When Pat and Anna Gillis were growing up in Lowell, Massachusetts, in the 1960s, the two sisters were inseparable. They were a familiar sight in their close-knit neighborhood, going to Catholic school each weekday, to the public library on Saturdays, and to church on Sundays. Pat was often shy, but would follow Anna into new situations, peppering her with questions the whole way, confident her big sister would know the answers.

But in adolescence, Pat began to pull away from Anna, spiraling downward into substance abuse. She struggled with addiction for 20 years, until finally at age 34 she stopped using drugs. For the next two years, Pat focused on repairing frayed relationships with her family, being a better mother to her two young sons, and healing from her troubled past. just as she was doing better, she died suddenly in her sleep last Halloween.

Anna was devastated by the loss of her only sibling. "I feel like an egg whose insides have been blown out," says the Bethesda, Maryland, writer and editor. "I look okay from the outside, but if someone squeezed me, I'd crumble."

Anna is among the estimated eight million people in the United States each year who lose a loved one. And while bereavement is one of the most profound and universal experiences of our lives, far too often people feel isolated in their grief, unsupported by those around them, and unprepared for the depth of their sorrow.

Throughout human history all cultures have created ways to honor the dead and help those who mourn. Neanderthals living more than 35,000 years ago buried their dead with cornflowers, grape hyacinths, and hollyhocks. In the Himalayas, the grave of a Neanderthal child was ringed with wild goat horns. Later, the Cro-Magnons adorned their dead with elaborate necklaces of ivory beads. The bodies of ancient Egyptians were mummified and buried with favorite objects.

"All cultures have a belief about the soul or spirit that continues on beyond the physical form," says psychologist Carol Wogrin, directo of the Bereavement Studies Program at Mount Ida College near Boston. "All cultures have a belief in treatment and disposal of the body and all have mourning practices. The specific content of those beliefs, though, varies tremendously."

Wogrin and other bereavement experts are concerned that today Americans are abandoning longheld customs. Until recent times, death was a familiar and intimate part of life. People typically died at home, often at a young age. The body was prepared and buried by family members or close friends. Funerals were performed by ministers who could speak with personal knowledge about the deceased. Food was brought to the bereaved family and those in mourning wore black or draped their doorways in black crepe.

But these traditions are fast disappearing. Death often occurs in a hospital or nursing home, where it is viewed not as an inevitable part of life but as a failure of medical technology. Family members often never see the body, but simply call the mortuary. Like Anna Gillis, people frequently live far from their hometowns and extended families. Once the funeral is over, the bereaved return to their routines and to friends, colleagues, or pastors who never knew their loved one.

In the book Grief Ministry, Helping Others Mourn, coauthor Donna Reilly Williams contrasts the American way of dying with what she witnessed in an African hospital. When a person died, drums began to beat in the hospital courtyard. Soon a pickup truck arrived, filled with family and friends from the village where the person had lived. For four hours, the group surrounded the bed, singing hymns, praying, eating, and lovingly holding and stroking the body. Even though patients were waiting in the hall for a bed, the hospital staff viewed this time of mourning as intrinsic to patient care.

Our culture tends to be uncomfortable with such displays of intense feelings. Some believe our inability to cope well with death is not a modern affliction but one rooted in our national psyche. "It's the old pioneering psychology [that] you have to be tough," says Vamik D. Volkan, professor of psychiatry at University of Virginia. "We do a lot more denial and repression of emotions than many other cultures," he says. In the traditional Turkish Cypriot culture, he points out, mourners went through the streets, screaming their pain and anger at the deceased for leaving them. In the Maori culture of New Zealand, bereaved family members cut their breasts to express their loss or subjected themselves to ritualized beatings by others. These customs, which seem strange to us, Volkan says, gave mourners an outlet for normal feelings of guilt and anger that accompany their grief.

Practitioners of some Eastern religions, such as Tibetan Buddhism, focus a great deal of attention on what they view as the cycle of life and death. The actions Buddhists take in life are believed to influence the direction they will take as they pass through death into rebirth. "We think about death a lot -- its inevitability and its unpredictability," says Konchog Norbu, who converted to Tibetan Buddhism eight years ago and is a monk at Kunzang Palyul Choling Buddhist temple in Poolesville, Maryland. "Based on its inevitability, we consider it prudent spiritual practice to prepare ahead of time."

