miércoles, 15 de mayo de 2013

Bereavement - How To Deal With Grief


Bereavement – Understanding and coping with Grief.

Only people who are capable of loving strongly can also suffer great sorrow, but this same necessity of loving serves to counteract their grief and heals them - Tolstoy

In truth, no written words can ‘cure’ someone suffering with the loss of somebody whom they love.

Grief cannot be ‘cured’ anyway, but it can eventually stop being as painful as you find yourself coming to terms and ‘moving on’. But how long will this take? This is an impossible question to answer and relies on many, many factors. One thing that I am sure of though is that it is better to travel the journey with someone to support you than to do it alone.

Perhaps you are asking ‘why has he written this article if he cannot stop the horrible feelings of loss, feelings of hopelessness and depression?’ Well, that’s a fair question and the answer is that I can help you to understand the grief process that you, and everyone at times in their lives, has to go through. By understanding this, you should be better able to deal with the strong negative emotions that you must feel. Also, recognising that it is a process gives hope to the idea that it will end in spite of how you may be feeling currently.

The primary purposes of this article are therefore to

1) Offer the reader and understanding and therefore help in dealing with the natural and painful process of grieving.

2) To reassure you that the emotional and physical reactions that you may be going through are normal and perhaps even necessary.

3) To explain why help will be of great benefit in supporting and guiding you through the stages of the grieving process and what form the help takes.

It has been written by me, as a Psychotherapist , and will hopefully be of interest and benefit to several types of readers:

a) Someone who has had a recent loss and is finding it hard to come to terms with it.

b) Someone who is anticipating a loss fairly soon and wishes to prepare for it.

c)Someone who has had a loss sometime ago and feels that they are still not over the pain.

Before we begin looking into this important process, I need to clarify a couple of things.

Firstly, what is grief? We can define it as the psychological reaction to loss. We usually think of the death of someone dear to us, but we also grieve for any loss in our lives that we consider significant.

These losses could include the loss of our own childhood if this was unpleasant, divorce, having a miscarriage or losing your job etc.

The first part of this article will introduce some background topics that will help give an understanding as to why this natural process can be so difficult.

Background

The process of grieving is a natural part of the human life experience. It is experienced differently by each of us and is affected by many factors which include culture, beliefs and the other loss experiences that we have had.

However, being a natural process is not enough to ensure that we are able to come to terms with our loss and ‘move on’ to adjust our lives and begin to function effectively again. Western society has been in a state of constant change for many years. This in itself offers stress and anxiety for many individuals. It has impacted on all aspects of our lives which includes the way we view matters such as grieving.

Social changes have seen a decline in what used to be support structures. Families used to live very near to each other, religion was strong and central to many communities, our local doctors knew us and understood us, good neighbours and others in the local community would be available to help in times of need. The decline of these support structures often means that we are (feel) more isolated thereby limiting our opportunities to share and express our emotion.

Are you able to openly show you feelings? Generally, men find this more difficult than women, at least in western society. Men are often raised being told nonsense such as “big boys don’t cry”, “real men keep their emotions under control” etc. Bottling it all up is not healthy. It is at the funeral that men can often allow themselves to cry just a bit.

Funerals play a very important part in saying goodbye and in the acceptance of the fact that a loved one is no longer part of our physical lives. You will also be able to look at the life of the deceased and see him or her in terms of celebrating that life rather than focusing on their death and absence. However, these often take place too soon after a death and can be perceived as a hurried affair. The friends and relatives attending the service will be good for you due to the support they offer, but after the service and follow up function, they leave perhaps taking with them that support.

This ‘hurried’, ‘compacted’ activity contributes to a your having a shorter time to fully grieve than is necessary.

Other difficulties include the way that friends, relatives and work colleagues relate to you. Perhaps they are too sympathetic, perhaps they avoid the subject (or you) altogether, perhaps they irritate by saying empty, albeit well meaning phrases like, “ I know exactly how you feel......”, “time is a great healer..”etc..

So let’s have a look at the process in more detail.

The field of grief counselling has benefited greatly from many dedicated and inspired researchers such as Elizabeth Kubler Ross, J William Worden. Their work and the contribution of clinical experience have shown that all loss has to go through stages. As previously mentioned, there is no fixed timescale involved as we are all affected by grief differently. How we react also depends greatly on the nature and circumstances of the death, but in general:

Shock

At this stage it has not yet been accepted that the death is real. Perhaps your sub conscious is protecting you to allow it to ‘sink in’ slowly so avoiding emotional overload. Others may even comment that you are coping well. You may feel ‘numbness’ and a sense of disbelief.

