Grieving is only love in another key.

Whilst it isn’t helpful to describe a series of stages of bereavement – as though each was a graduation from the previous one – there are characteristic responses which tend to follow severe loss. These are ways of coping with the unmanageable and gradually settling into ‘useful’ grieving.

‘There’s been a mistake – she went to Manchester today.’

It is not so much that we irrationally deny that a death has occurred – it is more that, for a while, we cannot conceive the world without the person we have lost. Smaller losses in life are no problem – our own experience and imagination will enable us to take them in our stride. However, if we have become very dependent on the person who has died, we are suddenly left apparently with no support and unable to continue. Before we can take the time to understand the reality, we are forced into some reaction: if we are not to collapse completely our only other choice is to resort to the temporary – but protective – first-aid of denial.

‘Of course I’m bloody angry; wouldn’t you be?’

As we emerge from the anaesthesia of denial, the rawness of our hurt can show in a fearful search for explanation of the death. Something or somebody must be to blame for this catastrophe: ‘there is a reason for everything’.

We have three choices for ‘blame’ (four if we find a belief in God is shaken).

• The doctor, the hospital, the wrong treatment, the drunken driver, the murderer, the railway company, ‘society’. This is the easiest choice: someone out there had caused the death and our hurt. It can feel good to be able to direct our feelings against someone who may or may not have been directly responsible. We can consider ourselves ‘victims’ which may, at least, be a role with which we are familiar.
• We may (or may not) have good reason to believe that the dead person was responsible for their own death. Maybe they were the drunk driver. ‘If only he’d gone to the doctor last year’; ‘Nobody needs to go rock-climbing’; ‘What about us who are left to pick up the pieces?’
  This is dangerous ground. It is hard to hold the positive memories and sense of loss alongside feelings of resentment and fury: they each interfere with our ability to focus on the other. Our ambivalence confuses us – we may be drawn into saying things which perhaps ought to remain not only unsaid, but unthought.
• We may search our imagination to find some word or action of our own that may conceivably have changed the way things turned out. It seems the most straightforward and least provocative way of looking for responsibility but, unfortunately, it is also the most self-destructive.

We almost always overestimate our own responsibility for events but once the fantasy becomes embedded in our sorrow it will gnaw away and become an unreasonable reality to us. Without people around us to give reassurance, it can, in extreme situations, stay with us for the rest of our lives.

The truth is, of course, that we rarely have any responsibility for someone’s death. Even death through accident or negligence is not intended. However, in our hunger for making sense of catastrophe we’ll try to personalise it. And we’re hardest on ourselves.

An exception is suicide, which often happens within difficult relationships: we might have made a difference there – but more about that on page 111.

Anger seems such a senseless, inappropriate feeling to have about someone who has died – who could possibly be blamed for dying? Grown-ups know how silly and unreasonable it is –and yet this sharp, resentful feeling can persist: it seems so childish.

In fact this apparently inexplicable feeling can so often be rooted in our early childhood. When a young child is separated from its parent for an appreciable time its first response when reunited is not overwhelming relief and pleasure, but furious anger. It has been suggested that this ‘disciplining’ of the errant parent is genetically programmed into our infancy to make sure our parent thinks twice about re-offending: babies know how vital parental access is and sometimes they need to emphasise it if there is ‘parental carelessness’.

When we are bereaved in adulthood we are vulnerable and our first responses to major loss are those last used when we were toddlers – even though we know they are unreasonable and illogical.

‘He just sits there, doctor: staring at the lawn. ‘

Usually in life, as we get older, we learn how to solve problems. We may not be successful but, mostly, we know all about complaining, negotiating, repairing marriages and calling emergency plumbers. Some problems are enormous and are beyond our resources – but at least we know that, if we chose to, we could achieve almost anything we want.

The loss of a loved one, however, may be the first time in adulthood that we are faced with something to which there seems no solution. The last time we felt like this was when we were three and became separated from our mother in the market – utterly at a loss about what to do. When we were three we were soon re-united and within 20 minutes everything returned to normal. Now, as an adult we can relive that toddler panic – but without any further prospect of seeing our ‘mother’ ever again. We will regain our survival skills – but not yet for a while.

Apart from the hurt of it all, our self-esteem may be dented if we are normally someone who is used to being on top of things. We may be hit with the realisation that ultimately we are without the power we thought we had: some things can’t be fixed – the most important things. This is just a short thought away from the sober truth of the inevitability of our own death: we knew, in principle, that one day we might die, but we would see what we could do about that when the time came.

‘I just don’t seem to be able to settle to anything.’

With some people there’s also an irrational, restless yearning – a need to search for the dead person. It is as though, in spite of our brain knowing the reality, our muscles are helplessly programmed not to leave any stone unturned. There is some comfort in long walks around places familiar to the person in life and unconscious scanning of faces in crowds sometimes has mistaken results. A variation of this restlessness can show itself in compulsive behaviour: the sort of manic activity which can make others – and us – think that we may be losing our minds:

• the three-hour washing and ironing session at 4am
• the daily jog to the point of exhaustion
• the complete spring-clean that ‘must be done’ by the time of the funeral.

Although such obsessional behaviour appears bizarre and worrying, it is not necessarily a sign of breakdown. There is some satisfaction to be gained: it is a way of channelling massive reserves of energy constructively. In the midst of our vulnerability and helplessness we can, at least, do something where we have some control.

Sometimes we can be surprised (and ashamed) by a marked feeling of euphoria. However, this has nothing to do with happiness but is a purely physical side effect of hormone changes in reaction to shock. It’s only the sort of ‘high’ we get after intense exercise but it can give us a deceptive feeling of spirituality and sharp sensitivity.

‘And then he just snapped at me, “Why don’t you go home
now....”’

It’s easy to take offence at the slightest thing: ‘insensitive nosiness’; ‘stupid questions’; ‘questionable motives’.

Funeral directors are often unfortunate targets: they have no previous relationship with the family, they’re being paid well to deal with the funeral and there is an enormous potential for them to get things ‘not quite right’.

• ‘I can’t stand his artificial solemnity.’
• ‘She had a very casual manner.’
• ‘He was wearing brown shoes.’

Such barbed, unreasonable anger can be hurtful but it does serve to give us a small opportunity of taking a grip on life when we are feeling otherwise disorientated.

