Bereavement and Its Causes, Symptoms and Treatment

1. The loss of a close relative or friend, which has ait emotional impact and can lead to months or even years of mourning. The grief associated with bereavement is not always easy to describe. There may be a good deal of ambivalence at the time – for example, sorrow and disappointment may be mixed with anger, guilt and anxiety. Bereavement is a stress that can precipitate psychiatric disorders, psychosomatic illness or suicide. Many women, for example, experience guilt about their role in the events leading up to the death of their husbands, and widowhood reduces life expectancy.

The reorganization that is called for following the death of a spouse introduces an added source of stress with regard to emotional deprivation and living arrangements, and the increased risk of death of the bereaved person. There are good reasons for supposing that preparation and psychological support help to alleviate the distress that leads to personal conflict. In older people, the awareness of dying has developed slowly. There has been enough time to adapt to the prevailing circumstances and time to learn appropriate strategies of adjustment. Without such adaptation, bereavement and the awareness of dying may evoke feelings of dread associated with a sense of isolation or rejection.

The Importance of Grief

Bereavement is the loss of someone very precious; grief is the resulting emotional experience of being bereaved. Most people think of grief as a natural response to bereavement. Indeed, they are suspicious of those who deny their grief. Nearly all of us see grief as therapeutic, and we are often told “Get it off your chest and have a good cry”.
Grief is more complicated than that. It is dynamic and we live through it. We go through several steps, each of which is hard work. It is not a passive process of the letting out of pent-up feelings but an active process of adjustment. It is a positive “letting go of something or someone that has been very precious to you for a long time.

Causes of Bereavement

Bereavement usually means loss through death but the same reaction can follow divorce or the disappearance of a friend or relative, the permanent loss of someone who was central in the lives of others. It does not matter whether the person was deeply loved or not; simply to lose someone whom you were used to living with can be enough to provoke problems.

It was really only in the 20th century and in the developed world that bereavement became a relatively unusual event. This is because the illnesses that used to cause high child mortality and poor life expectancy have been greatly reduced. Whereas even 75 years ago most people would have come across early deaths almost routinely, now death occurs mainly among the elderly. This means that the first bereavement experienced at close hand could be the death of a parent when the son or daughter are themselves well into middle age.

Ironically, we are surrounded by death in newspapers and films and on television but these are absolutely no preparation for the reality of the death of someone close to us.

Symptoms of Bereavement

There are three well-recognized phases to bereavement. Initially, there is often disbelief, especially if the death is unexpected. Although the person may have been ill and expected to die, the actual event comes as a psychological blow which we seek to reject. This phase lasts a day or two.

Frequently, there then follows a reaction of anger mingled with bewilderment. Questions tumble out. Why this person? Why now? Why in this way? The circumstances are picked over. Were they on the right treatment? Could this have been prevented? If they had taken a different route would they have avoided an accident? This phase can last many weeks and may never be entirely resolved.

Most bereaved people eventually reach the third stage of acceptance and reconciliation; things get back into context: the elderly do die, accidents do happen, tragedies do occur.

Treatment of Bereavement

Bereavement rarely needs medical treatment except, possibly, the short-tenn help provided by sedatives or sleeping tablets. Even medication such as this is probably best avoided for
what, after all, is a fundamental human experience. Someone experiencing profound sadness that lasts for longer than a few weeks may be slipping into a depressive illness, especially if there are other symptoms of depression such as disturbed sleep, self-neglect and morbid thoughts. In these cases an antidepressant is often helpful.

Prolonged grieving can suggest unresolved emotions towards the person who has died. One of the most common emotions is guilt for something that had not been sorted out by the time of death – ‘unfinished business’ as it were. These feelings, which are actually very common, are best handled by specialised counselling.

Coping with Bereavement in Old Age

1. It is important to realize that the feelings you are experiencing are normal. It is normal to feel rage and anger. You wouldn’t be human if you didn’t feel guilty, so don’t spend a lot of emotional energy on self-recrimination.
2. Try to find an understanding person to talk to. You can work out quite a lot of your anger, guilt, shame and grief on someone who will just listen, correct you when you over-react and sympathize with what you are going through. At this moment, when you are in the depths of despair, an objective viewpoint that doesn’t see life as entirely white or entirely black is one of the best helps you can have.
3. It is important to grieve. Grieve in your own time. Don’t take any notice of people who encourage you to snap out of it or get back to normal. You will know when your grieving work is done, because you will feel it has worked its way out of your system and you will feel like starting afresh. So if you really want to have a good cry, if you want to have a conversation with your dead partner, go ahead and do so.
4. Once the grieving is over, it is important that you start to think about regaining your identity, or even possibly building a new one. Resist the temptation to live in the past. Try to become your own person and to assert your own identity. Start shaping your life as it suits you by doing things that you are really interested in rather than continuing a past way of life.
5. Don t make any big decisions quickly, rather let yourself grow into them gradually. Some decisions may be quite hard to take at first. If left for several months or a year, a problem that seemed insoluble will have a very ready solution.
6. Whatever you do, try to stay mobile. Don’t find yourself chained to the house, unable to get out. Not only see people, but also do essential shopping to give yourself vital changes of routine.
7. Don t neglect your finances. This is not a time for them to get out of control and find yourself in debt. So keep an eye on them, budget your expenses and keep a good check on all your sources of income.
8. Though it seems unlikely while you are grieving, life does go on and you will live again. Meanwhile you should take good care of yourself. Reward yourself with a holiday. Spend some time in your favourite surroundings or take a course to study a hobby. Go and see members of your family and perhaps stay for a few days.

Commonly Asked Questions

What assists mourning and acceptance?

The process of mounting should include recalling as much as possible of the relationship, difficult memories as well as happy ones. This way each emotion can he dealt with and not left to engender guilt or resentment.

How can friends and relatives help?

Their immediate support is essential, especially in handling the administrative matters. They can help guide mourners through the process of remembering, putting an emphasis on the best memories. After the funeral they should keep in touch regularly because that is when grief can grow.

Should children be told about a death?

They will find out eventually so why conceal things? Young children, below eight years old or so, will not take it in, unless by relating the emotions to those they felt on, for example, the death of a pet. Older children follow the same pattern of mourning as adults but will need more help to express their emotions.

Complementary Treatment of Bereavement

Bach flower remedies – star of Bethlehem for the shock and grief of sudden loss, sweet chestnut for utter dejection, pine to relieve feelings of guilt, willow if there is inclination to bitterness. Acupuncture – see Stress. Aromatherapy – see Depression. Autogenic training is a self-administered psychotherapy that can help. Other therapies to try: yoga; hypnotherapy; tai chi/chi hung; biodynamics; healing; shiatsu-do; auricular therapy; homoeopathy; massage; chakra balancing.