Bereavement and Loss

When someone suffers the loss of a person or thing that was close to them they may experience a sense of grief or bereavement.  This is a very natural response when something we are attached to, disappears from our lives.  We often associate this feeling with the death of a loved one but it can also be experienced at other times, for example divorce, the loss of a job, or having to move away from the place that is familiar to you.   Some types of loss can be particularly difficult to cope with as they are often seen as less important in our society, for example miscarriage, stillbirth or the death of a beloved animal.  People might not understand the depth of feeling that the sufferer is experiencing and will sometimes tell them to 'pull themselves together' and 'move on'.

Loss can also be felt about an event which is anticipated but has not yet happened, for example children growing up and leaving home, the ageing process, or when a person or animal is given a terminal diagnosis and they and their family try to come to terms with the fact that they will probably die sooner than they had expected to.

Everyone's experience of grief is highly personal and is based upon their unique perception of the situation (Shapiro, 1993).  Events trigger different reactions in different people and our responses to trauma and emotional shock can vary hugely.  They can also depend on our past experiences, beliefs and values.  In addition they can be influenced by the other things going on in our lives at the time which can result in us feeling particularly vulnerable or sensitive.  However there are a range of common emotions that people experience.  These include feelings of sadness, anger, guilt, anxiety, loneliness, fatigue, helplessness, shock, yearning, emancipation, relief and numbness. 

People can also experience a range of physical sensations such as tightness in the chest and throat, hollowness in the stomach and breathlessness.  Thought patterns can be affected too, resulting in disbelief, confusion, preoccupation, hallucinations and a sense of the presence of the lost person or object.  These might then lead to a range of behaviours including lack of sleeping, appetite disturbances, absentmindedness, social withdrawal, dreams of the deceased, avoiding reminders of the deceased, searching, calling out, sighing, restless overactivity, crying, visiting places or carrying objects that remind the survivor of the deceased and treasuring objects that belonged to the deceased (Worden, 2005; Geldard & Geldard, 2001; Bowlby 1980).

Dr Elisabeth Kübler-Ross, who pioneered methods in the support and counselling of personal trauma, grief and grieving, proposed a model of the five stages of grief (denial, anger, bargaining, depression, acceptance).  This is actually a model for change generally and as such can help people to understand and deal with personal reaction to trauma.  It is not limited to death and dying. 

Dr Kübler-Ross's book, On Death and Dying (1969) was quite revolutionary at the time and was a catalyst towards changing previously held beliefs that bereavement should not be discussed and that death is a taboo subject.  This was very gratefully received by carers and by people who were dying or who had been bereaved, perhaps indicating the level of denial and suppression that had existed previously.  Dr Kübler-Ross gave people 'permission' to feel their feelings and to talk about them openly, perhaps for the first time.

The 'Grief Cycle' was never intended to be a rigid series of sequential or uniformly timed steps. It's a model or a framework rather than a process.  A model is less specific - more of a shape or guide.  People do not always experience all of the five 'grief cycle' stages.  Some stages might be revisited.  Some stages might not be experienced at all.  Transition between stages can be more of an ebb and flow, rather than a progression.  The five stages are not linear; neither are they equal in their experience.  People's grief, and other reactions to emotional trauma, are as individual as a fingerprint.

This model is useful because it recognises that people have to pass through their own individual journey of coming to terms with death and bereavement (and other kinds of loss), after which they usually reach an acceptance of reality, which then enables them to cope.  When we know more about what is happening and why we are experiencing these sometimes strange and frightening sensations, it often makes life easier.

The 'grief cycle':

1. Denial - Denial is a conscious or unconscious refusal to accept facts, information, reality, etc., relating to the situation concerned. It's a defence mechanism and perfectly natural. Some people can become locked in this stage when dealing with a traumatic change that can be ignored. Death of course is not particularly easy to avoid or evade indefinitely.
    
2. Anger - Anger can manifest in different ways. People dealing with emotional upset can be angry with themselves, and/or with others, especially those close to them. Knowing this helps keep detached and non-judgemental when experiencing the anger of someone who is very upset.
    
3. Bargaining - Traditionally the bargaining stage for people facing death can involve attempting to bargain with whatever God the person believes in. People facing less serious trauma can bargain or seek to negotiate a compromise. For example "Can we still be friends?.." when facing a break-up. Bargaining rarely provides a sustainable solution, especially if it's a matter of life or death.
    
4. Depression - Also referred to as preparatory grieving. In a way it's the dress rehearsal or the practice run for the 'aftermath' although this stage means different things depending on whom it involves. It's a sort of acceptance with emotional attachment. It's natural to feel sadness and regret, fear, uncertainty, etc. It shows that the person has at least begun to accept the reality.
    
5. Acceptance - Again this stage definitely varies according to the person's situation, although broadly it is an indication that there is some emotional detachment and objectivity. People dying can enter this stage a long time before the people they leave behind, who must necessarily pass through their own individual stages of dealing with the grief.

There are several different ways that a person can be supported through their grief.  GPs have traditionally often prescribed medication such as antidepressants though they are now more aware of the benefits of providing the person with the opportunity to talk to someone who understands.  They might therefore prescribe a course of Grief Counselling.  People might also be encouraged to make sure they get enough exercise, spend some time out of doors in the fresh air and natural light, and also to eat properly and try to get sufficient sleep.  Our animal companions can also suffer from grief following loss of a guardian or animal friend which can lead to behavioural changes such as being withdrawn, depressed or refusing to eat.  They too need exercise, a healthy diet and time outdoors. 

