Silva Neves Specialist Psychotherapy in Central London W1 & EC1

Bereavement. Loss & Grief. Dying. . Elaine white fluffy ball

Bereavement & Grief. The loss of a loved one

The death of a loved one can be devastating. There is no ‘right’ or ‘wrong’ way to grieve. Each bereavement is unique.
Sometimes we might feel many emotions at once like sadness and anger, for example. Other time, you might feel fine for a while and feel worse suddenly. Sometimes, you might struggle to wake up and start your day.
Emotions are like an ocean wave, they come, feel overwhelming at their peak, and then they pass, making room for another emotional wave.

There are different stages of bereavement or grief. If you’re experiencing any of the following, don’t worry, it is common. However, those stages of bereavement or grief are only broad information. If you are not going through some of these stages, it is also ok. Remember: each bereavement is unique.

The common stages of bereavement or grief are:
  • Accepting that your loss is real.
  • Experiencing the pain or grief.
  • Adjusting to life without the person who has died.
  • Putting less emotional energy into grieving and putting it into something new – in other words, moving on.

    Moving through those stages isn’t a smooth, linear process. Sometimes, people go back and forth on some of the stages.

    Feeling the grief.
    Give yourself all the time you need, there is no ‘good’ or ‘bad’ time scale to feel the grief. Some of the feelings that you might experience are:
  • Shock and numbness. This is usually the first reaction to the death.
  • Overwhelming sadness, with lots of crying.
  • Tiredness or exhaustion.
  • Anger. People can feel anger at the person who died, their illness, fate, medical professionals, or God.
  • Guilt. People sometimes feel guilty for being angry. People feel guilty for something they said, or didn’t say to the person who died. Sometimes, people feel guilty for surviving the person who died. Sometimes people feel guilty for being unable to stop their loved one from dying.

    All of those feelings are normal. It is ok to feel angry. It is ok to cry lots. It is ok to question yourself.

    Coping with grief and talking about the person who has died.
    People around you may not want to talk about the person who has died because they might not want to upset you. If you feel that you can talk about the loved one you lost, don’t stay isolated. Don’t hesitate to reach out to friends or your community.
    Anniversaries and special occasions can be hard. Do whatever is right for you to get through the day. It may mean taking the day off work. Or going to a Spa retreat. Or being around friends. Or you might want to do something that reminds you of a special time with that person, taking a favourite walk, for example, or going to their favourite place.

  • Bereavement. Loss & Grief. Dying. . Library Image: Depressed Person

    When grieving becomes difficult

    Each bereavement is unique. It is not possible to tell how long your grieving process will take. But if after 18 months you are experiencing some of the following difficulties, you may want to consider seeking professional help:
  • You can't get out of bed.
  • You neglect yourself or your family. For example, you don’t eat properly or your personal hygiene has declined significantly.
  • You feel you can’t go on without the person you’ve lost.
  • Your emotions are so intense that it’s affecting the rest of your life. For example, you can’t go to work, or you are misplacing your anger onto someone else.
  • You are misusing alcohol and drugs for a long period of time.

  • Bereavement. Loss & Grief. Dying. . Library Image: Reaching Hands

    Complex Grief

    Grieving can be complex in some specific circumstances:

    Grieving the loss of someone whom you had an ambivalent relationship with.
    For example, if you lost a sibling or a parent with whom you had a difficult relationship, there may be more intense anger or more intense guilt.
    You may not feel very sad at the loss of a family member but there may be tremendous pressure by others in the family to feel sadness or to cry. Some people may even criticise you if they notice you’re not sad enough.
    It is important to remember that not all death brings grief. It is ok to allow yourself to feel whatever comes naturally, even if it is relief, or a little bit of sadness but nothing too big. It is ok to think negative thoughts about the person who has died.
    In this circumstances, the guilt of not feeling too sad, or the pressure from others to feel sadder than you are can be the block of your grieving process and can transform into complex grieving during which you can develop some hyper-critical thoughts about yourself and feel like you are a ‘bad person’.
    Another complex grief is if you find out that your intimate partner had a hidden life after their passing. This can be deeply hurtful and the grief process may be disrupted significantly. It is important to seek professional help in these circumstances.

