“This couldn’t happen to me,” “There’s only one way out - to shoot,” “Lord, if you cure me, then I promise...”, “It’s all useless.” Denial, Aggression, “magical” thinking, the desire to “bargain” for health from higher powers are not contradictory positions, but stages of the same process of recovery from injury. This article is not so much for people with disabilities themselves, but for those who are close to them. The author is a neuropsychologist at the Three Sisters Rehabilitation Center Natalya Smirnova.
Stage one. Psychological shock and denial
In the first hours and even days, the victim experiences a state of shock, when he cannot fully understand what happened. At this time, a person may seem completely calm and reserved. After the shock, panic can set in and the person is seized by all-encompassing fear and horror. The darkest prospects for the future are being built. But it's still hard to believe that this is actually happening.
The peculiarity of the psyche is such that when it comes into contact with such negative emotions, it seeks to defend itself and suppress them. From this moment on, denial of one’s trauma arises. “This can’t be!”, “This is not happening to me!”, “Why me?”. A person loses interest in everything that happens around him, wants to turn back time to fix everything, does not want to accept reality. The characteristic state is stiffness, tension, and a feeling of the unreality of what is happening. A person seems to “freeze” in this situation so as not to face painful reality.
A short-term state of denial is a natural defensive reaction, but if a person remains in this state for too long, then, firstly, he actually experiences severe chronic stress, and secondly, he loses precious time to fight for his health. Therefore, it is important for loved ones to help the injured person realize and accept the fact of the injury as quickly as possible.
The task of this period is to experience all the complex feelings that accompany a person when realizing what has happened. The main help during this period is emotional support. It is important to just be there, listen to all the experiences, without trying to distract the person from negative feelings and thoughts. To alleviate his condition, it is necessary to speak out, cry, and experience all the feelings. Only then will relief come and it will be possible to move to the next stage.
Stage two. Aggression
When a person has experienced a state of shock after what happened and finally realized what happened to him, he moves to the next stage of experiencing his trauma - aggressive. Here a state of unbearable mental pain appears, which turns into anger and aggression at the injustice of fate, at the possible culprits of what happened, at friends, at doctors, at caring medical personnel. There are frequent cases of auto-aggression, that is, blaming oneself for what happened. Attempts at self-injury and suicide are possible.
Close relatives and those caring for the patient suffer the most from aggressive outbreaks. It is they who, wanting the best, touch a person’s heartstrings, once again reminding him of his helplessness, constantly offering to help and do something for him. All this leads to the loss of warm relationships with loved ones. It is during this period that it seems to relatives that there is “something wrong” with the person’s psyche, that he is going crazy.
The most common mistake at the stage of aggression is the lack of restraint of the relatives themselves and the manifestation of aggression in response. When relatives are offended, they accuse the victim of ingratitude.
It is important to understand that indignation, embitterment, resentment, and the desire for revenge at this stage are quite natural. This reaction usually occurs when a person feels helpless, and these feelings must be respected in order for grief to be experienced. And the task of this stage is to experience these feelings. It is necessary not to extinguish aggression, but to accept and treat it with understanding as a necessary stage of experience.
Stage three. Bargaining or compromise stage
At this stage, the person does not yet fully understand the essence of his trauma. This is largely due to a lack of information about the characteristics of the injury and treatment. They try in every possible way to protect a person from negative emotions and do not initiate them into the intricacies of the treatment process and possible consequences.
This approach has a rational meaning, but there is another side that is not entirely correct. The patient underestimates the efforts that must be made to recover. The so-called “magical” thinking appears, and the person comes up with the idea that everything can still be fixed if you ask God / the Universe strongly, and everything will return to normal. Attempts to make a deal begin - with higher powers and with oneself.
The principle here is: “If I behave well, I will get better quickly.” A person turns to God and reads the so-called “deal prayers”: “Lord, if You correct the situation, I promise...”.
During this period, a person and his relatives may turn to various charlatan methods of treatment, dubious techniques of alternative medicine, psychics, etc. This desire to find a magical solution, i.e. a quick and easy way to “heal”. Naturally, a lot of worries and doubts about our actions arise: “Maybe we turned to the wrong doctor, he (she) was admitted to the wrong hospital?”; “Maybe he (she) should have been admitted to the hospital earlier?”; “If only I had done such and such, this wouldn’t have happened,” “Are the doctors (and nurses) telling me the truth?”
Don't kid yourself, trauma won't go away, either magically, miraculously, or in any other way. Only persistent and possibly long-term work on the victim’s own self, conscientious implementation of the recommendations of specialists and, of course, faith in success will help overcome the injury.
During this period, close people should not convince a person that shamans and healers will not help him. It is better to talk with him more about the successes that are occurring in his recovery, rejoice at the slightest progress and instill in the person confidence in his abilities and faith in a successful recovery.
Stage four. Depression
When a person has already gotten a little used to his grief and has “let off steam”, when reality is finally realized, the fourth stage begins - depressive. It is characterized by “withdrawal,” a feeling of alienation and isolation. Unresolved questions arise about plans for the future, about starting a family, about the possibility of further employment, etc. Without finding answers to these difficult questions, a person loses interest in what is happening around him, gives up and withdraws into himself, and stops communicating with loved ones.
This stage is the most difficult for both the victim and relatives. This is where people can get stuck for a long time. depression leads to loss of energy and a feeling of complete hopelessness. This period is very dangerous, as the patient loses motivation for treatment, being sure that all this is useless. This may be followed by a negative attitude towards rehabilitation and refusal to practice.
First of all, you need to realize that depression is a temporary period. Over time, a person will be able to look at his life completely differently. Until this happens, it is important to respect his feelings and not downplay their significance.
A very big misconception is that, not wanting to focus a person’s attention on unpleasant emotions, relatives try in every possible way to avoid topics about his difficult experiences. As a result, a person withdraws into himself and is left alone with his painful thoughts, thereby exacerbating the depressive state. If a person wants to talk about his feelings, then he needs to be listened to, trying to understand what and how he is experiencing. Speaking about his experiences, a person feels that he is not alone, that someone understands how difficult it is for him now. It’s like a joke, repeated several times, ceases to be funny: painful feelings, if you talk about them, cease to be so painful and scary, they lose their sharpness.
And then it is important to help a person bring some new meaning into his life, subordinating his everyday actions. Offer the person to do something new, taking into account physical limitations for a given period of time.
The depression stage is a natural stage of living with trauma. However, it is important to be attentive to the person's condition at this time, as this reaction can worsen and turn into pathological depression. When thoughts about suicide appear and a person begins to think about where and how he can commit it, he urgently needs to seek help from a specialist (psychologist, psychotherapist, psychiatrist). In cases of severe depression, treatment may be necessary with special medications - antidepressants, which can only be prescribed by a doctor.
Stage five. Acceptance, revaluation
If a person goes through all four stages normally, the result will be the stage of accepting his condition. All acute experiences are dulled, and they are replaced by emotional balance. A new period begins when a person learns to live independently in his new state.
Acceptance and reconciliation are not the same thing. Acceptance means understanding that life is not about having trauma. You can accept your trauma. A person never ceases to be that same person with his own positive goals in life, which can be realized if he just wants to.
Often only after difficult trials does a person understand what he previously spent his precious time and energy on. He realizes what is truly valuable and important, and refuses the unnecessary and unnecessary.
Unfortunately, not every patient reaches this final stage of accepting the disease. Very often, people “get stuck” for a long time at one of the stages if there is no proper support from loved ones and doctors, or they may return to previous stages if new psychological difficulties associated with their physical condition appear.
During this period, it is very important to continue to discuss with the person all his experiences, as well as help in making plans for the future. The future is easier to accept if it is at least somewhat predictable and controllable. Let there be more friends, close, sincere people around, interesting ideas and missions for which it is worth living and being happy!
