Bereavement – what to expect
Introduction
Bereavement is a distressing but common experience. Sooner or later most
of us will suffer the death of someone close to us. Yet in our everyday life we
think and talk about death very little. So, we do not have much of a chance to
learn about grieving – how it feels, how to cope with it, what is “normal”.
The subject of death is often taboo, and those who
have been bereaved may feel they ought to hide
their feelings, not wishing to burden other family or
friends. However, evidence has shown that
adjustment is easier if the person feels free to
express their grief, and has access to practical
advice and support if needed.
What is grief?
Grief is the way we feel following a loss or bereavement. It is a normal
process which allows people to gradually adjust to their loss. If the death is
expected, relatives and friends may find themselves grieving even before the
death has occurred. They will grieve for what they have already lost and what
they expect to lose.
Grief is not just one feeling, but a whole succession of feelings, which can
take longer than expected to get through and which cannot be hurried. It is
common for these feelings to ebb and flow over a very long period of time,
whilst those around you may think “you should be over this by now”. Some
common experiences of grief are described below.
Shock
In the few hours or days following the death of a close relative or friend, most
people simply feel stunned, as though they cannot believe it has actually
happened, even if it was expected. This sense of emotional numbness can
be a help in getting through all the important practical arrangements that have
to be made, such as getting in touch with relatives and organising the funeral.
However, this feeling of unreality may become a problem if it goes on too
long. Seeing the body of the dead person may, for some, be an important
way of beginning to overcome this. Similarly, for many people, the funeral or
memorial service is an occasion when the reality of what has happened starts
to sink in. It may be distressing to see the body or attend the funeral, but
these are ways of saying goodbye to those we love.
The pain of grief
Feelings of numbness can soon be replaced by a sense of agitation, of pining
or yearning for the dead person. There can be a feeling of wanting somehow
Health Psychology Department
Gloucestershire Royal NHS Trust
to find them, even though this is clearly impossible. Other physical sensations
can include chest pain, dizziness, weakness and insomnia.
Bereaved people sometimes worry that these symptoms are a sign that they
are going mad. This is certainly not the case. However, grieving does require
an enormous amount of energy and mental effort with the result that bereaved
people can often find themselves too physically and mentally exhausted to
concentrate on anything. They may feel confused and forgetful and appear
easily distracted. Making the simplest of decisions can be overwhelming at
this time.
Disturbing images and nightmares
Events before, during and after the death can remain riveted in the mind of the
bereaved as though watching a video over and over. It may be that the brain
is trying to make sense of what is happened by continually replaying events in
an attempt to resolve it.
Some people feel that they “see” their loved one everywhere they go – in the
street, the park, around the house, anywhere they had spent time together.
These are strong memories of the person who has died and can help some
bereaved people to cope following the death.
Usually with time these images or nightmares lessen in frequency and are
less disturbing to the individual.
Difficult emotions
People often feel very angry at this time – towards doctors
and nurses who did not do enough, or even towards the
person who has left them. Another common feeling is guilt.
People find themselves going over in their minds all the things
they would have liked to have said or done, as they realise it
is too late to complete all that “unfinished” business. They
may even consider what they could have done differently that
might have prevented the death. Of course, death is usually
beyond anyone’s control and a bereaved person may need to
be reminded of this. Guilt may also arise if a sense of relief is felt when
someone has died after a particularly painful or distressing illness. This
feeling of relief is natural, extremely understandable and very common.
Thinking about the future without the deceased person can feel very
frightening, and for some this can result in anxiety or panic, particularly if the
bereaved person was very dependent, either practically or emotionally, on the
person who has died.
The sense of loss
In between states of agitation can be times of quiet sadness or depression,
withdrawal and silence. These sudden changes of emotion can be confusing
to the bereaved person, as well as to friends and relatives, but are just part of
the normal way of passing through the different stages of grief.
Health Psychology Department
Gloucestershire Royal NHS Trust
Although the agitation lessens over time, spasms of grief can occur at any
time, triggered by people, places or things that bring back memories of the
dead person. Other people may find it difficult to understand or embarrassing
when the bereaved person suddenly bursts into tears for no obvious reason.
At this stage it may be tempting to keep away from other people who do not
fully understand or share the grief. However, avoiding others can bring more
problems in the long-term, and it is usually best to start to return to one’s
normal activities as soon as feels comfortable.
In the meantime, the bereaved person may find themselves spending quiet
times thinking about the person they have lost, going over again and again
both the good times and the bad times they had together, and this is an
essential part of adjusting to the death.
Moving forward
As time passes, the fierce pain of early bereavement should begin to fade.
The sadness lessens and it becomes possible to think about other things and
even to look again to the future. However, the sense of having lost a part of
oneself never goes away entirely. Years later you may sometimes find
yourself talking as though he or she were still here with you.
These various stages of grieving often overlap and show themselves in
different ways in different people. The way we grieve often depends on the
nature of our relationship with the person who has died, the circumstances of
the death, and our previous experience of loss. If a relationship was confused
in life, chances are it will remain so after death. A sudden or untimely death
may understandably complicate the bereavement, as there has been no time
to prepare for the loss.
Remember that there is no “standard” way of
grieving. We are all individuals and have our
own particular ways of grieving.
Health Psychology Department
Gloucestershire Royal NHS Trust
Bereavement – How people cope
Once the initial shock and numbness recede bereaved individuals will have to
make choices about how they are going to cope with what has happened to
them.
At times people will let themselves be confronted by their loss and will react
by crying, remembering and thinking about the person who has died. At other
times, they will choose to be distracted by other tasks such as cooking,
washing or attending to any number of daily activities.
Bereaved individuals may feel surprised that soon after the death they find
themselves washing-up or gardening as if nothing terrible has happened.
They may feel odd about doing everyday things at such a time. Something
may then remind them of the person who has died and they find themselves
remembering something and crying in response.
It may be that this way of coping allows bereaved individuals to limit the
amount of pain experienced by balancing it with day-to-day activities. They
work through their grief in small, manageable steps at a
pace that suits them.
The important thing is to keep grieving and distraction
balanced. If the bereaved person is completely
preoccupied with grieving for the deceased, the balance is
disturbed, and that person may suffer as a result of
neglecting important tasks. Equally, the bereaved person
may be avoiding grief by focusing completely on the hereand-now. This imbalance may interfere with the healthy progression of the
grieving process.
This balancing act is ongoing and ever changing. As time goes by, it will
become more important for individuals to focus on learning new skills, and
make plans for the future. They may begin to take on some of the roles once
held by the deceased person, or find new people to fill some roles. This can
range from learning how to mend a fuse, to finding someone to share a day
out with.
It can be unhelpful to consider bereavement as something which one must
“get over” or “come to terms with”. We can’t expect someone who has been
bereaved to get back to being the same person they were before, as their life
will always be affected by the experience they have gone through in some
way. Hopefully however, they will gradually begin to be able to integrate the
loss into their lives and move forward.
Health Psychology Department
Gloucestershire Royal NHS Trust