Chapter 16 Bereavement
Aromatherapy, in its simplest definition, is a ‘balancing’ medicine that affects the whole person. Surveying the literature, it becomes clear that the theme of loss is seldom approached in core aromatherapy texts, yet is something that each of us experiences, not once, but often throughout our lives. It would be rare for a practitioner in any field of care not to be called upon to support a person through this traumatic event.
Bereavement is a fact of life. Talk of bereavement is mostly associated with death, but it is an emotional response that follows many events in life. Unlike many species in the animal kingdom, we take time to grieve after we sustain a loss: it may even be one of the things that make us distinctively human. The experience of grief almost certainly makes us more self-absorbed, grieving over what has been lost and because life has changed. It is ‘our’ loss and we are at the centre of our feelings and emotions. Loss is something we all have to come to terms with. In some ways the absolute nature of death may be easier to deal with than some of the less definite (even less obvious) happenings that cause grief.
Grief is essentially a product of love: the more we have loved, the greater our experience of loss. A world without grief would be a world without love: that, surely, would be sadder and more difficult to live with than loss. It is essential to recognize that we do not ever bring an end to the experience of loss, although
In normal circumstances it takes around 3 months for a person to accept that a bereavement has taken place: if the circumstances are traumatic or sudden, this period will most probably be extended. Grief takes time to adjust to and will become an important step towards recovery from the immediate trauma – there is no guaranteed formula that can act as an effective anaesthetic. One has to decide to face the pain – and it is not until that decision is made that moving beyond grief becomes possible.
Grief is a process with successive stages, the progression of which is not strictly linear: often a stage will be repeated and emotions apparently dealt with may be rehearsed again. Murray-Parkes (1986) speaks of five stages: alarm – searching – mitigation – anger and guilt – gaining a new identity. Ainsworth-Smith et al. (1988) identifies three stages: shock and disbelief – awareness – resolution. Bradley (1990) speaks of: numbness – pining – depression – recovery.
Shock following bereavement is controlled by the reticular activating system (Fig. 16.1). The reticular formation, a part of it, is a complex neural network in the central core of the brainstem which passes nerve impulses between the brain and the spinal cord, monitoring the state of the body’s behaviour and alertness (see Wikipedia). It has a vast number of synaptic links with other parts of the brain that constantly receive ‘information’, transmitted in ascending and descending tracts (Wilson 1994 p. 253). One of its functions is to pass (or block) selective information to the cerebral cortex. Stimulation of the reticular formation has been shown to produce first, curiosity, then successively (as the intensity of stimulation increases) attention, fear and panic (Murray-Parkes 1986 p. 51). It is because of this that:
Loss is so unwelcome that people often try to pretend it is not happening. This sort of avoidance is a self-protection mechanism as a means of getting through the crisis. Many speak of ‘being in a dream’, and one common feature to all who cope with loss is a determined unwillingness to plan clearly and to acknowledge that things actually are different and will not change. Some may turn to drugs (mostly prescription medication) or alcohol, with the ever-attendant danger of excess. This stage of grief does not need so much to be challenged as to be encouraged through, as it is unhealthy for an individual to linger in the denial stage.
Attempts currently being made to make people more part of – and involved with – the dying process are to be welcomed, for many are held back from coming to a point of acceptance because they have no real awareness of what has happened (it used to be popularly accepted that children had to be protected from death). As death is a normal part of life, true homoeostasis is brought closer if the loss is accepted and the bereavement embraced.
• anger directed against the person who has died: How could they do this to me? This sort of anger is more often thought than expressed: it is an emotive rather than a properly emotional response, not based on reason – and is unsustainable. It is easier to accept when there is a ‘reason’ to justify anger, for example if a person has been unreasonable, or there are debts. But someone who gets angry simply because they have been left alone, because they have been bereaved, can become very guilty about what appears to be self-indulgence.
• deflected anger: although many experience anger because the situation is not what they would have wanted (we would rather not have experienced loss), it becomes focused on the nearest available target. Doctors are not uncommon targets after a long illness: relatives sometimes find it hard to believe that there really was nothing that could have been done.
• frustration can be expressed as anger. Death is so absolute and immutable. Frustration (and subsequent anger) grows out of a sense of hopelessness and the inability to ‘make things better.’ Loss cannot be prevented, nor our reaction to it.
Remorse is stronger than regret and can be debilitating. It is to have to let go of someone who was loved while issues between the survivors and the deceased remain unresolved. It is difficult to live with, and the deep feeling of sorrow (and sometimes guilt) at missed opportunities is nigh on impossible to come to terms with. Many who have been hurt as relationships have ended reflect on ‘if onlys’ concerning what might have been said or done, or how things could have been worked through differently.
Anger and remorse are normal, natural reactions to loss. It is never good for an individual to suppress or attempt to contain these feelings, for they could become harmful. The bereaved person becomes a victim and is often handicapped in life if anger and remorse remain unacknowledged and unresolved.