1.1.2. Stages of bereavement
Let us move on to a detailed description of the dynamics of experiencing loss. Let's take as a basis the classic model of E. Kübler-Ross, since the vast majority of other models either start from it or have something in common with it. In foreign literature, an attempt has been made to correlate its stages with the names of the stages of grief proposed by other authors. We will follow a similar path with the intention of presenting a unified picture of grief from a time perspective, drawing on the observations and opinions of various researchers.
1. Shock and denial stage. In many cases, the news of the death of a loved one is akin to a strong blow that “stuns” the bereaved person and puts him in a state of shock. The strength of the psychological impact of the loss and, accordingly, the depth of the shock depends on many factors, in particular, on the degree of unexpectedness of what happened. However, even taking into account all the circumstances of an event, it can be difficult to predict the reaction to it. This may be a cry, motor excitement, or, on the contrary, numbness. Sometimes people have enough objective reasons to expect the death of a relative, and enough time to understand the situation and prepare for a possible misfortune. And yet the death of a family member comes as a surprise to them.
The state of psychological shock is characterized by a lack of full contact with the outside world and with oneself; a person acts like an automaton. At times it seems to him that he sees everything that is happening to him now in a nightmare. At the same time, feelings inexplicably disappear, as if they fall somewhere deep. Such “indifference” may seem strange to the person who has suffered a loss, and often offends the people around him and is regarded by them as selfishness. In fact, this imaginary emotional coldness, as a rule, hides deep shock at the loss and performs an adaptive function, protecting the individual from unbearable mental pain.
At this stage, various physiological and behavioral disorders are common: disturbances in appetite and sleep, muscle weakness, immobility or fidgety activity. A frozen facial expression, expressionless and slightly delayed speech are also observed.
The state of shock into which loss plunges a person at first also has its own dynamics. The numbness of people stunned by loss “may be broken from time to time by waves of suffering. During these periods of distress, which are often triggered by reminders of the deceased, they may feel agitated or powerless, cry, engage in aimless activities, or become preoccupied with thoughts or images associated with the deceased. Mourning rituals—the reception of friends, funeral preparations, and the funeral itself—often structure this time for people. They are rarely alone. Sometimes the feeling of numbness persists, causing the person to feel as if he is mechanically going through rituals.” Therefore, for those who have suffered a loss, the most difficult days are often the days after the funeral, when all the fuss associated with them is left behind, and the sudden emptiness that comes makes them feel the loss more acutely.
Simultaneously with shock or following it, there may be a denial of what happened, which has many faces in its manifestations. In the situation of losing a loved one, the relationship between shock and denial is somewhat different than in the situation of learning about a fatal disease. Because loss is more obvious, it is more shocking and more difficult to deny. According to F.E. Vasilyuk, at this phase “we are not dealing with the denial of the fact that “he (the deceased) is not here,” but with the denial of the fact that “I (the grieving) person is here.” A tragic event that has not happened is not allowed into the present, and it itself does not allow the present into the past.”
In its pure form, denial of the death of a loved one, when a person cannot believe that such a misfortune could happen, and it seems to him that “all this is not true,” is typical for cases of unexpected loss, especially if the body of the deceased has not been found. “It is normal for survivors to struggle with feelings of denial that arise in response to an accidental death if there is no sense of closure. These feelings may last for days or weeks and may even be accompanied by a feeling of hope." If loved ones are killed in a disaster, natural disaster, or terrorist attack, “in the early stages of grief, survivors may cling to the belief that their loved ones will be saved, even if rescue operations have already been completed. Or they may believe that the lost loved one is unconscious somewhere and cannot be contacted” (ibid.).
If the loss turns out to be too overwhelming, the subsequent state of shock and denial of what happened sometimes takes on paradoxical forms, forcing others to doubt the person’s mental health. However, this is not necessarily insanity. Most likely, the human psyche is simply unable to withstand the blow and seeks to isolate itself from the terrible reality for some time, creating an illusory world.
A case from one's life
The young woman died during childbirth, and her child also died. The mother of the deceased mother suffered a double loss: she lost both her daughter and her grandson, whose birth she was eagerly awaiting. Soon, her neighbors began to observe a strange sight every day: an elderly woman walking down the street with an empty stroller. Thinking that she had “lost her mind,” they approached her and asked to see the child, but she did not want to show her. Despite the fact that outwardly the woman’s behavior looked inadequate, in this case we cannot speak unequivocally about mental illness. Of course, we can assume that there was a reactive psychosis here. However, attaching this label in itself will advance us little in understanding the state of a grieving mother and at the same time a failed grandmother. The important thing is that at first she was probably unable to fully face the reality that had destroyed all her hopes, and tried to soften the blow by illusorily living out the desired, but unfulfilled, scenario. After some time, the woman stopped appearing on the street with a stroller.
In the case of a natural and relatively predictable death, explicit denial, such as disbelief that such a thing could happen, is not common. This served as a reason for R. Friedman and J. W. James to generally doubt that the grief process should begin to be considered with denial. However, here, apparently, the whole point is a terminological inconsistency. From the point of view of the terminology of psychological defenses, when speaking about the reaction to death, instead of the word “denial” in most cases it would be more correct to use the term “isolation”, meaning “a protective mechanism with the help of which the subject isolates a certain event, preventing it from becoming part of continuum of experience that is meaningful to him.” Nevertheless, the expression “denial of death” is already firmly rooted in psychological literature. Therefore, on the one hand, one has to put up with it, on the other hand, it should be understood not literally, but more broadly, extending to cases when a person is mentally aware of the loss that has occurred, but continues to live as before, as if nothing had happened. In addition, a discrepancy between the conscious and unconscious attitude towards loss can be considered as a manifestation of denial, when a person, on a conscious level, recognizes the fact of the death of a loved one, deep down in his soul cannot come to terms with it, and on an unconscious level continues to cling to the deceased, as if denying the fact his death. There are various variants of such mismatch.
Setting up for a meeting: a person catches himself waiting for the deceased to arrive at the usual time, looking for him with his eyes in a crowd of people or mistaking some other person for him. For a moment hope flares up in your chest, but in the next seconds the cruel reality brings disappointment.
Illusion of presence: a person thinks that he hears the voice of the deceased; in some cases (not necessary).
Continuation of communication: talking with the deceased as if he were nearby (or with his photograph), “slipping” into the past and reliving events associated with him. It is absolutely normal to communicate with the deceased in a dream.
“Forgetting” the loss: when planning the future, a person involuntarily counts on the deceased, and in everyday situations, out of habit, he proceeds from the fact that he is present nearby (for example, an extra cutlery is now placed on the table).
Cult of the deceased: keeping the room and belongings of a deceased relative intact, as if ready for the owner’s return.
A case from one's life
An elderly woman lost her husband, with whom they had lived a long life together. Her grief was so great that at first it turned out to be an unbearable burden for her. Unable to bear the separation, she hung his photographs all over the walls of their bedroom, and also filled the room with her husband’s things and especially his memorable gifts. As a result, the room turned into a kind of “museum of the deceased”, in which his widow lived. With such actions, the woman shocked her children and grandchildren, making them sad and terrified. They tried to persuade her to remove at least some things, but at first they were unsuccessful.
However, it soon became painful for her to be in such an environment, and in several stages she reduced the number of “exhibits”, so that in the end only one photograph and a couple of things that were especially dear to her heart remained in sight.
A metaphorically vivid and extremely pointed example of denying the death of a loved one is shown to us by the eastern parable “The Glass Sarcophagus,” told by N. Pezeshkyan.
“One eastern king had a wife of wondrous beauty, whom he loved more than anything in the world. Her beauty illuminated his life with radiance. When he was free from business, he wanted only one thing - to be near her. And suddenly the wife died and left the king in deep sadness. “For nothing and never,” he exclaimed, “I will not part with my beloved young wife, even if death has made her lovely features lifeless!” He ordered a glass sarcophagus with her body to be placed on a dais in the largest hall of the palace. He placed his bed next to him so as not to be separated from his beloved for even a minute. Being next to his deceased wife, he found his only consolation and peace.
