Understanding grief and bereavement after loss

Sudden loss in the midst of the current pandemic may be particularly traumatic

Friday, July 17 2020

The loss of a loved one is an intensely painful and devastating experience, and may often feel unreal. While grief and bereavement are experienced differently by everyone, there are some common aspects that may be helpful to understand, and to help one to eventually cope better with loss. 

“It is not only the passing of a loved one that leads to feelings of loss. People also experience grief in other events, for example when a relationship ends, or one loses a job or possessions such as one’s house as a result of financial difficulties. These instances have become increasingly common during the current COVID-19 pandemic,” says Megan Hosking, psychiatric intake clinician at Akeso mental health facilities.

Stages of grief and bereavement
“The most widely recognised stages of grief were first described by Dr Elizabeth Kübler-Ross, who was a Swiss-American psychiatrist. While these stages are often presented as a linear process, it is most important to realise that they are not meant to create neat and tidy packages for emotions, and do not necessarily follow in this order for everyone.

“Individuals experience each of the stages of grief and bereavement differently, and the length of time that each stage may last also varies from one individual to the next. A person who grieves may also move backwards and forwards between the stages of the grieving process,” she explains.

  • Denial

The first emotion many people experience following a loss is a state of shock and denial. Things may not feel real, make any sense, and the reality of the loss will not yet have set in. Denial may result in a person carrying on with life as though the loss has not happened and not feel the emotions associated with the loss.

  • Anger

Anger can often feel endless; one may feel angry at others – the deceased person, one’s family, the circumstances, the health system, doctors, their employer other people, and even a higher power. Feelings of regret and guilt (whether perceived or real) often manifest as anger against others who one thinks may have contributed to, or caused, their loss.

  • Bargaining

One may try to make arrangements, promises or bargain with others or a higher power to try and ‘reverse’ the loss, minimise one’s own sense of being harmed. This often happens when relationships end and one tries to get their partner ‘back’.

  • Depression

This stage is often where reality starts to set in and a person moves their attention to the present situation. One may feel intense sadness, want to withdraw from others, or feel like doing nothing. Depression as a stage of grief is not the same as depression as a diagnosable mental health illness. A state of depression following the loss of a loved one or other significant loss is a normal and appropriate response, and often with time, will transition into a space of acceptance.

  • Acceptance

Acceptance does not mean that everything suddenly feels right again, or that you are completely healed or ‘okay’ with the loss you have suffered. This stage is more about realising that life without your loved one or in your changed situation is the way things are going to be, and learning to live with that – even though it will still hurt, and you may still feel intense sadness or feel the loss daily.

Sudden loss
According to Hosking losing a loved one suddenly, as may be the case with the current COVID-19 pandemic, can be very traumatic and is also often experienced differently to a loss following a long-term illness or an expected loss. 

“There is no time to prepare for the loss, and often one may not have their full support system around. There may be lots of questions about the loss, the circumstances leading up to it, and what happened, and feelings of shock may last longer,” Hosking says.

It is not uncommon following a sudden loss to experience strong emotional and physical responses, which can include:

  • Shock symptoms such as shaking, inability to move, stomach aches and headaches, exhaustion, and feeling on edge. These will usually pass after a few days; if they don’t, one should seek professional assistance.
  • Insomnia and nightmares.
  • Feeling alone and that no one understands you and what you are going through.
  • Anger and regret.

“Following a loss, feelings of sadness, desperation, guilt, anger, loneliness, difficulty sleeping, mood changes, appetite and energy changes are normal. However, if any of these emotions feel overwhelming or persist for a long time, then seeking professional help is a wise option,” Hosking advises.

Supporting a loved one
“If someone close to you has lost a loved one – partner, parent, child or friend – it can be challenging to know how to support them and care for them,” adds Sandy Lewis, head of therapeutic services at Akeso.

“When talking about loss, one needs to be very mindful of one's words, as it is a sensitive situation for all involved, and emotions are heightened. The conversation and support largely depend on the person experiencing the loss, your relationship with them, and their current circumstances,” she notes.

When talking to someone who has experienced a loss, saying the following may be helpful to express support:

  • “I am so sorry for your loss”
  • “I don’t know how you feel, but I am here to help in any way I can”
  • “You and your loved one are in my thoughts and prayers”
  • “I am just a phone call away” or “I am up early or late if you need anything”
  • “My favourite memory of your loved one is…”

It is important to avoid saying things like:

  • “At least he/she lived a long life, many people die young” (if an elderly person has passed)
  • “Only the good die young” (for a young person)
  • “He/she is in a better place”
  • “There is a reason for everything”
  • “I know how you feel”
  • “Just be strong”
  • “It’s for the best” (if the person who has passed had suffered seriously)

“Be supportive but do not try to fix the loss or the situation,” Lewis advises. “Don’t tell people what to do or feel – even if you have experienced loss, remember that your experience is not the same as theirs. Recognise the loss and what it means to the person, and don’t put a time-frame on how long they can grieve.”

“Other ways of showing support include making sure the person is safe, that their basic needs such as food are met, helping with their other responsibilities such as answering messages or paying bills, sending them a virtual hug if a real one is not possible in this time. However, involve them in decision-making where possible,” Lewis concludes.

Ends

About the Akeso Group
Akeso is a group of private in-patient mental health facilities, and is part of the Netcare Group. Akeso provides individual, integrated and family-oriented treatment in specialised in-patient treatment facilities, for a range of psychiatric, psychological and substance use conditions. Please visit www.akeso.co.za, or contact (011) 430 1890 for further information. In the event of a psychological crisis, please call 0861 435 787 for assistance.

For more information on this media release, contact MNA at the contact details listed below.

Issued by:           MNA on behalf of Akeso mental health facilities
Contact:               Martina Nicholson, Graeme Swinney, and Meggan Saville
Telephone:        (011) 469 3016
Email:                   martina@mnapr.co.za, graeme@mnapr.co.za or meggan@mnapr.co.za