LESSONS IN LOVE & LOSS
A grief therapist shares the strategies she has learnt in helping clients cope with bereavement
Bereavement is one of the few things in life that is guaranteed – and yet it is also one of the least understood. Grief psychotherapist Julia Samuel explains how building ‘pillars of strength’ – strategies that support us and, crucially, enable us to keep going – will help us live with and learn from losing a loved one
Every day thousands of people die, expectedly and unexpectedly; around 500,000 deaths a year occur in England and Wales. On average every death affects at least five people, which means that millions of people will be hit by the shock of the news. They will forever remember where they were when they heard that their parent, sibling or child was dying or had died. It will impact every aspect of their world for the rest of their lives and ultimately alter their relationships with themselves.
Death is the great exposer: it forces hidden fault lines and submerged secrets into the open, and reveals to us how crucial those closest to us have been. Love from others is key to helping us to survive the love we have lost. With their support, we can endeavour to find a way to bear the pain of going on without the person who has died – daring to trust in life again.
In my profession there is a wealth of well-researched practical strategies as well as psychological understanding, which are essential for anyone who is grieving. I want people to understand that grief is a process that has to be worked through – and experience has taught me that grief is work. Hard work. But if we do the work, it can enable us to heal.
Grief doesn’t hit us in tidy phases and stages, nor is it something we forget and move on from. The work involves finding ways of coping with our fear and pain, and adjusting to the ‘new normal’. That most people can somehow find a way to bear the unbearable says much about our extraordinary capacity to evolve as we work towards rebuilding our lives. THE PARADOX OF GRIEF is that finding a way to live with the pain is what enables us to heal. Coping with grief means enduring the pain as it hits (this often feels like a storm crashing over us) and then having a break from it through distraction, busyness and doing things that comfort and soothe us. Every time we alternate between these two poles, we adjust incrementally to the reality that we don’t want to face: that the person we love has died. It is often the behaviours we use to avoid pain that harm us the most. Talking to a friend when something troubles us is a (continues p76)
Death steals the future we hoped for, but it can’t take away the relationship we had
positive behaviour; numbing our pain with alcohol a negative one. The task of the bereaved is to differentiate between them while at the same time learning new behaviours that support our capacity to heal and express pain.
The person who has died feels alive to us,
even though we know that they are dead. We envisage their body as if they were alive. We wonder if they are lonely, cold or frightened. We speak to them in our minds and ask them to guide us in the big and little decisions in our lives. We look for them in the street, connect to them through listening to the music they loved or by smelling their clothes. We may have a sense of an ongoing relationship, while knowing that nothing will move forward again. When this is unacknowledged or even denied, our minds may become disordered or unbalanced; but when this is understood, our overwhelming feeling will be one of relief.
Alternating ‘letting go’ with ‘holding on’ is something we need to learn to live with. Rituals such as the funeral or visiting the grave give a shape to the letting go; the acknowledgment that this person has died and is no longer physically present. People then assume they must entirely forget their loved one and subsequently suffer guilt for abandoning them, but the relationship does continue, although in a radically different form.
Death steals the future we anticipated and hoped for, but it can’t take away the
relationship we had. The connection to the dead is maintained through our memories, which are probably the most precious gift we will ever possess. They become part of us, our guides as we carry on with our lives.
We may want to be happy again, knowing it is right and fair, but feel guilty because
somehow it feels wrong. There is often conflict between our head and our heart: our head knows it was, for example, a terrible accident, but in our heart we feel as if we have done something wrong. These polar opposites need to find a place where they can sit side by side. Understanding that we need to hold both concepts inside us can be liberating.
Society approves if the bereaved is brave and getting on with things. Paradoxically, the grief that should cause concern is one that has been cut short, for example by self-medicating. As a society we need to learn to support a healthy grieving and to help people understand that each person goes at their own pace.
Our culture is imbued with the belief that we can fix just about anything and make it better. Or, if we can’t, that it’s possible to trash what you have and start all over again. Grief is the opposite of this belief: it requires endurance, not avoidance, and forces us to accept that there are some things in this world that cannot be fixed.
There is often conflict between our head and our heart: these opposites need to find a place where they can sit side by side
WHEN A PARTNER DIES Few events are as painful, for it is the death of the dream of an imagined future, as well as the couple’s current life together. It is the end of a mutual set of circumstances: companionship, status and often financial security may all be affected by unwanted change. It is an uncomfortable fact that one study found the recently bereaved are six times more likely to suffer heart disease than the national average, which gives credence to the concept of being ‘broken-hearted’. Another revealed that surviving partners are 66 per cent more likely to die within the first three months after their partner’s death. WHEN A PARENT DIES Usually the first faces our eyes lock on to when we’re born are those of our parents; the first hands to hold are theirs. Every relationship we have is, in some way, related to the foundations that began with our parents.
When a parent dies, the intensity of what we feel will depend on the relationship we had. We may feel that the person who loved us most in the world has died, leaving us utterly devastated. Or we may be relieved that it is the end of a relationship that has always been disappointing or hurtful. We may have complex feelings of love and hate, relief and guilt. Undoubtedly it puts us in touch with our own mortality because we are often the next in line to die. WHEN A SIBLING DIES The ideal sibling relationship gives you your ‘team’, the people who are on your side through thick and thin for the rest of your life. The power of the sibling bond can overcome years of non-communication. Brothers and sisters are forever connected through shared genetics, history, secrets, memories and language.
While few adult siblings are completely estranged, around one third describe their relationship as distant or rivalrous. This does not make the death of a sibling less difficult, it simply adds a layer of complexity: the loss of an opportunity to repair what has been broken and regret for the actions of the past tend to bring with them their own attendant pain.
WHEN A CHILD DIES There is almost nothing more traumatic than the death of a child. It tears up the rule book of life: our children should bury us, not the other way round. The death of a child leaves a fathomless hole and, of all the losses, it takes parents who have lost a child the longest to rebuild their lives.
I urge couples, if they feel the need to see a therapist, to do so together. It is a loss that shakes the relationship and family system to the core, and it is hard to recover from without the participation of both parents in counselling. As many parents have said to me, having a child die makes you a member of a club that no one wants to be a member of and leaves many families with a sense that they are now outsiders. In addition, many feel that they have been singled out to have this terrible thing happen to them.
If couples can find ways of communicating with each other, they can become closer through their loss, as they are the only two people in the world who understand how the other feels. However, research shows that couples who already have difficulties in their relationship and who don’t seek support are more likely to separate following the death of a child. FACING YOUR OWN DEATH When the eventuality of death has been accepted and the focus is no longer on fighting for life but on finding a way to accept the limited future we may have, there can be a good death. If we choose to believe something that gives us comfort in life and in the face of death, we are likely to suffer less. If we have chosen to talk to the people around us about our dying, they will suffer less, too. Nobody can ever know what the dying person’s experience is like, but we do know that being present or absent at the death of someone we love stays with the people who love them for ever. A death where everyone is aligned in their feelings and thinking is easier.
We all want to die painlessly, peacefully and with dignity, and we want to be with the people who love us, in a place where we feel safe. We can’t control the outcome, but we can ensure we use all the means of support to make it as tolerable as possible.
Being present or absent at the death of someone we love stays with us for ever
JULIA SAMUEL, 57, MBE, is a grief psychotherapist who has spent 25 years working with the bereaved both in private practice and the NHS at St Mary’s, Paddington.