But the summer was hot, and, despite the coolness in the palace chambers, the wife’s body gradually began to decompose. Disgusting spots appeared on the beautiful forehead of the deceased. Her wondrous face began to change color and swell day by day. The king, filled with love, did not notice this. Soon the sweetish smell of decomposition filled the entire hall, and none of the servants dared to go there without covering their noses. The upset king himself moved his bed to the next room. Despite the fact that all the windows were wide open, the smell of decay haunted him. Even the pink balm didn't help. Finally, he tied a green scarf around his nose, a sign of his royal dignity. But nothing helped. All his servants and friends left him. Only huge shiny black flies buzzed around. The king lost consciousness, and the doctor ordered him to be transferred to the large palace garden. When the king came to his senses, he felt a fresh breath of wind, the scent of roses delighted him, and the murmur of fountains pleased his ears. It seemed to him that his great love was still alive. A few days later, life and health returned to the king. He looked for a long time, thoughtfully, at the rose cup and suddenly remembered how beautiful his wife was when she was alive, and how disgusting her corpse became day by day. He picked a rose, placed it on the sarcophagus and ordered the servants to bury the body.”
Anyone who reads this story will probably find it fabulous. However, even in its specific content, it is not so far from reality, where similar episodes also occur (take at least the previous case from life), but not in such an exaggerated form. In addition, let's not limit ourselves to a literal understanding of history. Essentially, it talks about the natural tendency for those grieving to cling to the image of the deceased, its sometimes unhealthy consequences, and the need to acknowledge the loss in order to move on with a full life. The king from the parable nevertheless admitted that his beloved had irrevocably ended her earthly existence; moreover, he accepted this fact and returned to life. In reality, from acknowledging the loss there is often a long way to go through suffering to the heartfelt acceptance of separation from a loved one and the continuation of life without him.
Denial and disbelief as a reaction to the death of a loved one are overcome over time as the bereaved person realizes the reality of what happened and gains the mental strength to face the feelings caused by this event. Then the next stage of grief begins.
2. Stage of anger and resentment. After the fact of loss begins to be recognized, the absence of the deceased is felt more and more acutely. The thoughts of the grieving person revolve more and more around the misfortune that has befallen him. The circumstances of the death of a loved one and the events that preceded it are replayed in the mind again and again. The more a person thinks about what happened, the more questions he has. Yes, the loss has occurred, but the person is not yet ready to come to terms with it. He tries to comprehend with his mind what happened, to find the reasons for it, he has a lot of different “whys”:
Why did he have to die? Why him?
Why (why) did such misfortune befall us?
Why did God let him die?
Why were the circumstances so unfortunate?
Why couldn't the doctors save him?
Why didn't his mother keep him at home?
Why did his friends leave him alone to swim?
Why doesn't the government care about the safety of citizens?
Why didn't he wear his seat belt?
Why didn't I insist that he go to the hospital?
Why him and not me?
There can be many questions, and they pop up in your mind many times. S. Saindon suggests that when asking why he/she had to die, the griever does not expect an answer, but feels the need to ask again. “The question itself is a cry of pain.”
At the same time, as can be seen from the above list, there are questions that establish the “guilty” or, at least, involved in the misfortune that occurred. Simultaneously with the emergence of such questions, resentment and anger arise towards those who directly or indirectly contributed to the death of a loved one or did not prevent it. In this case, accusation and anger can be directed at fate, at God, at people: doctors, relatives, friends, colleagues of the deceased, at society as a whole, at murderers (or people directly responsible for the death of a loved one). It is noteworthy that the “judgment” carried out by the grieving person is more emotional than rational (and sometimes clearly irrational), and therefore sometimes leads to unfounded and even unfair verdicts. Anger, accusations and reproaches can be addressed to people who are not only not guilty of what happened, but even tried to help the now deceased.
A case from one's life
An old man at the age of 82 died in the surgical department two weeks after the operation. During the postoperative period, his wife actively looked after him. She came every morning and evening, forced him to eat, take medicine, sit down, get up (on the advice of doctors).
The patient's condition hardly improved, and one night he developed a perforated stomach ulcer. The roommates called the doctor on duty, but the old man could not be saved. Several days later, after the funeral, the wife of the deceased came to the ward for his things, and her first words were: “Why didn’t you save my grandfather?” To this, everyone remained tactfully silent and even asked her sympathetically about something. The woman did not answer very willingly, and before leaving she asked again: “Why didn’t you save my grandfather?” Here one of the patients could not resist and tried to politely object to her: “What could we do? We called the doctor." But she just shook her head and left.
The complex of negative experiences encountered at this stage, including indignation, embitterment, irritation, resentment, envy and, possibly, a desire for revenge, can complicate the mourner’s communication with other people: with family and friends, with officials and authorities.
S. Mildner makes some significant points about the anger experienced by the bereaved:
This reaction usually occurs when an individual feels helpless and powerless.
After an individual acknowledges his anger, guilt may arise due to the expression of negative feelings.
These feelings are natural and must be respected in order for grief to be experienced.
For a comprehensive understanding of the experience of anger that occurs among the bereaved, it is important to keep in mind that one of its causes may be a protest against mortality as such, including one’s own. A deceased loved one, unwittingly, makes other people remember that they, too, will have to die someday. The feeling of one’s own mortality, which is actualized in this case, can cause irrational indignation at the existing order of things, and the psychological roots of this indignation often remain hidden from the subject.
Surprising as it may be at first glance, the reaction of anger can also be directed at the deceased: for having abandoned and caused suffering; for not writing a will; left behind a bunch of problems, including financial ones; for making a mistake and not being able to avoid death. Thus, according to American experts, some people blamed their loved ones who were victims of the September 11, 2001 terrorist attack for not leaving the office quickly. For the most part, thoughts and feelings of an accusing nature towards the deceased are irrational, obvious to an outsider, and sometimes realized by the grieving person himself. Intellectually, he understands that death cannot (and is “not good”) to be blamed for, that a person does not always have the opportunity to control circumstances and prevent trouble, and, nevertheless, in his soul he is annoyed with the deceased. Sometimes anger is not expressed explicitly (and perhaps not fully realized), but it manifests itself indirectly, for example, in the handling of the deceased’s belongings, which in some cases are simply all thrown away.
Finally, the bereaved person's anger may be directed at himself. He can again scold himself for all sorts of mistakes (real and imaginary), for not being able to save, not protecting, etc. Such experiences are quite common, and the fact that we talk about them at the end of the story about the stage of anger , is explained by their transitional meaning: they have an underlying feeling of guilt that relates to the next stage.
3. Stage of guilt and obsessions. Just as many dying people experience a period when they try to be exemplary patients and promise to lead a good life if they recover, something similar can happen in the souls of those who are grieving, only in the past tense and on a fantasy level. A person suffering from remorse over the fact that he was unfair to the deceased or did not prevent his death may convince himself that if only it were possible to turn back time and return everything back, then he would certainly behave in the same way. to another. At the same time, the imagination can repeatedly play out how everything would have been then. Tormented by pangs of conscience, some bereaved people cry out to God: “Lord, if only You would bring him back, I would never quarrel with him again,” which again sounds like a desire and a promise to make everything right.
Those experiencing loss often torment themselves with numerous “if onlys” or “what ifs,” which sometimes become obsessive:
"If only I knew..."
"If only I had stayed..."
“If I had called earlier...”
“If I had called an ambulance...”
"What if I didn't let her go to work that day...?"
"What if I called and told her to leave the office...?"
“What if he had flown on the next plane?..” This kind of phenomenon is a completely natural reaction to loss. The work of grief also finds expression in them, albeit in a compromise form that softens the severity of loss. We can say that here acceptance fights denial.
