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LOSS AND THE NATURAL HEALTHY BUT CHALLENGING GRIEF IN OUR LIFE

I trained in 1982 in bereavement counselling and over the past thirty five years I have worked with people to enable them to respond to the challenge of working through the all important stages of adapting to loss in their life.

Before we begin lets explore all the forms of loss that create a grief response in our life resulting from our loss.

The death of someone we love

Divorce and separation from someone we loved

The Loss of a job or career

Retirement

Physical illness

Life threatening illness

The grieving response affects people in different ways and there is no right or wrong way to feel because each of us is different with different personalities. Just as in life we do it our way but the journey through the stages of responding to powerful loss in our life have to be travelled.

Generally there are four stages to responding to a powerful loss in our life:

- accepting that the loss is real

- experiencing the pain of grief

- adjusting to life as a result of this powerful loss

- and finally, putting less emotional energy into grieving and moving on in our life

You will feel:

- shock and numbness (denial is commonly how we describe this initial reaction) and people I have worked with often tell me how they feel as though they are in a dazed state most of the time.

- overwhelming sadness, with lots of tears

- a powerful tiredness and sense of exhaustion

- and, when someone has died, anger towards the person who has died or for some God.

- Guilt

We grieve after any sort of loss but the most powerful reaction is after the death of someone we love so I have provided links to the others forms of loss in the next paragraph and for the reminder of this page I will be focusing on loss when a person we love dies.

Divorce and separation from someone we loved

The Loss of a job or career

Retirement

Physical illness

Life threatening illness

A whole series of emotions surface beginning with feeling initially stunned and how we cannot believe this has actually happened even if the persons death was expected.

The Five Stages of Grief (Elizabeth Kubler-Ross)

DENIAL

Denial is the first of the five stages of grief and it helps us to survive the immediate loss.

The first few hours after a death we are stunned and this is present even if we have been expecting the death.

This sense of emotional numbness can help us to move through the practical arrangements that have to be made. But this feeling of unreality can be a problem if it goes on for too long. For many people the funeral or memorial service helps the reality of what has happened to sink in.

Soon this numbness disappears and may be replaced with a dreadful sense of agitation of pining and yearning for the dead person to be in our life again. Feelings of wanting to somehow find them, even if this is impossible which makes it difficult for us to relax or concentrate and it may be difficult to sleep and when we do the dreams can be a nightmare feeling.

In this first stage the world feels meaningless and at the same time overwhelming. Life makes no sense because we are in a powerful state of shock and denial. We wonder if we can go on, if we want to go on, if we can make it through this and so we just try to simply get through each day.

Denial is a natural way to help us pace our feelings of grief so that we know that there is only so much which we can handle at a time.

ANGER

anger may be directed towards the doctors and nurses for not saving the patient, the friends and relatives for not doing enough or for that matter the person who died 'if you had really loved me you would have fought harder to stay with me, and then even anger towards ourselves. Anger is a powerful and necessary stage of rebuilding and so be willing to experience and express the anger so that you don't become stuck at this all important stage of grieving. The truth is that this powerful anger appears to have no limits and can extend to your friends, the doctors who were involved in treatment, members of your family as well as the person who has died.

You may also ask 'Where is God in all of this and why am I going through this terrible pain' or 'what did I do wrong to deserve this?' Driving this anger is pain, a feeling of being deserted and abandoned. Whilst as a society we fear anger and its expression this anger is really an anchor, giving temporary structure to a feeling of nothingness. In the early stages of grief we feel as though we are lost in a sea with no real connection to anything anymore. When you get angry towards people or a situation it strangely gives structure where the anger becomes a bridge over the open sea. On a positive note your anger is another indication of the intensity of your love.

BARGAINING

Before a death it seems like you will do anything on earth to prevent their death. After their death bargaining may take the form of 'what if I devote my life to helping others, then I can wake up and realise this has all been a bad dream?' Here we become lost in a world of 'If only...' or 'What if...' statements. Essentially we want life to return to what it was. We want to go back in time - where we find the tumour early enough.. to recognise the illness earlier.....to stop the accident from happening ... if only...if only.

GUILT

Guilt is often bargainings companion in the sense all of the reflection and 'if only's' which often result in our feeling guilt when we reflect on what we could have done differently. We may even bargain with the pain and try to do anything so as not to feel such pain of loss. We attempt to remain in the past. Sometimes an event will trigger such feelings for a few minutes or an hour and othertimes a sense of loneliness and isolation can create such thoughts for days at a time.

INTENSE SADNESS

Many years ago when I began my career the literature on grief was entering mainstream and this all important stage was commonly labelled 'depression' however I did not agree with this and so in my lectures, workshops and seminars as well as one to one sessions I make it clear that the grieving response is a natural and healthy response and so words like depression can pathologise and so I will not use or allow this stage to be labelled as depression for it is a powerful and intense sadness.

All of the coping strategies and of the various stages of emotions to loss bring us to the present reality. Empty feelings and the grief enters our life at its deepest level. Deeper than we ever imagined to the degree where our coping strategies to deflect no longer work.

We withdraw from life left wondering at times if it is worth going on in life alone.

A feeling of guilt. People find themselves going over in their minds all the things that they should have said or done. Even to the extent of what they should have done to prevent the death. 'if I had realised earlier and made you see the doctor months before' or 'if we had led a different lifestyle and I had stopped you from smoking or drinking'. If only, if only and the list goes on.