    Death by suicide.
    Losing someone who had died by suicide is one of the worst grieving process to get through. There is so many questions that are often left unanswered.
    You may experience tremendous guilt: ‘I should have seen it coming’, ‘perhaps I could have done something about it’, ‘I shouldn’t have taken him more seriously’, ‘Why didn’t I notice anything?’, ‘I couldn’t have stopped her from killing herself’, etc… These thoughts can go round and round in a loop in your head to the point of making you physically and mentally unwell.
    There is also much stigma around suicide, which can be very difficult to cope with.
    It is important to seek professional help as soon as possible to help you with this complex grief.

    Losing a child.
    There is probably no more painful feelings that the ones of losing a child. The grieving process can be a long one, and it can easily get stucked, especially the feelings of not wanting to go on without the loss child, feelings of guilt for not be able to stop the death, or feeling extremely angry at fate.
    Life is never the same after the death of a child. It is possible to learn to live with the constant void that the child not being physically present creates. It is important to reach out to friends or your community whenever you can. Professional help can help you with learning to live with the void.

    Sudden death and traumatic death.
    An unexpected sudden death can be very traumatic, especially if the person who has died is young enough. Readjusting to the new reality can be especially hard. The feeling of numbness, sadness and anger can linger for a long time, creating very intense emotions that can disrupt the functioning of everyday living for a long time.
    Some sudden death can be a fatal heart attack. An aneurysm. A fatal car accident. Someone dying in a terrorist attack. A murder.
    There may be much anger towards fate, or perpetrators which can be hard to process without professional help.

    A loss that nobody talks about: if you lose your intimate partner, you also lose your sexual self.
    It is an area often missed in bereavement counselling and grief therapy. Often people don’t feel justified to talk about their sexual loss because it might sound ‘frivolous’ or ‘shallow’. Yet, the loss of your sexual self is an important loss. Psychosexual professional help can help you discuss this matter in a caring, non-judgmental and safe space.

    Bereavement. Loss & Grief. Dying. . Elaine white fluffy ball

    Helping the dying with dignity

    There is nothing more emotionally intense than thinking about one's own death.

    The emotional journey from the terminal diagnosis, to the decline and into death can be stressful, evoking many intense emotions. It is a difficult time to find someone to talk to. Many people around the dying person will have their own intense emotions, which can get in the way of helpful conversations.

    As a society, we are not comfortable talking about death and it can be a challenging topic to approach for many family members and friends, and even for the person dying. I am committed to make this conversation easier as I believe talking about death is an important part of life.

    I am experienced in supporting the dying person in various ways, as required and as appropriate:
  • Open discussion on death and dying.
  • Conversations on dying with dignity.
  • Making plans for the funeral, wishes and discussing other practicalities.
  • Exploring what hasn't been said yet and identifying if there are some things the dying person wishes to say before death.
  • Overall emotional support through the health decline and dying.
  • Emotional support of the family and loved ones.
  • Continued emotional support for the survivors after death.

    My approach is integrative, holistic, humanistic and existential.

  • Bereavement. Loss & Grief. Dying. . Angry Man

    Disenfranchised grief

    Disenfranchised grief is when the survivor is denied a chance to openly grieve their loss.
    It often occurs when there is a betrayal at the time of death, for example a big secret emerging when one dies (an affair, financial secret, illegal behaviours, etc.). Or it can be grieving somebody who is judged as a bad person, such as a criminal, murderer, illegitimate family member or a paedophile.

    The hallmark of disenfranchised grief is isolation and loneliness. The survivors often experience a lot of shame, guilt, depression, anger, frustration and intense prolonged sadness.

    The therapeutic process helps survivors grieve their loved ones properly.

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