Unlike the endless “whys” characteristic of the previous stage, these questions and fantasies are aimed primarily at oneself and concern what a person could do to save his loved one. They, as a rule, are the products of two internal causes.
1. The first internal source is the desire to control the events happening in life. And since a person is not able to fully foresee the future and he is not able to control everything that happens around him, his thoughts about a possible change in what happened are often uncritical and unrealistic. They relate, in essence, not so much to a rational analysis of the situation, but to the experience of loss and one’s helplessness.
2. Another, even more powerful source of thoughts and fantasies about alternative developments of events is a feeling of guilt.
It is probably not a great exaggeration to say that almost everyone who has lost a person significant to them in one form or another, to a greater or lesser extent, obviously or in the depths of their souls, feels guilt towards the deceased. What do bereaved people blame themselves for?
For not preventing the death of a loved one;
For having voluntarily or unwittingly, directly or indirectly contributed to the death of a loved one;
For cases when they were wrong in relation to the deceased;
Because they treated him badly (offended him, got irritated, cheated on him, etc.);
For not doing something for the deceased: not caring enough, not appreciating, not helping, not talking about their love for him, not asking for forgiveness, etc.
All of these forms of self-blame can give rise to a desire to return everything back and fantasize about how everything could have turned out differently - in a happy, rather than tragic, direction. Moreover, in many cases, those who are grieving do not adequately understand the situation: they overestimate their capabilities in terms of preventing the loss and exaggerate the degree of their own involvement in the death of someone they care about. Sometimes this is facilitated by “magical thinking,” which is clearly observed in children and can reappear in adulthood in a critical situation in a person “knocked out of the saddle” by the death of a loved one. For example, if a person sometimes regretted in his soul that he had connected his life with his spouse, and thought: “If only he could disappear somewhere!”, then later, if the spouse suddenly really dies, it may seem to him that his thoughts and desires “materialized”, and then he will blame himself for what happened. The grieving person may also believe that his bad attitude towards his relative (nit-picking, dissatisfaction, rudeness, etc.) provoked his illness and subsequent death. At the same time, a person sometimes executes himself for the slightest offenses. And if he still happens to hear from someone a reproach like “it was you who drove him into the grave,” then the severity of the guilt increases.
In addition to the already listed types of guilt regarding the death of a loved one, which differ in content and causality, we can add three more forms of this feeling, which A. D. Wolfelt calls. He not only designates them, but also, turning to those who are grieving, helps them to take an accepting attitude towards their experiences.
Survivor's guilt is the feeling that you should have died instead of your loved one.
Relief guilt is the guilt associated with feeling relieved that your loved one has died. Relief is natural and expected, especially if your loved one suffered before they died.
Guilt of joy is guilt about the feeling of happiness that reappears after a loved one has died. Joy is a natural and healthy experience in life. This is a sign that we are living life to the fullest and we should try to get it back.
Among the three types of guilt listed, the first two usually arise soon after the death of a loved one, while the last - in the later stages of experiencing loss. D. Myers notes another type of guilt that appears after some time has passed after the loss. It is due to the fact that in the minds of the grieving person, the memories and image of the deceased gradually become less clear. “Some people may worry that this indicates that the deceased was not particularly loved by them, and they may feel guilty about not being able to always remember what their loved one looked like.”
So far we have discussed guilt, which is a normal, predictable, and transitory reaction to loss. At the same time, it often happens that this reaction is delayed, acquiring a long-term or even chronic form. In some cases, this type of experience of loss definitely indicates ill health, but one should not rush to classify any persistent feeling of guilt towards the deceased as a pathology. The fact is that long-term guilt can be different: existential and neurotic.
Existential guilt is caused by real mistakes, when a person really (relatively speaking, objectively) did something “wrong” in relation to the deceased or, on the contrary, did not do something important for him. Such guilt, even if it persists for a long time, is absolutely normal, healthy and testifies, rather, to the moral maturity of a person than to the fact that not everything is in order with him.
Neurotic guilt is “hung” from the outside - by the deceased himself, when he was still alive (“You will drive me into a coffin with your swinish behavior”), or by those around him (“Well, are you satisfied? Did you bring him to life?”) - and then is introjected by the person . Suitable conditions for its formation are created by dependent or manipulative relationships with the deceased, as well as a chronic feeling of guilt that formed before the death of a loved one, and only increased after it.
The idealization of the deceased can contribute to an increase and maintenance of feelings of guilt. Any close human relationship is not without disagreements, troubles and conflicts, since we are all different people, each with our own weaknesses, which inevitably manifest themselves in long-term communication. However, if a deceased loved one is idealized, then in the minds of a grieving person his own shortcomings are exaggerated, and the shortcomings of the deceased are ignored. The feeling of one’s own badness and “worthlessness” against the background of an idealized image of the deceased serves as a source of feelings of guilt and aggravates the suffering of the grieving person.
4. Stage of suffering and depression. Just because suffering is in fourth place in the sequence of stages of grief does not mean that at first it is not there and then it suddenly appears. The point is that at a certain stage suffering reaches its peak and overshadows all other experiences.
This is a period of maximum mental pain, which sometimes seems unbearable. The death of a loved one leaves a deep wound in a person’s heart and causes severe torment, felt even on the physical level. The suffering experienced by the bereaved is not constant, but usually comes in waves. Periodically, it subsides a little and seems to give a person a break, only to soon surge again.
The suffering of bereavement is often accompanied by crying. Tears may well up at any memory of the deceased, about the past life together and the circumstances of his death. Some people who are grieving become especially sensitive and ready to cry at any moment. The reason for tears can also be a feeling of loneliness, abandonment and self-pity. At the same time, longing for the deceased does not necessarily manifest itself in crying; suffering can be driven deep inside and find expression in depression.
It should be noted that the process of experiencing deep grief almost always carries elements of depression, which at times develop into a clearly recognizable clinical picture. A person may feel helpless, lost, worthless, and empty. The general condition is often characterized by depression, apathy and hopelessness. The grieving person, despite the fact that he lives mainly in memories, nevertheless understands that the past cannot be returned. The present seems to him terrible and unbearable, and the future is unthinkable without the deceased and, as it were, non-existent. The goals and meaning of life are lost, sometimes to the point that it seems to the person shocked by the loss that life is now over.
Distance from friends, family, avoidance of social activities;
Lack of energy, feeling overwhelmed and exhausted, inability to concentrate;
Sudden bouts of crying;
Alcohol or drug abuse;
Sleep and appetite disturbances, weight loss or gain;
Chronic pain, health problems.
Although the pain of bereavement can sometimes become unbearable, those grieving may cling to it (usually unconsciously) as an opportunity to maintain a connection with the deceased and testify to their love for him. The internal logic in this case is something like this: to stop grieving means to calm down, to calm down means to forget, to forget means to betray. And as a result, a person continues to suffer in order to thereby maintain loyalty to the deceased and a spiritual connection with him. Understood in this way, love for a loved one who has passed away can become a serious obstacle to accepting the loss.
In addition to the indicated non-constructive logic, the completion of the work of grief can also be hampered by some cultural barriers, as F.E. Vasilyuk writes about. An example of this phenomenon is “the idea that the duration of grief is a measure of our love for the deceased.” Such obstacles can probably arise both from within (having been learned in due course) and from without. For example, if a person feels that his family expects him to grieve for a long time, he may continue to grieve to reaffirm his love for the deceased.
5. Acceptance and reorganization stage. No matter how severe and prolonged the grief, in the end a person, as a rule, comes to emotional acceptance of the loss, which is accompanied by a weakening or transformation of the spiritual connection with the deceased. At the same time, the connection between times is restored: if before the grieving person lived mostly in the past and did not want (was not ready) to accept the changes that had taken place in his life, now he gradually regains the ability to fully live in the present reality surrounding him and look to the future with hope.
