Bereavement
is a distressing but common experience. Sooner or later most of us will
suffer the death of someone we love. Yet in our everyday life we think
and talk about death very little, perhaps because we encounter it less
often than our grandparents did. For them, the death of a brother or sister,
friend or relative, was a common experience in their childhood or teenage
years. For us, these losses usually happen later in life. So, we do not
have much of a chance either to learn about grieving - how it feels, what
are the right things to do, what is 'normal' - or to come to terms with
it. In spite of this we have to cope when we are finally faced with the
death of someone we love.
Here
you will find information about some of the ways in which people grieve
after such a loss, about the ways in which bereaved people can get stuck
in the grieving process, and the help available.
Grieving
takes place after any sort of loss, but most powerfully after the death
of someone we love. It is not just one feeling, but a whole succession
of feelings, which take a while to get through and which cannot be hurried.
Although
we are all individuals, the order in which we experience these feelings
is very similar for most of us. Grief is most commonly experienced after
the death of someone we have known for some time. However, it is clear
that people who have had stillbirths or miscarriages, or who have lost
very young babies suffer a similar experience of grieving and need the
same sort of care and consideration.
In
the few hours or days following the death of a close relative or friend,
most people feel simply stunned, as though they cannot believe it has actually
happened. They may feel like this even if the death has been expected.
This sense of emotional numbness can be a help in getting through all the
important practical arrangements that have to be made, such as getting
in touch with relatives and organising the funeral. However, this feeling
of unreality may become a problem if it goes on too long. Seeing the body
of the dead person may, for some, be an important way of beginning to overcome
this. Similarly, for many people, the funeral or memorial service is an
occasion when the reality of what has happened really starts to sink in.
It may be distressing to see the body or attend the funeral, but these
are ways of saying goodbye to those we love. At the time, these things
may seem too painful to go through and so are not done. However, this often
leads to a sense of deep regret in future years.
Soon
though, this numbness disappears and may be replaced by a dreadful sense
of agitation, of pining or yearning for the dead person. There is a feeling
of wanting somehow to find them, even though this is clearly impossible.
This makes it difficult to relax or concentrate and it may be difficult
to sleep properly. Dreams may be extremely disturbing. Some people feel
that they 'see' their loved one everywhere they go - in the street, the
park, around the house, anywhere they had spent time together. People often
feel very angry at this time - towards doctors and nurses who did not prevent
the death, towards friends and relatives who did not do enough, or even
towards the person who has left them.
Another
common feeling is guilt. People find themselves going over in their minds
all the things they would have liked to have said or done. They may even
consider what they could have done differently that might have prevented
the death. Of course, death is usually beyond anyone's control and a bereaved
person may need to be reminded of this. Guilt may also arise if a sense
of relief is felt when someone has died after a particularly painful or
distressing illness. This feeling of relief is natural, extremely understandable
and very common.
This
state of agitation is usually strongest about two weeks after the death,
but is soon followed by times of quiet sadness or depression, withdrawal
and silence. These sudden changes of emotion can be confusing to friends
or relatives but are just part of the normal way of passing through the
different stages of grief.
Although
the agitation lessens, the periods of depression become more frequent and
reach their peak between four and six weeks later. Spasms of grief can
occur at any time, sparked off by people, places or things that bring back
memories of the dead person. Other people may find it difficult to understand
or embarrassing when the bereaved person suddenly bursts into tears for
no obvious reason. At this stage it may be tempting to keep away from other
people who do not fully understand or share the grief. However, avoiding
others can store up trouble for the future and it is usually best to try
to start to return to one's normal activities after a couple of weeks or
so. During this time, it may appear to others as though the bereaved person
is spending a lot of time just sitting, doing nothing. In fact, they are
usually thinking about the person they have lost, going over again and
again both the good times and the bad times they had together. This is
a quiet but essential part of coming to terms with the death.
As
time passes, the fierce pain of early bereavement begins to fade. The depression
lessens and it is possible to think about other things and even to look
again to the future. However, the sense of having lost a part of oneself
never goes away entirely. For bereaved partners there are constant reminders
of their new singleness, in seeing other couples together and from the
deluge of media images of happy families. After some time it is possible
to feel whole again, even though a part is missing. Even so, years later
you may sometimes find yourself talking as though he or she were still
here with you.
These
various stages of mourning often overlap and show themselves in different
ways in different people. Most recover from a major bereavement within
one or two years. The final phase of grieving is a letting-go of the person
who has died and the start of a new sort of life. The depression clears
completely, sleep improves and energy returns to normal. Sexual feelings
may have vanished for some time, but now return - this is quite normal
and nothing to be ashamed of.
