Coping with Bereavement
In this article, we will be talking about how to deal with bereavement and how to approach it. We will define what bereavement is, look at the stages of bereavement and some words of comfort for the bereaved and how you can support a friend or loved one through this difficult time.
WHAT IS BEREAVEMENT?
Bereavement is the experience of losing a loved one. Within the course of our lives, we’ll all have many different experiences of loss and will have to grieve those losses. Some, such as weaning and death, happen to all of us and can be called ‘necessary losses’ (Lendrum & Syme, 1992). Others, which do not happen to all of us, are more circumstantial.
All losses can however be - and often are - sources of personal growth and maturity. Examples of circumstantial losses that lead to deep grief and a period of bereavement are separation; divorce; emigration; miscarriage; death of a child, relative or a friend, ageing, imprisonment, the birth of a handicapped child, disability, rape, sexual abuse, physical and verbal abuse, hospitalisation, blindness, deafness, loss of speech, infertility, death of a pet, natural disasters, bankruptcy, loss of a job, leaving home, menopause and so many more.
STAGES OF BEREAVEMENT
Studies have shown that men and women have very similar patterns of responses to grief. There are usually four phases to mourning with associated feelings:
Numbness; this phase comes with feelings of shock and disbelief
Yearning; in this phase, the predominant feelings are reminiscence, searching, hallucinations, anger and guilt
Disorganisation and despair; this phase has feelings of anxiety, loneliness, ambivalence, fear, hopelessness and helplessness
Reorganisation; the predominant feelings in this phase are acceptance and relief
It’s important to note that the above phases do not occur in this order but overlap and some phases may recur - for example, we can move from yearning to acceptance and then back to feeling incredibly angry. Most people need at least two years to feel reorganised in their lives, but I always say to my patients that bereavement isn’t about getting over the loss but about learning to live with it.
HOW TO DEAL WITH BEREAVEMENT
Every culture has mourning rites and ways of handling death which is there to help the person mourn someone’s death. Usually, these rituals will facilitate grieving as families and communities come together to ‘share’ the grief and provide support.
Some families are more prone to denial and so the griever will sense that it’s not okay to express his/her feelings. This repression of feelings may eventually express itself in physical or mental illness.
In this case, it would be helpful for the grieving person to seek bereavement counselling with a professional in order to have a safe and non-judgemental space to express their despair, pain and all the other complex feelings.
Many people nowadays are separated from their family and community; it’s not uncommon for us not to know our neighbours and to feel isolated.
In this situation, it’s also recommended to seek bereavement counselling rather than to try and go through the grief alone because otherwise there’s a risk that the griever will be prone to prolonged grieving and possibly a breakdown. This professional support will help the grieving person to also cope with their everyday activities as they go through the bereavement.
Suicide Bereavement
In grieving a suicide the mixed feelings will often be extremely intense and difficult to bear. The feelings oscillate between intense anger at the person who committed suicide, overwhelming sorrow over the hurt they must have felt, and extreme guilt at not having noticed the torment in time to save them.
Those mourning a loss through suicide will often have a more tortuous bereavement period because of all these emotions and will often not allow themselves to express the anger they feel which in turn further prolongs the grief period.
SIGNS OF GRIEF IN A CHILD
One important factor which affects an individual’s capacity to grieve is their age and emotional maturity at the time of the loss - for example, children at different ages have different understandings of death and separation. Below is guidance on signs of a grieving child and the responses to give:
(Lendrum & Syme, 1992)
1) Sign: over-dependence on the parent, frightened and clingy behaviour, difficulty with every separation. Helpful response: recognition and understanding of the child’s feelings of fear about loss. Recognition an understanding that children often blame themselves for a loss of a loved one and feel fearful about this power they assume they have, that someone has died because of an angry feeling or thought they had.
2) Sign: Daydreaming. Helpful response: recognition of the child’s difficulty in facing reality and his/her need to escape into their own imaginative world. It would be important to show interest and curiosity about this world they escape to.
3) Sign: Bedwetting. Helpful response: understanding that children often regress when they are hit with loss and are grieving; they regress in order to express their need to be cared for. You can help them express their needs in other ways and express to them that you understand and support their need for more care.
4) Sign: symbolic stealing and forgetting. Helpful response: often children ‘steal’ in times of bereavement because they have a fear of losing someone else they love. You need to enable the child to express this fear and not feel guilt or shame.
5) Sign: Excessive fear and compliant behaviour becoming ‘bad behaviour’. Helpful response: Recognition of the child’s fear of being punished again (another loss). Once this fear lifts, it is sometimes followed by a period of difficult and oppositional behaviour; this is often a positive sign that the child is expressing his/her angry feelings. Bear with it and show compassion and understanding and it will soon pass.
Adolescence is a particularly difficult time during which to grieve the loss of a loved person because adolescence is a transition period of loss and gain where the adolescent is having to deal with losing his/her childhood and moving towards adulthood.
Likewise, the transition period for adults where the children have left the home is a particularly difficult time to mourn the loss of a loved one. The parents have to deal with adjusting to the loss of their children living at home and this makes them more vulnerable. Another transition period in the life-cycle that can make people more vulnerable to other losses is retirement.
BEREAVEMENT COUNSELLING
People grieving will often suffer from having hallucinations, nightmares, feelings of guilt and shame, feelings of real anger and a sense of injustice. All these can be present at different times or even simultaneously and can often make everyday life difficult to live through. Seeing a professional will help you understand and make sense of what you’re going through.
The professional will also give you helpful tools to manage the feelings, to not be afraid of the hallucinations and to accept the thoughts you have rather than be frightened by them. It’s extremely hard to deal with grief and have to work, parent and live life on a daily basis - we all need extra help at times and with a professional’s help the grieving period should be reduced.
Sometimes bereavement therapy isn’t enough (usually in cases of child bereavement or homicide) and a person may need trauma therapy (for example EMDR) depending on the circumstances of the loss.
WORDS OF COMFORT FOR THE BEREAVED
The best way to give support to a grieving person is to just be there and listen. No words are going to comfort but your presence will the biggest support. Small gestures are important too such as taking food round if you know they will not have the energy to make food, suggesting you go for a walk (if need be in silence), suggesting looking after the children after school or the weekend to give them some space.
Many times people say things to be supportive and it just makes the bereaved person feel misunderstood and alone. Here are examples of what not to say:
You’ll get over it
Please don’t cry, it will make you feel worse
Every cloud has a silver lining
There’s light at the end of the tunnel
You’re better off without him/her
It’s God’s will
It’s time you got back to normal
It was meant to happen
In summary, going through grief will take varying lengths of time for people depending on the person they’ve lost, the circumstances in which they lost that person and their own circumstances at the time of the loss. Some grieving persons will be able to heal from the support of their family and community and others will need the help of a professional for a shorter or a longer period of time.
Don’t hesitate to seek professional help as grieving a loss is one of the most difficult challenges we face in our life-cycle.
Reference:
S. Lendrum & G. Syme ‘Gift of Tears’ A practical approach to loss and bereavement counselling. Routledge 1992