Lately we’re awash in information about grief. So many experts (self-proclaimed or otherwise) are writing and talking about what grief is, how it looks and making recommendations for getting over or through it. Undoubtedly the pandemic has been a catalyst for all this pontification and some valid research. After all, millions of folks worldwide have perished as a result of the pandemic not to mention jobs lost and lives shattered.

Those of us in the Western world, in particular, don’t do death well and we don’t do grief either. That stiff-upper-lip thing really gets in the way of processing grief. I recently heard a journalist talk about getting over the death of her father sounding as though grief is a spigot that you tighten when it’s leaky. Taking our cues from a young journalist about grieving is like getting medical advice from George Clooney who once portrayed an ER doc on TV.

On the other hand, Nora McInerny’s May 17th episode of Terrible, Thanks for Asking hit the mark for me. She discussed the new diagnosis of prolonged grief disorder that appeared in the fifth— most recent—edition of the Diagnostic and Statistical Manual of Mental Disorders. The DSM is the bible of psychiatry; it is used by mental health professionals to diagnose various psychiatric conditions.

The benefit of the DSM is that mental health providers can use a common language for diagnosing disorders which informs research and influences treatment modalities.

One downside of such a tome is that labeling behaviors medicalizes the human experience and its wide range of behaviors. Like fashion and fads, what is considered aberrant or unhealthy behavior can be highly subjective and driven by societal norms. When the DSM was first published in 1952, homosexuality was listed as a disorder. This was true until 1973.

Another downside is the influence the pharmaceutical industry has over these diagnoses. The financial ties between drug companies and those who develop the DSM has been investigated over the years. The industry’s financial gain of a behavior being identified as pathological is clear.

For better or worse, the DSM is used for insurance reimbursement. No insurance company on earth will sign off on someone getting therapy so that they can be the best version of themselves possible. Those seeking reimbursement for therapy need a diagnosis such as anxiety, depression or prolonged grief disorder.

Prolonged grief disorder is described as “persistent and pervasive longing for, or preoccupation with, the deceased that lasts at least six months after loss.”  If you’re outraged by this diagnosis, you’re not alone. By pathologizing what is part of life; i.e., grieving, we might further disparage those who grieve in their own way and in their own time. Grief is not a problem; it’s not a mistake—it’s a byproduct of love.

Of course, grief that results in agoraphobia, addiction or a number of other conditions is a problem. The problem isn’t grief, however. Perhaps we’re splitting hairs about what’s cause and what’s the behavioral effect, but stigmatizing grief in a society that already encourages the bereaved to move on is not helpful.

I’m having a hard time understanding—at this particular point in time—how the parents of the 19 children (and two teachers) massacred in their Texas school room on May 24th, would not persistently long for their child after six months, a year, two years or more.

We all grieve differently. Some people openly weep while others only show their grief in private. Some try to keep themselves busy to get around grieving whereas others spend months in bed. My dear friend Nancy died on April 24. I wept when I heard the news and was sad and teary for days afterward. Then I was fine…until I was preparing Brussels sprouts the way she taught me. This simple act triggered my loss and reminded me of how much I loved her. That’s the way grief rolls—at least for me. Riding the waves of grief requires balance.

I’m at the stage of life where I’ll get more and more experienced at grieving. I don’t look forward to getting good at grieving, but unless I kick the bucket before most of my friends and loved ones, I suspect that I’ll be able to live with grief. As friends who’ve lost children have said, one can learn to breathe with a hole in your heart.

“How lucky I am to have something that makes saying goodbye so hard.”

—Winnie the Pooh