How To Handle Intense & Complicated Grief
In Part 1 of our series on Grief In The Time of Conflict, we looked at how to let go of grief, guilt and resentment after the loss of someone you had been in a conflict ridden relationship with. In Part 2, we look at how each individual’s grief can be unique and how to deal with it.
Each individual’s grief is unique, says Dr Sandip Deshpande, Consultant Psychiatrist, Director, People Tree Maarga Hospital. “For example, when a parent with five kids dies, each child will grieve differently depending on what his/ her unique relationship was with the deceased. All relationships have their challenges. There is usually a mixture of emotional response ranging from ‘good riddance’ to a ‘gap in one’s life’ to a ‘great sense of yearning’ to do the unfinished business to feeling ‘I wish I had not been so nasty to her…’ It is difficult to predict which way the journey would go. At times the survivors’ anger may even be channelized towards the caregiver or doctors. However, in every case our end goal is to get the survivor to healthy reorganised behaviour.”
Dr Sandip Deshpande speaks of one such case: A man in his early 50s, single, whose father had died early and who undertook the responsibility of caring for his mother even though he had four other siblings. On the mother’s first death anniversary, he made a serious suicide attempt. It turned out he had remained single due to the fear that his future wife would not accept his mother. And he had a highly enmeshed relationship with his mother. He suffered from clinical depression after her death, plagued by both guilt of omission and guilt of commission. He had his mother’s picture on his mobile screen and constantly looked at it for fear that he would forget her face. “Such intense grief reactions can usually be helped professionally in several different ways. Helping the client verbally sketch an accurate memory picture to see the good and the bad in the person to replace their own biased point of view; bereavement counsellors also do a companioning model where they take them through the journey of grief and bereavement and get them to look back at the good times they had or recreate factual details rather than hold anger. There’s also the empty chair technique, which for example helped a woman who was very angry with her husband and who she never told what she always wanted to say,” adds Dr Sandip Deshpande.
“Sometimes complicated grief can result in mummification as in the case of a wife who continued to charge the mobile phone of her husband even a year after he had died. She also set a place for him at dining table, would not allow anyone to sit in his chair and refused to dispose his belongings.”
Recognising The Signs
Is it possible for the family to sense that a survivor’s grief is showing pathological signs and needs professional help to heal? Dr Deshpande says that generally speaking if the relationship has been abusive or had suppressed hostility, or if the person has suffered multiple losses, or if the death itself was violent, or there have been previously unresolved losses then it could lead to pathological grief. This would show up in severely negative anniversary reactions, total denial of either facts of the loss or irreversibility of the loss, or mummification of the deceased’s things, as we saw earlier.
“We need to perceive that relationships are not only black or white, they span a spectrum and when a person dies it is okay to say he or she had certain qualities that I was not comfortable with. Usually the stock response to death of a person is to idolise him or her but it may not always apply and that’s okay too,” Dr Deshpande adds.
For the large part we have been speaking about couples’ loss because by the time one of the couple dies they have often spent more time with each other than with their own parents. However, several other relationships may also cause complicated grief, for example when an estranged adult child dies. Along with the grief and guilt on the death of an adult child the parent will often feel anger that the child who walked away did not finally make the effort to come back. There is a sense that it was the adult child who walked away and it is also his responsibility to come back and this unfinished business can lead to complicated grief too. Again, what are the lessons for the living in this? While you are still healthy share your thoughts on how you want your body to be honoured after your death – buried/ cremated, by strict adherence to rituals, by creating your own rituals or by ignoring all ritual. Make a will that is clear about how you want your assets to be divided. When we have clarity on these crucial matters there is that much less opportunity for conflict and ambiguity in the survivors.
Steps to resolve complicated grief
John James and Russell Friedman in their book, The Grief Recovery Handbook, suggest writing a letter to the dead person detailing everything you wanted to say to him/ her: how did that person hurt you, what did you want from him/ her? Ask a trusted friend to listen to you read out the letter with total presence and absolute absence of judgement. Then make a conscious choice to let go of all the resentment and burn the letter. Experience the peace of letting go. Then write a letter to yourself detailing why you had felt angry and bitter, why you don’t feel the need to hang on to those emotions and how good it feels to be free of all those toxic emotions. Explore ways to live a happier life. It’s important to understand that each person’s grief is unique and complex and a different process may work for each individual.
The process of mourning
The Tasks based approach by William Worden
Task I: To Accept the reality of the Loss
Task II: To experience and process the pain of grief
Task III: To adjust to a world without the deceased (the external, internal and spiritual adjustments)
Task IV: To find an enduring connection with the deceased. Reinvest in the new reality: re-place not replace
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