Health Care

Accepting Loss

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Accepting Loss

by Sheldon H. Kardener, MD


The natural rhythms of life between the constants of birth and death involve change, the third constant. In the face of change, our ability to adapt determines how we emotionally approach life’s seasons and new situations. One part of us tries to keep change at bay, which can lead to conflict if we no longer desire what we attempt to preserve. Then, avoiding the dreaded feelings of hopelessness and helplessness dictate our actions. Another part of us accepts the inevitability of change; we adapt and mold what we value and allow those values to find meaningful expression in the new circumstance.


When unresolved Needs constrain the person because letting go would mean having to accept loss, he may re-create past scenarios in the present with the hope that “this time I will prevail.” Therapy enables the patient’s Adult to observe, understand, and modify or discontinue this recapitulation. The person can then move on in life, able to tolerate the loss that accompanies growth. Similar intense feelings may be generated by both experiences, but there is a world of difference between a breakdown—being controlled by the past, and a breakthrough—taking charge of the past. The latter involves giving up painful, self-defeating ways of relating and troubled sets of relationships for more appropriate ones as we progress in our lives.


The essence of Hinduism, expressed in the Bhagavad Gita and succinctly condensed here, is “attach, detach, transcend.” We cannot survive if we do not attach, and we cannot grow (transcend) if we do not detach. Judith Viorst expressed the importance of tolerating feelings of detachment in her well-titled book Necessary Losses. Ramen’s expression “there is no healing without grieving” also emphasizes the importance of tolerating the sadness of loss. If tears are shed, they are tears of resolution, not resignation.


We often confuse such sadness with depression, but there is a distinct difference between the two. When we are sad, we retain the belief that whatever we changed or gave up—voluntarily or inevitably—will somehow improve our lives. Our hope survives our loss. On the other hand, when depression overcomes us in the face of loss, we abandon hope. Take, for example, the child who has grown, matured, and is now going off to college. Though the parents and adult child may feel loss and sadness, they also appreciate the appropriateness of those feelings. In a healthy relationship, neither parent nor child would do anything to interfere with these natural feelings. Conversely, if the parents fear that their child’s growth will leave them bereft of purpose and value, they may attempt to block his leaving or become despairing and depressed. There is a time for all things, it says in Ecclesiastes (3:1), including a time for attaching, a time for detaching, and a time for transcending. Grief and sadness reasonably accompany any loss without ever becoming depression. The equations below distinguish between these two states.


Sadness - Hope = Depression


Depression + Hope = Sadness


About Sheldon H. Kardener, MD

Sheldon H. Kardener, MD, has written, lectured and taught extensively while practicing psychodynamic psychotherapy for over 40 years.  Always on the cutting-edge, he’s often called the father of Focused Dynamic Therapy™.  His book, Breaking Free:  How Chains From Childhood Keep Us From What We Want, is a breakthrough book… the biggest breakthrough in psychotherapy since the 60s which brought us Berne’s Transactional Analysis in Psychotherapy and Games People Play and Harris’s I’m OK – You’re OK.  Learn more at or call 310.399.8727