Grief, loss and bereavement – What to expect. What to do.

What does bereavement feel like, emotionally and physically, and how can you help yourself during that time?

Bereavement happens to us all, and is not necessarily related to death (our own or someone else’s), but to situations and experiences coming to an end.  This can be distressing.

Loss and grief are normal feelings and phases we go through in life. It can be confusing, frightening, painful. Here are some explanations of what to expect and some self help suggestions.

I will focus on the experience of the death of another person. The points will still apply if you are grieving for another kind of loss (eg a relationship, job) or mourning your own health or life, if you are affected by a life-changing or life-shortening illness.

1. What is bereavement?

Bereavement is an emotional transition between loss and renewal.

We have choices how to manage this process. It might not feel or look like that to you at the beginning of the bereavement journey, which can be a very dark and lonely place indeed.

If you think about it, life is about things starting or coming to an end: our childhood, our teens, middle age, older age, time at school, moving house, town or country, relationships, jobs, illnesses, health and lives.

Our history of endings and the way they may have impacted us and the way we deal with it, all that is partly quite individual, and also depends on the society we were brought up and live in and the history and events that shape our life time.

2. Like with life, death can occur in so many circumstances:

• Some deaths are expected and we can prepare for them.

• Other deaths are unexpected and come as a shock.

• Deaths can be self-inflicted, due to natural causes, disasters or lives taken by others.

• We may have a lot of information about what has happened, or not.

• There may be a body, or not.

• We may find out immediately, or not for some time.

• We may have been in regular contact with the person, or not.

• We may have parted on good terms, or not.

• The person who has died may have lived with us or been in a relationship with us for a long time.

• There may have been good times, there may have been difficult times.

• We may be sad about their death, we may (also) feel a sense of relief.

The circumstances can vary so much.

3. What do bereavement, loss and grief feel like?

While your experience of bereavement is as individual as you, there are also common themes that apply to us all:

• We all move through bereavement stages, not necessarily in the same order or at the same speed.

• The length and intensity of the overall experience depend on the nature of the loss and the nature of our relationship with the person who has died, the timing of death, our support network, our previous experiences of death and loss.

• Bereavement does not necessarily get more easy or difficult the more we experience it.

• It can remain just as painful and devastating.

• However, we can develop an inner trust, that the pain will lessen with time, and that we can continue to live in the knowledge that we will emotionally survive the loss and pain.

4. Look at bereavement as a process

Then you may end up feeling less overwhelmed and with a greater sense of control, and are less at risk of getting stuck in these difficult and often dark places.

It may give you hope and trust that you can survive these emotions and develop an attitude and view on things, that might be helpful to you in your life with and beyond bereavement.

While this does not bring back the person or circumstances you may have lost, or reverse your health situation, it can help you feel more settled and emotionally strengthened.

Let me take you through it.

5. What does this mean in practice?

i. Emotional signs of bereavement

The sensation of bereavement immediately after we learn of the death can be mental, emotional and physical – like an electric shock, combined with feeling sick and breathless.

In that moment, which can stretch over days, weeks, even months, which can diminish and return from nowhere, in that moment not much else matters.

We do not have room for anything else, mentally or emotionally. We are all consumed by the feeling of being bereft and struggling to comprehend or accept the reality of what has happened.

• We feel denial: “This cannot have happened. How? It is impossible.”

• In the world of disbelief we can feel isolated and isolate ourselves from others, who seem to move on, and tell us time is a great healer, that we will get over it, that death is part of life. But at that moment, it seems nothing can help; it all feels alien.

• We may try and make sense of what has happened.

• We may be angry with the person who has died and left us behind. We are angry with others and ourselves.

• We may bargain and blame, in an attempt to gain some control of the situation: “If only I had… If only s/he had… Why didn’t I…”

• We may feel depressed, numb, lack motivation and feel overwhelmed.  Our energy, emotional and often physical strength is weakened. We may feel vulnerable and sensitive.

• Practical issues around funerals or burials and other arrangements can feel overwhelming and may cause anxiety.

