Grief and Bereavement
Jayne Cowan is a QCH Practitioner and has been a volunteer with a local hospice for eight years, working in the Supportive Care team, on the hospice Bereavement Support Line and providing one-to-one sessions for bereaved people.
Using her vast experience, Jayne has written an article for Quest on the subject of grief and bereavement, including advice about how best to support those in grief and signposting to resources that may be helpful.
Grief is organic, universal and everyone’s grief is unique, but nevertheless, it can be isolating and lonely. Being completely overwhelmed by the impact of a loved one’s absence shatters the grief sufferer’s assumptive world and grief cannot be fixed.
We live in a society where we have lost the old customs around grief and bereavement and the structures for processing and holding grief. This might have been different if we had a more open social attitude to grief, but this needs a shift in cultural perspective. Many people have little knowledge of grief until it happens to them, mainly because it isn’t a topic that is talked about openly today.
Feedback from groups and communities offering support to the bereaved shows that people have a massive thirst for openly talking about their suffering, joining together, and knowing that they are not alone, having common experiences that can be shared with others. A 2019 survey reported that one in four people said they would avoid somebody who was grieving because they didn’t know what to say, this results in the bereaved feeling so much lonelier.
Love and Loss
For most, love is the most profound source of pleasure, while the loss of those whom we love is the deepest source of pain. Hence love and loss are the two sides of the same coin, it’s impossible to have one without the other. Consequently, it is crucial to acknowledge the pain of grief and give it the space it needs.
Grieving is the internal part of loss, it’s how we feel, and it does not end on a specific date, yet, as a society, we are under pressure to “get over a loss” to “get through the grief”, but for how long do you grieve someone? Whatever the relationship to the person who has died, is it a year or two or maybe five? Or does it never end? The aftermath lasts a lifetime. The pain arising from the death of a loved one, the lost connection with the person who has died, can be so intense, so heart-breaking.
What everyone who is grieving has in common is a need for their grief to be witnessed. You can’t reframe it. A person’s need is for someone to be fully present to the extent of the loss without pointing out silver linings. Acknowledgement is everything, and it can’t be made right. Grief belongs to the griever- so it’s essential to follow their lead.
You cannot bring a person back but acknowledging and feeling your grief will begin the process of healing and growing through it. There is no quick fix to the pain of a death, so this makes grieving hard. Knowing this helps form realistic expectations.
How one grieves relates to the person who has died. You cannot compare one person’s grief to another’s; maybe thinking of grief as a journey is helpful. Paths will vary, different routes will be taken, and some will be longer than others, but we are likely to visit some of the same places along the way.
How do you help a grieving friend? Here’s a useful video from Megan Devine, author of It’s Ok That You’re Not Ok.
Bereavement during the Covid-19 pandemic adds another dimension
The trauma of hospital visits, unable to hug, hold hands, as you watch your loved one struggle for breath, separated by PPE, screens, being kept at a distance, perhaps coping with the trauma of seeing a loved one for the last time as they leave in an ambulance with no chance to say goodbye.
At the very beginning, there was little understanding of whether the bodies continued to spread the virus, so loved ones were buried in hospital gowns, pyjamas, sometimes in the clothes they were wearing when admitted to hospital. Denying the bereaved the opportunity to choose a coffin, or place tokens or jewellery that would have symbolic value to the deceased. Funerals have been limited to a small number of mourners and mourners not being able to hug one another, not being able to carry the coffin – that one meaningful and final act taken away can intensify the pain of losing a loved one.
Tragically, many people lost more than one relative, the loss of two or three of your family close together is a complicator of grief. People who might have coped with one death without professional help are less likely to cope with further losses, they are more likely to become anxious and depressed, fearful that other family members may die.
For some, it has resulted in further trauma, getting your last communication with your loved one returned in the post, realising it hasn’t been read, the world arguing over whether your loved one’s death was actually due to Covid-19, was it something else? The thought of your loved one being laid to rest without you there because you weren’t permitted to cross borders or visit other countries, imagining your loved one perhaps dying alone with no family by their side and being unable to have any visitors for three weeks before their death. The tragedy of bereavement by Covid 19 is like no other grief.
Being in lockdown, isolated from friends and family, could cause feelings of numbness to drag on. This is quite normal, our brain’s way of keeping us safe in difficult times is to continue with daily tasks even if doing them in a daze. People bereaved by Covid-19 say that even though they have been to the funeral and seen the coffin, they continue to believe they will meet their loved one again. What has made the numb period different for these bereavements is the isolation, the bereaved and the deceased robbed of face-to-face contact and touch of other family members.
10 things you can do when in grief
- Take a walk, in grief, we need to symbolically keep moving, but we also need to move physically. We can slow down in suffering, so it’s good to keep our bodies moving (take this time to think about your loved one).
- Journaling and naming 3 things you have managed to do today (not a gratitude list, as this can be difficult in grief); this may be as simple as “I got out of bed today”, “I managed to eat today”. Focus on what you can still do.
- Engage in the bigger world, 30 minutes a day watching world news or reading a paper.
- Take time each day to send love to the person who has died. Journal or write postcards to the loved one (keeping the bond and connection).
- Distract yourself; your mind needs a break. Binge watch a TV series or movie, reread your favourite novel. Do this as much as you like. You’ll know when you’ve had enough. It is ok to be distracted.
- Talk about your loss; we usually know the people in our lives willing to listen, it’s essential to have our grief witnessed.
- Recognise something in your life that continues after the death of a loved one (love persists, your hair and nails still grow).
- Do something nice for yourself.
