Bereavement

Elisabeth Kubler-Ross, the author of On Death and Dying, sets out the Five Stages of Grief as follows:

• Denial Denial and isolation are described as a temporary defence
• Anger  Why me? This stage is often difficult to cope with with strong emotions
• Bargaining  A real attempt to postpone the reality
• Depression Overwhelmed by the great sense of loss
• Acceptance The strong emotions fade and there comes a time of peace and reflection

It is important to emphasise that these stages are only part of the framework of learning to live with bereavement. They are tools that may be helpful in framing and identifying some of the emotions but they are not defined, definite stages.  Not everyone goes through all five stages, nor is the progression through them always linear – people can move from Stage One to Four and back through Stage Two, for example. Each individual grieves in their way.

It can be helpful to set out some of the emotions, physical symptoms and behaviours associated with grief. We need to also bear in mind that there can also be anticipatory grief where a death is expected, for example a person with a terminal illness or advanced old age.

SHOCK: Disbelief is one of the first emotions particularly if the death is unexpected

DENIAL: Inability to accept the reality of the death

NUMBNESS: Feeling like running on auto-pilot

ANGER: Why me? Why did they have to die?

DEPRESSION: Feeling lost, helpless, despairing

GUILT: The ‘what ifs’ and ‘if onlys’

ACCEPTANCE: Beginning to accept the reality of the death (this does not cancel out the sorrow or sense of loss.)

The mind and body are inextricably linked, and bereavement can have physical effects too:

• Loss of appetite or an urge to over-eat
• Hypersensitivity to noise, light, smells
• Breathlessness or a sense of having a stone in the chestWeakness or light-headedness
• Problems sleeping
• Visual or auditory hallucinations

The last symptom is very common, where the bereaved person feels that the deceased is present, may hear their voice, laughter or smell their scent or imagine that they see them in a crowd.  Our senses do play tricks on us, particularly in traumatic situations such as bereavement.

Bereavement can have an impact on our day-to-day behaviour. You may experience:

• Restlessness and over-activity
• Visiting places the deceased may have liked
• Sitting in their bedroom for long periods of time
• Absent-mindedness or a feeling of not being in complete control

Many of these will pass with time. If any become chronic or start affecting the health of the bereaved person, medical help is advised.

• Try to regulate your sleep if it becomes an issue
• Take care of your health as best you can
• Be gentle with yourself, acknowledge that you need to be patient
• Leave major decisions until you begin to feel more like yourself
• Accept help from friends particularly practical help such as meal preparation, a lift to work etc
• Use whatever resources help, but be wary of mediums or spiritualists
• If rituals help, such as visiting the grave, going on a favourite walk or lighting a candle, do embrace them.

Life does go on.  Grief is not something you “get over”, rather it becomes part of you that will become integrated into who you are. To grieve indicates that you cared about the deceased, and it is an entirely natural reaction. 

There will always be memories and anniversaries, but eventually you will adapt to a changed life with different relationships and perspectives. If you feel you cannot move on, please seek help as acute, unaddressed grief can be detrimental to both mental and physical health.