Claire Bidwell Smith‘s book Anxiety: The Missing Stage of Grief  took its roots from a magazine article in which the author had posited that anxiety should actually take the place of the bargaining stage in the most commonly accepted model of bereavement.

“Even more than depression, anxiety is the response my grieving clients express a desire to overcome since experiencing loss. They describe feelings of panic and obsessive thinking about their own deaths and potential illness. They tell me about bouts of helplessness and of feeling overwhelmed by life itself, about panic attacks and moments of such paralyzing fear that they pull their cars over on the way to work.”

From an interview Caroline Leavitt conducted with Smith: “There is simply no question that loss causes anxiety. Loss is nothing but a reminder that life is precarious and that we are not in control. This realization coupled with the intense emotions of grief are the perfect recipe for anxiety. It also doesn’t help that we live in a ‘grief-illiterate nation,’ as Maria Shriver says. We often feel very alone and unsupported going through the grief process and do not know where to turn. Not having the proper support can also lead to a greater sense of anxiety.”

Smith knows from personal experience as well as professional. Her mom died of cancer during the author’s freshman year at college. Panic attacks and self-medication with alcohol became a significant part of her life. A powerful article excerpt:

My mother’s death rocked me. I was absolutely floored by it. Nothing could have prepared me for it. Not the five years we’d spent helping her combat her illness, not the talks my father had with me about her potential demise, not the school guidance counselor’s sessions. The truth was I never believed she would actually die. Because: Mothers don’t die. Bad things don’t actually happen.

I now understand that these beliefs were at the root of my anxiety. When my mother’s death disproved the two things I’d so fervently held onto, the whole floor dropped out. If my mother could die, anything, absolutely anything could happen.

Now Smith coaches grievers on understanding this aspect of the process and on learning ways to work through it. From the critique of Anxiety: The Missing Stage of Grief by Kirkus Reviews:

The author notes that while the brain is processing the separation, regret, and other emotions accompanying loss, that loss is also tangible: ‘We are forced to rearrange our lives to accommodate for the absence of this person.’ In discussing that rearrangement and those emotions, Smith turns from the canonical work of Elisabeth Kübler-Ross to more recent practitioners, such as Thomas Attig, who analyzes the changes that accompany loss, including, inevitably, changes in one’s own identity, a potential cause of grief all its own. 

Not everyone can be Claire Bidwell Smith’s actual client, of course. She does, however, provide a self-guided online grief program. Visit Smith’s site.