From reading and the work I did with Hospice as a result of experiencing my sister's death (Cindy James), I learned that people can mourn other losses in the same way they mourn death. Initially in the mourning process, the existence of the lost object or person is prolonged in the mind of the mourner until the loss can be gradually accepted. There is shock, numbness, disbelief, denial and finally acceptance that a death or loss has occurred. When the numbness wears off, intense emotional pain and gut-wrenching emptiness is felt and it can be scary, but it is natural, common, and healthy, and gradually diminishes, although commonly reappearing as an anniversary reaction. While in this stage of the mourning process you search for your loved one, call out to her, cry, and eventually realize she is still with you in your heart and your remembrances of her. You become obsessed or consumed with thoughts and memories and feel irritable and "not yourself," at times unable to function. You have trouble with your appetite, your sleep, your energy level, and you feel restless, often losing interest in activities you once found enjoyable. You also have trouble concentrating, with your mind daydreaming, or you experience confusion and forgetfulness, and battle with feelings of guilt, and may even wish to be dead. You can become depressed and in fact can exhibit many of the same symptoms as patients who suffer from primary affective disorders (depressive symptoms). And if you have inadequate social support or a fear of or resistance to mourning, you can enter the realm of complicated or unresolved grief with its various psychiatric syndromes and psychosomatic syndromes-such as anxiety attacks.

Adjusting to a life without Cindy took time. I found new ways to focus my energy-by journaling (and eventually compiling my book, Who Killed My Sister, My Friend), by walking in nature and more, and later, by joining Hospice as a volunteer when I was ready. And I restructured my social network, eventually fostering friendships with casual acquaintances that helped me through my despair and understood what it is to experience loss. Through it all I found there was no timetable for my grief. With gentle urging, subtle guidance, and unfailing support from a counselor, I acknowledged my heartache by talking about what happened (sometimes repeatedly). I expressed my deepest feelings to my sister, Marlene, to the counselor, and to a few other friends. And by remembering Cindy, I mourned. And when I got stuck I answered many questions, such as, "What do you wish you could have said to Cindy?" "What do you miss the most?" "Where were you and what were you doing when you heard the news?" "What was she like?" "What kind of a person was she?" "What is the hardest thing for you?" Eventually the bitter sadness of loss transformed into a sweet sadness or nostalgia and I was able to love again and reach out to others, touching their lives and letting them know they are not alone in loss.