Written By Philippa Walsh
Bereavement in context
Loss is a universal experience. Whether it is felt through a redundancy, a bankruptcy, the breakdown of a relationship or a bereavement; no individual is immune from it.
While loss is not generally welcomed; losing an aspect of our lives or someone that was meaningful to us, is considered to be a normal part of the human condition.
Due to it's finality, bereavement can be described as the ultimate loss and has long been thought of as one of life's most stressful events.
As a direct consequence of its irreversibly, those left behind may experience a number of cognitive, emotional and social difficulties. Collectively recognised as grief, these difficulties can be viewed as the price we pay for for forming loving attachments to others.
Common feelings after loss
When we lose someone, there is no right or wrong way to feel. Every bereavement is unique and can therefore provoke a wide spectrum of different emotions.
Some of the more common ones we may experience are shock, numbness, a sense of yearning, anger, agitation, guilt, sadness or even relief (depending on the relationship with the person prior to their death or the circumstances of the death).
Immediately after the death of a loved one, it is not unusual to feel stunned or a sense of disbelief - even if the death was expected as a result of illness.
Emotional numbness (resulting from the loss not having fully been processed), can actually help us get through the practical arrangements that need to be made, such as informing others and organising the funeral.
If this feeling persists beyond 6 to 12 months post-loss however, this can be indicative of a more prolonged grief reaction in which professional support may prove beneficial.
For many individuals, the funeral is when the reality of the loss starts to be acknowledged. It can be a very distressing time and there might be an initial desire not to attend. You must do what feels right for you, but be aware that this decision may lead to regret later.
Once the sense of emotional numbness has passed, this may be replaced by agitation, or a deep yearning for your loved one or friend. This may result in a period of anxiety, disturbed sleep or lack of concentration. It is common to feel agitated for several weeks after the death.
Often this can be followed by a period of intense sadness or depression, leading to social withdrawal and introspection.This is completely normal. Those who do not feel any intense emotions and are able to get on with their life fairly quickly, should not be judged negatively.
The grief process is not linear, fixed or the same for everyone. Loss is a unique experience, you should not feel ashamed for not outwardly expressing grief, or coping 'well enough'.
You may continue to feel the 'presence' of the person you lost, as places and objects continue to remind you of them. It is typical to feel anger at this time. You may feel angry towards the healthcare or other professionals who were unable to prevent the death, friends and relatives who didn't do enough, or even towards the person who has passed away, for leaving you without them.
Another common feeling is guilt. You may find yourself thinking about things that you didn't get the chance to say or do prior to the death. You may even believe yourself responsible for the loss and feel that you should have prevented it yourself.
On the whole, death is usually beyond anyone's control and you may need to remind yourself of this. If your loved one or friend passed away after a distressing illness, you may feel guilty if you feel relieved that they no longer have to suffer.
To feel relief is natural, understandable and common. In circumstances in which your relationship with the deceased was difficult - such as losing an abusive partner; it is very common to feel relief.
A bereavement can be a bewildering time, in which you may oscillate between one emotion and another or feel several conflicting emotions at once. It is not uncommon to feel tearful, angry or relieved all at the same time. During this time, it may be that you wish to be alone to process the loss and your feelings about it.
This type of reflection is essential in order to accept the reality of the death and to come to terms with what's happened. Be mindful that talking to a supportive friend or relative can also help once you've been able to identify some of your feelings. It is not uncommon to feel a 'burden' to family, but going through grief completely alone can be very challenging.
How long is it 'normal' to grieve for?
As time goes on, the acute pain of loss usually begins to fade. It may become possible to think about other things and look to the future. Despite this, the sense of having lost someone important does not go away entirely. There may be ongoing reminders of the loss, in seeing other people together with their loved ones and media images of 'perfect' families. In time, the pain of this will lessen.
Recovery from a major bereavement usually occurs within one or two years. The final phase of grieving is one in which you are able to integrate the loss into your life story and feel able to rebuild a life around it. The depression will usually fade and sleep and concentration levels should return to normal. If you suffered from low libido immediately post-loss, this will usually recover.
Remember that there is no one way of processing and recovering from bereavement. Culture, religion, the circumstances of the loss and your relationship with the deceased prior to their death, will all play a part in how you grieve.
If the loss occurred in particularly traumatic or ambivalent circumstances, bereavement can be prolonged or delayed beyond 1 to 2 years. The loss of an unborn child through miscarriage or still birth, the loss of an infant or adult child, and loss through suicide or homicide are such examples.
Having to certify a missing person dead, or not having a loved one's body found following an accident or homicide can also be intolerably painful. Conversely, the death of a loved one who had dementia or a brain injury can also be particularly distressing. Losing someone who was physically present, but emotionally absent can lead to some very conflicting feelings.
When to seek professional support
Whilst the majority of people are able to recover from a bereavement without the need for any formal intervention, it is estimated that around 10% of the bereaved population struggle.
The acute emotions and sense of disbelief normally associated with the early days of loss, may become relentless and persist for a number of years beyond the death.
This debilitating and enduring form of grief is widely referred to as prolonged grief disorder (PGD), with symptoms manifesting in two areas: separation distress and traumatic distress.
Typical of separation distress is an ongoing yearning to be with the deceased and a preoccupation with memories leading to loneliness and feelings of isolation. Traumatic distress is indicated by feeling that life lacks meaning, the avoidance of loss reminders, numbing, ongoing shock and disbelief at the loss and feelings of hopelessness.
It is important to seek bereavement support BEFORE your grief reaches this point. Whilst bereavement counselling can interfere with the natural grieving process if undertaken too early (within 3 to 6 months of loss), it is important not to suffer in silence if you feel unable to cope and have no one supportive to talk to.
Practical tips after a bereavement
- Do not make important financial, domestic, career or personal decisions immediately after your loss. Wait until you have processed how you feel and are able to focus with clarity.
- Do seek professional guidance if you have lost someone that you are financially dependent on. Free services such as Cruse Bereavement Care or the Citizen's Advice Bureau may be able to advise you on where you stand and how to proceed.
- Try not to feel a 'burden' on family and friends. if they avoid talking about the deceased, this is usually because they do not wish to upset you. Talking about the person can be painful, but helps.
- It might be tempting to withdraw from your usual social activities and hobbies; but try to maintain some sense of routine as much as you are able. This can take several weeks, but completely withdrawing from everything can lead to a further state of depression.
- Try not to increase your drinking during this time. It can be appealing numbing out your feelings; but will only delay the grieving process which needs to be experienced in order to recover.
- Remember to eat little and often if you feel unable to eat your usual meals. Your body needs fuel to process what you're going through. It takes mental and physical energy to do the practical tasks following the death of a loved one.
- Try and get outside and go for a walk - even if this is something you find challenging or is an activity you used to do with the person you lost. Staying in and closing yourself off to the outside world can intensify and prolong feelings of isolation.
- If you are struggling to sleep, understand that this is normal and will usually correct itself after a little time. If this has continued for several weeks and it is impacting on your day to day functioning, discuss this with your GP who will decide if medication is appropriate. You may also choose to read my article on 'Get a Better Sleep'.