Bereavement and loss

There are many losses we suffer

From the loss of belief when we first find the truth about Santa Claus (perhaps surprisingly, this early jolt can cause very real distress); through friendships that start and founder along the way through life, family fall-outs, places we move on from, jobs we leave, loves that burn out, hope and innocence transformed, on to people who actually die – family members, friends, workmates. Every step forward implies a loss, something that has been left behind, and to some extent we can be expected to cope with a lot of this – it is, after all, part of normal human existence and humans are incredibly good at emotional survival.

The trouble often comes when we expect everyone to react in a similar manner, and become impatient for recovery. Because we differ from each other in terms of personality, life experience, philosophy, belief systems, it is to be expected that we will have different reactions to loss yet often the message received by the bereaved person is “You should be getting over it by now”·.

To lose a loved one is to lose part of ourselves. We don’t merely grieve for the loss of the other person (or sometimes even a close pet) but for that part of ourselves that seems to have been lost at the same time. To some extent, the grieving can only stop when we realise we will still survive the loss. To an outsider, who can’t see the nature of the attachment, such grief can seem overplayed; this is not a criticism of the bereaved person, but a failure of the observer to empathise sufficiently. Sometimes, it is because the observer hasn’t resolved their own losses and doesn’t want to be reminded of them, and at other times it is because they haven’t yet experienced such attachment or such loss.

Bereavement is part of a human process, and it often follows a well-defined course starting with denial and ending with acceptance. To get from one to the other, through several intermediate stages, can take many years and it is not always a process that can be hurried. One person may be back on their feet in no time at all, whilst another may take more than a decade to show real recovery of any sort.

One of the important aspects of this process is that there does come a time when external help may be appropriate. If there is absolutely no shift at all in the first few months, it may well be worth talking to someone – a close friend, a GP, a therapist – to discuss the way that the loss is being experienced; sometimes people do get stuck, and the right approach can sometimes help to resolve something, to enable some movement forward. On the other hand, although the immediate aftermath of a loss is emotionally awful, there is very seldom anything anyone can do to make it better – apart from a friendly word there is little that counselling or medicine can offer at this time.

However it is important to talk when the time is right. Having access to people who are prepared and able to listen enables a bereaved person to offload some of the distress and hurt, giving an opportunity to retain a sense of perspective. That is when services such as EAP helplines, Cruse Bereavement Counselling, Samaritans, GP Counselling, and other community services come into their own, providing real help at the time that the bereaved person can best use it.

Grief is the term given to describe the feelings and reactions of the bereaved. It is normal and necessary and affects everyone, albeit in very differing ways as mentioned above.

There are no right or wrong ways to react – some people cry others don’t. Feelings and thoughts can change from moment to moment and day to day. In time the intense emotional swings will lessen as the bereaved person begins to adapt to the change of living without the person who has died.

Effects of Bereavement

Bereavement is a different experience for everyone and reactions will vary from person to person. Some of the common feelings include:

• Shock – even if the death is expected when it occurs there is always the shock of the loss

• Disbelief – it may take time to believe the news. Sometimes the funeral may help to make it feel real

• Loss – not only is the person lost to you but also their love, their friendship, intimacy, opportunities, hopes and dreams

• Sadness – this may last a long, long time as life will never be quite the same

• Depression – feeling ‘down’ is a normal part of grief and you may lose interest in the other aspects of your life for a while

• Anxiety – you may have concerns for your own health and well-being. if the person who has died was very close you may worry about how you will manage without them

• Anger – with the world, God, other people for:
– causing the death
– not being able to cure the illness
– not being able to understand your feelings
– making thoughtless comments
– having fun

• Anger – with yourself for:
– what you did
– what you didn’t do
– with the person for dying and not here

These feelings of anger can be very difficult to bear so it is important to remember that they are normal reactions to grief. If they do not pass in time then they may need to talk to someone who understands the bereavement process.

• Guilt – for saying something unkind or hurtful:
– for not visiting when you promised to
– for feeling angry
– for being alive when they are dead (survivor guilt)

If the death of the person was from suicide, guilt feelings may be more intense and may be accompanied by feelings of shame and blame. Talking to someone who understands may be helpful.

• Injustice – ‘It’s not fair’ may dominate your thoughts. Questions such as ‘why did she/he die so young?’ and ‘why did this happen to me?’ may be difficult to avoid

• Envy – for people having what you don’t have anymore
– for lives that seem so easy
– for being happy

• Loneliness – grief is a lonely process because only you know exactly how you feel and only you can work through it. You may feel that no-one cares and no-one understands. You may be lonely because the person who died filled a large part of your life

• Relief – especially if the person was ill for a long time or if the person’s quality of life was diminished greatly.

It is understandable to want to avoid the feelings described above but grief needs to be experienced and expressed in order to move on and learn to live with the loss.

