COVID-19 Complicates Grieving

The spring of 2020 has brought us drive-up funerals (LATimes.com).

Spring is typically a gentle season known for its renewal, which makes spring deaths feel incredibly discordant. Yet over a 15-day period this May, my extended family lost two relatives to COVID-19. There will be no hugs at the funerals, burial is delayed, and Shivah will be observed remotely. What began as an international news story happening far away has stealthily and menacingly crept ever closer.

Grief is in the air. Americans are all mourning the loss of normalcy. We are mourning the lives we knew, and all the things we took for granted, like dining in crowded restaurants, grocery shopping without masks, and sending our children to learn and to enjoy the company of their friends at school. 

That grief is even more palpable for families dealing with death in this moment. They have been unable to sit with loved ones as they succumb to COVID in hospitals, unable to honor loved ones with community-wide funerals, and unable to participate in physical religious mourning rituals that offer the comfort of community and some sense of closure, like wakes or Shivahs

While all of these restrictions have been implemented to protect survivors’ physical health, they take their own psychological toll. Four mental health experts, three based in New York City and one in Washington, DC, weighed in on how this mourning period is affecting us in the present, and potentially into the future.

Dr. Sara Nash, assistant professor of psychiatry at Columbia University Medical Center, described her recent work with patients and medical staff, observing that “as there are fewer people in the ER now, there’s more space for people to feel [grief].” Nash’s department has used technology to virtually connect hospitalized patients to “family, whether or not the patient can hear.” 

Nash described how it felt it talk to: 

the son of a 96-year-old woman clearly dying of COVID . . . Just having that incredible intimacy, sitting with someone suffering so deeply who can’t be with their loved one was incredibly tragic. He’s Catholic, and I’m Jewish, and we just prayed together in this meaningful moment. . . It’s a very different kind of grief. The inability to hold one another, to be present with one another physically. The degree to which this will traumatize people in the future, I’m not sure.

Nash continued, “Maybe mental health gets destigmatized because everyone is experiencing this. There are people who are more vulnerable than others to traumatic events, so it wouldn’t surprise me if there are downstream consequences, but it’s hard to say just yet what those will be.”

Ruthie Arbit of Arbit Counseling observed that COVID has put many American families in situations that have historically been more familiar to military families, such as burying loved ones without saying goodbye. 

“We’ve never experienced all these aspects [of grief and death] upended for so many families,” she noted, explaining: 

Grief is a normal and necessary part of life, but our responses to it are not always normal. How you will respond to grief depends on the type of death, coping skills, resilience, your own trauma history, and a myriad of other factors. In COVID times, all grieving families will lack access to typical coping strategies including community, rituals, families, exercise, fresh air, workplace routines, workplace accommodations, and religious connectedness. 

Arbit worries that those mourning alone could develop depression or anxiety in the long-term, if they avoid and don’t process their new grief. 

Dr. Dan Shalev, a psychiatry fellow at Columbia University Medical Center, is also concerned about complicated grief. The rapid decline of his COVID patients’ health has left many families feeling unprepared for the weighty life and death decisions they face, like whether to intubate or resuscitate an ailing loved one. 

“We know from the literature that when loss occurs in a chaotic phase, it’s associated with more complicated grief,” he cautioned. “The social conventions of loss and death have been utterly disrupted, and that’s not been replaced yet.” 

According to Dr. Shalev, “having to navigate this new domain of having to do everything with tech—we haven’t really figured out how to support people through that. It’s a work in progress.” 

Dr. Jessica Hirsh Weiss, co-director of Grand Central Psychology, described our current situation as “uncharted territory,” where we need to be creative about how we handle funerals and mourning customs. Even so, Weiss remains optimistic about where this grief may take us.

“It’ll be ‘yes, and,’” she said. “We’ll be a little bit broken as a society and traumatized by this, but my hope is that we’ll come out more resilient.”  

Americans are dealing with a lot right now, but if this experience makes us better, we will have gained something amidst all the suffering. Let’s hope we all experience some post-traumatic growth.

This article appeared in the Family Studies blog.

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