Loss occurs in may
forms, death of a loved one, parent, child or friend, break-up of a
relationship, separation from those we love, loss of a beloved pet and leaving
a home full of memories when you move house. When we experience the
loss of someone we love we can feel confused and part of the suffering comes
from striving for clarity whilst trying to make sense of everything that is
happening.
Why did this happen?
What went wrong?
Why did they die? As
if death could have been controlled.
How can I go on?
Because life is about
searching for meaning and making sense of the world around us a close personal
death and traumatic loss brings a need to for order and reason. In my own experience after
the death of my husband I could not see the future. I was desperate to find a
clear path and find meaning and order and felt frightened by the lack of
structure. A grieving person can
experience a clouded mind and heart interspersed with clear moments of lucidity.
However at the same time ones mind is crowded with self doubts and uncertainty.
Perhaps life is truly
meant to be directionless? Maybe each one of us is fumbles our way down
corridors without end, one merging into the next. Each scrabbling down gravel paths, grasping
for foot holds, reaching out blindly for something solid to hold on to but
finding only shifting ground.
My first husband Alan died over eleven years ago and up to his diagnosis and subsequent death I thought I knew where I was going and life felt
reasonably secure. I realise however that uncertainty is a part of grief and
insecurity becomes a part of the daily survival. This was something I could
never have anticipated. As a psychotherapist I have become over the years self aware and
during my phases of grief I travelled very slowly through the process taking
two steps forward and one step back.
Coming to terms with
the reality of his death was the early part of the path I travelled and even
though each step involves expressing painful emotions and struggling with the
emptiness inside every so often I would touch something that brought meaning back
into my life. However that dissolves slowly like a carved figure in ice. At the
time of moulding it bore shape and substance, but as the days past its once sharp
edges became blurred as it melted against the heat of any new found hope.
During the first year
after the death of any loved one it seems as if one is thrashing around for a
place to rest, yet there seems nothing to rest on. Nothing seems solid enough
to sustain you, maybe wishing you had died as well whilst also afraid to die.
When someone we love
dies we are thrown into a surreal world where everything looks different and
yet remains the same. In many ways those first weeks of bereavement can be
likened to having a psychotic breakdown where the world has changed around you,
the people you knew are not the same and the only person who understands your
reality is you.
When someone you love
is dying before your eyes, in a terminal illness for example; it is difficult
not to be sucked down the dark tunnel to the unknown, clinging on to the hands
of someone who hangs over a cliff edge, knowing they cannot return, being the
one to let go because you have no choice, feeling fingers stretching to hold
onto the loved one as they make the rest of the journey alone. Wanting to go
and yet wanting to stay in the world, fighting the invisible force that is
death as it waits to take the life they hold.
As a young
woman I was a nurse and came very close to those who were dying, to those whose
loved ones were dying and to those who were left behind. Years later as a
psychotherapist, I worked with individuals who wanted to die, who find
the world difficult to be in and life hard to manage. I have worked with the
grief stricken and the recently bereaved. However the closest I have stood next
to death was seeing my husband die of terminal cancer and face his own death. I
recall being on watch for the moment of death, and waiting for the right time
to say goodbye. Even though I wanted to stay with my husband and did not want
him to leave me we had to let go of each other as his time drew nearer. His not
wanting to leave was the greatest pain I have ever experienced; his not wanting
to die caused me the greatest suffering. His fear of the unknown and having to
go there without me was the most dreadful fact I have ever held. He used to say
that death did not frighten him but the passing through the process of dying did! That is familiar to most of us I think.
We humans suffer an
internal conflict that rests somewhere inside between the concept of living and
dying. It is a daily event to experience the possibility of death or be next to
areas alluding to death. It waits with its unknown quality around every corner
and when individuals are faced with it and feel its alien presence, some
respond overtly with calm assurance, ‘yes’ it comes to all of us. Whilst others
struggle with the dilemma, it’s not about me,
and it’s not my turn and I intend to live a long time.
It is familiar to
catch and absorb glimpses of the wonders of life as we see, feel and touch the beauties
of nature. Sunset on an autumn evening and the early morning song of a thrush
form your roof top, only to merely ponder upon the mysteries of death, we do
not want to look it in the eye lest it notice us. It is not easy to come to
grips with living and existing alongside the permanence of death and the
anxiety it brings.
Death Anxiety runs through
our tissues, a bodily occupation popping in and out of conscious awareness.
Like the feel of a missed heart beat or a mishap that shocks us into conscious
reality. We are confronted by it day by day, both in fantasy and reality,
within our relationships and by the media. It is offered with its starkness as a
regular diet. Something we are forced to eat even though it may make us sick.
We have to chew on the toughness of the meat even when vegetarian.
We live in a society
that is conditioned to deny death, hidden and talked about behind closed doors.
