Bereavement

The loss of a loved one through death is perhaps the most painful experience a human being can have: both painful to the bereaved and also painful to those who in turn have to watch that person’s suffering. What goes on in the grieving process and how can it go ‘wrong’?

Throughout this century psychologists and psychiatrists have tried to find a causal link between bereavement and mental illness. Grief and bereavement are, unavoidably, periods of intense emotional distress but the bereaved person often finds the behaviour that accompanies this distress painful in its own right. Much of this is normal, what psychologists recognize as ‘healthy’ grief. Occasionally, however, the process is less than healthy and can eventually lead to mental disturbance or breakdown.

The phases of mourning

Psychologists have divided mourning into four phases: numbness, yearning, despair and finally acceptance. Naturally the phases vary in length for different people; they may also interchange with each other unpredictably. Other important influences on this cycle of grief and mourning are the relationship of the bereaved to the deceased, and the circumstances of the death.

Death is usually easier to accept when someone has suffered a long and painful illness, or when the person has lived to a ripe old age. It is hardest to accept in circumstances such as a road accident, the death of a baby or when someone dies in early adulthood. The first phase of mourning is one of numbness. This can last for hours or even days, and often depends on how the news is broken. Many of those who have lost their husbands report a sense of being unable to comprehend the news, yet being overcome with intense outbursts of sorrow. The bereaved person may even appear to be in a state of shock. For this reason, it is obviously much better if there is a trusted friend or relative who can ‘take over’ and carry out such necessary formalities as registering the death and making the funeral arrangements. The second phase is one of yearning and searching for the dead person. As the reality of the death becomes fully understood, the bereaved person tends to be restless, and preoccupied with thoughts of the dead person. At this stage, widows have often spoken of sensing the presence of their dead spouse. Vivid dreams of the deceased person are common, with feelings of utter loneliness and desolation on waking. There may also be anger towards those felt to be responsible for the death, such as doctors and sometimes even themselves. Many psychologists believe that the acceptance of condolences from family and friends signifies the first full acceptance of the death.

Adjustment

A third phase – of despair – sets in as the victim of bereavement finds it necessary to adjust to the new situation. The more difficult this adjustment, the greater the likelihood of a chronic, and harmful, form of mourning setting in. Widows may have to take on the role of breadwinner or decision-maker; widowers to become comforter and housekeeper. Many have to come to terms with living on their own. The more successful this adjustment, the better the prognosis for coming out of mourning.

Socially the adjustment is harder. Most widows do not remarry. This is partly because of a shortage of suitable partners, but more because they avoid mixing with the opposite sex, which provides too painful a reminder of their loss.

Widowers, on the other hand, are more likely to remarry; they are generally more successful at meeting people and building a new life after the loss of a spouse.

Many widows have hallucinations of their dead husband years after the death. They often believe their husband is with them ‘in spirit’ and may have inner conversations with him. This is recognized as a healthy way of adjusting to the new situation. In other cultures, notably the Shinto and Buddhist religions, this process is encouraged because of the great respect in which family ancestors are held. Widows build altars to their dead husbands, and continue to seek their advice on family matters, so death is merely the transition from living person to revered ancestor.

Most cultures’ mourning rites have much in common. Despite religious differences, they serve the same functions: to help the acceptance of a death, to mark a period of recognition of grief and mourning and to bring ritual mourning to an end thus signifying the return to normality.

The acceptance of loss

Although most bereaved people do reach a stage of acceptance – the fourth phase of mourning – the loss is sometimes never fully resolved. In a similar way, many divorced people refuse to give up the belief that they will one day be reunited with their partner, and many divorcees pass through the same stages of mourning as do bereaved people. The death of a child can be an agonizing experience for parents. For those with a terminally ill child, mourning begins at the time the condition is diagnosed; the period of yearning and searching is often a quest for a ‘miracle cure’ or the search for more information about the child’s disorder. The birth of a stillborn child is equally distressing, but many societies provide no means for the grief to be expressed. This is also true of families who experience the sudden death of an infant. Whatever the circumstances, it does seem that the experience of grief is essential. People who have difficulty in expressing their grief in bereavement have a higher incidence of subsequent mental breakdowns than those who grieve easily. This is where bereavement counselling can help: those who are in grief may be assisted in resolving their emotional difficulties and distress; and others may be encouraged to achieve the emotional release of grief necessary before they can return to a state of normality. Bereavement counsellors can assist and help people to overcome a mental block or some similar obstacle, so that the grieving process can run its natural and necessary course.