Accepting the inevitability of death, discussing it openly, and giving the bereaved ongoing comfort can prevent long-term emotional and physical turmoil. Mourners can be helped immensely by participating in meaningful rituals and having the opportunity to talk about their loved one as time passes. But the value of this kind of support is often not understood in our society.

Lee Pollak directs a bereavement center at the Jewish Family and Children's Services Agency in San Francisco. The hardest part of her job is recruiting people to participate in support groups and other programs offered at the center. "Many think they should be able to go it alone and that they don't need support or education," she says. "They think everyone suffers, and it's acknowledging that you're weak to get help."

The Ways of Grief

Grief, though universal, is at the same time very individual. "The more complicated the relationship was in life, the more complicated in death," says Pollak. Take the death of a spouse when a marriage was fraught with problems. "At death, what comes up are all the disappointments of dreams that didn't come true, the lost opportunities, the unresolved passion of those angry feelings that have no place to go," says Pollak. "It says a lot for trying to resolve issues, if possible, during life."

Some losses are easier to accept. The "best" death seems to be when our loved one is ill or quite elderly and the relationship among family members is strong and caring. Nothing is left unsaid, whether words of love or forgiveness. This was the case for Kathleen Phelan, a Dominican sister in Washington, D.C., whose mother, Ada, was a widow suffering from Alzheimer's disease. "She was a tiny, stronghearted, gritty little thing," says Kathleen. Although Ada no longer recognized her, Kathleen traveled across the country as often as she could to visit her mother in a San Diego nursing home. Ada held on for years, through many broken bones and severe dementia, but finally succumbed three days after Christmas in 1997.

When death was approaching, Kathleen was able to be there. She searched for words to comfort her mother. "I knew my father was still alive in her mind," she says. "So I leaned over and whispered, 'Soon you'll be dancing with Ned.' She looked over at me, and her eyes opened up. I will never forget the luminous smile that came across her face. It was almost as if she were looking right through me to those people who were in her deepest memory." Even as she grieves for her mother, Kathleen knows Ada's suffering is over and that is a great relief. It was, she says, "like opening a window."

For people such as Lynne and Todd Waymon, who lost their only child in a car accident, no such consolation can be found. The Waymons were living what they describe as a "charmed life" before their son's death. They both have fulfilling work, Todd as a professor at the local community college and Lynne as a self-employed speaker and writer. They have a loving marriage, are actively involved in their community, and were devoted to 16-year-old Matthew, whom they'd adopted from India as a baby. Matthew was a handsome and good-natured young man, an avid soccer player with a large circle of friends. The Waymons's house was a gathering place, with teenagers slouching on the wide front porch, helping themselves to food from the refrigerator, and watching sports on big-screen television.

On a hot July day in 1998, Matt headed off to summer school with his buddies. On the way home, his close friend, who was driving too fast, lost control of the car. The car flipped, fatally crushing a 40-yearold father of 3 in his pickup truck, and killing Matt and Irn Williams, another boy in the car.

The depth of the Waymons's grief and shock was almost unbearable. "The future is destroyed," says Lynne, as she and Todd, five months after the accident, sit in their living room surrounded by pictures and mementos of Matt. "Our whole frame of reference had to do with being proud of him and watching him walk into the future knowing he was going to fall in love, go to college. We were so involved with his life, probably overly involved," Lynne adds, smiling sadly.

Anna Gillis, too, was shaken to the core by her sister's death. "The strangest thing about grief is the way it bites you when you're not paying attention," she says. "Odd little things knock you completely flat." Soon after Pat's death, Anna was hiking in the woods with her husband when she was suddenly jolted by a memory of youthful autumns: Pat and she anxiously waiting outdoors for their father to come home from work to take the out for Halloween.

