Coping with Bereavement

What is bereavement?

Within the course of our lives we will all have many different experiences of loss and we will have to grieve the losses. Some losses such as weaning and death happen to all of us and can be called ‘necessary losses’ (Lendrum & Syme, 1992). Other losses which do not happen to all of us are more circumstantial losses. 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, stillbirth, miscarriage, death of your child, death of close friend, ageing, imprisonment, 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, natural disasters, bankruptcy, loss of a job, leaving home, menopause and so many more losses that we may experience in life.

Phases 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:

1) Numbness; this phase comes with feelings of shock and disbelief
2) Yearning; in this phase the predominant feelings are reminiscence, searching, hallucinations, anger and guilt
3) Disorganisation and despair; this phase has feelings of anxiety, loneliness, ambivalence, fear, hopelessness and helplessness
4) Reorganisation; the predominant feelings in this phase are acceptance and relief

It is important to note that the above phases do not occur in this order but overlap and some phases can come back again and again. 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 and not feel the loss as much but I always say to my patients that bereavement isn’t about getting over the loss but more about learning to live with the loss.

Of course, the loss of a child is, in my experience, the most difficult loss because there is such a sense of injustice that the person feels extremely angry for many years. 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 and overwhelming sorrow over the hurt the person must have felt to have killed themselves, then extreme guilt at not having noticed the torment the person had been going through and not managed to save them.

Survivors of the suicide will often have a more tortuous bereavement period because of all these
emotions and they will often not allow themselves to express the anger they feel which will further
prolong the grief period.
How to deal with bereavement
One important factor which affects an individual’s capacity to grieve is their age and emotional
maturity at the time of the loss. Children at different ages have different understandings of death
and separation; below is a guidance on signs of a grieving child and the responses to give
(Lendrum & Syme, 1992)
1) Sign: over-dependance 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: Day dreaming. 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: Bed wetting. 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 move 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 which can make
people more vulnerable to other losses is retirement.
Every culture has mourning rites and ways of handling death which are 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 to support the person grieving. Some families are more
prone to denial and so the griever will sense that it is 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 grief can take us through. Many people nowadays are separated from their
family and community; it is not uncommon for us not to know our neighbours and to feel isolated.
In this situation it is also recommended to seek bereavement counselling rather than to try and go
through the grief alone because otherwise there is 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.
Bereavement counselling
People grieving will often suffer from having hallucinations, nightmares, feelings of guilt and
shame and feelings of real anger and a sense of injustice. All these feelings are present at different
times or even simultaneously and can often make everyday life very difficult to live through.
Seeing a professional will help you understand and make sense of what you are 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 and feelings you have rather than be frightened by
them. With a professional’s help the grieving period will be shorter and you will not have to suffer
from physical ailments or a breakdown; it is indeed extremely hard to deal with grief and have to
work, parent and live life on a daily basis and we all need extra help at times.
Sometimes bereavement therapy is not enough (usually in cases of child bereavement or
homicide) and a person may need trauma therapy (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 varied time for people depending on the person they
have 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.
Do not hesitate to seek professional help as grieving a loss is one 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