Rage creeps up on you unawares. I was coming back from London and as I walked along a crowded compartment and saw people laughing and talking and reading and sleeping something in my mind went briefly out of gear. Their normality was hideous to me. I was in hostile country, an enemy alien.

Mary Stott, The Guardian

It’s as though such ‘thoughtless’ behaviour was deliberately insulting – ‘How can they be so casual and disrespectful; they must know he died two days ago.’

At other times this anger may simply be the outward expression of our own inability to cope.

Remember, anger is almost the first response to anything, however kindly meant.

Virginia Ironside, You’ll Get Over It!, 1996

‘She broke down and wept – even though she was only a distant
cousin...’

Often a bereavement can trigger connections with previous losses. It’s as though the present shock activates and opens our mental cupboard of unresolved grief and this undone work from the past becomes attached to our present bereavement. Also, the way we are feeling now may remind us of past pain.

This may explain why we often experience the keenest grief for people with whom we had the most difficult relationships.

People who have had open, shared and mature relationships are much less likely to be burdened with regrets and unfinished business: they can simply concentrate on the sadness of the present time and then to look to the future.

‘And he was standing there as plain as you...’

The dead are often just as living as the living are, only we cannot get them to believe it. They can come to us hut, till we die, we cannot go to them. To he dead is to be able to understand that one is alive.

Samuel Butler (1835–1902), Notebooks

With so much energy invested in the searching, it is not surprising that many people ‘find’ the person who has died. In one study (W. D. Rees British Medical Journal, 1967) found that 39 per cent of 293 bereaved spouses had experienced a sense of the presence of their partner: 14 per cent had actually had hallucinations or illusions of a physical presence. Generally these were people who were older, lonelier and more bereft than others – but their experiences, far from making things worse, seemed to have a positive, helpful effect. In any case, there is enough evidence to show that such sensations can be a normal part of bereavement and not an indication of psychiatric illness.

Similarly about 50 per cent of people take their grief to bed with them and report the presence of the dead person in dreams. These usually evoke happy memories – only to be shattered in the cold light of day.

‘She grows more like him every day...’

Another way in which survivors cling on to the memory of the person they have lost is to develop symptoms similar to those leading up to the death. Similarly, we might adopt habits, interests and mannerisms which characterised the dead person:

A hitherto rather dull wife whose witty husband had died surprised herself and all around her by her newly acquired gift of repartee. She tried to explain this by saying alternately, ‘I have to do it for him now’ or, ‘It isn’t really me, he speaks out of me’ (like a ventriloquist).

Lily Pincus, Death in the Family, 1976

‘He’s just been dead six weeks and I can’t remember what he
looks like...’

For various reasons... my heart was lighter than it had been for many weeks. For one thing, I suppose I am recovering physically from a good deal of mere exhaustion... And suddenly at the very moment when, so far, I mourned H. least, I remembered her best...

Why has no one told me these things? How easily I might have misjudged another man in the same situation? I might have said, ‘He’s got over it. He’s forgotten his wife,’ when the truth was, ‘He remembers her better because he’s partly got over it.’

C. S. Lewis (1898–1963), A Grief Observed

It seems puzzling that partners can have been together for many years and yet can, so soon, go out of focus for their survivor. It could simply be an unconscious way of avoiding the pain of the loss – we block out memories, which fuel the hurt. More commonly, however, this lack of clarity comes after a long, close relationship. We have been so linked to a partner in so many complex ways, that, so near to their loss, we have difficulty in keeping them in our mind as a whole. The very act of deliberately straining to hold on to their presence in our mind makes things harder. It may be only later, when we have cleared away some of the confusion, that we can really grasp the full reality of our memories. C. S. Lewis described this very well some months after his wife died.

...as I have discovered, passionate grief does not link us with the dead but cuts us off from them. This becomes clearer and clearer. It is just at those moments when I feel least sorrow – getting into my morning bath is one of them – that H. rushes upon my mind in her full reality, her otherness. Not, as in my worst moments, all fore-shortened and patheticised and solemnized by miseries, but as she is in her own right. This is good and tonic.

C. S. Lewis (1898–1963), A Grief Observed

‘I keep going over those last few days in my mind...’

Normally when we are faced with significant problems in our lives we like to have full information and a chance to influence what the effect on us will be.

When someone close dies unexpectedly or after a very short illness we are cheated of this involvement. Often this has been such a disaster for us that we sometimes can’t resist the temptation to replay the time leading to the death: we meticulously examine how our intervention could have made a difference.

Because it is a fantasy (and we know it) we shall always be frustrated by the reality of their death without our involvement: this might lead us to start the process all over again ... and again.

Although this may seem an unhealthy obsession at the time it does have a positive aspect. By pretending things had been otherwise – ‘If only I’d insisted on driving’ – we imaginatively become engaged in the drama leading to the death: there is a greater sense of completeness.

We can also imagine important final conversations – what were the words we both left unsaid?

‘She seems much more settled in herself....’

The dramatic time of acute shock and sharp distress comes to a close. It is now time for the quieter, more long-lived phases of bereavement to set in.

When we live in a continuing relationship our native optimism gives us a continuing (maybe unrealistic) hope that, together we can sort out any difficulties between us.

The moment someone close to us dies, however, the state of our relationship becomes frozen. What we are left with will be with us forever. We are left with an emotional snapshot of how things were at the time of the death.

When we suffer normally – from an illness perhaps – we are sustained by the thought that we will get better and we can look forward to noticeable improvements. The quality of grief suffering, however, is different. For a time we don’t want things to get better – fresh grief involves a yearning to go backwards, not forwards.

A friend assured me in his letter that though I could not see beyond the suffering, I should in time come through it. I laughed that his consolation should be so unconsoling; for I wanted nothing better than to live always in the immediacy of the loss. In the sharpness of it I felt near to her. The worst was the best.

Lawrence Whistler, The Initials in the Heart, 1987

If the memory of the dead person is fixed at a time when there were unresolved difficulties, we are left stranded and impotent with a situation, which we shall never again be able to influence.

‘I just feel so “down” all the time...’

We are used to being in an active relationship where hurts can be repaired: where there is always room for improvement. Our inability to have any further effect on things – at the very moment when we have been deprived of our main support – can paralyse us emotionally and this helplessness can easily slide into depression.

It is cruel that this will also be happening at a time when other pressures begin to make demands. Following the death there may be threats of money problems, difficulties with housing or family relationships; we may, ourselves, need to give support to other dependants. Within days we will be called on to make a formal public appearance at the funeral – the centre of attention – and then, to some extent, to act as host to the funeral gathering.

