Dr. Anupam Dey, Grief Management, MEGA ARTICLES

THE WHYS AND THE WHEREFORES

“Why did this happen to me?” he shot back. His eyes were almost bloodshot. His whole body was shaking, gesturing the disbelief in his soul. I could hear the clock ticking by as a cloud of silence encompassed us. He continued, “Never in my life have I touched liquor nor do I have any bad habits, then why?” From the corner of his right eye, I did see a tear drop fall. “They said, you are on the best around here, can you not do something? Are you really telling the correct thing?” he questioningly smiled at me while tears flowed down like a leaking drain pipe. I nodded in unison only to find him suddenly slouching on his chair, to collapse.

Scenes like this happen at my Surgical out Patient Clinic on a daily basis. He had come with complaints of acidity, heartburn, vomiting and significant weight loss. Investigations revealed that he had Cancer of the Stomach and as a Surgeon I had to tell him this. The myriad of emotions that he displayed came very suddenly, just when I explained him his condition. Youngish man of 38 years, his whole world came crashing down. As a doctor I knew his pain and thought process. His myriad of emotions that flowed through him, asking the “The Whys and Wherefores” is how we define Grief.  Every time grief makes its presence felt in my office, lines written by the Poet Delmira Agustini come alive:

“Suddenly I laugh and at the same time cry

And in pleasure many a grief endure

My happiness wanes and yet it lasts unchanged

All at once I dry up and grow green”

(Excerpted from the Poem, I Live I Die I Burn I drown by Delimira Agustini)

 

Grief is a natural response to loss. It’s the questionable emotional suffering you feel when something or someone you love is taken away. The more significant the loss, the more intense the grief will be. However, even subtle losses can lead to grief. For example, you might experience grief after moving away from home, graduating from college, changing jobs, selling your family home, or retiring from a career you loved. Grieving is a personal and highly individual experience. How you grieve depends on many factors, including your personality and coping style, your life experience, your faith, and the nature of the loss. The grieving process takes time. Healing happens gradually; it can’t be forced or hurried—and there is no “normal” timetable for grieving. Some people start to feel better in weeks or months. For others, the grieving process is measured in years. Whatever your grief experience, it’s important to be patient with yourself and allow the process to naturally unfold.

In her groundbreaking book, On Death and Dying noted Swiss-American Psychiatrist and pioneer of Near Death Studies, Elisabeth Kubler-Ross, says that there are 5 stages of the grieving process.

  • Denial:“This can’t be happening to me.”
  • Anger:Why is this happening? Who is to blame?”
  • Bargaining:“Make this not happen, and in return I will ____.”
  • Depression:“I’m too sad to do anything.”
  • Acceptance:“I’m at peace with what happened.”

If you are experiencing any of these emotions following a loss, it may help to know that your reaction is natural and that you’ll heal in time. However, not everyone who grieves goes through all of these stages—and that’s okay. Contrary to popular belief, you do not have to go through each stage in order to heal. In fact, some people resolve their grief without going through any of these stages. And if you do go through these stages of grief, you probably won’t experience them in a neat, sequential order, so don’t worry about what you “should” be feeling or which stage you’re supposed to be in.

Grief is not a medical condition until depression sets in and adds injury to insult and yet Psychiatrists have gone ahead to define a Symtomatology for it. While loss affects people in different ways, many experience the following symptoms when they’re grieving. Just remember that almost anything that you experience in the early stages of grief is normal—including feeling like you’re going crazy, feeling like you’re in a bad dream, or questioning your religious beliefs.

  • Shock and disbelief– Right after a loss, it can be hard to accept what happened. You may feel numb, have trouble believing that the loss really happened, or even deny the truth. If someone you love has died, you may keep expecting him or her to show up, even though you know he or she is gone.
  • Sadness– Profound sadness is probably the most universally experienced symptom of grief. You may have feelings of emptiness, despair, yearning, or deep loneliness. You may also cry a lot or feel emotionally unstable.
  • Guilt– You may regret or feel guilty about things you did or didn’t say or do. You may also feel guilty about certain feelings (e.g. feeling relieved when the person died after a long, difficult illness). After a death, you may even feel guilty for not doing something to prevent the death, even if there was nothing more you could have done.
  • Anger– Even if the loss was nobody’s fault, you may feel angry and resentful. If you lost a loved one, you may be angry with yourself, God, the doctors, or even the person who died for abandoning you. You may feel the need to blame someone for the injustice that was done to you.
  • Fear– A significant loss can trigger a host of worries and fears. You may feel anxious, helpless, or insecure. You may even have panic attacks. The death of a loved one can trigger fears about your own mortality, of facing life without that person, or the responsibilities you now face alone.
  • Physical symptoms– We often think of grief as a strictly emotional process, but grief often involves physical problems, including fatigue, nausea, lowered immunity, weight loss or weight gain, aches and pains, and insomnia.

Grief though is just a passing phase. It fades away with time but is the first step towards depression. If handled correctly it is a roller – coaster that ends quickly. As a doctor I often have to deal with this and this had lead to a care plan that starts immediately I encounter grief in action.

  • Turn to friends and family members– Family members and friends are superb in doing this. I might be technically better at handling grief but strong family bonding wins over all technicalities. It then boils down to one fact, “Better Relationships lead to better grief handling”. A grieving person should have good inter-personal relationships to handle grief better.
  • Draw comfort from your faith– If you follow a religious tradition, embrace the comfort its mourning rituals can provide. Spiritual activities that are meaningful to you—such as praying, meditating, or going to church—can offer solace. If you’re questioning your faith in the wake of the loss, talk to a clergy member or Elder in your religious community.
  • Join a support group– Grief can feel very lonely, even when you have loved ones around. Sharing your sorrow with others who have experienced similar losses can help. To find a bereavement support group in your area, contact local hospitals, hospices, funeral homes, and counseling centers. Look to open up on social media if you can’t open up to anyone. Social Media nowadays has various openings for grieving people.
  • Talk to a therapist or grief counselor– If your grief feels like too much to bear, call a mental health professional with experience in grief counseling. An experienced therapist can help you work through intense emotions and overcome obstacles to your grieving.
  • Take care of yourself and your family. Eating well, exercising and getting plenty of rest help us get through each day and move forward. 
  • Remember and celebrate the lives of your loved ones. Possibilities include donating to a favorite charity of the deceased, framing photos of fun times, passing on a family name to a baby or planting a garden in memory. What you choose is up to you, as long as it allows you honor that unique relationship in a way that feels right to you. If you feel stuck or overwhelmed by your emotions, it may be helpful to talk with a licensed psychologist or other mental health professional who can help you cope with your feelings and find ways to get back on track.

It is no secret that we live in a throwaway society and that goes for bereavement too. People don’t want to hear too much about your grief when they are too busy living. It forces them to look in the mirror and confront their own mortality. Thinking too much about grief is maudlin and thinking too much about death seems macabre and wasteful. Let’s choose to examine the open wound of our grief and almost befriend it. It has visited and cast its shadow over our life. We can only live with it. We should be open to what it has to teach us, that when those we love die, they leave holes in our lives that can never be filled. Grief is the fate of us all. Maybe it’s about time we all had an honest conversation about it.

If I should go before the rest of you 
Break not a flower nor inscribe a stone, 
Nor when I’m gone speak in a Sunday voice 
But be the usual selves that I have known. 
Weep if you must, Parting is hell, 
But Life goes on, So sing as well.

Joyce Grenfell

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