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Chrsitina Rasmussen
Elina Rasmussen and her infant sister, Isabel, just before their father was diagnosed with terminal colon cancer. "We didn't know life was going to change," their mother said.
I tell people who come to me who have lost their children, their spouses, that the first thing they have to do is get real with themselves. When you are grieving and in pain, it can be very confusing. You don't know who you are without that person. Or who you want to be. —Christina Rasmussen

Christina Rasmussen, 41, and Elizabeth Berrien, 32, live in different worlds, their paths unlikely to cross. A few years ago, though, each suffered a pair of life-altering losses that looked remarkably similar.

Berrien, now of Charlotte, N.C., went into labor with her first child on the due date after an uncomplicated pregnancy. He died when his umbilical cord cut off oxygen in the last frantic moments of his delivery. She and her husband, Brian Woods Jr., were devastated but determined to help each other through it. When she got pregnant again, they were scared but excited.

That baby girl, Ella, was six months old when her father, a Special Forces soldier, was mortally wounded in Afghanistan.

On the other side of the country, Rasmussen's first baby, Elina, died shortly after birth, her tiny lungs never fully developed. Rasmussen, who lives in San Francisco, had other children. She was mom to an infant and a toddler when her always-healthy husband, Bjarne Rasmussen, just 31, was diagnosed with advanced colon cancer. He died four years later.

Their losses are not alike. Each grieved in her own way, supported by a different cast of people who cared. Each found and took her own baby steps forward, her life changed forever.

Grief and loss are like that, experts say, the fallout as unique as the individuals who died. There's no wrong way to grieve, no perfect degree of sorrow. It's a complicated porridge of personalities and relationships. Some people cry easily while others are naturally stoic. A warm relationship can comfort during loss or increase devastation. An aloof relationship stirs different but sometimes equally distressing emotions. The age of the survivor and the person who died; whether death was anticipated, violent or natural; and the individual's support system all carve steps in a journey through grief.

Both women work professionally with those who grieve and have written about their losses in hopes of helping others. Rasmussen wrote "Second Firsts: Live, Laugh and Love Again." Berrien's book is "Creative Grieving: A Hip Chick's Path from Loss to Hope."

No working map

The long-touted "stages of grief" don't apply to losing a loved one, experts say. In 1969, Swiss psychiatrist Elisabeth Kubler-Ross offered a theory that was intended to help those with terminal diseases understand the flood of emotions they might feel. Someone given a terminal diagnosis would pass through denial, anger, bargaining, depression and, finally, acceptance. Those stages came to be viewed as a guide for everyone working their way through loss.

There were two problems with the way the stages were later used: Not every loss triggers grief, and individuals make personalized journeys, so following a one-route-through-grief map is akin to looking for grocery stores in Chicago and Fiji using the same guide.

"Grief doesn't work that way," said Jeff Fleming, bereavement coordinator at Primary Children's Hospital in Salt Lake City. "Everyone's grief is different, though there may be commonalities."

The stages present grief as a linear progression, he said. It isn't.

"You may be angry, then not angry, and a year later you may be angry again," Fleming said. "It fluctuates. Maybe you will never be angry."

When two people grieve differently, neither is doing it wrong, he said.

Some people have "relatively modest emotional reactions." That doesn't mean they are not upset, said Anthony D. Mancini, assistant professor of psychology at Pace University in Pleasantville, N.Y. "They kind of weather the storm, do OK and come out the other side and are fine. That's a key point. There's no recipe for grieving."

Therapy is a wonderful tool to help with grief if someone needs it, Mancini said, though most people won't require professional help.

"People are equipped to deal with loss and, for the most part, they do," Mancini said. "Our research shows 50-60 percent of people do just fine. They make changes to their lives, reorganize and manage to move on. It's a subset who really, really struggle and, in that case, therapy is enormously effective. Like any treatment, it should be delivered to those who need it."

Speak or be silent?

