This document discusses grief and loss in the context of addiction and recovery. It defines grief and outlines the typical stages of grief: denial, anger, bargaining, depression, and acceptance. It notes that grief from addiction loss involves mourning not just people but old ways of living and relating. The recovery process often involves grieving the loss of rituals, relationships, and roles tied to the addiction. Managing grief in recovery requires acknowledging feelings, avoiding relapse triggers, and caring for one's physical and mental health through social support, journaling, exercise and counseling.

1. Intro to Addiction Studies

2.  Grief is the acute pain that accompanies loss. Because it is a reflection of what we
love, it can feel all-encompassing. Grief is not limited to the loss of people, but when it
follows the loss of a loved one, it may be compounded by feelings of guilt and
confusion, especially if the relationship was a difficult one.
 keen mental suffering or distress over affliction or loss; sharp sorrow; painful regret.
 “Only people who are capable of loving strongly can also suffer great sorrow, but this
same necessity of loving serves to counteract their grief and heals them.”
― Leo Tolstoy

3.  Many of the symptoms of grief overlap with those of depression. There is sadness,
and often the loss of capacity for pleasure; insomnia; and loss of interest in eating or
taking care of oneself. But symptoms of grief tend to lessen over time, although they
may be temporarily reactivated on anniversaries or when other reminders of a loss
arise. While negative thoughts such as “life is unfair” and “I’ll never get over this”
are part of the normal grieving process, it is important to prevent them from guiding
your actions.

4.  1.) Denial - The first reaction to learning about the terminal illness, loss, or death
of a cherished loved one is to deny the reality of the situation. Denial is a common
defense mechanism that buffers the immediate shock. For most people
experiencing grief, this stage is a temporary response that carries us through the
first wave of pain of the loss, numbing us to our emotions.
 2.) Anger - Anger may be directed at our dying or deceased loved one. Rationally,
we know the person is not to be blamed. Emotionally, however, we may resent the
person for causing us pain or for leaving us. We feel guilty for being angry, and
this makes us more angry. The doctor who diagnosed the illness and was unable to
cure the disease might become a convenient target.

5.  3.) Bargaining - The normal reaction to feelings of helplessness and vulnerability is
often a need to regain control through a series of “If only” statements, such as:
• If only we had sought medical attention sooner…
• If only we got a second opinion from another doctor…
• If only we had tried to be a better person toward them…
 4.) Depression - There are two types of depression that are associated with mourning.
The first one is a reaction to practical implications relating to the loss. Sadness and
regret predominate this type of depression. We worry about the costs and burial. We
worry that, in our grief, we have spent less time with others that depend on us. This
phase may be eased by simple clarification and reassurance. We may need a bit of
helpful cooperation and a few kind words.
 The second type of depression is more subtle and, in a sense, perhaps more private. It
is our quiet preparation to separate and to bid our loved one farewell. Sometimes all
we really need is a hug.

6.  5.) Acceptance - Reaching this stage of grieving is a gift not afforded to everyone.
Death may be sudden and unexpected or we may never see beyond our anger or
denial. It is not necessarily a mark of bravery to resist the inevitable and to deny
ourselves the opportunity to make our peace. This phase is marked by withdrawal
and calm. This is not a period of happiness and must be distinguished from
depression.
 Stages developed by Elizabeth Kubler-Ross, MD in 1969.
 Books: On Death and Dying/On Grief and Grieving – great reads and helps to
prepare you for dealing with grief and treating those who are experiencing grief
related challenges.

7.  1.) Grief is hidden and never dealt with – Patters of avoidance can lead to drug
and alcohol abuse. Avoidance strategies only work for so long.
 2.) Using drugs and alcohol can cause more negative feelings – Alcohol is a
depressant. Built up feelings of guilt, shame, depression, regret.
 3.) Replacing a person or a relationship with a substance – How do I live without
this person? Escapism.
 4.) Lacking the proper coping skills.

