Coping with loss and bereavement

Coping with loss and bereavement

Every time there is a significant change in our lives, such as loss and bereavement, we experience a range of feelings. It can be a confusing and frightening time. Understanding loss and bereavement can help with the grieving, and to understand what is happening. Coping with loss and bereavement is an important step forward.

The terms loss, bereavement, grief and mourning are explained below:

 

  • If bereavement is what happens to you, grief is how you feel and react.
  • If bereavement is a wound, grief is the inflammation that follows.  It causes pain, swelling and disturbance of function.  It can last a long time and may leave scars.  However, it is the process by which healing occurs.
  • Mourning is what you do.  It is vital to have something to do, to have a ritual to follow so that there is a recognised role for everyone concerned.  Mourning can help to allow reality to be faced. (Wilson R, 1993)

JOURNEY OF GRIEF

In her book ‘Through Grief – The Bereavement Journey’  Elizabeth Collick says “There is no way round grief, only a way through”.  In other words there is no escape from it. Every bereaved individual needs to follow their own unique journey of grief. The only way to understand what the death means to someone is to allow them to share their feelings, experience and their needs. This can be done with

The actual death of someone close may be just one aspect of the difficulties of bereavement. It can be complicated or feel deeper from other factors. Such as person’s personality or background; their relationship with the dead person; the circumstances of the death/how they died; and the bereaved person’s recovery environment.

THE WHIRLPOOL OF GRIEF 

A good way to understand the grief journey is explained by Dr Richard Wilson’s visual picture Whirlpool of grief’. The picture below shows an oarsman rowing along the ‘River of Life’. When they experience the death of someone who is close to them, they are  plunged down the ‘Waterfall of Bereavement’ otherwise known as the ‘Whirlpool of Grief’.

“Coming down the waterfall represents a sudden disruption to one’s life, which may have been flowing along quite smoothly up to this point.  It represents shock and numbness.  The whirlpool represents the emotional upheaval and disorganisation that follows (anger, guilt, anxiety, etc.).  being ‘all washed up’ on the banks of the river could represent ‘being stuck’ and unable to move on.  Before being able to progress one would have to get back into the whirlpool and experience the emotional turmoil.  With gradual acceptance of the loss, one would be able to move along the river of life again.”

 THE TASKS OF GRIEVING or MOURNING

Professor William Worden (1991) stresses that mourning, which he defines as the emotional process that occurs after a loss, is an essential and necessarily painful healing process, which is achieved through a series of tasks.

‘Tasks of Mourning’

  • To accept the reality of the loss
  • To work through (experience) the pain of grief
  • To adjust to the environment in which the deceased person is missing
  • To emotionally relocate the deceased and move on with life

Facing Reality

When someone dies, even if the death is expected, there is often a sense that it hasn’t happened.  This first task is to fully comprehend the reality that the person is dead, that they are gone and will not return.  There is likely to be an initial state of shock and numbness, sometimes manifesting itself as uncontrollable crying/hysteria or the antithesis of displaying no emotion at all, appearing very controlled, calm or detached.

This initial shock may last several days (sometimes much longer) and usually allows the bereaved to deal with all the necessary practicalities and cope with the funeral without losing control – a form of emotional protection.

Some people may not immediately be able to acknowledge what has happened and may cope by denying it or refusing to talk about it.  Being able to see the dead person, being involved as much as possible in the preparations for the funeral, and observing rituals and traditions, all assist people to face the reality of what has happened.  Families from ethnic minorities may need permission and support for the mourning rituals appropriate to their culture.

 Experiencing the pain of grief

As the numbed feeling gradually subsides and the reality of what has happened is experienced, the bereaved person may have intensely painful feelings, which may last weeks or months.  Their grief may overwhelm them so that they are incapable of thinking about anything or anybody else but themselves and how they feel.  It gets in the way of everything they think and do.  They may overreact to other people’s comments and appear irritable.

As well as feeling extreme sadness, the bereaved often experience guilt, anger and resentment.  Many people experience guilt with some aspect of their relationship with the dead person. Often people struggle with the things they have (or have not) said or done.  Maybe they had not spent enough time with them or really listened.