A person restores temporarily lost social connections and makes new ones. Interest in meaningful activities returns, new points of application of one’s strengths and abilities open up. In other words, life returns in his eyes the value it had lost, and often new meanings are also discovered. Having accepted life without a deceased loved one, a person gains the ability to plan his own future destiny without him. Existing plans for the future are being restructured and new goals are emerging. Thus, a reorganization of life occurs.
These changes, of course, do not mean oblivion of the deceased. It simply takes a certain place in a person’s heart and ceases to be the focus of his life. At the same time, the survivor naturally continues to remember the deceased and even draws strength and finds support in the memory of him. In a person’s soul, instead of intense grief, a quiet sadness remains, which can be replaced by a light, bright sadness. As J. Garlock writes, “loss is still a part of people’s lives, but it does not dictate their actions.”
The attitude towards a deceased loved one and the fact of his death, which is formed after the acceptance of the loss has occurred, can be conditionally expressed in approximately the following words on behalf of the survivor of grief:
"He and I had a lot of fun, but I'm going to have a good time with the rest of my life because I know that's what he would want for me."
“My grandmother was such an important part of my life. I'm so glad I had the time to get to know her."
Let us emphasize once again that in real life grief occurs very individually, albeit in line with a certain general trend. And just as individually, each in our own way, we come to accept the loss.
Case from practice
To illustrate the process of experiencing loss and the resulting acceptance, we present the story of L., who sought psychological help regarding the experiences associated with the death of her father. It cannot be said that it clearly traces all the given stages of grief (which in its pure form only happens on paper), but a certain dynamics is evident. For L., the loss of his father was a doubly difficult blow, because it was not just death, but suicide. The girl’s first reaction to this tragic event was, in her words, horror. Probably, the first shock stage was expressed in this way, which is supported by the absence of any other feelings at the beginning. But later other feelings appeared. First came anger and resentment towards the father: “How could he do this to us?”, which corresponds to the second stage of experiencing loss. Then the anger gave way to “relief that he is no longer there,” which naturally led to the emergence of feelings of guilt and shame and thereby the transition to the third stage of grief. In L.'s experience, this phase turned out to be perhaps the most difficult and dramatic - it lasted for years. The matter was aggravated not only by L.’s morally unacceptable feelings of anger and relief associated with the loss of his father, but also by the tragic circumstances of his death and past life together. She blamed herself for quarreling with her father, avoiding him, not loving and respecting him enough, and not supporting him in difficult times. All these omissions and mistakes of the past gave the wine an existential and, accordingly, sustainable character. Subsequently, to the already painful feeling of guilt, suffering was added over the irretrievably lost opportunity to communicate with his father, to better know and understand him as a person. It took L. quite a long time to accept the loss, but it turned out to be even more difficult to accept the feelings associated with it. Nevertheless, during the conversation, L. independently and unexpectedly came to understand the “normality” of her feelings of guilt and shame and that she had no moral right to wish that they did not exist. It is remarkable that accepting her feelings helped L. come to terms not only with the past, but also with himself, and change his attitude towards his present and future life. She was able to feel the value of herself and the living moment of her current life. It is in this that a full-fledged experience of grief and genuine acceptance of loss and the feelings caused by it are manifested: a person not only “returns to life,” but at the same time he himself changes internally, enters another stage and, perhaps, a higher level of his earthly existence, begins to live in something new life.
The work of grief, which has entered the stage of completion, can lead to different results. One option is the consolation that comes to people whose relatives died long and hard. “In the course of a serious and incurable illness, which is accompanied by suffering, the death of the patient is usually presented to those present as a gift from God.” Other, more universal options are humility and acceptance, which, according to R. Moody and D. Arcangel, need to be distinguished from each other. “Most bereaved people,” they write, “are inclined toward resignation rather than acceptance. Passive resignation sends a signal: This is the end, nothing can be done. ...On the other hand, accepting what happened makes it easier, pacifies and ennobles our existence. Here concepts such as: This is not the end are clearly revealed; this is just the end of the current order of things."
According to Moody and Arcangel, people who believe in being reunited with their loved ones after death are more likely to experience acceptance. In this case, we touch on the issue of the influence of religiosity on the experience of loss. In Russian literature one can come across the idea that, as a rule, a non-believer person goes through the “stages of dying” described by E. Kübler-Ross, while for believers another option is possible, the development of internal changes. In addition, according to foreign studies, religious people are less afraid of death, which means they are more accepting of it. Accordingly, in this situation, it can be assumed that religious people experience grief somewhat differently than atheists, go through the indicated stages more easily (perhaps not all of them and to a less pronounced extent), are comforted more quickly, accept the loss and look into the future with faith and hope.
Of course, the death of a loved one is a difficult event associated with much suffering. But at the same time, it also contains positive opportunities. Just as gold is tempered and refined in fire, so a person, having gone through grief, can become better. The path to this, as a rule, lies through accepting the loss. R. Moody and D. Arcangel describe many valuable changes that can occur in the life of a bereaved person:
Loss makes us appreciate the loved ones who have passed on more, and also teaches us to appreciate the remaining loved ones and life in general.
After a loss, we uncover the depths of our souls, our true values and prioritize accordingly.
Loss teaches compassion. Those who have suffered a loss usually feel the feelings of others more subtly and often feel a desire to help other people and alleviate their condition. Overall, relationships with people improve.
Death reminds us of the impermanence of life. Realizing the fluidity of time, we appreciate every moment of existence even more.
Many grief survivors become less materialistic and more focused on life and spirituality. Grief teaches humility and wisdom.
Loss promotes the realization that love is more than our physical body, that it connects two people in eternity.
Through loss, a sense of immortality may arise or be enhanced. We carry within us a part of everyone we meet along the path of life. In the same way, some part remains in the souls of others. We all inhabit each other and in this sense achieve a kind of immortality.
To conclude the conversation about accepting loss and, in general, about the process of experiencing grief, let us again turn to the book by R. Moody and D. Arcangel. In their views on the experience of loss, three options for the development of this process can be identified: two types of overcoming grief - restoration and transcendence - and fixation on grief.
Restoration: at the end of the transition period that comes after the death of a loved one, a person’s life is restored to a normal state, his personality is stabilized, maintaining the same content (basic values, ideas and ideals, the personal model of the world remain unchanged), and life is reborn.
Transcendence: This is a process of spiritual rebirth that requires the deepest penetration into grief, which not everyone can or wants. At the point of maximum loss, a person feels as if he were buried with the deceased. After this, his basic personal characteristics undergo changes, his vision of the world is enriched, and his life receives qualitative development. A person becomes more courageous, wiser, kinder, and begins to appreciate life more. The attitude towards others changes: compassion, understanding and selfless love increase.
Fixation on grief: Moody and Arcangel call it "the tragedy of the hardened heart." The human condition in this case is characterized by despair, anger, bitterness and sadness. He lacks spiritual faith, meaning in life or the ability to adapt, fears his own demise, and suffers from prolonged stress or illness.
In the Moody and Arcangel system, the first option for experiencing loss can be regarded as the norm, and the other two can be regarded as deviations from it in one direction or another: transcendence - towards personal and existential growth, fixation - towards illness and maladjustment.
The important thing is that fixation on grief is not the only option when the experience of loss becomes unhealthy. And now we will move on to discussing the so-called “pathological” (S. Freud) or, according to other versions, “painful” (E. Lindemann), “complicated” (A. N. Mokhovikov), “dysfunctional” (R. Moody) grief.
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– The death of loved ones is one of the most difficult tests in the life of each of us. This is why it is often so difficult to help a grieving person, because everyone reacts to this shock in their own way. Are there any general recommendations on how to provide moral support to someone who has experienced loss?