At best we will have been well prepared for the death, have had a good relationship, a large family, supportive friends and no financial worries. At worst we will be young, with children, little support, few resources and the death will have been unexpectedly sudden.

We should be concerned if we were not depressed in such circumstances. We should expect that for some days, weeks or months there will be a muddled change in our feelings and behaviour. However, if there is an increase or persistence in some of the symptoms of depression we should take notice. Some of these symptoms are:

If we are alone the despair – if unsupported – may not be interrupted: there may be no one to nudge us into different ways of thinking and feeling. Also isolation gives us less motivation to keep up with our daily routine, standards of housekeeping, personal appearance and social behaviour.

These can all be signs of a normal response to the loss of someone close: we shouldn’t think that we are suffering from some disorder. Our GP may offer us a short-term course of anti-depressants. She is not trying to fob us off with tablets –modern anti-depressants can be dramatically effective in giving a lift that gives us the confidence and strength to cope. Usually our need for such a welcome chemical crutch is short-lived and we shouldn’t be surprised if the doctor is reluctant to continue the prescription – the grief work to come is best done with a clear head.

‘She’s coping very well in the circumstances.’

Many people become very skilful at preventing grief intruding into consciousness. These are people who believe themselves to be in charge of feelings and experiences from their past. Maturity will tell us the truth, however – they are normally in charge of us. Just as stress involves pent-up undischarged energy, grief involves unexpressed and often confused feelings of loss, desertion, anger, guilt, love, fear, helplessness – we’ll have our own list.

There is something almost tangible about these feelings. It is as though there were a measurable amount of ‘grief-stuff stored in the body under pressure. We won’t be ‘better’ until we are rid of it.

We can discharge it quickly, in liquefied form, through our tear ducts, we can form it as accurately as possible into spoken or written words or we can seal it up and not allow ourselves or anybody else to get near it.

The trouble is we can never really contain it: it generally finds a way out. It might explode painfully under the mounting pressure in ten years time or, more likely, its harmful influence will seep, a few molecules a day, into all parts of the body appearing as anxiety, depression, insomnia and all sorts of aches and pains: this could last up to a lifetime.

On the other hand, there are some people who have developed the trick of coping with difficult feelings by simply setting them aside and refusing – successfully – to deal with them. We may be shocked and anxious to ‘help him to get in touch with his feelings’ but we ought to be cautious about such ruthless invasion of someone’s defence mechanisms – it may cause more harm than good.

‘Now that he’s dead I can start to go to the cinema again.’

As we come through the turbulence of the shock we look around us and begin to take stock of our new situation: we compare our life now to what it was before the death. For some people who have experienced the sudden death of a loved one there will be a yearning to put the clock back. For others, however, the death will have been the climax of months of anxiety, distress and physical and emotional caring.

It would be unsurprising if part of us was not immensely relieved at the lifting of this emotional and physical burden. However, our first response to this sense of relief may be guilt: it can seem shocking to look forward to our own comfort after someone’s death. It’s hard to remember that we are very complicated people with many strands to our lives and many mixed feelings. Simultaneously we would do anything for the death not to have happened and we are pleased that we can resume other aspects or our lives. These facts are both true but they are not connected.

Often, if the end has been hard and painful, we will be pleased that the dead person is no longer suffering. It is perfectly normal and acceptable for us also to feel some respite. It is one of the first signs of strength for the recovery to come.

‘I keep taking one step forward and two steps back...’

Our previous experience of ordinary pain is that it begins severely and gradually reduces at a regular rate until we recover. Most people who are bereaved are surprised that grief doesn’t seem to work like that.

...it is more accurate to describe the process like a roller coaster of many ups and downs with gradual improvement over time... The early months following the loss were the most difficult and these early indicators were relatively good predictors of long-term adjustment. The ups and downs of the roller coaster can easily be precipitated by mistakenly seeing the face of the deceased in a crowd, hearing an old familiar song on the radio, driving by the hospital where the spouse was treated, or conversely, feeling proud for successfully balancing a chequebook for the first time, meeting a new friend at a club, or simply mastering the timer of a microwave oven.

Lund, 1989 (reported in The Handbook of Grief 1993

The body has a system for dealing with pain – it won’t allow us to experience more than we can stand: when it gets too much it will switch off. People suffering the agony of burns report that there are occasional moments of numbness when the pain will subside. The same applies to emotional pain. Our minds seem to have safety valves, which can shut down distress when it threatens to overwhelm us. It’s worth keeping this in mind –a breathing space is just around the corner.

The sense of loss wells up, a feeling so intense that one cannot imagine an end to it. But then, after a time, the numbness comes, a period of calm and relief. Soon numbness is replaced by another wave of loss. And so it continues: waves of loss, calmness, loss, calmness. This is the natural cycle of pain. And as soon as you reach an overload, your emotions shut off, you literally stop feeling for a little while. These waves continue with smaller amplitudes and longer rest periods, until the hurt finally ceases.

Matthew Kay and Patrick Fleming, Self Esteem, 1987

‘It makes you think...’

Death is a crisis that forces all concerned – the dying and their bereaved survivors – to look at the ‘meaning’ of their lives. In between births and deaths we are easily distracted by the business of living, but when we are faced with our own imminent death or the loss of an important relationship, we cannot avoid taking stock of what we have been doing with our lives. We need to evaluate our existence.

In a close relationship where we have lost someone, a large part of our life may have been dismantled and we are going to have to work out how to keep things going until we can rebuild things. Whatever happens, we are not going to be able to continue as before.

There are two extreme ways of proceeding.

• If we have had an open, ‘mature’ and ‘honest’ relationship, which preserved our independence, it will not be too difficult to adjust. The hooks of dependence will have been only lightly attached and we can recover easily those parts of ourselves which we had invested in the relationship.
• We can shut off those parts of ourselves where we used to be closely dependent on the dead person. We may be so lacking in inner resources or outside support (or both) that we take on a new role as a disabled ‘victim’. Some people can retain this disability for the rest of their lives.

The biological purpose of grief

Sorrow that has no vent in tears makes other organs weep.

Anon.