Feelings of anger can be extremely powerful.  The bereaved person may feel anger towards the dead person; anger for the loss of control that death brings; anger at the medical team for not curing the illness or keeping the dead person alive; and anger at God for letting it happen.  They may feel resentment of a family member who they feel contributed in some way to the death.

Adjusting to the environment without the deceased person

The new reality of facing life without someone you love is a difficult and painful process.  No one can fill the aching void the person has left and each day life brings constant reminders of their absence.  The future seems uncertain or even frightening and a tremendous effort is required to get through every day.  It may take many months before the bereaved person is able to dwell less on the sad events surrounding the death and starts to function more as they did before the loss.

Reinvesting in the future

This involves moving on to a new way of life without the dead person, whilst holding on to memories.  It is a way of reinvesting in life again alongside the knowledge that the dead person will never be forgotten.  This can often feel like a betrayal and is perhaps the most difficult task of all.

The bereaved are able to:-

Have a sense of resurrection

  • Put their sadness aside
  • Look to the future, whilst recalling happy times spent with the person who has died
  • Find comfort and pleasure in their memories.
  • Life becomes more meaningful and they regain a sense of control

It is normal at anniversaries for feelings of grief to be aroused again and to be as vivid as on the day the death occurred but this settles more quickly and becomes less painful.

Grief is not a mental illness, although sleeplessness, anxiety, fear, anger and a preoccupation with self can all add up to a feeling of ‘going mad’.  These feelings are natural and when experienced and expressed will become less frequent and begin to subside over time.  Talking about them and bringing them into the open is helpful.  Expressing grief is cathartic and attempts to short circuit these feelings rarely help in the long term and may cause deep seated problems in the years ahead.  If grief is denied, or anger and guilt persist to the exclusion of other feelings, counselling can help to address these issues.

Other posts talking about loss and bereavement are:

Painful place called Bereavement

Six Steps to dealing with bereavement

Let;s talk about dying and bereavement

Dealing with loss or bereavment

Birds have anxiety

A new acquisition in our therapy room that I rent from cornerstone has been the book All birds have anxiety by Kathy Hoopmann. This anxiety book is there for clients to browse at. All birds have anxiety is aimed at children but I feel it is an useful and fun read for anyone experiencing anxiety or wanting to find out what anxiety is all about. It is written in an easy to understand language with just the right empathy and even with some humour.

If your child is suffering from anxiety, its important to start a conversation with your child about stress and anxiety. A great way to start this is through a book. Birds have anxiety so why can’t we?

The book clearly is a guide to help children understand what it means to have anxiety. Sometimes anxiety is good if it helps us achieve our goals but when anxiety stops us doing things on a day to day basis, we need to find coping strateiges to try to help control the anxiety. The anxiety coping techniques touches upon some useful CBT techniques but in a friendly approachable way – cuddling a pet, eating well and exercise.

As you can see from the picture of on the right each page is full of bright and beautiful pictures of bird. These natural birds are photographed in what can appear as an anxious state to help illustrate what it feels like when we’re anxious.

The author, Katty, then cleverly uses captions of words to go alongside these pictures. It is a book that can encourage a child to talk about anxiety and to help them understand any of their friends who experience anxiety too.

 


Heres some feedback from clients and friends children:

It helps me understand that I am not alone, one client recently commented to me, and helps me reflect when my anxiety is a problem to stopping me doing things.’

I was struck by the pictures and related phrases to certain birds. The owl says anxiety is not my fault and it will not rule me. The bird with spikey hairs says it isn’t the end of the world if i make mistakes’

A humouous way to explain anxiety. I need a pet to hug!

Other books which can help children overcome anxiety are:

For Young children

What to do when you worry too much – A kids guide to overcome anxiety
Cool cats, calm kids by Mary Williams
Wilma Jean the worry machine by Juilia cook

And a helpful video for young children

For teenagers
Stress 101
Anxiety sucks
Anxiety survival guide for teenagers
A still quiet place for teens

Hazel has moved

Hazel has moved to 59 Wostenholme Road….

In February this year, Hazel moved her counselling practice from Wainwright Thearpy Centre to 59 Wosteholme Road. Hazel has stayed in Sheffield and remains in Netheredge (S7).

