Bereavement

Chapter 16 Bereavement






Bereavement as loss


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.


Every change involves loss and gain: arriving; departing; growing; declining; achieving; failing.


The old environment must be given up, the new accepted (Murray-Parkes, 1986: 30).



The grief process


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.


Whichever scheme is followed, there is much that is common ground, accepting the difference in phraseology. The author suggests that there are five distinct stages in working through grief:



Shock


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:







Anger and remorse


There are some strange reactions to loss. Anger following bereavement comes in many different forms, i.e.



To help relieve these situations with essential oils, see below.)


The problem with anger is that it is always self-destructive, even for those who are able to express anger.


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.

Dec 12, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Bereavement
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