Separation and Pain

At this stage you may have feelings of intense pining and yearning. These emotions can ebb and flow and can often give concern and be distressing for those close to you that are witnessing this

You may find yourself asking others to reassure you that the person really has gone from your life.

You are likely to have feelings of emptiness and possibly keep ‘seeing’ the deceased.

Despair

This can be a very dark place for the person grieving as the full realisation of a life without the loved one now takes hold. Common thoughts include “what is the point of living without him/her?”, “how will I cope on my own?” You may find it difficult to function normally, become absent minded or depressed.

Acceptance

When you have passed through the previous stages you will start to believe in the possibility of ‘moving on’. This will initially be intellectual acceptance as there will still be emotional mood swings and depressions at times. Anniversaries, birthdays and other special times may still give problems for a time. Resuming a social life may give rise to feelings of guilt that your life is moving on or that others may think that you have now forgotten the deceased.

Resolution and re-organisation

Having got to this stage, you will now be able to discuss your loved person with others and recall fond memories without becoming upset. You shall also be able to lead a full social life without feelings of guilt.

Feelings, behaviours, thoughts and physical responses on your journey

Let’s have a look at some of the above. By being aware and exploring these sensations, may help you to realise that these are normal responses and ones that you can work through.

Feelings:

Anger, perhaps at the person who has left you. Certainly, God regularly gets an ear bashing!

Guilt, perhaps at having anger, perhaps because you have survived, perhaps you don’t know why.

Anxiety: For those having experienced an unexpected death of a loved one, you are now plunged into an uncertain future and may have concerns as to how you will cope, ever be happy again or perhaps even exist.

Emptiness, aching, loneliness as you are constantly reminded of their absence.

Tiredness/fatigue are very common symptoms which perhaps slow us down a bit and help with the healing process.

Yearning is yet another common and perfectly natural occurrence. As you move toward acceptance, this need will lessen.

Other common signs: Confusion, worries about not saying goodbye, obsessive thoughts about the deceased, hallucinations, sleep problems, absent mindedness and many more.

If you have religious beliefs, these can often be challenged at this difficult time. As mentioned earlier, God can be a focus for blame and unanswerable questions that can then make us feel gulty.

Pathological aspects.

You may hear this word which simply means that the grief process is perhaps excessive in its intensity say, resulting in certain types of behaviour or symptoms. These could include:

Quite severe depression

Difficulties in talking about the deceased without intense emotional reaction.

Excessive euphoria after the death.

I do not want to dwell on these because you may start to incorrectly analyse your feelings and this is not the purpose of this article. If you beleive, or others tell you, that you are overreacting or use language that suggests this, then see a mental health professional who is best qualified to help you through.

I hope that you found this information comforting insofar as all those bereaved suffer some if not most of these ‘symptoms’. I also hope that you can begin to realise that it can be very difficult to see your own way through this ‘fog’ of negative emotion. Without support, some can become ‘stuck’ at a particular stage which is clearly undesirable. So where can support be found and what can be expected?

If you have a close and caring family this can be a great help at least at the beginning but at some point you may need professional help. This can be provided by someone from your religious community, voluntary grief workers or professional mental health professionals such as psychotherapists and grief counsellors.

What can you expect?

The person that you select to accompany you on your journey through grief should offer these qualities:

a) He/She recognises that it is your journey and that you set the pace and timescales.

b) He/She listens to you and only speaks when needed or when appropriate.

c) Offering an environment that you accept as a ‘safe place to cry’.

d) He/She travels ‘beside’ you on this painful journey, guiding gently, always supportive.

e) NEVER be judgemental.

Finding the appropriate companion for your journey of grief can be done through voluntary agencies such as Citizens Advice Bureau (UK), age support organisations, religious groups and counselling/therapy practioners which can be found in the yellow pages or online.

I wish you well on your difficult and painful journey and leave you with the knowledge that it is perfectly possible to come through this experience and to be able to get on with your life again. This does not mean that you will forget the one you have lost. You have simply adjusted your life.

David Carroll Dip CP Dip Hyp LHS
http://www.wessexwellbeing.com
email: david@wessexwelleing.com


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