People report feeling better after a cry, according to a study by University of Minnesota biochemist, William Frey who discovered the neurotransmitters leucine and prolactin in emotional tears; the substances were not found in tears shed in response to sliced onions. Tears may help the body alleviate stress and cleanse itself of toxins, as do other exocrine processes, e.g. sweat, urine, and exhaled air.

Women cry five times more frequently than men. Women’s tears also flow down the face more than men’s – where they well up in the eye. The average length of a crying spell is one to two minutes.’

David B. Givens, Centre for Non-Verbal Studies, 1999

I used to think that bereavement was a very sophisticated, almost romantic, essentially human response ‘grief for the loss of love’. However, it is not the case that grieving is a sign of fine feeling, higher sensitivity and advanced civilisation. It is a raw, unhinged, animal activity.

John Bowlby, the authority on attachment and loss, considered the research into bereavement reactions in animals (geese, dogs, chimpanzees, orang-utans). He wrote in ‘Processes of Mourning’ 1961 (International Journal of Psychoanalysis):

Members of lower species protest at the loss of a loved object and do all in their power to seek and recover it; hostility, externally directed is frequent; withdrawal, rejection of a potential new object, apathy and restlessness are the rule.

Konrad Lorenz described what happened when a greylag goose becomes separated from its mate:

The first response to the disappearance of the partner consists in the anxious attempt to find him again. The goose moves about restlessly by day and night, flying great distances and visiting places where the partner might be found, uttering all the time the penetrating trisyllabic long-distance call... All the objective observable characteristics of the goose’s behaviour on losing its mate are roughly identical with human grief.

On Aggression, 1963,

The same automatic reaction happens to us when someone important to us dies. Because we are so unused to having to cope with such massive loss we have never learned how to behave ‘properly’: our instinct takes over.

There are three conflicting biological responses.

• There is an impulse to call out loudly in a piercing scream for the lost one so that they can be relocated: we’ll seek out places where they can usually be found and repeat the cry.
• There is, however, a conflicting impulse. We are frightened and lonely: we have lost our protection so we don’t want to draw too much attention to our vulnerability.
• The result is that we scream silently. We breathe in deeply and let out a stream of strangled, muted yelps. We sob.

The effect of forced expiration means that we need to protect our eyes from excess pressure. To do this we will screw up our face around the eyes – which will affect our tear ducts –causing us to weep. (The same process happens in laughter but then it’s Ha! Ha! Ha! rather than Oh! Oh! Oh! – and there’s no worry about holding back.)

This wish to shout out loud very quietly can best be seen in the mouth and throat. If you mime shouting as loud as you can and then do nothing more than close your lips you will reproduce exactly the feeling of a sob. (Notice that your eyes will automatically have become screwed up.) You will feel the strained muscles in your throat just as if you were sobbing.

Of course, it’s not as simple as that. We don’t sob and then stop: we do it intermittently. It is as though we cry out in one place, are satisfied there is no one there, but resume the sobbing the next day when we go into the garden and find the rosebush that she was going to plant – maybe she’s here. These are the recurrent ‘pangs of grief.

One of the by-products of this sobbing and weeping is that other people have become used to recognising it as a signal of extreme distress and an urgent call for help. Most people will penetrate walls of social reserve to cross over the road to a weeping stranger – ‘Are you alright?’ We all have the right to make the appeal and we all have the duty to respond to it.

Grief is a tree that has tears for its fruit.

Philomen c.300 BC

When we burst into tears we almost inevitably say ‘I’m sorry’. What we mean is T apologise for choosing you to comfort me’. The reply ‘Don’t worry about it’ means ‘It’s OK, I accept your appeal. I’m here to help in any way I can’. If someone replies ‘Come on now – dry those tears’ they’re either embarrassed, feeling inadequate (but still maybe wanting to help) or, less commonly they mean to say ‘Please stop signalling for help: I don’t want to be available’.

Maybe the raw crudity of extreme grief is why we can so often find it embarrassing in ourselves and in others. We normally go to great lengths to present ourselves as competent and responsible. When our ‘adultness’ is knocked aside by such overwhelming primitive feelings, it sparks off fears of being out of control – we are shocked by the prospect of chaos.

For this reason British grief is expressed very tentatively. Women tend to be less careful about showing their feelings compared to men whose past history has shown them that control is a vital tool of power. As we (men) gradually give up our need to be seen in control we will become less guarded about expressing vulnerability. (I wonder if one of the less welcome results of feminism will be that girls will grow up to appear as ‘tough’ as men.)

Some Eastern religious groups are much less inhibited about expressing grief. Perhaps their stronger sense of community support for individuals makes people more confident about appearing vulnerable and claiming the support of others.

Biologically, the beginning of the ‘cure’ for grief lies in recognising, admitting and describing our loss and having examined all parts of our life that were touched by the dead person finally admitting that they are definitely nowhere to be found. The search is called off.

Ophthalmologists are familiar with a condition called ‘dry eye’ – particularly common in older people who have been tearfully bereaved. There is a loss of the ability to weep. Whilst there’s probably a straightforward physical reason for this, it remains a neat metaphor for the healing effect of tears.

What can make grieving better or worse?

There are a variety of personal and life experiences, which can shape the path of our bereavement.