‘Guilty for dying and unsure how to live’ (Lang )
In our society we do
not fully succeed in defending against death but we humans encompass a basic
psychological defence; denial. Denial means
non-communication, disguising death in encoded messages and doing very little
to decode it. So often we collude with others to avoid discussion. Some pass
over the subject of death as if a swear word, too disgusting for family members
to hear. When a loved one is ill, injured or there is a terminal condition in
the family there are those amongst us who use expressions like, ‘hope’ and
‘lets not cross that bridge’ in order not to feel and to pretend that death will
not occur. Covering the ears of our children should they have to know of its
certainty too soon? Sadly for those who are
grieving, the space where they are tolerated may be limited by fears of
infection.
Loss is painful, and
if undelt with, reinforces denial which helps stifle the pain and reality.
Patterns of learned behaviour in relation to dealing with painful feelings are handed
down through families, misguided methods on route to protection. Denial itself
is a protective mechanism, a method of self support when little or no holding was
offered in times of need and loss as children. Denial may be encouraged in
order to protect those who are afraid of the emotions surrounding loss. Shushes
and silence fill the gaps of awkwardness when unspoken instructions are given
not to speak of ‘conditions’ or ‘illness’.
When an individual is
faced with the loss of a loved one they have to contend with their own
historical patterns of behaviour about dealing with it. How loss and death were
dealt with in the family will be the legacy and coping mechanism from those who
have gone before. Familial methods will be the base line coping strategy. Conscious awareness of
illness, injury or death in others often arouses feelings of loss and
depression; it opens up a path of vulnerability and helplessness; bringing a
sense of impermanence and instability to the world around.
It can be seen in many
forms in someone who has experienced bereavement.
Living for the
children
Being constantly on
the go
Hyperactivity, which helps
keep the pain at bay
Suppression of tears and
breath holding
These are also
indications of the early stages of grief but if they continue indefinitely then
it moves more into the category of avoidance.
When someone is not
willing to fully express feelings of grief there are generally symptoms of some
kind. These can be either psychological or physiological.
Physical symptoms may
manifest in the form of aches and pains at the least, and at worst peptic ulcers,
heart conditions, blood pressure etc.
Psychological symptoms
might be seen as vehement self reproaches, emptiness, phobic behaviours and
suicidal attempts.
When we avoid grief it
lies deep within, only to manifest at some stage later in life. Suppressing the
pain of loss takes up a great deal of emotional and psychic energy which
eventually leads to exhaustion.
When grief becomes
chronic the individual is obsessed with thoughts of the dead person, unable to
think about anything else. For example, the bereaved person keeps the bedroom
as a shrine, clothes in the wardrobe and photographs everywhere. Those with
chronic grief can also isolate themselves and will not take support from
friends and family.
For some bereaved
there is a natural urge to isolate, but again, when it progresses beyond
healthy it becomes chronic. This can be identified when the grieving person is
unwilling and unable to acquire new skills and move on, this means they are
unable to reinvest energy into other people and form new ways of being and new
relationships. There is a fine balance between healthy and chronic.
Death anxiety comes in
day to day ways of being but also we are forced to look at our own mortality
when we are faced with the concept of our own loss or someone else’s.
Death anxiety is a
form of anticipatory loss, a fear of death itself which is forced into
conscious awareness bringing the true sense of life and its impermanence, its
fragility in our daily lives.
We cope with this in
two major ways Primarily bringing it
fully into our conscious awareness by working with those who are dying, or with
religion. Believing in life after death helps us face the fear of the unknown.
Imagining our loved ones waiting for us helps us cope with the sense of
emptiness that comes with the anticipation of our own death. Foreseeing another
life after this one eases the fear and insecurity that surrounds death.
Secondly, not facing the concept of death at all, keeping it in the recesses of
the mind to avoid there being nothing else, this way the individual can avoid
facing the unknown quality of death, thus making communication about it conscious,
and unconscious, direct or disguised.It seems that for many
of us, we manage the death anxiety as short term, mobilising the obliterating defence
of denial that prevents the disruptive element of our mortality from arising. However
there are others of us who face death each day and manage it but still only in
short bursts.
Death is inherent in all living creatures a
struggle goes on between creation and destruction, operating in harmony or in
opposition. John Bowlby has written much about attachment and the significance
of mourning in childhood, and tenuous or disorganized systems that influence
the child’s urge to adapt and stay attached to the original carers it is later
that is work was brought in line with motivation to live thus striving to live.
Much of psychotherapy is working with early anxious attachment and anticipatory
loss influencing adult here and now relationships. When an individual comes to terms with the
early death anxiety and acceptance that everything must end and die attachments
and ambivalence in attachments would seem to diminish. It is the fear of
endings based upon death anxiety that instills fear of loss because it may
incur death itself; within a child it is more likely to be fear for survival
itself.
Finally when we allow the concept of death
to invade our conscious awareness there is nothing to fear in forming new attachment
because loss is inevitable in all things. In the theory of bereavement an
individual who comes to terms with the early death anxiety accepts everything
must end. Allowing the concept of death to invade the conscious awareness makes
fear of attachment meaningless.