The beginning…

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Building a positive relationship between supervisor and supervisee

Positive Supervisee Relationship

A positive relationship between supervisor and supervisee is important. Millar, Holloway and Henderson (2014) say that encouragement is at the heart of a counselling supervisory relationship. They emphasise the need to build an equal relationship. So how is a positive relationship between supervisor and supervisee achieved?

Maintaining ethics

A contract between the counsellor and supervisor is essential. Not only does it ensure boundaries are kept but enables a solid working alliance between the supervisor and supervisee. A contract should be underpinned by an ethical framework, such as the BACP framework. This allows the supervisee to explore freely their fears and reflections on their work. Additionally it encourages the supervisor to reflect in-depth on whether they are maintaining a balance between taking appropriate responsibility for the supervisees work and the clients well being. Alongside this supervisors need to question themselves to whether they are competent to supervise the work. The ethical framework encourages good practice on both sides.

Working partnership

A cooperative working partnership is essential. It enables the supervisee to inspire to be the best counsellor and ensure the supervisor guides the counsellor to reflect rather than ‘police’ the supervisees’ work. Yes, the supervisor will have more experience but she/he must not show inferiority or superiority or it will destroy the balance of the relationship. It is not helpful for the supervisor to always say ‘this is how I do things’. Supervisors need to encourage supervisees to expose themselves to problematic issues to allow them to work their own way forward and to reflect on how they are doing. A supervisee does not want to be compared with their supervisors work or be told what to do. They want and need an equal professional relationship. This needs honesty on both sides. Both parties need to feel free to say how they are doing in their work (especially if it exposes vulnerabilities) and how they feel about the supervisory relationship. Challenges from both sides need to be embraced as an opportunity to grow rather than being seen as a criticism.

Explore and Reflect

Exploration and enabling the supervisee to explore what is going on is an important part of supervision. It is tempting as supervisor to respond with our own theories, interpretations and answers. However, supervisors need to encourage supervisees to explore and gain insight by asking respectful and leading questions. This helps supervisees conclude on their own to how they are doing and what they could do more effectively. Often questions that focus on past experiences, including positive ones can help encourage a new perspective.

Feedback……

can be helpful for a supervisee. Supervisors need to support the supervisee to have the courage to be imperfect. Honest, encouraging feedback will help educate and develop the supervisee. When we trained as counsellors we learnt about constructive feedback – always sandwich bad comments in between good ones. Supervisors need to do the same – highlight the counsellors strengths before presenting areas for development and change. When feeding back the negative, supervisors need to focus on what the person is doing rather than comparing or criticising. In other words avoiding words such as ‘unethical’, ‘non-empathetic’. Descriptive feedback allows the supervisee to see what they have been doing. It is always better to ask a supervisee if they would like to hear what your own views. Remember you want to keep the relationship equal.

Encouragement

Supervisors need to encourage the supervisee to assess their competencies and effectiveness. However, in addition they need to reflect on their own effectiveness. There needs to be opportunity for feedback on both sides. Also supervisors can reflect in their own supervision, as well as develop their own professional development.

A supervisory relationship needs to grow.

As Millar, Holloway and Henderson say…. We all have tendencies to move into judging and defensive positions at times, and we all make mistakes. When we can embrace these moments with compassion, it is gratifying to realise that they offer great opportunities for professional growth.

Anthea Millar, Jim Holloway, Penny Henderson ‘Becoming an encouraging Supervisor, Private Practice BACP, Spring 2014

Miller, Holloway & Henderson Practical Supervisor Helping Professions

Hazel is an experienced supervisor and presently has a free slot available for online supervision. Ring or text 07814 363855 for more details.

Learning from our mistakes

learning from our mistakesThis morning I was running late with Radio 2 playing in my car. Right Said Fred were playing Johnny Cash’s version of Ring of Fire live but unfortunately the lead singer, Fred, forgot the words. Not once but twice! As a listener it didn’t matter to me. However, I did wonder how Fred felt. He was laughing but considering there are over 7 million listeners Continue reading

Help, my Mum and Dad are toxic and causing too much pain. How do I let go?

Help, my Mum and Dad are toxic and causing too much pain. How do I let go?

Help Mum and Dad are toxicClients often battle over society’s pressure that you must look after their parents versus the fact their Mum and Dad is toxic and malicious and causing them too much pain. The guilt of this keeps them maintaining a relationship with your parents, even if it draining to them. This in turn causes them Continue reading