How To Cope With Bereavement

How To Cope With Bereavement

At some point in our lives, most of us will have to deal with the inevitable pain brought about by the loss of a parent, or possibly a partner or child. Grieving is a relatively normal part of life, yet it is an isolating experience, and never more so than during the last year’s pandemic. To find out more about how to cope, we asked two bereavement counsellors to share their insights.

How would you categorise the feeling of bereavment?
“The most common experience is a feeling of intense sadness. The sadness comes over you in waves, one minute you’re feeling that you’re doing okay, then in the next moment you’re plunged into a dark place. Long bouts of uncontrolled crying often come with the sadness and it’s often accompanied by a feeling of physical pain. People find they literally hurt inside and this is because grief is felt in the pain centre of our brain in exactly the same place as injury pain.
“Grief is also frightening and people talk about feeling an overwhelming fear. Many people experience an irrational guilt, feeling that they could have done more or that they are in some way to blame. Many people find themselves searching for the person they may have lost, even to the extent of chasing after strangers in the street thinking they’ve seen their loved one. People also experience difficulties in concentrating, forgetfulness, difficulty in getting to sleep or staying asleep and changes in their weight, either from loss of appetite or comfort eating sugary foods.” – Dr John Wilson, director of the bereavement service at York University’s counselling and mental health clinic
People talk about ‘stages’ of grief – can you explain?
“In 1969, Elisabeth Kübler-Ross published a book called On Death and Dying in which she describes the five stages of grief: denial, anger, bargaining, depression and acceptance. Her model is still commonly used even though more stages have been added over the years. The most important thing to note is that grief stages are very rarely linear – people might move from anger to depression, then bargaining, back to anger. Sometimes a stage is completely left out; it can be very confusing as it makes people feel that they are not ‘grieving right’. However, it is all part of a ‘healthy’ grieving process.
“Denial: This is a bad dream; I will wake up and my loved one is still alive. This is not real, it can’t be! Denial is a powerful defence mechanism that protects the person from being overwhelmed by grief
“Anger: How dare she leave me! Why didn’t the doctors help him? I hated that nurse, if it wasn’t for her, she would still be alive! Anger is another coping mechanism as it masks the actual pain that is experienced. Anger is often the more acceptable emotion, especially for men – instead of breaking down and crying, breaking things seems to be more expected.
“Bargaining: I’ll become a better person if I can only talk to him one more time. I start going to church if my loved one is looked after in heaven. Bargaining often happens pre-bereavement: I’ll start looking after the children more if she only gets better. Bargaining often means a change in behaviour if a loved one can either be saved or brought back.
“Depression: Who am I without them? People often feel foggy, lost, fearful and heavy in this stage. It can be described as the quieter stage, although it can be messy. It’s here when the pain fully hits and people need to be mindful of their mental wellbeing during this time, as prolonged depression might signify an issue.
“Acceptance: The final stage in which people are able to accept that their loved one is gone and won’t come back. At this point, they have adjusted to day-to-day life without them and have found an emotional space for them to be able to continue loving them without being floored by the memory.” – Katharina Wolf, a bereavement counsellor at the Royal Trinity Hospice 
Why is it still considered such a taboo topic?
“Strange, isn’t it? We talk about sex more easily than we talk about death, although hopefully this is slowly changing. Possibly, it’s something that people postpone thinking about for as long as they dare. This is a shame because it leaves people unprepared for sudden deaths and late diagnosis of terminal conditions. We will be helped in the long run if we’ve discussed the inevitable more freely. It is, after all, something that will happen to all of us.” – Dr John
How might symptoms of grief differ between losing a parent or a partner?
“At some level, as you get older, you unconsciously prepare yourself for the death of your parents. Although both of my parents died suddenly, it didn’t come as a massive shock. Another reason is if your parents have done a good job, they have taught you to be independent, not to need them in adulthood in the same way as you did when you were a child. Losing a partner is a completely different experience. Your lives are enmeshed, especially if you did everything together and had not retained independent friendships outside of the marital home. Grief for a partner is almost always more intense than grief or a parent and it is also accompanied by massive feelings of loneliness and a totally disrupted lifestyle.” – Dr John
After losing a parent, how might you be able to help the other parent?
“In my experience, the surviving parent is often very good at protecting their children by saying that they’re doing okay when actually they’re not. Don’t take what they tell you at face value. Ring them and if possible, visit them regularly. Make sure that they are able to do the mundane things like shopping, keeping medical appointments and organising household repairs. Check they’re eating well and make space for them to talk about their grief.” – Dr John

Grief is felt in the pain centre of our brain in exactly the same place as injury pain.

