My husband doesn’t understand how I feel about our miscarriage. What can I do?

Answer by Christiane Manzella, PhD, FT

You are not alone. It's very common for couples to react differently after pregnancy losses such as miscarriages and stillbirths. And emphasizing this difference – "You are too sad!" or "You are not sad enough!" – only adds another layer of stress to a very difficult time. It can be hard to believe that someone who handles grief differently from you feels it as deeply as you do. It may help to know that even though grief follows some general patterns, each person's response is unique.

Grief also varies significantly by culture. In America, there's a strongly held belief that acute grief comes with tears and an intense expression of emotion. It's considered normal to cry, express feelings, and process grief while adapting to the loss. This is called intuitive grief, and in our culture it's often associated with women.

An equally valid but less accepted pattern of grief is called instrumental grief. In this type of grief, someone takes charge and emphasizes being "strong." We often associate this kind of grief with men, but it can pertain to anyone, especially if he or she tends to be a problem solver in life. People who grieve this way actually find they have kind of nervous energy or restlessness that helps them to get things done. Rather than crying or withdrawing from activity, people experiencing instrumental grief work on mastering emotions and "taking care of business." For them, attending to practical matters may be a deep source of consolation.

By contrast, someone who copes by focusing on emotions may find handling practical matters a horrible chore and an unwelcome reminder of the loss. For them, being allowed the freedom to cry or be angry and feel a whole range of feelings can be the most effective way to adapt to the loss. Many people experience a combination of the two approaches.

Open communication is the best way for couples to work through grief and understand each other's viewpoint. I suggest sitting down with your husband and talking about how he feels and what helps him. You can also ask him to listen to what helps you.

Intuitive grievers often like to talk about the good memories before the loss (maybe feeling the baby kick) or revisit the difficult moments (such as when the kicking stopped) that preceded the loss. If this is how you are grieving, it's important for your husband to allow you the time to do it. Likewise, if he feels the need to take care of things, make plans and look forward, he should be allowed to do so without being made to feel that he is not experiencing the loss as deeply. If you can both understand how you are coping in this difficult time, it will help you give each other the space to do so.

Another challenge that couples face is the timeline of grief. Our cultural norms don't allow much time to grieve early losses such as stillbirth and miscarriage. You may be receiving messages from your partner and others that it is time to "move on," "get over it," or "try again." But grief is not a onetime emotion; it's an evolution of feelings and thoughts that help you incorporate this sad event into your life and move through it into your future. This takes time. How long is different for everyone, but both women and men say they start to feel like themselves again six to eight months after the loss.

Couples may also have a different timeline for being ready to resume their sexual relationship. Sexuality and pregnancy are so intertwined that it can be difficult for some women to resume sexual activity, while their partners may find that connecting through sexual activity helps them heal. Again, the simple yet profound act of clearly communicating what you feel and hope will help you connect in a way that's comfortable for both of you. For example, tell your partner if you want to be held in an affectionate but nonsexual way. Knowing each other's wants and needs and finding your own ways to affirm your connection will come out of open communication.  

Sometimes your spouse may not be the best person to help you with your grief. It can be very helpful to find a trusted confidant or participate in a support group. When you are both given the time and space to grieve as you need to, it's possible to become more united as a couple.

After several months, if you're still having difficulty moving forward, connecting with each other, and functioning in life, it might be time to get help from your doctor or a mental health professional.

Christiane Manzella, PhD, FT

Christiane Manzella, PhD, FT

Christiane Manzella, PhD, FT, is the Seleni Institute's clinical director and has been a therapist and grief counselor in New York City for more than 20 years. Dr. Manzella earned both her master's degree in clinical psychology and doctorate in counseling psychology from New York University and carried out her doctoral dissertation research at Beth Israel Medical Center hospice, with postdoctoral supervision in grief and bereavement work. She was named a Fellow in Thanatology: Death, Dying and Bereavement (FT), awarded from the Association of Death Educators and Counselors (ADEC), and most recently has been elected to their board. 

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