In addition there are various complementary or alternative therapies that can also support both people and animals in times of loss.  Homeopathy includes several possible grief remedies, the most appropriate depending on the person / animal, their symptoms and the situation.  Some of these are listed below:

• Ignatia - This is the first remedy a Homeopathic Practitioner thinks of when someone has suffered the loss of a loved one.  This remedy often applies when there are symptoms of a lump in the throat, spasms in the body, feelings of disappointment in your life’s dreams, and an overall feeling that you must keep your grief suppressed and under control.
• Natrum Muriaticum - This remedy is often indicated in a romantic loss in very introverted people who hold everything in.  They feel the loss as a breaking in half of their own identity.  They will cry horribly while alone, looking at pictures and listening to music, yet dread to show their feelings in public.  This Homeopathic remedy is especially indicated in cases where long term illness progressed from the loss.
• Arnica - is a remedy indicated where the loss was perceived as a blow.  Often this is a financial loss such as a job or investment crash.  In this case you would feel hurt, bruised, and tender and not want to engage with the hard world.  The opposite could be the case when you toughen up and engage life in a blunt forceful manner in order to regain what you lost.
• Magneseum Muriaticum - This remedy can be indicated after the loss of a care giver where you feel abandoned and forsaken, left on your own and unable to fend for yourself.  This can be accompanied with digestive ailments.
• Phosphoric Acid: for those exhausted from grief. They cannot perceive information as well as before. Debility comes from grief, mental shock, unhappy love, homesickness or even bad news. They will give short answers and they dislike talking. They may say that 'life is useless' and everything feels 'dark'. The biggest characteristic of someone needed Phos Acid is indifference to the things that they used to love.
• Causticum:  for those suffering a weakened nervous system and connective tissues. There is often a history of slowly progressive debility, stiffness, and even paralysis. The 'Causticum' personality is serious, intense and sensitive and often overly sympathetic. This is especially true when hearing of unfortunate people, animals or events.

Bach Flower Remedies can also be helpful for those experiencing bereavement.  These are some essences that can be used:

• Rescue Remedy – this is a combination of 6 essences that restore clarity and calm, and reduce panic and shock. Rescue is a good choice for survivors whenever death has occurred suddenly and unexpectedly, as well as when the individual has passed after a long, physically and/or emotionally arduous period.
   
• Water Violet –specifically indicated for the processing of grief. This is called for when the person / animal withdraws from company, seeking solace in isolation. It will typically will bring on a short-term release of tears as grief is released and processed.
   
• Honeysuckle –for those who pine away for lost loved ones, living overmuch in the memory of what was. Honeysuckle helps regain normal, healthy remembrance while allowing one to move on and face the present hopefully.
   
• Gorse –when the person seems to have lost hope.
   
• Gentian – the flower essence for setbacks.  Some individuals are prone to taking difficult life events to heart, and losing faith that life is overall good.
   
• Olive –for exhaustion. Olive restores emotional energy, and in doing so, improves the ability to regain physical energy and stamina.
   
• Hornbeam – an excellent choice when grief drains one’s enthusiasm about life.
   
• Star of Bethlehem – the remedy specifically for shock, pain, and numbness brought on by trauma.
   
• Elm –for overwhelm. Indicated when this loss has added yet another strain, and the individual appears hard pressed to handle one more thing. Elm restores stamina.
   
• Mimulus – the remedy for fears, a not uncommon response to loss.  Mimulus increases courage in the face of uncertainty.
   
• Aspen – the essence for anxiety.  Aspen reduces apprehension.
   
• Clematis – the remedy for the drifting, daydream-y, in your own world response that can be an avoidance of painful reality. Clematis restores mental clarity and presence of mind.

Other therapies include acupuncture and massage which can help to unblock 'stuck' energies helping people and animals to move on through their grief journey. 

Healing too can be very beneficial, not only after the person or animal has died but also, in the case of illness, as a support before and even at the death itself.  The healer needs to be clear that healing does not necessarily mean that a person or animal will be 'cured'.  In fact death can be the ultimate healing because the person or animal has been 'released' to move on.  The person might not be ready to see things in these terms but they can be encouraged to seek healing for their animal / friend / family member and themselves to give them a sense of peace, acceptance and love.

After the death the healer can give the person whatever time and space they need to explore their feelings in a safe and non-judgemental environment.  This can also be an opportunity for them to explore their beliefs around death and what happens beyond this.  Death can be seen as a natural part of the Cycle of Life.  It is not something to be feared or avoided and does not even have to be seen as the End - it is more of a transition.  Of course the person or animal is no longer here in the same form and we might be sad that we cannot interact with them in the same way but we be happy for them that they are no longer suffering and in time can reach a point where we can celebrate and remember fondly all the wonderful times we shared and be grateful for their presence in our lives.

References

• Shapiro, C.H. (1993). When Part of the Self Is Lost. San Francisco, CA: Jossey-Bass Inc.
• http://www.gotosee.co.uk/healtharticles/2011/03/bereavement-loss-grief-counselling-cheltenham/
• Geldard, D. & Geldard, K. (2005). Basic Personal Counselling: A Training Manual For Counsellors. NSW, Australia: Pearson Education.
• http://www.businessballs.com/elisabeth_kubler_ross_five_stages_of_grief.htm
• http://homeopathic-treatments.com/?p=171
• http://www.wellness-star.com/Homeopathy/homeopathy-grief.shtml
• http://www.aldaronessences.com/articles/Easing-Grief-With-Bach-Flower-Remedies.html#.U7p-xvldXrU