• Everything is too much, even our usual routines, and we are afraid we can no longer cope.

• We may miss the other, are regularly confronted with reminders of them (photos, smells, clothing, letters, emails, food, a song, a location, a walk, an argument and so much more depending on the nature of the relationship), especially if we have lived or worked together.

• Places, where we spent a lot of time (eg our homes) together, are constant reminders of their presence or lack of, and a way of life that has also come to an end.

Gradually we may start facing up to the reality that the other has died and that we continue living without them. We learn to accept and bear the pain with greater calmness than depression.

ii. Physical signs of bereavement

I have already talked a bit about the initial shock. You may also experience any of the following physical symptoms, which can occur particularly, if the death itself, the way you experienced and the impact it has on your life, is difficult and traumatic.

• Shock and stress reactions, like being on high alert, with stress easily triggered. You may feel jumpy, have a twitchy eye, tense muscles etc.

• Your breathing may change and may become more shallow and laboured. A reduced intake of oxygen can lead to dizziness.

• You may experience chest pain.

• Heightened anxiety, a semi/permanent state of flight or fight, may lead to heart racing, hypersensitivity of the senses (eg noise intrusion), stomach-churning and constipation, feeling sweaty.

• You may experience tension headaches, difficulty in focussing and holding concentration, disturbed sleep.

• Your appetite and eating habits may change, which may lead to weight gain or loss.

• Overall you may feel more tired and need more energy than before for your daily routines.

• All this and more can impact your immune system and leave you more vulnerable.

6. Some suggestion of how you can help yourself

Dealing with the emotional and physical aspects of bereavement can be very individual.

Some people prefer for a time to avoid reminders of the person and their death.  Others create their own meaningful ways of support, rituals, comfort and closeness. None of this is set in stone, and it can change over time.

i. Emotional Self Care

It is important you decide which, if any, of the following is helpful to you. This is not an exhaustive list and you may have your own, very different, ideas. What is important, is that you follow your intuition, and make time for dealing with emotions.

• Visiting a grave or other place of meaning regularly,

• Taking a regular walk that would have been shared in the past,

• Speaking with the deceased (in our head or out loud),

• Meditate, pray or engage in any other religious or spiritual activities,

• Wearing an item that belonged to them (e.g. a ring or watch),

• Taking an item of their clothing to bed, looking at pictures, letters, listening to music and more.

• Keep a diary, draw or be creative in other ways.

• Speak with someone about how you feel: a trusted friend, a counsellor or therapist.

• Identifying activities that help you stay calm and grounded (music, meditation, being quiet etc).

ii. Physical Self Care

Again, this list is not exhaustive, and you may feel that you are better off doing other things.  That is ok, as long as you pay attention to your body, and take care.

• For as long as you need, reduce stress, responsibilities and obligations.

• Have plenty of rest.

• Keep an eye on your diet, your alcohol intake if you drink, your smoking if you smoke and any other ways of self-medication and attempts to numb the pain. This will only delay the real grief recovery and may lead to additional physical and emotional complications.

• Have a daily routine.

• Boost your immune system with the right nutrition and the support of other alternative therapies.

• Spend time outside, in nature, and do some moderate exercise, like a walk.

7. Overall

In cases where we mourn the death of another, the bereavement journey takes at least one year, while we go through various anniversaries or annual events of meaning to us, which we can no longer share with the person who has died.

Having read sofar, you may be forgiven for feeling overwhelmed. Is bereavement an impossible mountain to climb and come down from again? Do not despair. You do not have to remember it all, and this is not intended to be a 10 point list to adhere to, or you fail.

As I said before, the experience of bereavement will be individual to you.

You may not believe it now, but you will know what is best for you, if you allow your inner wisdom some space to guide you.

Try to avoid blocking your bereavement process by holding on to negative thoughts. When you notice these thoughts and feelings, then notice them, as a bystander might notice a breeze or storm pass by. We do not expect the storm to stay forever.

We may have to do some repairs and some things will never be the same again, but we can survive.

(This post was first published by PsychReg.)