– Indeed, on the one hand, grief is a deeply individual, complex process. It must be borne in mind that in most cases, all experiences associated with loss, even if they are very difficult or seem strange and unacceptable, are natural forms of grief and need understanding from others. Therefore, it is necessary to treat manifestations of grief as sensitively and patiently as possible. However, it also happens that a person who has lost a loved one begins to abuse the sympathy and patience of others and, taking advantage of his position as a grieving person, tries to extract some benefit from it or allows himself to behave incorrectly, rudely. In this case, those around you are not obliged to endlessly endure the unceremoniousness of the bereaved person, much less allow him to manipulate them
On the other hand, all people are similar in some ways, so we can identify relatively universal stages that grief goes through in its course - in psychology, five such stages are distinguished. It is clear that this division is arbitrary, but it allows us to identify general patterns.
– Probably the first reaction to such an event is some kind of shock, especially if death came suddenly?
– You are right, the news of the death of a loved one is akin to a strong blow that “stuns” the bereaved. Psychologists call this stage the shock and denial. The strength of the psychological impact of loss depends on many factors, in particular, on the degree of unexpectedness of what happened, but often people have enough objective reasons to expect the death of a relative (old age, long illness, etc.), and enough time to realize situation and prepare for a possible outcome, and yet the death of a family member comes as a surprise to them.
The first reaction to the news can be very diverse: screaming, motor excitement, or, conversely, numbness. Then comes a state of psychological shock, which is characterized by a lack of full contact with the outside world and with oneself. A person does everything mechanically, like an automaton. At times it seems to him that he sees everything that is happening to him now in a nightmare. At the same time, all feelings inexplicably disappear, the person may have a frozen facial expression, expressionless and slightly delayed speech. Such “indifference” may seem strange to the bereaved person, and often offends the people around him and is perceived as selfishness. But in fact, this imaginary emotional coldness, as a rule, hides deep shock at the loss and protects a person from unbearable mental pain.
This stupor may be alternated from time to time with periods of agitation or aimless activity. A person, most often under the influence of thoughts or memories of the deceased, is overcome by waves of suffering, and he begins to sob, realizing his powerlessness, or becomes completely absorbed in mourning rituals (receiving friends, preparing for the funeral and the funeral itself). At this time, the bereaved are rarely left alone, so the most difficult days for them are the days after the funeral, when all the fuss associated with them is left behind, and the sudden emptiness makes them feel the loss more acutely.
– What is denial? Does a person not believe that all this is really happening and that his loved one really died?
– This phenomenon can occur simultaneously with shock or after it and has very diverse manifestations. In its pure form, it usually occurs in cases where the loss is unexpected, for example, if relatives died as a result of a catastrophe, natural disaster or terrorist attack. Even after rescue operations are completed, relatives may believe that their loved one is not dead, but is somewhere unconscious and unable to make contact.
The state of shock and denial of what happened sometimes take such paradoxical forms that they even make others doubt a person’s mental health. However, most often, this is a defensive reaction of the psyche, which cannot bear the blow and seeks to temporarily isolate itself from reality by creating an illusory world. Let me give you an example. The young woman died during childbirth, and her child also died. The mother of the deceased lost both her daughter and her grandson, whose birth she was looking forward to. Soon her neighbors began to observe a strange picture: an elderly woman walked down the street every day with an empty stroller. People thought she was crazy, but in this case we cannot definitely talk about mental illness. Most likely, the woman first tried to soften the terrible blow by illusorily living out the desired, but unfulfilled, scenario. This conclusion is confirmed by the fact that after some time this behavior stopped.
– Or could it be that a person understands with his mind what happened, but on a subconscious level refuses to believe it?
– Such internal discrepancy often occurs, and it can be considered as a variant of denial. The options for its manifestation can be different: people unconsciously look for the deceased with their eyes in a crowd of passers-by, talk to him, it seems to them that they hear his voice or that he is about to come out from around the corner. It happens that in everyday affairs, relatives, out of habit, proceed from the fact that the deceased person is nearby, for example, they put an extra cutlery on the table for him.
Sometimes such rejection takes the form of a cult of the deceased: his room and belongings are kept intact, as if he might soon return. All this produces a painful impression, but is a normal reaction to the pain of loss and, as a rule, passes over time as the person experiencing the loss realizes its reality and gains the mental strength to face the feelings caused by it. Then the next stage of experiencing grief begins.
- Which?
– Stage of anger and resentment. After the fact of loss is realized, the absence of the deceased is felt more and more acutely. The grieving person replays over and over again the events that preceded the death of a loved one. He tries to comprehend what happened, to find the reasons, and he has a lot of questions: “why (why) did such a misfortune befall us?”, “why did God allow him (her) to die?”, “why the doctors couldn’t help him.” save?”, “why didn’t I insist that he go to the hospital?” “why him?” There can be a huge number of such “whys”, and they pop up in the mind many times. At the same time, the grieving person does not expect an answer as such; this is also a unique form of expressing pain.
Simultaneously with the emergence of such questions, resentment and anger arise towards those who directly or indirectly contributed to the death of a loved one or did not prevent it. In this case, the accusation can be directed at fate, at God, at people: doctors, relatives, friends, colleagues of the deceased, at society as a whole, at murderers (or people directly responsible for the death of a loved one). Such a “trial” is more emotional than rational, and therefore sometimes leads to unfounded and unfair reproaches against people who are not only not guilty of what happened, but even tried to help the deceased. Thus, one elderly woman, whose husband died in the hospital, despite the efforts of the doctors and her care, reproached his neighbors in the ward for “not saving” her husband, although they called for help immediately when they saw that he got sick.
This whole complex of negative experiences - indignation, embitterment, resentment, envy or the desire for revenge - is quite natural, but it can complicate the communication of the grieving person with family and friends and even with officials or authorities. It is important to understand that this reaction usually occurs when a person feels helpless, and these feelings must be respected in order for grief to be experienced.
– How can we explain the fact that some people are angry not at others or fate, but at the dead themselves?
– Surprising as it may be at first glance, the reaction of anger can also be directed at the deceased: for leaving and causing suffering, for not writing a will, leaving behind a bunch of problems, including material ones, for that he could not escape death. For the most part, such thoughts and feelings are irrational, obvious to an outsider, and sometimes the grieving people themselves are aware of this.
In addition, the death of a loved one makes other people remember that they, too, will have to die someday. This sense of one's own mortality can cause irrational resentment of the existing order of things, and the psychological roots of this resentment often remain hidden from the person. With his indignation he expresses a protest against mortality as such.
– Probably, the most common situation is when a person who has experienced a loss scolds himself for mistakes, for not being able to save, for not saving...
– Indeed, many people suffer from remorse over the fact that they were unfair to the deceased or did not prevent his death. This state marks the transition to the next stage of grief - stages of guilt and obsessions. A person can convince himself that if it were possible to turn back time, he would definitely behave differently, replays in his imagination how everything would have been then, calls on God, promising to fix everything, if only He will give a chance to return everything back. Instead of endless “why?” no less numerous “ifs” come, sometimes acquiring an obsessive character: “If only I knew...”, “If I had called an ambulance in time...”, “What if I had not allowed them to go at such a time...”.
– What caused this “search for options”? After all, what happened cannot be changed... It turns out that the person still does not accept the loss?
Such questions and fantasies are no longer aimed at finding the “guilty” from the outside, but mainly at oneself and concern what a person could do to save his loved one. As a rule, they are the product of two internal reasons.
The first is the desire to control the events happening in life. And since a person cannot fully foresee the future, his thoughts about a possible change in what happened are often unrealistic. They are essentially not so much a rational analysis of the situation as an experience of loss and helplessness.
Another, even more powerful source of thoughts about alternative developments of events is the feeling of guilt. Moreover, the self-accusations of those grieving in many cases do not correspond to the truth: they overestimate their ability to prevent the loss and exaggerate the degree of their involvement in the death of someone they care about. It seems to me that it would not be an exaggeration to say that almost everyone who has lost a loved one, clearly or in the depths of their souls, feels to one degree or another guilt towards the deceased.
– What exactly do bereaved people blame themselves for?