There is the tragic possibility you might even lose a child as you grow older – is there any way to cope with this?
"Losing a child later in life, who is likely to be an adult, is just as painful as losing a very young child. However, it comes with a different set of challenges, especially since people might tell you how lucky you are that you had so many years with them. A lot of the support might go to the surviving spouse and their children, leading to you experiencing what we call 'disenfranchised grief'. When this happens, it's important to seek support; you might have a supportive partner or friends, and counselling can also be helpful. Try connecting with Compassionate Friends, an organisation helping parents deal with the loss of a child at any age. And don't forget there's shame here, too – specifically, the thought ‘I'm starting to find joy in my life again, but how can I when my child is gone?’ Understand that joy and grief can exist in the same space, they are not mutually exclusive." – Katharina
"I wouldn't ever talk about a hierarchy of grief intensity according to age, but each decade carries its own typical issues within the uniqueness of each person’s grief. It’s true that whether you’re 80 losing a 60-year-old child, or 22 losing a toddler, it’s still your baby. People often talk about the natural order of things, and never expecting to bury their child. It’s hard to generalise, with grief being so unique, but there are typical reactions to draw on. The elderly person may have depended on their child for practical and emotional support and if their child lived nearby, it’s a huge change. Young deaths are coloured by dashed expectations and older deaths by loneliness, although after the death of, say, a 50-year-old, my professional experience tells me parents tend to mourn more for their child missing out on watching their own children and grandchildren grow up more than anything." – John
Is there anything you should or shouldn’t say?

“There are many things that you shouldn’t say. In a nutshell, anything that, if you’re honest, is to make you rather than them feel better. Don’t say things like: ‘he had a good innings’; ‘she’s out of pain now’; ‘he’d want you to get on with life’; ‘let go and move on’. Instead, listen. Do say: ‘I’m here for you’, but only if you mean it. Rather than say ‘ring me any time’, make a point of doing the ringing.” – Dr John
Are there any practical exercises you can try to help ease the suffering?
“Grief is an active process – it can be helpful to acknowledge that you have an element of control within it, meaning that you have grief tasks to fulfil:
“Task 1: Accept the reality of the loss (overcome denial)
“Task 2: Process the pain of grief. Pain is inevitable, it is about enduring it and working through it, sometimes with the help of a counsellor. 
“Task 3: Adjust to a world without the deceased. This is very practical – she always paid the bills? Now you will have to. You would go on walks together, how does it feel to go alone or with a friend?
“Task 4: Find an enduring connection with the deceased in the midst of embarking on a new life. Love never dies and people continue bonds well past death; task four is about finding emotional space for the deceased without it interrupting other relationships and daily life. Completing these tasks means that we can remember our loved ones fondly and not experience pain from remembering what we have lost.
“Another good way to help ease suffering is to practise mindfulness, especially in the beginning when feelings of pain are overwhelming. Think about it this way – what does a ship do when the sea gets stormy? It puts down an anchor. Try out a few techniques like rooting yourself firmly to the floor with both feet and holding on to a chair, feeling the texture of the chair and the strength of your grip. This can help to bring yourself back to the here and now and ride out the wave of pain. You might have to try out a few techniques to find one that works for you.” – Katharina

When might be the time to seek professional help?
“You’ll probably find that as time goes on you cry less often and, when you do cry, it’s not for as long. This can be a subtle change, so it may help to keep a diary or journal to be able to look back on how things have improved. If things really are no different after six months to a year, you may need professional help. If your answer to most of the following questions is ‘No’, that may be an indication too:

  • Can you talk about your loss without being overwhelmingly upset?

  • Can you make sense of what happened?

  • Do you understand what caused the death?

  • Have the guilty feelings ended?

  • Can you look at photographs and listen to music which reminds you of them?

  • Can you talk about your memories of being with them without getting too upset?

  • Are you comfortable with laughing and feeling happy sometimes, without feeling guilty?

  • Are you comfortable visiting places you had good times together?

  • Are you comfortable going to their final resting place?