• Our earlier grief experiences. If we have had a particularly difficult bereavement in the past we will be tempted to associate how we felt then with how we feel now.
  It need not have been a death – we may, for example, remember our parents divorcing when we were children or an elder sister moving away from home. The keenness of our loss from that time may become transferred to the present situation. We should ask ourselves what – precisely – our grief is about. It is almost certain that we will find loss more difficult later on if a parent died when we were children
• Was it a sudden death? There is a lot of evidence that, if we have time to adjust to someone’s impending death we can settle ‘unfinished business’ and the process of grieving will have a better outcome.
• Similarly, if the time leading up to the death was painful and protracted, if the end was expected earlier and people were ‘over-prepared’ and exhausted by long periods of caring there will be a less satisfactory bereavement.
• How much change will the death bring to our life? If the only thing to change is the absence of the dead person, there is less to cope with. To handle our grief together with our children’s sense of loss, a reduction in income or housing problems will make things much worse and our changed circumstances will forever remind us of the pain of that time. Our bereavement might become ‘stuck’.
• What sort of a person were we before? If we were an anxious, dependent person before, we will have fewer inner resources to cope with the challenge of our loss. Similarly, if we have had poor physical or mental health we may have a bad time.
• What was our relationship with the person? If we were close we would have been able to share feelings and tie up loose ends. If we had a stormy, difficult relationship things will have been left unsaid and harsh feelings may be left hanging in the air. We may carry a burden of guilt that we could have behaved better.
  The dying person will have a disappointing end to their life. If we are in such a situation it is clearly better to have put old quarrels behind us and to try to make some sort of reconciliation, perhaps with the help of someone else.
• Particular categories of people are harder hit. Men more than women: young people more than older people: bereaved parents more than anyone.
• Are there other people around us for support? It is common for even well-meaning friends to steer clear of bereaved people because they are sensitive to hurting them further by talking about their loss. This is usually not the real reason: they may be embarrassed by the death and feel unable to find the right words.
  The more contact with people who are comfortable about ‘just being there’, quietly giving practical help and wishing to listen, the better will be the grieving work.
• Are there children or other dependent relatives involved? It may be that the bereaved person is in such a state of shock that they are not able to give much attention to the children and their needs. They of course are in as much need of care as their surviving parent. If there is no support from others to help meet these needs, there may be extra distress to deal with in the future.
• The disbelief and unreality that may be in the air can be intensified if the bereaved person has not been able to see the body. If we have not seen the evidence there is always some hopeful mileage in our sad fantasy that they are not really dead. This is of course, all the more likely when there actually is no body – such as a drowning at sea. It sometimes takes much strength to face up to rational reality when we can conjure up comforting hope. On the other hand, there’s maybe some wisdom in holding back our acceptance.

After the Vietnam War some women finally came to believe that their ‘missing’ husbands were actually dead. They went through the grieving process and dealt with their loss, only to have their husbands, who had been prisoners of war, released and returned to them. This may sound like a good plot for a Hollywood romance, but in reality this situation caused great difficulties for these couples and some of the marriages ended in divorce.

J. William Worden, Grief Counselling and Grief Therapy,

Routledge 1993

• Health before bereavement. Illness can be worsened by the stress of grief and be a distraction.
• Reduced material resources. If there is sufficient money around many of the practical problems that arise can be avoided. Many people are forced into new responsibilities –arranging the funeral, driving, odd-jobs, decorating, housework – which could be set aside for the moment if temporary help could be bought. One writer concludes the most effective support to many bereaved people – more than any other form of support – would be an immediate government grant of £5,000.
• Young widows, in particular, are especially vulnerable to unusual emotional disturbance and often have periods of intense depression and persistent ill health. (Although the young bereaved are usually greatly distressed at first, they recover more successfully than older people who, on average, are less immediately affected, but slow to return to ‘normal’.)
• Personality factors. People who will cope well are those who are emotionally stable, mature, conscientious, conservative (with a small d), socially precise and optimistic. People who will cope less well are those who are emotionally unstable, with a negative outlook, apprehensive, worried or highly anxious.
• Type of death. ‘Socially unspeakable’ deaths, including suicide, murder, catastrophic circumstances, and ‘stigmatised’ deaths are harder to bear.
• ‘Secret’ deaths. These are deaths – usually involving terminations of pregnancy or miscarriage, where, for whatever reason, there may be no public knowledge and therefore no sensitivity or support from family or friends.
• Circumstances following the loss. Other bereavements or other family or practical problems may distract us unhelpfully from our grieving and make recovery more difficult.

The four best predictors for recovery

• Initial effects of the bereavement: people who coped well at the time of the death recover much more quickly than people who had a very difficult time at the beginning.
• Good communication: people who were communicative with others about their thoughts and feelings tend to recover better.
• Positive self-esteem and personal skills: both these qualities are helpful to recovery.
• Time since the death: it is, indeed, a great healer.

Characteristics of successful grievers

Research (Ann Kaiser Steams, Coming Back, Methuen 1989) amongst people who have coped particularly effectively with crisis and loss shows that they have particular traits.

• They will have anticipated the loss to some degree and imagined what the implications might be.
• When it’s not possible to plan ahead they will identify with strong and resourceful people and learn from them. They may have inspirational role models to guide their attitudes.
• They prefer to turn away from negative, non-productive feelings and try to approach the situation without much complaint.
• Although they are personally resourceful, they are willing to seek help and support from others when needed. They know how to express their feelings freely and honestly.
• They are usually optimistic and they normally have an underlying need for personal growth and learning.
• They take responsibility for their own lives and ‘own’ their decisions: there is little inclination to look to others for blame.
• They are interested in regaining control of their situation following a crisis. They are prepared to analyse what has happened and make plans for what needs to be done.
• They tend to have a set of beliefs – not necessarily religious – which guides their life: a commitment to a set of principles by which they live.
• Even in the depths of early distress they can at times see humour when it is there: they can acknowledge the pain but don’t take themselves too seriously – they are able to laugh at themselves.
• They try to see some possible positive gain in the outcome of the loss, either for themselves or others.
• They are determined people, prepared to put much energy into their recovery.
• They are able to be flexible, adaptable and imaginative about the future.
• They are at ease with themselves and the world as it is.
• They enjoy solving problems, restoring order and ‘making things better’.
• They like being with other people who will tend to be positive-thinking.
• They look forward to the future more than they dwell in the past.
• They are able to let go of past resentments, regrets, guilt and injustices.

Women are better than men at grief?

The thing that sticks in my mind about Uncle Steven was that, the same afternoon of the day Auntie Judith died he went into the office to keep an appointment with a client (he was a solicitor). He said that contracts needed to be exchanged and... ‘Life goes on.’

Of course men have losses in life – but we have less practice than women. As the sexes adopt more sensible, sharing roles, things will surely change, but traditionally women have had more than their fair share of loss. Because of their greater engagement with childcare and the family they have been hit harder than men. These losses seem cleverly spaced to give you just enough time to recover before the next one arrives.

• Loss of total dependence on a parent as a toddler.
• Loss of dependence on the family with the onset of adolescence.
• Loss of virginity in young adulthood.
• Loss of independence (and surname) on marriage.
• Loss of career after childbirth.
• Loss of children to school.
• Loss of grown-up children from home.
• Loss of ovulation and childbearing capacity.
• Loss of partner through (usual) pre-decease.

Older people who are bereaved will have learned to be men and women in the first half of the twentieth century. Gender differences then were usually much clearer.

Although there is a risk of stereotyping responses there are general differences in the way that men and women respond to emotional crises.

