Bereavement

The Death of a loved one is a huge loss to those of us left behind. Bereavement causes a range of reactions and people experience grief in many different ways. The mourning process can take a long time and there is no fixed period after which a person can expect to feel better. This is essential to those who have experienced bereavement as it enables them to adapt to their loss and carry on with living.

So what reaction can we expect if someone we care about died?

The loss of a loved one leaves you feeling sad and lonely. You may suffer deep sorrow that you are without the love and understanding of that person. Losing a partner or a close friend may make you feel especially lonely as you were used to a close day by day relationship and shared everyday activities.

Anger is a frequent experience after such a loss. This comes from a sense of frustration that there was nothing anyone could do to prevent the death. You may also feel angry with the deceased person for leaving you.

Guilt and self-reproach are common responses to loss. You may feel guilty about things left undone, unresolved quarrels, words said or left unsaid. Usually people blame themselves for something that was neglected around the time of the death. To feel guilt is normal but usually unjustified.

Fatigue is frequently experienced, it may take the form of apathy or listlessness. This can be surprising and distressing to a person who is normally very active.

The pain of losing a loved one can often result in a sense of despair and helplessness, which is hard to breathe. This is extremely stressful.

The shock of the death may numb those left behind – leaving them bewildered, stunned and unable to think clearly. This occurs most often in the case of a sudden death. In a way, the shock protects those involved from being overwhelmed by feelings. After the death of someone close, those left behind may have a sense of longing to see, hold, hear and talk to the person who has died.

It is normal to experience a sense of relief when someone dies after a length or particularly painful illness. It is normal to feel relieved after a person with whom you have had a difficult relationship died. Guilt often accompanies this sense of relief, but it is a normal part of grieving.

Physical reactions are also often associated with acute grief and these play a significant role in the grieving process. Some such reactions include tightness in the chest and throat, feeling short of breath, hollowness in the stomach, muscular tension, diarrhoea, dry mouth, headaches, a sense of depersonalisation. If these symptoms persist or become of concern to you, consult your doctor for a check-up.

Certain thoughts, such as disbelief or confusion or preoccupation are common in the early stages of mourning. They usually fade after a short period of time. If they persist, they can lead to anxiety and depression.

Disbelief is often the initial response when hearing of a death. There is a feeling of unreality. This may continue for some time.

You may feel confused or unable to concentrate. It is difficult to get your thoughts in order and you may become forgetful.

You may become preoccupied with thoughts of the person who has died. You may find yourself concerned with how to recover them or have intrusive and distressing images of the person suffering or dying.

You may experience a feeling that the deceased person is somehow still in the current area of time and space. Hallucinations, both visual and auditory, are frequent experiences among bereaved people. These usually occur within a few weeks following a death.

Sometimes particular behaviours are associated with normal grief reactions. They usually correct themselves over time. They may include sleep and appetite disturbances, absentmindness, social withdrawal, dreams or nightmares of the deceased person, avoiding reminders of the deceased, sighing, over activity, crying, visiting places of carrying objects that remind you of the dead person and/or treasuring objects that belonged to them.

Adapting to the loss.

The mourning process enables those left behind after the death of a loved one to adapt to the new situation and get on with their live. It is therefore very important process to complete. There are a number of tasks associated with mourning (Worden, 1991). They do not necessarily occur in a specific order, although often a particular sequence does occur. The tasks of the mourning process are as follows:

Accepting the reality of the loss

The first task of mourning is to come face to face with the reality that the person is dead. It involved intellectual and emotional acceptance of the finality of the loss. Many people try to protect themselves from this by denying the meaning of the loss. They may deny that they miss the deceased person or that the person has died at all. Belief and disbelief coexist while trying to come to grips with the reality of the loss. Traditional rituals, such as a funeral, help many bereaved people move toward acceptance of the death.

Working through the pain of grief

It is necessary to work through the emotions, behavioural and often physical pain of loss being experienced. Avoiding or suppressing this pain can result in the development of various symptoms, for example depression or heart disease. Not everyone experiences the same intensity of pain in the same way, but it is impossible to lose a loved one without experiencing some level of pain. Some people try to avoid this by denying the pain, avoiding painful thoughts and reminders of the dead person, and by using drugs and alcohol. This experience must be gone through so that a bereaved person does not end up carrying the pain with them through the rest of their lives. Space to do this is required even if society appears to give the indirect message that ‘you don’t need to grieve’.

Adjusting to a new environment in which the deceased is missing.

Adjustment to a new environment will mean different things to different people depending on their relationship with the deceased person and the various roles they played. It might mean for example, living alone, being without parental guidance and support, raising children alone or managing finances alone. Full recognition of the changed circumstances may take a considerable period of time.

Bereaved people may have to develop new skills and take on new roles. They are often confronted with the challenge of adjusting to their own sense of self. Attempts to fulfill the deceased’s roles may be met with initial resentment. These negative feelings usually give way to more positive ones as the bereaved learns new ways of dealing with the world.

As such a loss can challenge a person’s fundamental valued and beliefs, this may require the bereaved person to adjust to these too. Searching for meaning in the loss, especially where there are sudden and untimely deaths, may mean adoption of new beliefs or modification of the old ones to reflect that fragility of life and the limits of control.

Not adapting to the loss may mean that bereaved people may not develop the skills they need to cope with the new situation. They may withdraw from the world and develop a stance of helplessness.

Emotionally relocating the deceased person and moving on with life.

This entails finding an appropriate place for the dead person in one’s emotional life. It is about evolving some ongoing relationship with the thoughts and memories associated with them in a way that allows the bereaved to go on living effectively in the world. For many, this is the most difficult part of the mourning process. It can be hindered by holding onto the past attachment rather than going on and forming new ones. Later in life, the bereaved person may realise that their own life stopped in some way at the point that the death of their loved one occurred.

An indication of a completed mourning process is when a bereaved person is able to think of the deceased person without pain or intense crying. Mourning is over when people can reinvest their emotions back into life, feel more hopeful, experience gratification again and adjust to new roles.

How can we help ourselves in the mourning process?

Losing someone you love through death is a traumatic experience. A period of healing is needed in order for those left behind to be able to move forward with their lives. Mourning may absorb all our energies initially, but gradually the intensity of the pain will lessen. The process can helped by the following:

• Talk about the person who has died – his or her qualities, what you enjoyed doing together, ‘mixed’ memories and how the impact of the death affects you.
• Don’t isolate yourself from friends and family. Let them know your needs and how you feel. Accept their support.
• Don’t expect to complete the mourning process by a specific date. Give yourself time and don’t compare yourself with others and how they have coped. Grieving may come and go, It may reappear and need to be reworked.
• Try not to tax yourself with many news responsibilities or major life changes during this time. Discuss them with people you trust.
• Take time to do things you enjoy. Rest and eat well.
• Keep a diary of your thoughts and feelings.
• Read about other people’s experiences of bereavement. Join a bereavement group or speak to a chaplain or counsellor in order to help you work through your grief.