Watching a television news report of serious flooding recently I was concerned to hear the way in which a priest described people’s distress. “I actually saw a grown man in tears,” he said. Why shouldn’t a grown man be in tears? What message was that priest conveying to the millions watching? That things needed to be pretty awful for a grown man to cry? That men should not cry? That men are different to women? What is a grown man?
In my work with bereaved people I see so many people who are afraid of their feelings, who are embarrassed to cry and think they should be strong – whatever that means! Plus everyone around them is reinforcing the same message.
So let’s get a few things straight: When awful things happen to people they will be distressed – that is normal. They may rage, cry, scream, sob, be stunned into shock, disbelief and silence and a whole range of other emotions. These are all normal reactions to bereavement and are a healthy way to express the myriad of painful feelings that we all feel when we lose someone dear to us. They can go on for a long time – often years. They might resurface on anniversaries, birthdays or, for young people who have lost a parent, on important days such as a wedding day or the birth of a first child. When grieving, men are no different from women or children and will experience the same feelings, their emotions are not numbed or reduced in some way. What do we mean when we tell people to be strong? Don’t cry? Don’t show your feelings? These are almost certainly not helpful concepts. To suppress or hold back emotional reactions can prolong or deepen people’s distress. Often the last thing that the bereaved person feels is strong so to tell them that they must be can leave them feeling as if they are abnormal or failing in some way. Bereavement is messy. Our feelings and behaviour can be confusing, chaotic and contradictory and that is to be expected. Those around the bereaved can want to tidy things up such as wanting to stop the distress or crying. People can find themselves being persuaded to dispose of clothes and belongings with the well meaning, but ultimately unhelpful advice, “to stop you being reminded of him”. We use euphemisms like ‘passed away’ instead of died, or even, increasingly, ‘passed’.
As I write this looking out of my window, my postman has just passed – but I’m pretty sure he’s not dead! We often use euphemistic language as it’s easier for us to say. It may not be easier or helpful for the bereaved person who is struggling to accept the reality of the loss.
Not talking about a person’s distress or avoiding tears is not helpful and likely to create hurt and isolation. The bereaved person has not forgotten that their loved one has died and you are not reminding them when you bring up their name. You are expressing love and care by showing them that you remember the person who has died and how significant they were.
If only we could break down some of these misconceptions a lot of my work would be unnecessary. Often the work of the bereavement counsellor is to provide a safe space for those who are grieving to express their sadness, to tolerate their despair without trying to stop it and most importantly to reassure them that their reactions are normal and they are not going mad. People might say to me, “I wish they had taken me with them.” Those around them might say, “don’t be silly, don’t talk like that, you’ve got your children.” They already know that.
They just need to be allowed to say things that might feel impossible to say elsewhere. Just to respond by saying, “that sounds really tough” or “I can see how sad you are” might be enough.
Over time most people learn to manage their grief and to integrate the deceased person into their emotional lives. This might take years. For many they might never “get over it” and this can be an unhelpful expectation. For close losses lives will always be changed, for example the loss of a child or a partner.
Finding ways to manage their loss and carry on with their changed lives in a meaningful way might be the best outcome for some.
Of course there is such a thing as complicated or prolonged grief that might necessitate the intervention of skilled help. A counsellor or GP, in the case of depression that would benefit from anti-depressants, might be helpful. Complicated or prolonged grief might manifest itself by the distress continuing for many years, long term depression (depression is normal and common in the bereaved and not necessarily a cause for alarm), the inability to take part in normal activities, ongoing mental health issues such as agoraphobia, eating disorders or self harm, an inability to invest in other relationships, such as a parent with their children after the death of a spouse, and high levels of distress much of the time.
There are factors that we know predispose to a complicated or prolonged grief reaction and these include concurrent losses such as other bereavements, job loss, a hidden relationship such as an extramarital affair, same sex relationships, divorce, an ambivalent relationship with the deceased, pre-existing mental health issues, highly dependent relationships and suicide or violent death such as murder.
For those interested in the academic perspective of bereavement Colin Murray-Parkes, William Worden, Tony Walter, Elizabeth Kubler Ross and others have written much about the stages and tasks of bereavement. Stroebe and Schut have put forward a helpful Dual Process Model of Grief in which the bereaved needs to balance the expression of their feelings, as described above, with the practical need to invest in other relationships, return to work, manage or learn everyday tasks (perhaps how to use the lawnmower or washing machine) and establish a life in which the deceased has gone but is not forgotten.
In the end the words of Earl Grollman, Internationally recognised bereavement counsellor, perhaps summarise what I have been trying to say in a few words:
“Grief is not a disorder, a disease or a sign of weakness. It is an emotional, physical and spiritual necessity, the price you pay for love. The only cure for grief is to grieve.”
This article first appeared in More to Death the official magazine of the Natural Death Centre.
Peter Pitcher is a psychodynamic counsellor specialising in bereavement.