"Grief is extraordinarily delicate, both from the perspective of saying something and from the perspective of not saying something," Mancini acknowledged.

It's possible to say the wrong thing or cause hurt by silence. "I think you have to take your cues from the person. Generally, people don't mind talking about loss. Avoiding the topic is probably not helpful. Diminishing the experience of grief or the magnitude of the loss is also not helpful."

His suggestions are basic: Avoid bromides like "your son is in a better place." Don't be reluctant to talk about the person who died. "There's a delicate balance to be struck."

Grief is a normal human experience, and Mancini said people can help each other through it, taking cues from the bereaved. "People need to be with their loss and they also need to be away from it. Alternating between confronting it and being able to distract oneself — that kind of oscillation is quite helpful."

Judging someone's loss by what you can see is not valid. "People display different degrees of grief," he said.

Young mourners

How children handle loss depends partly on their mental health and developmental stage. But a child's understanding isn't always age-based, said Fleming. "Some kids have a far greater understanding of death well before a child of an older age might."

Fleming never says, "I understand what you're feeling. I lost my dad, too." Relationships are unique. In fact, when Fleming was growing up, his father was lost in an abusive alcoholic spiral. He never knew the father his older sister mourned and did not share her grief.

Children show both joy and sorrow through play, so experts sometimes help young mourners express themselves with books, dolls and art. People often misjudge what a child feels. At a funeral, a little boy may run up to the coffin, look with a sad face and then scamper off to play. That's not a sign he doesn't care.

Fleming was in grade school when Taffy, the family dachshund, died. The accusation by his sister that he didn't care still hurts him. "I didn't have a concept of death. When my turtle died, I dug it up to see if it had come back alive or gone to heaven. You have to try to enter a child's world to understand where they are."

With kids, he said, "Answer the questions they have. Sometimes we answer things they aren't asking or we shut them off."

Finding her way

Rasmussen, a life coach, had studied psychology and grief. When Bjarne died, "I still was not able to use the tools in my world. I could not find what I needed to help me," she said.

That changed after she read about the brain's ability to keep learning and alter itself. The concept of "neuroplasticity" became the foundation for how she moved through her bereavements.

"When we are grieving, we go through the infinite loop of loss," said Rasmussen. "Wake up every day, experience the loss and grief, go through the painful stories again and again." She describes an endless road she cruised until she decided to take a different route. She set out to change her brain.

"I tell people who come to me who have lost their children, their spouses, that the first thing they have to do is get real with themselves. When you are grieving and in pain, it can be very confusing. You don't know who you are without that person. Or who you want to be."

She had to wade through her what-ifs and myriad emotions. The first time she laughed, she covered her mouth, feeling guilty for allowing joy into her dark world. The hardest part was realizing she needed a new life. People can't move forward because "most are trying to go back to a life they no longer have and it's like trying on clothes that don't fit — and trying and trying. The moment they realize their old identity is no longer the identity they have, the faster they will re-enter life."

It's easy to become overwhelmed, she said. "We take small steps so we don't alert the fear center of our brains. One thing at a time."


Berrien moved closer to family. She wanted to savor motherhood, especially after losing her son, Tookie. But she needed lots of support. She went to counseling, which had helped when she finally tried it after the baby died. She ate when she could and walked to build energy. Later, she co-founded a group called Soul Widows and a center, The Respite, focused on helping those who grieve heal.

Berrien, a certified grief coach, said you can keep moving forward without locking the loved one who died in your past. "You don't have to get over that person," she said.

She makes sure Ella, 4, knows her dad through photos and videos. Grieving doesn't happen on a timeline — "Six weeks, get back to work" — or end like the chapter of a book.

Berrien remarried and has two stepchildren, but she never let go of the people who loved her first husband. They tell "Brian stories." She also longs for stories about her son. She and her sister talk about who the baby might have become. It's comforting.

Rasmussen remarried, and between her and her new spouse they have four girls. "It's a great life," she said. "We live life in the present."

But they have never stopped honoring the past.

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