As the memory hit her, Ann says, "I burst into what I can on describe as keening. I was positively primal; it came from deep inside and I just wailed." Anna, who is half Irish American and half Argentinean, was reminded of the banshees of Irish legend. "I always thought the wailing of the banshees sounded weird. Now it sounds incredibly healthy," she says. "Instead of wailing, those who lose a loved one go around trying to be dignified all the time. In fact, the grief is ready to explode inside them."

Finding Meaning in Ritual

As intensely painful as grief can be, pioneers in the field of bereavement counseling find that much can be done to ease this difficult journey. Having a meaningful service of farewell; receiving practical support from friends, neighbors, and employers; honoring loved ones at special times throughout the year; and acknowledging the long-term nature of the grieving process can bring real comfort to those in pain.

Every faith has rituals that often correspond to the psychological stages of grief. One of the most developed traditions comes from Judaism, which has detailed laws and customs, from the moment of death through a year of observances. Jews do not believe in cremation or in embalming the body for viewing, which they see as disrespectful of the deceased. The funeral and burial take place as soon as possible, followed by a week-long Shiva, during which the bereaved receive visitors at home. Throughout the year, special prayers from the congregation offer consolation to mourners.

"From a psychotherapeutic point of view, Judaism has a very functional attitude towards death," says Pollak. "It focuses on a year's worth of activities to mark a loss, with a number of different rituals that mirror what we know are clinical needs."

Islamic mourning practices are similar. In the Arab Islamic tradition, services are held at the mosque. The body is ceremonially washed, wrapped in white, and buried as soon as possible. For three days, mourners stay at home to receive visitors who recite a passage from the Koran when they arrive. Forty days later a special time of remembrance is held.

In Tibetan Buddhism, the focus is on helping the dying person rather than on comforting those left behind. If death is anticipated, the community drops everything and begins round-the-clock prayer. The teacher or lama is nearby, helping the person negotiate the process of death. "The whole idea is to have somebody die in a very conducive spiritual environment," says Konchog. "If we feel everything has been done for the person that's died, there isn't so much grief."

For people closely tied to religious communities, the rituals and customs -- no matter what they are -- can be comforting. Even those who have abandoned their childhood faith can find the traditions consoling. But without strong ties to a community, people can be isolated in their grief. Increasingly, funeral directors find themselves dealing with clients they've never met who have no traditions or religious practices on which to draw. "We're less likely to know the people with whom we're working when they come in our front door," says 0. Duane Weeks, director of the New England Institute of Funeral Service Education at Mount Ida College. "We have an hour or so to get them to trust us with this very important thing that needs to be really good and really special."

Weeks identifies two parallel changes going on in American attitudes toward funerals. On the one hand, a growing number of people opt for no rituals whatsoever, a change that Weeks finds troubling. On the other hand, there is a positive movement toward services in which mourners ask to be active rather than passive participants.

In the Catholic church, for example, families are more likely than in the past to want the funeral to be personalized. When Ada Phelan died, Kathleen found the pastor open to her ideas for the liturgy. Joined by sisters from her congregation, she selected music, Scriptural passages, and prayers of petition. At the service, she welcomed mourners and told them of her mother's life.

"The liturgy for me was very consoling and intimate," she says. In contrast, when she lost her father 25 years ago, her input was not welcome. 'To me, my mother's funeral was a celebration of the two of them."

Anna Gillis delivered the eulogy at her sister's funeral. "I wanted people to remember what was best about my sister," she says. This was especially important to Anna since her sister's former substance abuse was well known in the community. Anna spoke of Pat's kind-hearted nature, her sense of humor, her generosity and curiosity. "Giving the eulogy felt like a proper goodbye," she says. "You've publicly stated, this person is dead but I want to remember them. It was a way for me to make my amends publicly for anything I may have said about her. It was also a gift to my parents and to my nephews."

On the other end of the spectrum are those who see no value in having a service. "A high percentage of the people I meet believe that the memorial service or funeral depends on the wishes of the deceased," says Don Montagna, leader of the Washington Ethical Society in Washington, D.C. "I tell them the memorial service is not for the dead, but for those who suffer the loss. The purpose is to honor our loved ones and the important role they played in our lives. We're also sending a message to ourselves -- we could drop dead tomorrow. Do we really want no one to look up from his workbench?"