8.  Grief is not only stimulated by losing loved ones or possessions, grief is also
engaged when someone loses a way of living or a way of looking at themselves
which had been a way of life. In the process of recovering from an addiction, grief
emerges in reaction to the intense changes taking place in an individual and in a
family as the addiction problem is addressed. Understanding and accepting this
process of grieving helps recovery to be less of a mystery.
 The person in recovery is going to miss the distraction, relaxation, intensity and
high the behavior or substance offered to them. The person in recovery is going to
miss their “easy” way to escape difficult feelings and experiences and will in fact
be overwhelmed at times by all they are now having to experience without a
buffer.

9.  Rituals - People in recovery come to miss the rituals surrounding their “acting-
out” behaviors. The places, patterns and secret activities of their substance or
behavior addiction were built into their life just as solidly as a job or home and
changing these is difficult and sometimes painful.
 Relationships - The person in recovery often loses relationships that were
maintained with people they involved in their acting-out or using. For some whole
social groups and specific activities like “happy hour”, “being online” or “sensual
massages” have to be given up in the name of avoiding a return to the addiction.

10.  Relationship role - Certain patterns of relating become ingrained into
relationships particularly in those relationships where addiction is present. A
partner who has been in the caretaking role for an addicted person, i.e. covering
up their problems, smoothing over problems, making up for the addicts’
shortcomings (parenting, financial, etc.); will have a difficult transition in retaking
the reigns of their own lives and trusting the addicted person to now actually be
more responsible.
 Loss of predictability - As difficult as being in a relationship with a person with a
SUD can be, at least there is some emotional and situational predictability once
the patterns of the addiction are established. People in recovery can actually be
more moody, vocal about their needs and wants and assertive than someone living
in the shame of their addiction. These can be difficult changes for a partner to
understand and tolerate.

11.  One common misconception about ending active addiction and entering recovery is
that there will be immediate relief and positive benefits for all. In fact recovery is
a lengthy process which often can bring painful emotional and circumstantial
realities forward in the early stages before the more comforting and feel-good
benefits take place. Part of recovery is allowing long hidden secrets to be disclosed
and long-buried disappointments and fears to be revealed.
 Acknowledge your feelings of sadness, anger, regret, and guilt. There’s no way
around it. Coping with grief is tough, but if you don’t face the painful emotions,
they are bound to come out, and they can take over your life.
 Don’t let anybody tell you how to grieve, or that the process should be squeezed
into a specific timeframe. Although there are some commonalities, your experience
is yours alone, and you must work through the process in your own way.

12. • Take care of yourself. Grief is exhausting, so be sure to get enough rest. Eat a healthy diet
without a lot of carbs, sugar, or junk food.
• Reach out to friends and family, even when you don’t feel like it. Meet a friend for a movie or a
cup of coffee. Seek out people who understand, as spending time with folks who don’t “get it” is
likely to be counterproductive.
• Avoid triggers that may lead to relapse. Don’t spend time with people who make you
uncomfortable. Avoid places and things that expose you to drugs and alcohol.
• Be aware of special dates, especially during the first couple of years. Anniversaries, birthdays
and holidays are especially difficult when you’ve given up drugs or alcohol, or if you’ve lost a
loved one. Don’t isolate yourself; plan to do something special with family and friends or
schedule a counseling session.
• Record your feelings in a journal. Read books that will inspire you and provide greater insight on
how other people cope with grief and loss.
• Get moving. If it’s difficult to get motivated, hit the gym or ask a friend to take a walk with you.
Turn on your favorite music and dance, as dancing will help you express anger or sadness.

13.  In therapy, we help to uncover beliefs that may be hindering healing, such as
guilt, regret, distorted thinking, “what it” thinking around the loss.
 Processing the loss and exposing yourself to the full emotional experience
 Letter writing
 Empty chair technique
 Art therapy
 Music therapy