Grief is love, not a mental disorder

Soon, it will be two years since I lost my best friend and father, Garry Greenberg, to covid-19. He was 68 years old. I think about him every day. I’m pouring coffee and I hear his laugh; I’m running and I think of something I want to tell him.

I flash back to a soccer game I played at age 12. Only minutes remained. Score tied. A tense, respectful silence among the parents on the sideline was broken by the sudden boom of a fog horn: womp, womp, wooooomp. “Go, Dev, go!”

That was my dad. That was always my dad, radiating boundless love and support. When I picture him, I picture the sparkle in his huge “Greenberg eyes,” beach days filled with Billy Joel and sandy snacks, his 6-foot-4 bear hugs that winded me.

I also picture the first time I ever saw my dad on Zoom. It was April 2020, and he was sedated on a ventilator in a crowded New York City hospital. I was gripping my brother Kyle’s hand nearly 100 miles away, and it felt as if an octopus were squeezing my heart. My dad was thinner than I’d ever seen him. He looked scared and alone. Machines beeped everywhere, so the social worker held her phone closer to him. Every word I spoke sounded saccharine and wrong.

Since he died, on April 25, 2020, I have immersed myself in a world of grief and loss, seeking solace and connection. I have joined support groups, read dozens of grief-related books and explored ways to devote my career to supporting the bereaved.

The purpose of this work has been to internalize the message that what I’m feeling is okay. If grief is the corollary to love, if grief is love, why set expectations on its pace or texture? Why pathologize love?

It’s not just personal indignation that stirs me about the association’s decision. I worry for others who have loved and lost — at some point, all of us. I worry that this framing will render us even lonelier in our pain, even more convinced that our nonlinear, unpredictable paths through loss are “wrong.”

Grief is an experience with no road map. Ask anyone who has lost an immediate family member about grief’s “five stages,” and you’re likely to get a shake of the head. No, grief is more akin to bushwhacking through a gnarly forest. Each of us needs validation that we can cry out from the thorns in our sides, that we aren’t crazy for enjoying a sudden clearing, that whatever route we’re taking (granted we aren’t harming ourselves or others) is the right one.

Many of the symptoms the psychiatric association uses to define “prolonged grief” are shockingly common. “Intense emotional pain (e.g., anger, bitterness, sorrow)”? Let’s call that a Tuesday. “Identity disruption”? When you’ve walked through a portal through which you cannot return, of course your sense of self changes dramatically.

Further, duration of grief isn’t the appropriate parameter to define who needs medication for what they’re feeling. One therapist I’ve spoken with said that grieving only starts at the one-year mark. “Prolonged grief” is perhaps a way of defining every instance of grief.

The association’s choice risks creating false positives: Doctors might tell people that they are mentally ill, when they are moving through their losses in constructive ways. We live in a society that fears death and fails to honor loss (see: absent workplace bereavement benefits). The last thing grieving people need is another layer of alienation.

Some instances of grief, of course, are debilitating to an extreme and merit tailored support. The association is right that additional research and treatment options should be provided for such cases. Yet to properly care for those individuals, we must not conflate their experiences with the intense but ultimately normal pathways of most grievers.

C.S. Lewis compared the death of a loved one to an amputation. W.S. Merwin’s loss went through him “like a thread through a needle,” everything “stitched with its color.” Linda Pastan described grief as a “circular staircase,” an inescapable trap.

It is time we accept that we don’t “move on” but move forward. It’s time we stop pathologizing grief.

Here, we can all learn something from my dad. When he lost his beloved sister Lenore on April 25, 2007, exactly 13 years before his own death, he let himself break. He had the courage to face his pain, embrace it and not force it to go away in weeks, months, even years. He recognized the centrality, the necessity, of grief. A circular staircase, a trek in the woods and a condition of love.