There can be many reasons for this, starting from the fact that they did not prevent the departure of a loved one or directly or indirectly contributed to the death of a loved one, right up to remembering all the cases when they were wrong in relation to the deceased, treated him badly (offended, irritated, cheated on him). etc.). Many people blame themselves for not being attentive enough to a person during their lifetime, not talking about their love for him, not asking for forgiveness for something.
This can also include specific forms of guilt, for example, the so-called survivor's guilt - the feeling that you should have died instead of your loved one, the guilt only for continuing to live while a loved one died. Some people experience guilt associated with a sense of relief that a loved one has died. In this case, you need to let them know that relief is a natural and expected feeling, especially if the deceased suffered before death.
In later stages of bereavement, another type of guilt often arises. – “guilt of joy,” that is, guilt about the feeling of happiness that reappears after the death of a loved one. But joy is a natural, healthy experience in life, and we should try to recapture it.
Some people, some time after a loss, worry that the image of the deceased and memories of him fade in their consciousness, as if relegated to the background. Anxiety is also caused by the fact that, in the opinion of the person himself (and often those around him, for example, relatives), such a state indicates that his love for the deceased is not strong enough.
– So far we have discussed feelings of guilt, which are a normal reaction to loss. But it often turns out that the feeling of guilt takes on a chronic form. How can you tell when it becomes unhealthy?
Any persistent feeling of guilt towards the deceased should not be classified as a pathology. The fact is that long-term guilt can be different: existential and neurotic. The first is caused by real mistakes, when a person really did something “wrong” in relation to the deceased or, on the contrary, did not do something important for him. Such guilt, even if it persists for a long time, is absolutely normal, healthy and speaks more about the moral maturity of a person than about the fact that there is something wrong with him.
Neurotic guilt, on the contrary, is “hung” from the outside either by the deceased himself, while still alive (with statements like “You’ll drive me into a coffin with your behavior”), or by others (“Well, are you satisfied? Have you made it? Have you left the world?”) and then translated man into the inner plane. Dependent relationships with the deceased, as well as chronic feelings of guilt that formed even before the death of a loved one, greatly contribute to the formation of such guilt.
The idealization of the deceased can contribute to an increase and maintenance of feelings of guilt. Any close human relationship is not without disagreements and conflicts, since we are all people with our own weaknesses and shortcomings. However, in the mind of the grieving person, his own shortcomings are often exaggerated, and the shortcomings of the deceased are ignored, which only exacerbates the suffering of the grieving person. Although suffering itself constitutes the next stage, it is also called stage of depression.
– It turns out that suffering is not in the first place? Does this mean that at first it is not there, and then it suddenly appears out of nowhere?
- Not certainly in that way. The point is that at a certain stage suffering reaches its peak and overshadows all other experiences.
This is the period of maximum mental pain, which can even be felt physically. Suffering is often accompanied by crying, especially when remembering the deceased, the past life together and the circumstances of his death. Some grievers become especially sensitive and may cry at any moment. Another reason for tears is a feeling of loneliness, abandonment, self-pity. At the same time, longing for the deceased does not necessarily manifest itself in crying; suffering can be driven deep inside and find expression in depression. In general, the experience of deep grief almost always contains elements of depression. A person feels helpless, lost, empty, lives mainly in memories, but understands that the past cannot be returned. The present seems unbearable to him, and the future unthinkable without the deceased. The goals and meaning of life are lost, sometimes to the point that it seems to the person shocked by the loss that his own life is now also over.
– What signs can be used to determine that a grieving person is depressed?
The general condition is often characterized by depression, apathy, and hopelessness. A person moves away from family, friends, avoids social activity; There may be complaints about a lack of energy, a feeling of weakness and exhaustion, and an inability to concentrate. Also, a suffering person is prone to sudden bouts of crying and may try to drown out his pain with alcohol or even drugs. Depression can also manifest itself on a physical level: in sleep and appetite disturbances, sudden weight loss or, conversely, weight gain; Even chronic pain may occur.
Paradoxically, despite the unbearability of suffering, those grieving can cling to it as an opportunity to maintain a connection with the deceased, to prove their love for him. The internal logic in this case is something like this: to stop grieving means to calm down, to calm down means to forget, and to forget = to betray. As a result, a person continues to suffer in order to thereby maintain loyalty to the deceased and a spiritual connection with him. Some cultural barriers also contribute to this, for example, the common idea that the duration of grief is a measure of our love for the deceased. Similar barriers can probably arise from outside. For example, if a person feels that his family expects him to grieve for a long time, he may continue to grieve to reaffirm his love for the deceased. This can be a serious obstacle to accepting the loss.
– Perhaps acceptance of loss is the final stage of grief? What is she like?
– You are absolutely right, this is the last stage – stage of acceptance and reorganization. No matter how difficult and prolonged grief may be, in the end a person, as a rule, comes to emotional acceptance of the loss. At the same time, the connection between times is, as it were, restored: a person gradually stops living in the past, the ability to fully live in the surrounding reality and look to the future with hope returns to him.
A person restores temporarily lost social connections and makes new ones. Interest in meaningful activities returns. In other words, life regains its lost value, and often new meanings are also discovered. Existing plans for the future are being restructured and new goals are emerging. Thus, a reorganization of life occurs.
These changes, of course, do not mean oblivion of the deceased. It simply takes a certain place in a person’s heart and ceases to be the focus of his life. At the same time, the survivor naturally continues to remember the deceased and even draws strength and finds support in the memory of him. In a person’s soul, instead of intense grief, there remains a quiet sadness, which can be replaced by a light, bright sadness.
I want to emphasize once again that the stages of experiencing loss that I have listed are only a generalized model, and in real life, grief occurs very individually, albeit in line with a certain general trend. And just as individually we come to accept loss.
– Could you give an example from practice to more clearly demonstrate the change in these stages of grief?
– For example, you can tell about the case of a girl who turned to psychologists for help because of her experiences related to the death of her father. It came as a doubly hard blow because it was suicide. The girl’s first reaction to this tragic event was, in her words, horror in the complete absence of other feelings. This is probably how the first, shock, stage was expressed. Later, anger and resentment towards the father came: “How could he do this to us?”, which corresponds to the second stage of experiencing loss. Then the anger gave way to “relief that he is no longer there,” which led to the emergence of feelings of guilt and, thereby, the transition to the third stage of grief. The girl blamed herself for quarreling with her father, not loving and respecting her enough, and not supporting her in difficult times. In addition, she was worried about the lost opportunity to communicate with her father, to better know and understand him as a person. To her. it took quite a long time and help to accept the loss, but ultimately she was able not only to come to terms with the past, but also to come to terms with herself, and change her attitude towards her present and future life. It is in this that a full-fledged experience of grief and genuine acceptance of loss is manifested: a person not only “returns to life,” but at the same time he himself changes internally, reaches another stage, perhaps a higher level of his earthly existence, begins to live a somewhat new life .
– You said that this girl had to resort to the help of a psychologist. How can you tell if your reaction to loss is normal or if you need to see a specialist?
– In a number of cases, indeed, the experience of loss goes beyond the conventional limits of the norm and becomes complicated. Grief can be considered complicated when it is inadequate in strength (it is experienced too severely), in duration (it is experienced for too long or is interrupted) or in the form of experience (it turns out to be destructive for the person himself or for others). Of course, it is very difficult to clearly establish the boundary where normal grief ends and complicated grief begins. But in life this issue often has to be resolved, so the following approach can be offered as a guideline: if grief seriously interferes with the life of the grieving person or the people around him, if it leads to serious health problems or threatens the lives of the grieving person or other people, then grief follows considered complicated. In this case, you need to think about seeking professional help (psychological, psychotherapeutic, medical).
– How can complicated grief manifest itself at each stage of loss?
– Here we can take as a basis such a criterion as duration: the normal process of experiencing loss is disrupted if a person is “stuck” for a long time, fixed at a certain stage. In addition, complicated grief has qualitative differences within each stage. For example, at the shock stage, diametrically opposed reactions are possible: a critical decrease in activity up to a state of stupor, the inability to perform even the simplest, habitual actions, or, on the contrary, rash decisions and impulsive actions that are fraught with negative consequences.
