Survivor's Guide
Loss and Grief

What affects people's Grief Reactions?

Everyone deals with cancer, changes, loss and grief in their own way. Grief is as unique and individual as falling in love. There's no right or wrong way to grieve. It's very personal and your reactions will vary depending on several factors.

Personality is shaped by genes (meaning it can be inherited from a parent) as well as by life experiences. Some people find it easier to talk about how they feel than others. You may be the type of person who finds relief from crying while others find ‘letting go' and crying very difficult. Some people say they like to ‘mull things over' or ‘sort things through' alone before they reach out to tell people how they're really feeling.

Cultural and religious beliefs
People's reactions to changes due to cancer can be influenced by cultural views and religious beliefs. How you cope with serious changes and losses will depend a lot on your own values and how you view the world.

Grief reactions can differ greatly between men and women. Gender is one of the most significant factors in reactions to loss and grief. Generally, women tend to want to nurture and be nurtured through a loss. They want to talk about it and may cry a lot. They're more likely to seek support from friends, family or support groups than men. Men tend not to want to talk about their loss but rather ‘problem solve' or do something practical to keep their mind busy. 

People may feel they have to react in a particular way. For example, men may feel they should be ‘manly' and not cry or show grief. They may think tears are a sign of weakness. For women, tears may be seen as acceptable but anger often isn't. These differences help us to understand how men and women grieve and react emotionally.

Your age will affect how you cope with changes and your reaction of loss and grief. Children and adults both grieve, but differently. Changes in behaviour are common. Adults and teenagers may become angry, quiet, unwilling to talk, distant and inward-looking. A younger child (under 13) may cry more easily, become needier or have outbursts of anger towards their friends and siblings.

Children of different ages cope with their grief in different ways. Some may begin having nightmares. Others cope by acting younger than they are. Children often don't have the language skills to use the right words to describe how they're feeling. Instead they may behave in ways that indicate to others they're grieving. Children and adults may appear unaffected by the loss and then express their grief at unexpected moments. It's important, no matter what their age, that someone knows they can express their grief and feel they have support.

Other people's reactions
How those around you react to your loss can affect how you cope. Not everyone will react in the way you thought or hoped they would. Some people will want to listen to your intense feelings and help in any way they can. Others may think they can't support you and may be fearful of upsetting you if they talk about your losses. There will be some people who find it too hard to listen or lack understanding about why you may be grieving.

If you've been treated for cancer, you may be surprised to hear people say things like:
  • 'You should be grateful to be alive after your treatment for cancer.'
  • 'You're so lucky to have been diagnosed with your type of cancer; other cancers are so much worse.'
  • 'You must feel great now your treatment is over.'
  • 'You need to try and get over what has happened and move forward.'
  • 'But you look so good! It's hard to believe anything happened to you.'
  • 'You must stay, think and act positive!'
Although often well meaning, such comments can be unhelpful. They can make you feel you shouldn't be grieving or your suffering is not real. This can be painful and difficult to cope with when, for you, the loss is so significant you can't think of anything positive about your situation. Occasionally some people may not even comment about what is happening to you. This can also be as hurtful as a thoughtless or well-meaning comment.

Not everyone will understand that, even if you know you'll probably survive the cancer and some of the changes in your life may not be obvious to them, it can still create a lot of grief. Talking to someone who has been through a similar experience may be helpful. 

Although it can be difficult to talk about some of the changes and losses in your life, it's important to try to express them. Those close to you may not understand what you're feeling or even know you're grieving major life changes. You may have to be the one who reaches out and asks for support. Letting those you trust know how you feel and why can help them be more supportive and caring. Being open and honest about your losses will probably help you deal with them better. Some people may find it easier to express their feelings to others in writing or drawing.

Carers' reactions
Cancer significantly affects carers' lives, too. Carers grieve about their own losses and changes caused by cancer, such as the loss of how things used to be with the person now affected by cancer. They also grieve the loss of normality and security about their future. They may feel sad about the possible changes in relationship roles within the family.

Sometimes the person who has cancer feels differently from those caring for them. This can cause conflict and misunderstandings within important relationships. Both may grieve for the loss of the relationship as it was, but in very different ways.

It's important to talk to each other about your feelings. Be as honest as you can. Listening to each other can be comforting and reassuring. Knowing you both feel a sense of loss about things will help you support each other the best you can.

Other factors
Other factors may influence your reactions, including:
  • The nature of the loss: was it loss of a job, of a body part, of libido, or loss through a death? All will affect you differently.
  • How the loss happened: was it sudden or unexpected?
  • Your personality and your usual way of coping with difficulties.
  • Help and support from others: the more support people have the better they usually cope.
  • Your life experience in reacting to other losses and what you have learned from others.
Written by Annie Angle, cancer nurse (Dip. Oncology Nursing, Royal Marsden, London). Reviewed by Voula Kallianis, Social Worker, St Vincent's Palliative Care Unit; Eugenia Georopoulos, Project Officer, Centre for Culture Ethnicity and Health; Wendy Thurling, Senior Bereavement Counsellor, Australian Centre for Grief and Bereavement; Jane Fletcher, Deputy Head, Cabrini Monash Psycho-oncology Research Unit and Director Melbourne Psycho-oncology Service; Associate Professor Michael Jefford, Medical Oncologist, Peter MacCallum Cancer Centre; Marie Craw; Nadia Montibellar; Neil O'Loghlen; Lesley Bawden; Meg Rynderman, Cancer Connect and Australian Cancer Survivorship Centre Volunteer; Majella Franklin.