- Write down 3 things that you want to do before the death. A place to visit, a hobby that has never been taken up, a TV show you wanted to watch but never made the time.
- Do something for someone else. A random act of kindness.
What to say…and what not to say!
The Best Things to Say to Someone in Grief
- I am so sorry for your loss.
- I wish I had the right words; just know I care.
- I don’t know how you feel, but I am here to help in any way I can.
- You and your loved one will be in my thoughts and prayers.
- My favourite memory of your loved one is…
- I am always just a phone call away
- Give a hug instead of saying something
- We all need help at times like this; I am here for you
- I am usually up early or late if you need anything
- Saying nothing, just be with the person
The Worst Things to Say to Someone in Grief
- At least he/she lived a long life; many people die young
- He is in a better place
- She brought this on herself
- There is a reason for everything
- Aren’t you over him yet? He has been dead for a while now
- You can have another child still
- She was such a good person God wanted her to be with him
- I know how you feel
- She did what she came here to do, and it was her time to go
- Be strong.
I have found that some therapeutic techniques are sometimes difficult to apply to grief but I have learned by working with clients what may be appropriate – here are some suggestions.
- Positive Psychology
- Havening therapy
- EFT Tapping (please contact Jayne if you would like a copy of a script)
- “Safe place” visualisation
- Butterfly tapping
- Balance Breath
- Journaling/writing letters or postcards to the person who has died.
- Pain Visualisation Meditation (please contact Jayne if you would like a copy of a script)
- Filling in the pieces of the death. Having a better understanding helps (please contact Jayne for a questionnaire to help with this).
“When you’re feeling your worst, that’s when you get to know yourself the best “
Creativity can be helpful.
Encourage creativity, for often words just don’t do it. Explain to a bereaved person that through creativity, you can find ways to express yourself far better than words can ever do. Creativity can help with adapting and shifting the internal sense of yourself to be a person who is alive and living without the person you love. Grief is invisible, the relationship continues, and the love never dies.
Pain is the agent of change.
“We must embrace pain and burn it as fuel for our journey”.
Feelings that might be felt:
When someone dies, we feel the pain of the death, but because of how we feel we can cut ourselves off from others which can be very isolating. We are good at supressing pain, and it naturally feels like the thing to do, but it makes the whole process more painful. What we resist persists. When you push your feelings down, they often become deeper and more rooted and pop up when we least expect them. We can’t avoid the pain; we can only delay it, and we can pay the price for that delay. It is estimated that unresolved grief contributes to 15% of psychiatric referrals. We can only begin to manage our painful emotions when we recognise that they are there. Identifying and labelling emotions reduces their intensity.
A new brain imaging study by psychologists at the University of California revealed that verbalising our feelings makes our sadness, anger, and pain less intense. This helps to see emotions more objectively, a temporary reaction to a situation and not a permanent part of ourselves. Emotions are not facts about who we are. When we experience a mix of emotions it can help to observe and label what we are feeling.
To identify emotions its helpful to do a body scan from head to toe
How strongly to you feel on a scale of 1-10 the following emotions?
Anger, Anxious, Jealous, Sad, Guilty, Hopeless, Out of Control, Lonely, Happy, Calm, Loved, Excited, Confident, Hopeful, Content, In Control – See how these change over time.
Helping grieving children and young people
Many children and young people can show sadness and distress when reacting to a death, whilst some react in the opposite way. Some will not know how to react as they are unclear what has really happened. Their response will also be age-related. It will also be affected by the relationship they had with the person who has died.
As said before, every person and therefore a child too is unique and will cope with the death of someone important in their own way. Children can grieve just as deeply as adults but show it in different ways.
Behaviours and challenges may be:
- Social and/or emotional isolation
- The entire support system is grieving
- Family and friends have no idea what to do or say, so instead, they do or say nothing
- The support provided has been alienating, minimising, or offensive
- The grieving person doesn’t know what they need
- The grieving person doesn’t know who they can count on or trust
- The grieving person doesn’t know who to ask for help
- Conflicts and negative feelings (i.e., blame and anger) among those in the support system.
- Sad, low depressed, angry, irritable, guilty, relieved, or numb (to name a few)
- Anxiety about their own health and of others, fear that they could die.
- Unmotivated and Uninterested
- Physical symptoms: stomach aches and upsets, headaches
- Withdrawal from school and friends
- Reverting to younger behaviours, regression
There is no magic formula but things that help include:
- Create a safe place to listen
- It always important to be honest and clear with young people, giving age-appropriate information.
- Reassure them that it is ok to feel upset. It is ok that you’re not ok.
- Find ways of helping them express their emotions
- Important to reassure them: whatever they are feeling is ok and they are not to blame.
- Make sure important and significant adults are there for them.
- Keeping to normal routines and a clear demonstration of that is important.
- Take time to talk about what has happened, ask questions, and answer theirs
- Create memory boxes. Scrape books and photo albums
- Being listened to and given time to grieve in their own way
- Use clear language such as ‘dead’ and ‘death’ rather than ‘Gone to sleep’ or ‘loss’ these terms can be confusing to children. If a person is lost maybe, they can be found?
- Respect the family’s beliefs not your own.
- Encourage normal routines.
- Reassure the child or young person that it is still ok to have fun and laugh
- Do something to express grief: writing letters and poems
Children and young people
Grief and Trauma
A short Course in Happiness after Loss: Maria Sirois
A Grief Companion: Sasha Bates
Its Ok That You Are Not OK: Megan Devine
Grief Works and This too shall Pass: Julia Samuel
Modern Loss: Rebecca Soffer and Gabrielle Birkner
The Invisible String: Patrice Karst (children’s book)