Having
said all this, there is no 'standard' way of grieving. We are all individuals
and have our own particular ways of grieving.
In
addition, people from different cultures deal with death in their own distinctive
ways. Over the centuries, people in different parts of the world have worked
out their own ceremonies for coping with death. In some communities death
is seen as just one step in the continuous cycle of life and death rather
than as a 'full stop'. The rituals and ceremonies of mourning may be very
public and demonstrative, or private and quiet. In some cultures the period
of mourning is fixed, in others not. The feelings experienced by bereaved
people in different cultures may be similar, but their ways of expressing
them are very different.
Even
though children may not understand the meaning of death until they are
three or four years old, they feel the loss of close relatives in much
the same way as adults. It is clear that, even from infancy, children grieve
and feel great distress.
However,
they have a different experience of time from that of adults and 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. Young people may not speak of their grief for
fear of adding extra burdens to the grown-ups around them. The grief of
children and adolescents, and their need for mourning, should not be overlooked
when a member of the family has died. They should usually, for instance,
be included in the funeral arrangements.
Family
and friends can help by spending time with the person who has been bereaved.
It is not so much words of comfort that are needed, but more the willingness
to be with them during the time of their pain and distress. A sympathetic
arm around the shoulders will express care and support when words are not
enough.
It
is important that, if they wish it, bereaved people are able to cry with
somebody and talk about their feelings of pain and distress without being
told to pull themselves together. In time, they will get over it, but first
they need to talk and to cry. Others may find it hard to understand why
the bereaved have to keep going over the same ground again and again, but
this is part of the process of resolving grief and should be encouraged.
lf you don't know what to say, or don't even know whether to talk about
it or not, be honest and say so. This gives the bereaved person a chance
to tell you what he or she wants. People often avoid mentioning the name
of the person who has died for fear that it will be upsetting. However,
to the bereaved person it may seem as though others have forgotten their
loss, adding a sense of isolation to their painful feelings of grief.
It
must be remembered that festive occasions and anniversaries (not only of
the death but also birthdays and weddings) are particularly painful times
when friends and relatives can make a special effort to be around.
Practical
help with cleaning, shopping or looking after children can ease the burden
of being alone. Elderly bereaved partners may need help with the chores
that the deceased partner used to handle - coping with bills, cooking,
housework, getting the car serviced and so on.
It
is important to allow people enough time to grieve. Some can seem to get
over the loss quickly, but others take longer. So don't expect too much
too soon from a bereaved relative or friend - they need the time to grieve
properly, and this will help to avoid problems in the future.
There
are people who seem hardly to grieve at all. They do not cry at the funeral,
avoid any mention of their loss and return to their normal life remarkably
quickly. This is their normal way of dealing with loss and no harm results,
but others may suffer from strange physical symptoms or repeated spells
of depression over the following years.
Some
may not have the opportunity to grieve properly. The heavy demands of looking
after a family or business may mean that there just isn't the time.
Sometimes
the problem is that the loss is not seen as a 'proper' bereavement. This
happens often, but by no means always, to those who have had a miscarriage
or stillbirth, or even an abortion. Again, frequent periods of depression
may follow.
Some
may start to grieve, but get stuck. The early sense of shock and disbelief
just goes on and on. Years may pass and still the sufferer finds it hard
to believe that the person they loved is dead. Others may carry on being
unable to think of anything else, often making the room of the dead person
into a kind of shrine to their memory.
Occasionally
the depression that occurs with every bereavement may deepen to the extent
that food and drink are refused and thoughts of suicide arise.
Occasionally
sleepless nights may go on for so long as to become a serious problem.
The doctor may then prescribe a few days' supply of sleeping tablets.
If
the depression continues to deepen, affecting appetite, energy and sleep,
anti-depressant tablets may be necessary; these are not habit-forming.
If the depression still does not improve, the family doctor may well arrange
an appointment with a psychiatrist.
If
someone is unable to resolve their grief, help can be arranged through
a family doctor or one of the valuable voluntary or religious organisations.
For some, it will be enough to meet people and talk with others who have
been through the same experience. Others may need to see a bereavement
counsellor or psychotherapist, either in a special group or on their own
for a while.
Bereavement
turns our world upside-down and is one of the most painful experiences
we endure. It can be strange, terrible and overwhelming. In spite of this,
it is a part of life that we all go through and usually does not require
medical attention. For those who do run into trouble, help is at hand,
not only from doctors, but from the organisations listed on the Help Organisations
page. |