• He will tend to consider the broad situation. She will concentrate on the details.
• He may ‘think’ about the situation. She will focus on her feelings.
• He might try to be logical. She may rely on intuition.
• He may want to contain his emotions. She will want to express them.
• He may want to keep busy as a distraction. She will focus on her pain.
• He might avoid showing his feelings to strangers. She may welcome support from others.
• He might seek comfort and intimacy in sex. She may have no interest.
• He will tend to want things to get back to normal. She knows things will never be the same again.

To a lesser extent this will be generally true for people brought up in more recent years. The rapid changes in gender roles which we have seen in the last few decades will mean that there may be much less distinct grieving patterns in men and women in the future.

On the other hand we know so little about differences in the psychology of men and women. There is some evidence that the more straightforward, ‘no nonsense’ response seen so often in men may be a positive in-built genetic function, whose purpose is to ensure that ‘life goes on’. Men’s less demonstrative response also allows them to set aside their own feelings to look after their partner and ensure family survival.

Men will tend to approach loss with a wish to reorganise things and restructure family life. We do this because it involves a lot of thinking and planning and we may be biologically more comfortable with this. We will also have other characteristic responses:

• Remaining silent is a good protection against facing up to vulnerability.
• Experiencing solitary grief in private ‘spares’ others from seeing our pain. (There may be a lot of lengthy dog-walking.)
• Getting involved in activities – work, legal action, domestic support – will take up energy and thought: we won’t have time to feel or reveal our pain.

We will be much happier with a ‘problem-solving’ approach and we’ll be much more responsive to ‘How did you react?’ rather than ‘How do you feel?’

Men and women seem to deal with their grief according to the strengths of their gender – this may be something to be celebrated rather than criticised.

Carl Jung says we balance our lives as we age... men become more in touch with their feminine qualities and women become more aggressive and in touch with their male qualities.

If there is some truth in this we may need to hesitate before being critical of men’s ‘difficulty in looking at their feelings’ – maybe (in spite of evidence to the contrary) masculine stoicism and apparent reluctance to grieve can be a normal and successful way of dealing with bereavement.

Unsurprisingly, research confirms that women show much greater distress after a bereavement and they are harder hit during the first year. They also seek medical and psychiatric help more readily.

Men, on the other hand, seem to cope well at first –although many more men than women will suffer a heart attack in the months after the loss of a partner. Another study (Young, Benjamin and Wallace, 1963) of 4,486 widowers over 54 revealed a 40 per cent increase in death rates during the six months following the death of a spouse.

Also, when men are followed up two to four years after the death they are usually found to have taken longer to recover than women. The general life expectancy of these widowers is reduced by 18 months as opposed to six months for widows and there is a 66-fold increase in suicidal deaths in widowers compared to a ten-fold increase for widows.

In a 1995 study of parents who had lost a baby it was concluded:

Mothers and fathers grieve differently: mothers grieve for their babies, fathers grieve for their wives.

Although there is much encouragement for men to express their feelings, paradoxically, when they do, there is some evidence that other people find it genuinely upsetting. The family – particularly the children – may find such vulnerability shocking in their father (it may also be the first time they have seen their father in tears).

Men in this situation are leaving the protector/provider role and the result is that the family experiences anxiety at the loss of that function. These men often quickly realise the discomfort of others with their tears, and this solidifies their solitary grief. In this way, men’s so-called ‘emotional immaturity’ can be seen as simply a different, authentic and positive response.

Just because men cry less than women doesn’t mean they feel less

The physical production of emotional tears is triggered by the hormone prolactin. Levels of this chemical drop at about the time a young boy enters adolescence. This makes it more difficult for men to access ‘emotional’ tears. This could have a genetic function – it may have been important for early Man not to reveal himself as vulnerable in the face of crisis.

... Another physical difference is provided by research, which indicates that men and women have significant differences in brain structure.

One hypothesis theorises that this difference gives a woman a greater connection between her verbal capacity and her feelings, and leaves a man less able to verbalise feeling states. If this hypothesis is true, it would help explain why men tend towards activity in engaging their grief.

Tom Golden, Swallowed by a Snake: The Gift of the Masculine Side of Healing, 1999

Further research reveals that the network of connections in a woman’s brain to do with communication amounts to 40 per cent of the total area: in men it’s 7 per cent. Men sometimes find it easier to find a pathway to their grief through anger: women find it easier through sadness:

Many times in working with men I have found that while a man is expressing anger (and I mean really expressing it... loudly, with movement of the body, etc.), he suddenly will be moved to tears. It is almost as if touching on that profound and deep feeling of anger has brought him in touch with his other feelings. This process is reversed with women. Many times a woman would be in tears, crying and crying. I might ask what her tears are about, and she often would state plainly and many times loudly Tm angry. ‘

Tom Golden, Swallowed by a Snake: The Gift of the Masculine Side of Healing, 1999

A further implication of these broad differences between men and women in their grieving needs is that we ought to expect different forms of support. To complain that ‘men are notoriously bad at dealing with their feelings’ is as unhelpful and offensive as to say ‘women like to wallow in their feelings: they should get themselves more organised.’

Most of the material in this book will necessarily relate to women’s grief, because it is much more visible, accessible and ‘helpable’: men will apparently cope well and be less vulnerable. However, some research, published as The Erst Year of Bereavement (Ira O. Glick, Robert S. Weiss and C. Murray Parkes, Wiley 1974) which contrasted widows with widowers came up with some other interesting results.

• Men tended to react to the traumatic disruption to their lives: women were more affected by the loss of the person.
• Men tended to think that they had lost ‘part of themselves’: women talked of loneliness and ‘abandonment’ by their dead partner.
• Men had more difficulty settling back into their working lives: for women work was often a helpful distraction.
• After a year 74 per cent of the women still cried occasionally as opposed to 40 per cent of the men.
• When they had some forewarning of their partner’s death, men were better prepared: women tended not to want to believe it until it happened.
• Men were more ‘realistic’ in their attitude to their loss, showing fewer signs of hostility, injustice or disbelief.
• Men felt considerably more guilt about their own part in the time leading up to their partner’s death but it was not long-lived: women felt less guilt but it lingered longer – and often increased.
• Men were twice as likely to have had ‘involuntary visualisations’ of their dead partners than women.
• Only a quarter of the men had talked with family or friends about their feeling as opposed to half the women.
• Men were seen by others as needing practical help because ‘they couldn’t do household tasks’: women were supported so that they could ‘attend to their feelings’.
• Men were all grateful for the help and support they received: women were sometimes critical.
• Only 4 per cent of the men had asked for professional help with their grief: with women the proportion was 40 per cent.
• Men were much less interested in the details of funeral arrangements and less satisfied with funeral directors.
• Men were more ready to seek a new partner sooner than women – sometimes after only a few months. However, they often brought their grief with them into their new partnership – causing further difficulties.
• Men who had been forewarned of their partner’s death tended to adjust well to remarriage. Where the death had been unexpected they generally all had problems adjusting to a new relationship – but they tried. With women, the sudden death of their partner was much more likely to cause an almost phobic aversion to seeking another partner.