“Don’t worry too much if you still answer ‘No’ to some of these even after a year grieving for your partner. It’s a slow process and everybody deals with things differently. Only a small number of people, perhaps three in 20, will need professional help.” – Dr John
What’s the difference between depression and grief?
“In the first few days and weeks, depression and grief can be very similar, because new grief numbs you. After that, grief is a feeling of sadness, relieved by periods of functioning reasonably well and being able to get on with things. It comes over you in waves and the waves get further apart as time goes on. Depression is a constant and overwhelming feeling of sadness, a feeling of not wanting to go on and difficulty energising yourself. Grief can trigger depression, particularly for people who have been depressed in the past.” – Dr John
Is there a way to cope with loneliness after the loss of a partner?
“There’s no simple answer to that. If you do have family and friends, try to reach out to them. They may be leaving you alone because they think that’s what you want. Some people find it helpful to take up new interests. I’ve known people whose salvation was getting themselves a cat or dog to look after. You may be able to find a local support group of people bereaved in similar circumstances to yours. Such groups can be an absolute lifeline.” – Dr John
How might you talk to friends or other family about how you’re feeling?
“You don’t know until you’ve tried it. Be prepared to be both hurt and amazed. If you risk sharing your feelings, some friends and family will rise to the occasion and you’ll get what you need. Others won’t be able to cope, but at least you’ve tried. Don’t make their discomfort your responsibility. There will be some people who want to help but who are cautious. Try telling them that it’s okay with you to get upset in front of them and that it helps to have a good cry alongside someone you trust.” – Dr John

If you think you should have tried harder, cared better, be compassionate with yourself – you did the best you could during a difficult time. Your relationship is much more than the final weeks or months.

Is there such a thing as keeping ‘too busy’?
“Total distractions like throwing yourself into work or campaigning invariably leads to you bottling up your grief and getting out of the habit of grieving. It so often ends in tears. Other people distract themselves with sugary foods and alcohol. If you feel you are bottling up your grief, it may well help to talk to a professional or trusted friend.” – Dr John
What about the practical side – how can you make sure you’re okay to deal with that?
“Funeral directors are extremely skilled in helping you through the arrangements. They will be expecting you to find it difficult.  So too are registrars of death certificates. The registrar will explain the Tell Us Once scheme. If you sign up to this scheme, all official departments of government are notified of your changed circumstances, to save you having to do it. If you have to go somewhere to make arrangements, take a friend or family member if you feel vulnerable.” – Dr John
A lot of people experience guilt after losing someone – especially if they were ill. Any advice?
“Feelings of guilt are very common but if there is guilt about something at the end-of-life of a loved one, it’s only a snapshot of your relationship with them. If you think you should have tried harder, cared better, be compassionate with yourself – you did the best you could during a difficult time. Your relationship is much more than the final weeks or months. If you feel relieved that the person has died and you are finally free, remember it is not because of a lack of love, but solely because the situation was unsustainable and torturous for both. It’s not the loss you’re relieved about, but the struggle that came with, for example, the illness. If you are starting to feel happiness again and feel guilty, always remember that your partner’s or parent’s goal in life was to be part of your happiness, not the opposite. Your happiness means you are moving towards acceptance and have found a place for your love to continue in a way that is no longer devastating.” – Katharina
If you shared children, how might you talk to them about the loss of a partner?
“Just recognise that your feelings are yours and nobody else’s and the others who have gone through the same loss will experience it very differently. We should all be prepared to own our feelings and to accept the feelings of other family members. You have a right to say how you feel but, sadly, you can’t control how others react. Try not to get into a ‘My grief is worse than your grief’ competition with your children. It’s not helpful. Other people’s grief is not better or worse, it’s just different.” – Dr John
‘Moving on’ is such a personal topic. Any thoughts?
“This expression gets tagged onto the expression ‘letting go’ too. A far better way of looking at things is to talk about ‘moving forward’, taking your loved one into a new, optimistic future. Many people eventually begin to explore, with their counsellor, the idea of a new partner and a counsellor will help to explore this. The best new partners understand that you will always need a place in your heart for the loved one you have lost. Quite often they too need the same. Yes, it may cause sensitivity in the family, and a counsellor will help you explore this and hopefully find a way forward.” – Dr John
Finally, is there ever such a thing as ‘closure’?
“‘Closure’ is such an overused and unhelpful word, a throwback to the last century. You never get over the loss of a loved one, you learn to live with the grief, which becomes lighter in time, and you adapt your life to be without them. If you allow yourself to look at photographs and fondly remember all the things you did together, you can develop a new symbolic relationship. We call this a ‘continuing bond’ which allows you to take your loved lost one into your future.” – Dr John

Dr John Wilson is a fellow of York St John University, and director of the Bereavement Service in the University’s Counselling and Mental Health Clinic. His book, The Plain Guide to Grief, is available now.

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