Complicated forms of loss denial are characterized by the fact that a person, even at a conscious level, stubbornly refuses to believe that his loved one has died. Moreover, even personal presence at the funeral does not help to acknowledge the reality of the loss. Even crazy ideas can arise on this basis. For example, one woman did not acknowledge the fact of her father's death for 40 years. She claimed that during the funeral he moved and breathed, that is, he did not die, but was pretending.
At the stage of anger and resentment, a complicated form of reaction to loss is, first of all, strong anger, up to hatred of other people, accompanied by aggressive impulses and expressed in the form of various violent actions, including murder. Moreover, aggression can be directed at random people who have nothing to do with what happened. Thus, a veteran of the war in Chechnya, having returned to peaceful life, even after many years could not come to terms with the death of his guys. At the same time, he was angry at the whole world and at all people “for the fact that they can live and be happy as if nothing had happened.”
At the stage of guilt and obsessions, the complicated experience of loss is expressed in a severe feeling of neurotic guilt, which pushes a person to somehow punish himself or even commit suicide. A person feels he has no right to live as before and, as it were, sacrifices himself. However, this sacrifice turns out to be meaningless and even harmful. An example is the case of a girl who lost her father, who was the closest person to her. She blamed herself for not caring enough about him during his life, while he did everything he could for her. She believed that she should have been in his place, that she had no right to live further, she saw no prospects in life: “I have no right to live, what prospects could there be?”
At the stage of suffering and depression, the complicated forms of these experiences reach such a degree that they completely unsettle the grieving person. His own life seems to stop; experts talk about symptoms such as continuous thoughts of worthlessness and hopelessness; thoughts about death or suicide; persistent inability to perform daily activities; uncontrollable crying, slow responses and physical reactions; extreme weight loss.
Complicated grief, corresponding in form to clinical depression, sometimes leads to a downright disastrous outcome. A good example of this is the so-called death from grief. If childless spouses live together all their lives and one of them is not adapted to life without the other, the death of the husband or wife can be a real disaster and end in the imminent death of the surviving spouse.
– How can we help a person truly accept a loss and come to terms with it?
– The process of experiencing loss, which has entered the completion stage, can lead to different results. One option is the consolation that comes to people whose relatives died long and hard. Other, more universal options are humility and acceptance. However, this is not the same thing. Passive humility seems to send a signal: this is the end, nothing can be done. And accepting what happened makes it easier, pacifies and ennobles our existence: this is not the end; it is just the end of the current order of things.
People who believe in reunification with their loved ones after death tend to come to acceptance more quickly. Religious people are less afraid of death, which means they experience grief somewhat differently than atheists, they go through all these stages more easily, they are comforted faster, they accept the loss and look into the future with faith and hope.
This may seem blasphemous to some, but the loss of a loved one often becomes the impetus for changes for the better in the soul of the grieving person. Loss forces us to honor loved ones who have passed on, and also teaches us to appreciate the remaining loved ones and life in general. In addition, grief teaches compassion. People who have suffered loss are usually more sensitive to the feelings of others and often feel a desire to help them. Many grief survivors discover true values, become less materialistic, and become more focused on life and spirituality.
Ultimately, death reminds us of the impermanence of life, and therefore makes us appreciate every moment of existence even more.
In the life of almost every person, sooner or later a breakup occurs. Our life is structured in such a way that from time to time we have to part with something or someone. Sometimes it overtakes us suddenly, and sometimes naturally, when the relationship has already become obsolete.
But, as a rule, parting is always a painful process, especially if you have to separate from a loved one. It's like falling into a deep hole full of sadness, pain and disappointment. And sometimes at this moment you can’t even believe that someday you will find a way out of this “valley of tears.” But no matter how much it seems to us that the whole world is collapsing, we must not forget that all this is temporary.
It is difficult to get used to the idea of loss, and sometimes it seems completely impossible. Looking forward is scary, but looking back is painful.
In psychology, separation is called the loss of a relationship. In 1969, American psychiatrist Elisabeth Kübler-Ross introduced a system that came to be known as the “5 Stages of Loss,” the experience after a breakup before we are ready for a new relationship.
5 stages of loss
1. Stage - denial
This is a state of shock when it hasn’t “reached us” yet. At this stage, what happened is simply “not believable.” The head seems to understand, but the feelings seem to be frozen. It seems like you should be sad and bad, but you don’t.
2. Stage of expressing feelings
After the initial awareness of what happened, we begin to get angry. This is a difficult phase in which pain, resentment, and anger are mixed. Anger can be obvious and open, or it can hide somewhere inside under the guise of irritation or physical ailment.
Anger can also be directed at a situation, another person, or oneself. In the latter case, we are talking about auto-aggression, which is also called guilt. Try not to blame yourself!
Also, very often an internal ban on aggression is activated - in this case, the work of loss is inhibited. If we do not allow ourselves to be angry, then we “get stuck” at this stage and cannot let go of the situation. If the anger has not been expressed and the loss has not been mourned, then you can get stuck in this stage and live like that for the rest of your life. You need to allow all the feelings to come out and it is due to this that relief and healing occurs.
3. Stage of dialogue and bargaining
This is where we are overwhelmed with a lot of thoughts about what and how we could have done differently. We come up with a variety of ways to deceive ourselves, to believe in the possibility of returning a lost relationship, or to console ourselves that all is not lost. It's like we're on a swing. At this stage of loss, we are somewhere between fear of the future and the inability to live in the past.
To start a new life, you need to end the old one.
4. Stage of depression
The stage comes when the psyche no longer denies what happened, and an understanding also comes that it is pointless to look for those to blame or sort things out. The fact of separation, the loss of something valuable that was in this relationship, has happened. Everything has already happened, nothing can be changed.
At this stage, we mourn the loss, miss what was so important and necessary. And we have no idea how to live further - we simply exist.
5. Acceptance stage
Slowly we begin to crawl out of the quagmire of pain and sadness. We look around, looking for new meanings and ways to live. Of course, thoughts about what was lost still visit us, but now we are already able to think about why and why all this happened to us. We draw conclusions, learn to live independently and enjoy something new. New people and new events appear in life.
How long does each stage of separation last?
From a few days to several months, and some even years. For each case, these numbers are individual, since this is influenced by various factors: the duration and intensity of the relationship, the reason for the separation. Often different emotional stages flow smoothly into each other or repeat.
In addition, everyone’s behavior and attitude towards this critical event is individual. While some experience this grief for months, others quickly find a new adventure to quickly forget about the separation. And it is very important to give yourself enough time to survive the breakup in order to accept, realize, transform the situation and learn a life lesson.
The common truth is known: “Any difficult situation, any crisis is not a “misfortune”, but a test. A challenge is an opportunity to grow, to take a step towards personal excellence and a better life.”
To improve your emotional state, do not allow yourself to be “lazy” and close yourself within four walls. Let every day bring something new, let it be filled with actions, deeds, trips, meetings, new discoveries and little pleasures. Go wherever there is nature, sun, children's laughter, where people smile and laugh.
Don't ignore your health
Grief has many physiological manifestations, causing insomnia, apathy, loss of appetite, disorders of the gastrointestinal tract, cardiovascular system, and provokes a decrease in the body’s protective properties.
See a Psychotherapist
In case of an unfinished separation, the help of a psychotherapist is required, since the trauma of losing a loved one continues to destroy life, taking away his inner strength. If you feel pain, resentment, anger, worry, irritability, or anxiety when remembering the breakup, then the breakup is still not over.
Psychotherapy is aimed at helping a person go through all stages of experiencing loss. The psychologist helps the client to recognize and express previously suppressed feelings using body-oriented therapy methods (based on working with the body and emotions).
With love, your Angela Lozyan