The stage of agitation is usually strongest around two weeks after the death and then a feeling of intense sadness (I do not use the word depression for this is a natural process and the word depression can be associated with non-natural states). Withdrawal and silence and this sudden change in emotion can be very difficult for friends and family to understand. Intense feelings of sadness can be sparked by small things such as opening a drawer and seeing something we were not prepared for. People, places bring back memories of the dead person.

At this stage friends and family often find it difficult to understand what is happening. For them their lives have moved on whereas for the bereaved person everything on a day to day basis has drawn to a halt!

Often it can be very difficult for friends and family to be with the person who is grieving because of their pain, for example when the person bursts into tears for no apparent reason. At this stage it may be tempting to keep away from other people who do not fully understand or share the feelings of grief. In fact, in my experience, unless someone has been through grief they often find it very, very difficult to understand the process themselves.

In bereavement we spend a lot of time just sitting doing nothing. Thinking about the person we have lost, going over and over again both the good times and the bad times together. This is essential part of coming to terms with the death and should not be rushed through.

As time passes the powerful emotions begin to subside. The intense sadness begins to lessen however the sense of lost a part of ourselves never goes away entirely. For bereaved partners there is a sense of having lost a part of oneself which never entirely goes away.

For younger bereaved there are constant reminders of this new singleness in seeing couples together and watching 'happy families'. After some time it possible to feel whole again even though there is an essential part of us which is missing.

The various stages of mourning often overlap so don't, for one moment, think that you are not progressing through your grief. Most people recover within two years with the first year being the year of reflection - 'this time last year we were doing. . . ' and the second year - 'last year when they died. . . '

ACCEPTANCE

This is not a stage of feeling everything is OK no, this stage is about accepting the reality in our life and that they are not going to return and we are preparing for the next stage of rebuilding.

The final phase is letting go of the person who has died and this stage is very challenging as you being the stage of rebuilding.

There are no standard ways of grieving given certain key factors in our personality and events that have happened earlier in our life and this is what I explore when I am working with people on a one to one basis.

Anticipatory Grieving

This is a natural process that both those who are dying as well as those who are close to the person who is dying go through. Many of the elements of the actual grieving response after the person has died compose this process however the intensity of the reality of a person's death takes these natural responses to another level.

 

The Dying Go Through The Grieving Response

This process for one who knows that they are nearing the end of life is termed 'anticipatory grieving'. I might also add that those who are close to the person who is dying also share in this process of anticipatory grieving.

On diagnosis the person experiences a total sense of emotional numbness ' the doctor has got it wrong, the rest results are someone else's - I need to go and see another doctor who is more expert.

 

The once the reality of the prognosis sinks in then a feeling of anger - why me.

The intense sadness as the person reflects back over their life. For those who have entered old age this may not be the case at all so it depends at what stage in a person life a terminal prognosis is recieved.

 

Then there is a final stage of acceptance. Here another challenging phase begins. That of rebuilding a future life.

 

Children and Adolescents

Even though young children may not understand the meaning of death they feel the loss of close relatives in much the same way as adults. However, unlike adults research has shown how children may go through the stages of mourning quite rapidly. In their early school years, children may feel responsible for the death of a close relative and so may need to be reassured that it is not their fault. Young people may not speak of their grief for fear of adding extra burdens to the grown ups around them especially when they see the pain that these adults are going through.

Bereavement Following A Suicide

As well as the usual feelings of bereavement, you may have a number of conflicting emotions such as:

- Anger with the person who has taken their life
- Feeling rejected by what they have done
- Confused as to why the did it
- GUILTY - most people who take their own life as an act of desperation. How could you have not noticed how they were feeling?

- Guilty for not having been able to stop their death. You may go over and over this in your mind and explore the times you spent with them. Of course, even if you had managed to prevent their suicide attempt, there could well have been further attempts which you could not have stopped.

- Worries about whether they suffered

- Conflicting feelings over the fact that they no longer have to endure their life of distress

- Relieved that you no longer have to be there to support them or deal with their suicidal thoughts and urges

- Ashamed by what they did - particularly if your culture or religion sees suicide as sinful or disgraceful

- Reluctant to talk to other people about it because of the stigma of suicide in your culture

- You may feel that other people are more interested in them or the drama of the situation rather than your feelings for the person who has died

- Worried around thoughts of suicide that you may have had yourself

- Isolated - it can help to talk to people who lost a loved one through suicide


Unresolved Grief

Grief that does not progress and interferes with the persons ability to function in their day to day life.

Unresolved grief is more common in people who:

- Are unsure how they feel about the person who has died.

- Have negative views of themself and low self-esteem

- Feel guilty about the death where they feel they could have prevented a serious accident, suicide leading to the death and also when someone suddenly dies and you didn't have the chance to say important things to them

- Where violence has caused the death. People who experience a traumatic loss are at the risk of developing post-traumatic stress disorder (PTSD)

- Experiencing a death that others do not recognise as significant such as when a miscarriage occurs.

How people react to unresolved grief

- They may act as though nothing has changed in life (denial) and refuse to talk about the death

- Become preoccupied with the memory of the person who has died and are not be able to talk or think about anything else

- Distraction where they focus on work and more work - the workaholic

- Drink more alcohol or become dependent on drugs

- Become overly concerned about their health in general or about an existing health condition and see a doctor more than usual

- Become progressively depressed or isolate themselves from other people

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