus support meeting every Monday on In The Rooms, and for eight months, we have had more than 100 attendees participate. In fact, the entire website has doubled in membership since the pandemic began. People in recovery are trying to find various methods of connection because in-person meetings are not possible at this time.

Original grief

I believe the different types of grief created by the pandemic are also connecting back to people’s original grief and, therefore, increasing the intensity of emotions. As stated previously, I have identified original grief as the grief felt with the perceived awareness of our earliest emotional woundings. I believe that whenever we feel highly activated or charged, our original grief is being tapped into by whatever current trigger is occurring in the moment.

Jaak Panksepp’s research in his text Affective Neuroscience states that grief and social bonding are related together in the mammalian brain. A lack of social bonding, or a feeling of loneliness, is also what we feel when we feel grief. Grief is the experienced and felt loss of a lack of social bonding.

Essentially, all grief is connected not only in our brains, but also in our feelings and in our bodies. A current feeling related to grief, sadness or aloneness is going to track back to our original grief and make today’s feelings more intense or charged. In this way, original grief is being tapped into during the pandemic because at some point, we are feeling fear, anxiety, aloneness or loss. And because the trigger is safety-related and there is a possibility of sickness or death, the depth of the grief is beyond today’s situation; it actually connects back to the deepest and most disturbing grief we have ever experienced. Stated differently, our original grief is being tapped into daily due to the pandemic’s daily triggering of fear, loneliness and uncertainty.

A specific example of how daily triggers can connect back to one’s original grief is in the case of abandonment. During the pandemic, if one is feeling isolated and lonely, and if one’s original grief involves abandonment by parents or other primary attachment figures, then the current feeling of loneliness will connect back to early childhood abandonment, and that feeling will be more intense. This can also be the case if physical or emotional safety is a part of our original grief, because both are being triggered due to COVID-19.

As an example, one of my clients, “Colleen,” experienced abandonment by her father in her early teen years. Her experience was horrid and included lack of food and utilities. In addition, Colleen’s mother was so distraught after Colleen’s father left home that she abandoned Colleen emotionally. So, Colleen has always reported feeling deep aloneness.

During the pandemic, Colleen’s abandonment schema has been triggered again because of the constant isolation. Colleen feels like she has been abandoned and forgotten by the world. In her treatment, we are using this time to dive deep into her original grief, which she reports as, “I do not matter to anyone, not even my parents, who are supposed to love me.”

Treating Collen’s original grief is also soothing her current sadness about feeling alone and forgotten during the pandemic because both are connected in her social bonding neural pathway. Conversely, if we addressed only Colleen’s current feelings about COVID-19 and loneliness, we would not be addressing all that affects her because her original grief would continue to be tapped into. Thus, it would serve as an unknown trigger for her loneliness. In this way, knowing our original grief can be a very empowering process for identifying and treating not only our foundational aloneness, but also the current triggers that we experience as adults.

This unprecedented and difficult time in our world is certainly a trigger for most of us. If we can be aware of some of the deeper feelings underneath, like the various kinds of grief we are experiencing, then we can be more self-aware and take active steps to heal our ultimate trigger of original grief. The deep grief awareness of original grief can empower us to heal not only our foundational pain but also the current triggers introduced by the ongoing pandemic.

 

****

Related reading, from Counseling Today columnist Cheryl Fisher: “Counseling Connoisseur: Death and bereavement during COVID-19

****

Sophia Caudle is a licensed clinical mental health counselor with three private practices in North Carolina. She specializes in sex addiction, sex therapy, and ambiguous and original grief. She conceptualized ambiguous grief via her work with partners of sex addicts, as partners experience the grief regarding the loss of their partner after learning of the double life of sex addiction. Contact her at sophia@bullcitypsychotherapy.com for more information about ambiguous grief and original grief, or to schedule your High Speed Grief Breakthrough Intensive.

****

Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

2 Comments

  1. Margaret McKay Durham

    I am the Executive Director of the Oklahoma Mental Health Counseling Association and I want to know if we could put this article on our website? Of course we would publish who wrote the article and give full credit to all involved.

    Reply
    1. Counseling Today Post author

      Hello Margaret, thank you for asking. You are welcome to share this article on your website, as long as you include the original link to the article on our website [https://wp.me/p2BxKN-6jf] and include language that it was “originally published by Counseling Today.”
      If you have any questions, send us an email at CT@counseling.org. Thank you.

Leave a Reply

Your email address will not be published. Required fields are marked *