Men may need more active, practical ways of working with their grief. They don’t want to be a burden to others, they want to maintain their independence, and they may want to ‘be strong’ in dealing with their grief. Unfortunately, the helping professions have traditionally been more familiar with working with women and the ‘talking therapies’ are consequently much more geared to looking at feelings. This not only may not be a successful way of helping men but it almost certainly discourages many men from seeking help.

The older, the easier?

Society avoids them, whether they are young or old, but especially if they are old, for in that case they are doubly distasteful. They have no one to talk to about the only subject that matters to them, the person they have lost.

Phillipe Aries, The Hour of our Death, 1983

We’ll see later how difficult loss can be in a young family. Young people are unprepared for death and are often lacking emotional, social and material resources, which will add to their problems. The shock and intensity of grief are much more marked in young adults. However young people often have more resilience than the older generation, they can respond more easily to change and they have a stronger constitution in the face of the side effects on the immune system. The blow is greater but recovery is quicker and more successful.

We tend to neglect grief in older people. As we age we tend to slow down, be less active, become more reflective and more aware of our mortality. When someone close dies it may not be unexpected: they may have been incapacitated for some time and others may assume that their survivor is coping reasonably well – at least she may look as though she is.

Indeed there may not be so much of an immediate trauma. However, in a 1991 study Grief in Elderly Adults (Omega) Peter Sable found much greater levels of distress in older than younger widows if you asked them ‘one to three years after their loss’. There are three good reasons for this:

• Longer relationships create greater dependence and, if they are unhappy, more regrets and greater opportunities for guilt.
• Older people are often less motivated to adapt to a new future.
• Our ability to respond to changes in our immune systems is reduced – leaving us open to physical symptoms of grief.

Bereavement in older people is, therefore, not as sharp initially but can be longer lasting and more problematic in the long run.

This is not to say that older people generally are not able to come through a bereavement successfully. Often age brings resilience, resourcefulness and stronger social supports. Even though over 70 per cent of bereaved older spouses reported the loss as the most stressful event of their lives, after two years over 80 per cent will be managing with a good degree of success.

Widowism

‘Widow’ is a harsh and hurtful word. It comes from the Sanskrit and means ‘empty’. I have been empty too long.

Lynn Cain, Widow, 1974

‘Widowism’ describes an underlying attitude which is cloaked in good intentions but which has a dark unconscious purpose. It has been handed down through the years and, although no one would agree with it these days, there is a danger that its resonance lives on in our attitudes, not just to widows, but to other bereaved people

If we look back on what has been written about grief, until recent decades, it’s mostly been by men describing women’s experience of bereavement. It tends to focus on the ‘catastrophe’ of the loss of her man and looks at ways in which she can ‘come to terms with her pain’.

The future lies in becoming used to her new life without her all-important partner and finding what comfort she can in her loneliness. It is describing the ‘end’ of a relationship and paints a bleak picture of a pathetic victim who may be fortunate enough (in exceptional circumstances) to be chosen by another man for a new relationship – although the context of age, lost social skills and poverty are also usually stressed.

Put this way – and I admit to some exaggeration – these are plainly sexist and ageist attitudes. The unconscious intention is to contain and remove an older woman – useless because of her lack of male support – from social circulation.

All right, it’s a far-fetched theory – but there’s the smell of truth in it.

Its deceptive appeal lies in its false logic: what greater honour could there be to the quality of the lost relationship than to declare it the most important, most unrepeatable experience of our lives? What greater expression could there be of our commitment than visibly to retire from life? To do anything else might give the impression that we could imagine something as good or better in the future.

Such an attitude might seem an exaggeration but it is almost universally common. In rural Greece, for example, it is the almost inflexible rule that a widow – even a young woman – should dress from head to toe in black and shun all male attention for the rest of her life.

When we look at other important transitional stages in life – leaving home, getting married – they all leave enormous losses in their wake, but we don’t dwell on what we’ve left behind: we see them as positive opportunities for development.

I’m not suggesting that the death of a lifelong partner could evoke any of the same hopes for the future but it seems a shame that there is such a universal social pressure on us to see only loss, failure, emptiness and hopelessness.

It was hard for her at first hut it’s good to see her out and about again. She’s had her hair restyled and she’s looking elegant. She’s going to sell the business and start an aromatherapy consultancy with a friend. She misses their life together but says she feels ten years younger. It’s all very exciting.

That’s someone talking about a friend six months after a divorce. Would it be unthinkable for a widow to talk in the same way?

Dr Morton Lieberman describes recent research he did with 700 widows and widowers.

I began this study with the typical mental health professional’s attitude – a male perspective – which I have now come to understand was coloured by the myths and half-truths that I brought to the study. I started out thinking of widowhood as an illness and expecting that recovery would be the return to ‘normality’ – a life similar in most respects to the previous one. What I found, instead, were women who discovered in themselves a new way – a way of strength and assurance.

Doors Close, Doors Open: Widows Grieving and Growing, 1997

Change can bring about growth

Happiness is beneficial for the body, but it is grief that develops the powers of the mind.

Marcel Proust (1871–1922)

When I am dead, my dearest,
Sing no sad songs for me;
Plant thou no roses at my head,
Nor shady cypress tree...
And dreaming through the twilight
That doth not rise nor set,
Haply I may remember,
And haply may forget.

Christina Rossetti (1830–94), ‘Song’

It is like being a budgie in a cage on a windowsill and finding that someone has left the door open. No, we may not have particularly enjoyed life in our cage, but we are used to it. Now we have a decision to make. We can cower in a corner, as far from the open door as possible; we can sit nervously just by the open door, admiring the view without the bars and imagining what it might be like outside; or we can attempt a first tentative flutter.