Effects on Behaviour

All the following are normal and understandable reactions to bereavement and may be part of your grieving process. With support, time and understanding they will eventually disappear and you will revert to your normal state. Grief affects our behaviour and some of the common effects include:

– Inability to get to sleep
– Inability to stay asleep through the night
– Waking too early

• Appetite – loss of appetite, or feeling sick on eating

• Tiredness – grief is stressful and you will use up a lot of your natural resources. If you are not eating and sleeping well you may become exhausted much more quickly than is normal for you

• Tearfulness – you may cry and you may be afraid that you will never stop crying. Don’t bottle up your tears, they will stop eventually and crying is the body’s natural outlet for emotions, strain and tension. Crying may bring relief.

• Preoccupation – you may imagine seeing or hearing the dead person. Many people have this experience – you are not going mad.

• Irritability – things you normally manage easily become irritations

• Anxiety and/or panic – this can be a reaction to strong emotions. You may feel you are going mad or that something terrible is going to happen. Talk to someone who understands so that you can stay in touch with reality while these feelings remain

• Inability to cope – ordinary things may seem insurmountable e.g. cooking, shopping

• Work may be too much, talk to your line manager
• Loss of interest – things that used to be interesting and meaningful now feel pointless

Physical Symptoms may also occur and can include:

• Nausea
• Palpitations
• Throat restriction
• Tightness in the chest
• Dizziness
• Heartburn
• Indigestion
• Diarrhoea
• Headaches

If you are concerned about how you are feeling or any of the above symptoms last for more than a few days consult your GP.

Resources to Help
Most people have reserves of inner strength that we call upon at difficult times, even if we are not

aware this is happening. There may be times when you feel you cannot cope but with the support
of friends and/or family and your inner strength you will find your way.

The following may also help and different things will help at different times so allow yourself to choose what fits for you day by day.

• Ask for help – many people find it difficult to ask for help but be brave for yourself and start by accepting help offered that you feel you would like. When asking for help approach someone you trust.

• Talk about how you feel – talking can bring relief and helps to clarify what you are thinking. It also helps to prevent feelings of loneliness. Good friends and people you trust are usually more than willing to listen. You may prefer to talk to someone completely independent – call the Right Corecare helpline.

• Writing about how you feel – if you don’t like talking you may find writing helpful. Choose the way that suits you best e.g. letter, poetry, diary

• Music – often music and songs can reach us when other things can’t. Choose music that fits with how you feel when you want to allow your feelings and music to change your mood when you need relief.

• Memories – remembering the person who has died may be painful at first but as time goes by memories often bring comfort and pleasure.

• Take care – often people feel they don’t want to be bothered with looking after themselves but nurturing does help. Try to eat well, relax in the bath, take showers and rest often – it is surprising how much energy we use grieving.

• Exercise – often the last thing you feel like but it can help to use up restless energy caused by frustration, anger and helplessness. It is good for your body – choose exercise you enjoy.

• Trust yourself – remember regularly that the way you feel is normal following bereavement and allowing your feelings and reactions is an important part of the recovery and healing process. If you want to be alone to take some time and if you want to be with people then go out to meet them. Follow your feelings as they change day by day.

• Be gentle with yourself – grieving takes time so don’t expect too much of yourself too soon. There are no rules. Take each moment and day as they come. Try to live in the present and don’t worry too much about what you should be doing tomorrow or next week. Sort things as you feel able and acknowledge yourself for managing each day.

Moving Forward
Following the initial shock most people start slowly to adjust to living without the person who has died. This adjustment time will differ for each individual and there is no set format for how long grieving continues. The change is usually gradual with the overwhelming feelings and/or preoccupation with the loss diminishing over time.

It is not ‘wrong’ to begin to ‘forget’ about the person who has died for a few hours or days. It does not mean you didn’t love them enough or that you are cold and unfeeling. We don’t think about people we love all the time when they are alive. People, living or dead, do not cease to exist when we stop thinking about them. You will always have your memories of the times you spent with them.

As time passes you will be able to think about others more and more and to begin to focus on your own life and what you want to do. You learn to live with your loss and although life will never

be quite the same again it will slowly become meaningful and enjoyable more frequently. Don’t
be surprised to be taken aback now and again when something reminds you of the person who has died – some music or a place may remind you – and the grief seems to wash over like a wave. This will diminish in time but when it happens it feels just as overwhelming as when the person first died.

Life will be different and you will also change because of your experience. You may want to look at your life and reassess your priorities, values, friendships, work, plans, hopes and dreams. It is important to think carefully before making any major changes and it is good to reassess at regular intervals.

You may also find that you are more sensitive to needs and difficulties both you and others face and that you have more understanding than you did before. You may be able to cope more with losses that you face and have more ability to manage life events.

Anniversaries of special events, birthdays and Christmas can be difficult, especially the first one or two after the death. It may be helpful to plan something special – you can ask someone to help with this if you like – to mark the day and allow yourself time to remember and grieve again for a short while.

Further Support

Cruse – Cruse offers face to face, email, telephone and web-support on issues of bereavement: https://www.cruse.org.uk/
Child Bereavement UK: produces guidance for employees and employers on returning to work: https://childbereavementuk.org/
Macmillan Cancer Support: https://www.macmillan.org.uk/