Grief

“I am sorry for your loss”

“My condolences”.

If we look for the statistics on any messaging app, these sentences have been used as much, in the last year and particularly in few weeks in India. as never before.

Covid-19 has affected each individual differently. And am not just talking about its mutant versions or its contrasting symptoms. Some have been directly affected by the virus gasping for oxygen, some who lost their loved ones to mourn and left in bereavement. The Covid impact on a mourner is not just that the person lost a loved one but also he has survived the dreadful infection leaving him with the infection fatigue.

Mourning is the process through which a bereaved person comes to terms with the loss. While we condolence the bereaved for the loss, the loss isn’t the general ‘lost and found. The loss in death is permanent. And this permanency makes the person grieve more and possibly lifelong.

UNDERSTANDING THE MOURNING PROCESS

Grief is universal. It affects everybody and everyone goes through different phases of mourning.

• The first phase is usually numb. The person becomes numb for a brief period of time. The numbness helps the person to do what has to be done immediately.
• The second phase is where the person has an intense feeling of longing for the loss. He/she wants the person to return and starts to see the permanency in the loss.
• Phase three is where the person has difficulty in functioning with the environment and seeks help and solidarity with the loved ones.
• And finally enters a phase where the person forms an organized behavior with the environment pulling self back to normal work.

Grief is how we respond to bereavement.

Grief represents a departure from the state of health and well-being, and just as healing is necessary for the physiological realm to bring the body back into homeostatic balance, a brief period is likewise needed to return the mourner to a similar state of psychological equilibrium. – Engel

Grief Counselling

Whenever the phone rings and one learns that a loved one has died unexpectedly, it creates a sense of unreality, which may last a long time. It is not unusual for the survivor to feel numb and to walk around in a daze following such a loss.

If you want to understand how someone will respond to a loss, you need to know something about the deceased. Kinship identifies the dead person’s relationship to the survivor. Such a relationship could be that of a spouse, child, parent, sibling, another relative, friend, or lover. A grandparent who dies of natural causes will probably be grieved differently than a sibling killed in a car accident.

How the person died has an impact on how the survivor deals with the various tasks of mourning. Traditionally, deaths are cataloged under the NASH categories: natural, accidental, suicidal, and homicidal. The accidental death of a child may be grieved differently than the natural death of an older person, whose death would be seen as occurring at a more appropriate time

People are losing several loved ones in a single tragic event or a relatively short period. When such multiple losses occur, there is the possibility of bereavement overload. There is too much grief and pain, and the person is unable to manage feelings associated with the second task of mourning. Intervention requires exploring each loss individually, beginning with the least complicated, looking at what has been lost, and gradually jump-starting the grieving process.

More important than the mere availability of support is the mourner’s perception of social support and satisfaction with it. Research has shown numerous examples where support was available but the person defined it as less than satisfactory. Social integration—the time spent with others and utilization of social support (confiding in others)—are two dimensions that go into support satisfaction
Social role involvements. Involvement in multiple roles has been found to affect adjustment to a loss by death. Persons who participate in more and varied social roles seem to adjust better to lose than those who don’t. Some roles measured in the research include those of parent, employee, friend, and relative, as well as involvement in community, religions, and political groups
Any counseling or therapy should be based on a solid theoretical understanding of human personality and behavior, not be merely a set of techniques. However, there are several techniques useful in doing grief counseling.

Writing

Have the survivor write a letter or letters expressing thoughts and feelings to the deceased. This can help survivors take care of unfinished business by expressing the things that they need to say to the deceased.
Extensive letter writing, including writing a farewell letter to the deceased. Translating experiences into language and constructing a coherent narrative of the event enables thoughts and feelings to be integrated, sometimes leading to a sense of resolution and fewer negative feelings associated with the experience. Keeping a journal of one’s grief experience or writing poetry can also facilitate the expression of feelings and lend personal meaning to the experience of loss.

Cognitive Restructuring

Cognitive restructuring may be necessary because our thoughts influence our feelings, particularly the covert thoughts and self-talk that constantly go on in our minds. By helping the client identify these thoughts and reality test them for accuracy or overgeneralization, the counselor can help to lessen the dysphoric feelings triggered by certain irrational thoughts such as “No one will ever love me again,” a thought that is certainly not provable in the present.

Certain special features should be considered in work with the survivors of those who die a sudden death.

A sudden death usually leaves survivors with a sense of unreality about the loss.

Whenever the phone rings and one learns that a loved one has died it creates a sense of unreality, which may last a long time. It is often found in cases of sudden losses has to do with the exacerbation of feelings of guilt. Feelings of guilt are common following any type of death. However, in the case of a sudden death, there is often a strong sense of guilt expressed in “if only” statements such as “If only I could have got the Oxygen on time,” or “If only I had been with him./her” One of the main issues of counseling intervention is to focus on this sense of culpability and help the survivor reality test the issues of responsibility.

Another feature of sudden death is the sense of helplessness that
it elicits on the part of the survivor. This type of death is an assault on our
sense of power and on our sense of orderliness. Often this helplessness is linked with an incredible sense of rage, and it is not unusual for the survivor to want to vent his or her anger at someone. Occasionally, hospital personnel become the targets of violence or the survivor expresses a wish to kill certain people for having been involved in the death of a loved one. It is not uncommon to hear litigious accusations coming from survivors of those who die a sudden death.

THE USE OF MEDICATION

There has been considerable discussion about the use of medication in the management of acute normal grief. The consensus is that medication ought to be used sparingly and focused on giving relief from anxiety or from insomnia as opposed to providing relief from depressive symptoms

One benchmark of mourning moving to completion is when the person is able to think of the deceased with less pain. There is always a sense of sadness when you think of someone you have loved and lost, but it is a different kind of sadness—it lacks the wrenching quality it previously had. One can think of the deceased without physical manifestations such as intense crying or feeling tightness in the chest. Also, mourning is finished when a person can reinvest his or her emotions into life and in the living.