Virginia Ironside, You’ll Get Over It!, 1996

The deeper that sorrow carves into your being, the more joy you will contain.

When you are joyous, look deep in your heart and you will find it is only that which has given you sorrow that is giving you joy.

When you are sorrowful look again into your heart, and you will see that in truth you are weeping for that which has been your delight.

Kahlil Gibran, The Prophet, 1926

How can there possibly be anything to be gained from the loss of a loved one? We are used to seeing death being associated with awkward and unremitting misery; it looks as though it causes nothing but harm. However, some losses can develop positive aspects.

‘You just sit there and III see to that...’

One of the secret rewards of bereavement is that we are made to feel special. We might be very cautious about admitting it but this is a rare occasion when we can expect and demand the attention and comfort of others. It’s a seductive feeling (similar to the fuss we get when we’re ill) because it takes us back to our childhood when we had our parents’ unconditional love and support.

It’s best that we accept this and resist any feeling of discomfort. Why not just yield to the interest and kindness of others? It is usually intended sincerely and likely to be useful.

On the other hand we might be more comfortable to be quiet and alone. If this is the case we should make our wishes clear: unwanted fuss can be very wearisome. (We might, however, have to cope with suspicions that we are avoiding things’.)

The other side of the coin, however, is that we may grow to like the attention far beyond the time when we actually need it. Fortunately, other people will let us know when we’ve ‘outstayed our welcome’.

Grief is the agony of an instant: the indulgence of grief the blunder of a lifetime.

Benjamin Disraeli (1804–81), Vivian Grey

‘We seem to have come closer together as a family...’

Although the focus is on the person who has died, the event brings together the immediate and the wider family –sometimes from a distance. The strengths and bonds of the family are reaffirmed and honest feelings are revealed which can deepen relationships: often, positive feelings emerge unexpectedly. (On the other hand, if they are the ‘wrong’ sort of honest feelings there can be family havoc.)

On the whole bereavement will tend to unite and mature a family. The surviving partner may think that it is the end of their world, but it isn’t. Just as the harshness of the winter gives way to spring, so we, if our bereavement has been successful, will eventually emerge from the worst of our grieving and realise the possibilities for the future.

‘You’ve only got yourself to think of now...’

Maybe for the first time in our life we can put ourselves first. Long-term family relationships can be very satisfying, but to sustain them we may have set aside some of our personal needs over a long period of years.

We would never have chosen it this way, but we can now reassess personal goals: there may even be life insurance money to help us on our way.

For the last 11 years Phillip was in a wheelchair and before that the children were at home, so I’d never even considered putting what I wanted first. I thought I was perfectly content –I never resented being a carer,

Although expected, it was still a shock when he died. For months after I was at a loose end. One day my sister jokingly suggested Greece. She reminded me how, as a teenager, I had been passionate about Greek mythology and used to dream of going there.

Gradually the idea began to form in my mind and I began to feel excited for the first time in years. The following year I spent four months touring archaeological sites and museums in Greece and Crete. It changed my life. I made new friends and I’m going back to Athens for three months in September.

Often, after living a rather dull, uneventful life, bereavement can act like an electric shock to force us to confront our future directly and look for a purpose in it. Our old way of life has been swept away and we can’t avoid facing the basic questions:

• ‘Why do I wish to continue living?’
• ‘What will I do now?’

At first our response to these questions may be negative and it would be better to put them to one side. However, they won’t go away: eventually we’re going to have to respond to them.

Many people, who can eventually come to accept their loss, will realise that there is a possibility of a new, different future, full of meaning and richness.

People who have had entirely happy marriages may often find, even in the middle of feeling unhappy, a weird sense of freedom when their partner dies, a feeling of release from being conjoined to another person. They are suddenly aware of how much their personality was buried or enmeshed with the other’s ... many is the man who suddenly finds that his wife has been keeping the joys of cooking from him for years, or the woman who delights in suddenly taking charge of everything and thrills at last to he in the driving seat of the car.

Virginia Ironside, You’ll Get Over It!, 1996

It is one of life’s laws that as soon as one door closes, another opens. But the tragedy is that we look at the closed door and ignore the open one.

‘It’s a lesson for all of us...’

I walked a mile with Pleasure;
She chattered all the way.
But left me none the wiser
For all she had to say.
I walked a mile with Sorrow
And ne’er a word said she;
But oh, the things I learned from her
When Sorrow walked with me!

Robert Browning (1812–89), ‘Along the Road’

Another pay-off is the simple realisation of the reality of death and the uncertainties of life – how we should value the present: death can come to anyone at any time: a bitter but maturing experience.

What would have been left unsaid to whom if you were to die in an hour’s time? What will you regret not having said to whom if they die tomorrow? As Elisabeth Kubler-Ross writes:

What I try to teach people is to live in such a way that you say those things while the other person can still hear them.

If we have made the journey through bereavement we will also be in a good position to help others through their grief:

The more people have lost, the more they will eventually have – to offer others.

Dr Colin Murray Parkes, Recovery from Bereavement, 1983

Working through the chaos and pain of bereavement is hard, but can be productive. The effort can have spin-offs, which can help us move into a more developed level of functioning.

By facing despair, and not succumbing, they know their inner capacities in a more complete way. These gains do not in any way diminish the fact of the loss. But yes they are benefits. Dearly purchased, hard earned benefits.

S. A. Schwartzberg, A Crisis of Meaning, Oxford University Press 1996

‘It’s like a bereavement...’

While we’re thinking about the nature of grief it’s worth remembering that bereavement is not some special set of feelings connected only with death. It’s to do with loss or sudden change.

Any important loss will carry its own quota of grief.

• We can grieve for our own physical loss if we become disabled.
• Sudden poverty can cause economic bereavement.
• Redundancy or retirement may cause us to feel bereaved of our work routine and sense of ourselves.
• Many separations – where there may be accompanying feelings of failure and bitterness – can have more impact on us than if our partner had died.
• We can celebrate our lottery win, but we may also grieve for our old, familiar way of life.
• Some degenerative diseases – Alzheimer’s Disease for example – feature total or intermittent loss of personality, causing confused grief for a living person – ‘For me, my mother died two years ago...’
• So-called ‘mid-life crises’ are often simply grief for the loss of our own unfulfilled ambitions – ‘This is as good as it’s going to get.’
• Theft or lost property can cause us what seems disproportionate distress.

It isn’t like a bereavement: it is a bereavement.