Just as long-held customs can be deeply consoling, so too can newly created practices. At the nonsectarian Saint Francis Center in Washington, D.C., rituals are seen as crucial to the grieving process. The center counsels people suffering all sorts of loss, not only the death of a loved one but divorce, incarceration of a parent, and illness. Among the center's programs are support groups for inner-city children who have lost multiple family members to violence, AIDS, accidents, and natural death.

"We help people develop their own rituals if they don't have institutionalized ones," says Saint Francis Center executive director Robert Washington. People are encouraged to plant trees, for example, or to make "memory boxes," which have been found to be especially meaningful for children. Inside the box go strands of hair, rings, and photographs. "On specifically designated occasions, they open up the box and reminisce," says Washington.

When young Matthew Waymon died, his friends seemed to know instinctively the power of ritual. They began by bringing flowers and handmade posters to the accident site. For several days they maintained a vigil there, a safe haven where normally tough-talking boys felt free to weep, to hold each other, and to say that they loved each other, words they wish they'd said to Matt but never had. Several later got tattoos dedicated to their friend. They also attended his memorial service, where 800 people came to pay tribute to Matt and honor the Waymons's loss. Matt was described by a leader of the Ethical Society, to which the Waymons belong, as having 'a wonderful sense of tease and fun and play. He was someone who was different, who was unfailingly kind, and who stood for good." Most moving were the young people who were introduced to the crowd as Matt's "heart friends." The teenagers, looking awkward in suits and ties, struggled to put words to their grief. "You could count on Matt to help you out. He was as good at listening as he was at talking," said one boy. "Everybody says Matt's gone, but I don't believe it," said another. "You see all these people here? If everybody loves him the way they do, he's not gone. He's still inside of us." Such testimonials, tearfully given, bring ongoing comfort to his family.

Social Support

"In my fog, I was aware that a lot of people were doing a lot of things for Todd and me and that made me feel very taken care of," says Lynne Waymon of the immediate aftermath of her son's death. Being members of the Ethical Society gave them a supportive community that brought food, helped make arrangements, and cushioned them in their sorrow. But before long, the phone began to ring less. "The world has gone on," Lynne says. "Your world, though, has a whole different calendar: before and after."

The actions or inaction of friends, co-workers, and medical staff play an important role in how people move through the grieving process. Workplaces, through supportive attitudes and policies, can help ease a person's suffering. Typically, only three days are allowed off from work even for the death of a close family member. "Workplaces are shooting themselves in the foot to think people can come back and be productive in that short a time," says Washington. "There are ways they can honor the grief that both help the person and allow them to be more productive -- giving them a lighter work load, more time off, or shorter work weeks for a while."

Todd Waymon found that a supportive environment allowed him to return to teaching sooner than expected. Rather than burying his grief, Todd began the first day by sharing his loss with his students. 'I told them if I'm late, if I break down crying, you'll understand." By creating an emotional bond, his students, in turn, were more open with him about their own private tribulations.

Perhaps the most precious gift to a grieving person is the opportunity to share stories of their loved one. The Waymons long to hear anecdotes about their son. One friend who didn't have the chance to know Matt invites Lynne to "tell me a Matthew story," a gesture she deeply appreciates.

Conversely, what is most hurtful is a failure to acknowledge the loss. "The main thing I notice is many people's inability to act," says Lynne. "The best ones say 'I don't know what to say.' The worst ones say nothing." She recalls one colleague who, like the Waymons, had adopted her child. Lynne assumed this friend in particular would identify with her loss. Yet when she came to Lynne's home on business, shortly after Matthew's death, she never expressed a word of sympathy.

"I wish there were more guidelines," says Lynne. 'It's all so hush-hush and secret and difficult to talk about." Saying the wrong thing, such as "It was God's will" or 'Everyone goes through it," can be hurtful. So too can acting uncomfortable if the bereaved person starts to cry. "People say, 'I'm so sorry I made you sad,"' says Lynne. 'It's ridiculous. I am sad. The best thing to do is let me talk about it." Her husband agrees. 'I have a thousand gallons of tears to shed," he says, "and I want to get on with it."

Kathleen Phelan feels her grieving was made more difficult by the staff of the nursing home where her mother had lived for nine years, the last two at $10,000 a month. Ada died on the weekend, and no social workers or administrators were available to offer professional services or to assist with necessary logistics. In fact, the home never acknowledged her mother's death. "No one came to the funeral or sent flowers or even a card," she says. After the funeral, when Kathleen came to pack her mother's belongings, her room had already been given to another patient, and all of Ada's worldly belongings were in four large garbage bags. A year later, the memory still angers and hurts Kathleen.

A Long Journey

There is no timetable for grief, and the journey is filled with peaks and valleys. Just when you feel you're getting better, a fresh wave of pain pulls you back. Finding ongoing ways to honor your loved one, experience the grief, and still carry on with life can be difficult.

When people feel they have exhausted their own resources, they sometimes seek help from a grief counselor or bereavement center. The Saint Francis Center helps people to grieve "more efficiently and effectively," says Washington. For example, a mother with young children who has lost her husband cannot afford to stop functioning. Counselors might urge her to set aside a time each evening, once the children are in bed, to play music that reminds her of her husband, think about him, cry, and then to put it away. "The important thing is to help them open up their pain which is easy, but also learn how to close it down," he says.

Anna Gillis found comfort in a support group at the center. "I'm physically detached from the places and people who would be able to best help me get over my grief," she says. In the support group, she is able both to share her sorrow and to console others in turn.

Creative expression -- keeping a journal, writing poetry, painting, dancing -- is also healing. Lynne Waymon took up singing in a chorus as a way to bring a spark of joy into her life as well as refocus her attention. "I have to think real hard to figure out these alto parts, and it feels good because my mind is so destroyed," she says. "I enjoy the concentration a lot." Also, she and Todd each find it helpful keeping a journal. Writing down her feelings calms Lynne when she can't stop crying. For Todd, the journal is a record of his emotional journey.

"Grief has an absolutely transformative power," says Volkan. When we lose someone, he says, we lose what they give us, whether it's love, economic security, or guidance. Taking on these functions ourselves or being open to new ways of finding them can be an enriching experience. For some people, the bereavement process can bring a new appreciation for life, for their relationships, and for the world around them. There is a sense of joining in a universal experience and feeling more strongly connected to the rest of humanity.

"I've learned that grieving is a part of life, part of the experience of being human," says Anna Gillis. 'I can't bear now to hear people speak ill of others -- you don't know if you'll have them tomorrow. It's made me feel a lot more compassionate in general."

Pollak believes the language of grief should be changed. Grief is not something we "get over," or even "heal ftom," as if it were an illness, but rather a journey to a new stage of life. "The goal is not forgetting and it's not resolving," she says. "It's reconciling yourself to that loss and discovering some kind of spiritual meaning [in it]. You will always have a relationship with the person who has died, but the relationship is different. That is your quest -- to discover that relationship."

This transformative power of grief has been experienced time and again by Don Montagna of the Washington Ethical Society. When he began his career, he dreaded conducting memorial services but now he appreciates the opportunity to be involved in such experiences. 'The purpose of the ceremony is to purify, to keep the person's spirit alive," he says. "We let go of anything mundane or trivial, and we forgive the negative."

He urges the bereaved to not just go through the motions at the service but to experience fully what has been lost. He first meets privately with family members to learn as much as he can about the loved one's life -- the historical conditions in which they lived, their family background, education, career, relationships, warts and all. In some cases, dark secrets emerge, and survivors are guided toward a path of forgiveness. "If you recognize your parent made a mistake, you don't clean it up and say it doesn't matter. You have to say, 'I'll find better ways to manage my kids. Thanks, Dad, for teaching me this,'" says Montagna.

In every ceremony, those who attend are asked to silently reflect on a quality they most treasure about the deceased. "We get clear about what was the really special way that person had of being," he says. "We recognize that what we most appreciated is what we yearn and grieve for. By choosing one quality and making it stronger in ourselves, we fan the flames and keep the spirit of our loved one alive. If you do that, you really feel not only the importance of that person, but your connection to the whole human web."

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Beth Baker is a Takoma Park, Maryland, writer and a contributing editor to Common Boundary.

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