Ana María Egido: "Grief makes the person connect with the emptiness".

Ana María Egido presents the book "Grief and resilience: a guide for emotional reconstruction".

Grief is one of the most intense psychological phenomena and, while it lasts, more emotionally painful.

Based on a situation of loss, it goes hand in hand with the need to adapt to a new reality in which we miss something or someone. For this reason, emotional discomfort often goes hand in hand with objective changes in our environment: not being able to talk to someone, seeing the place where we live transformed, etc. It is, therefore, an experience that not everyone finds easy to manage.

To better understand the nature of psychological grief, we interviewed the psychologist Ana María Egido of the psychotherapy center El Prado Psicólogosco-author of the book Grief and Resilience: A Guide to Emotional Reconstruction.

Interview with Ana María Egido: understanding the grieving process.

To learn about the key ideas that help to understand grief, we interviewed Ana María Egido, psychologist at El Prado Psicólogos and co-author with Rosario Linares of the book Grief and Resilience: A Guide to Emotional Reconstructionpublished by Oberón.

How did the idea of writing the book come up?

Grief, whether due to a breakup or the death of a loved one, is one of the reasons why many people come to our office.

Despite the fact that grief is something universal, that is, something that all human beings will go through at some point in their lives, we observe that there is a lot of ignorance about it and this makes people experience it with greater suffering.

For this reason, we thought it would be useful to write a book aimed at the general population, so that those who read it can become familiar with the process and understand it better.

On the other hand, we also wanted to give it a practical approach, so in the first part of the book we talk about what grief is and what it feels like when we go through its stages, and in the second part, we focus more on what we can do to survive grief in a resilient way.

We are very grateful, over the last few months we have received many comments from people and colleagues who have recommended the book to both patients and acquaintances who are going through a bereavement because they consider it a complete guide that helps to understand the process and relieves emotionally those who are going through it.

Do we tend to overlook the existence of forms of grief that have nothing to do with the death of someone important to us?

Usually the word bereavement leads us directly to think of the death of a loved one, but there are other losses and events that can also cause us to go through bereavement.

In the book we have guided the process of grief based mainly on the loss by death and breakups, but beyond this, we wanted to offer a vision that can be useful in a general way for people who are going through any type of grief, so that in this way, they can identify the Pain that produces them and have resources to deal with it.

Depending on each person, there are other losses that can cause us to go through grief. In a chapter of the book we wanted to collect some of them referring to perinatal grief, since we have found that many couples suffer it without being able to express their pain or see their loss recognized.

It is a way of claiming and drawing attention to the fact that parents who have lost a child before birth or in the first days of life face a very painful grieving process that is rarely legitimized or recognized by health professionals, the family, the workplace or the closest circles.

We have come across cases in which they tell us how women who suffer an abortion are admitted to the same floor as those who are admitted to give birth, sharing a room with them.

Another of the demands they have is in relation to the recognition of bereavement. They tell us that people in their family, work or social environment do not understand why they feel sad for so long, do not give them the attention or help they need, or try to console them while encouraging them to have another child soon.

Another loss we cite, because we feel it is very important to make it visible so that it is taken into account due to the high level of grief it produces, is the death of a pet. People who are grieving the loss of their pet need to be accompanied, they need time to overcome the loss, and not recognizing this process only makes it more difficult for them to recover in an adequate manner. Animals are part of the lives of the people who care for them and leave a tremendous void after their death, so we believe it is important to respect and validate their pain.

Beyond the losses mentioned above, there are other types of circumstances that can lead to a grief process, such as loss of health (loss of physical or cognitive abilities), migratory grief (change of country of residence mainly) or loss of a job, among others.

From your professional experience, do you think that those who have gone through more bereavement situations tend to feel less discomfort, without ever having gone to therapy with this reason for consultation?

This is a complex question, as it depends on each particular case. Let's look at some possible scenarios in relation to this.

There are people who have suffered previous unprocessed losses and in whom the current loss reactivates these previous unprocessed griefs, so that even if they have suffered these experiences before, the current loss can make them feel worse, and often leads them to the consultation.

On the other hand, if the tasks of grief have been carried out adequately, having survived other losses in an adaptive way can make the following ones to be faced from these experiences that in the end teach us that we have been able to sustain the pain, so we will also be able to do it now.

But it is important to keep in mind that each grief is a world, and it depends not so much on having had previous experiences of grief, but on the moment in which the loss occurs, the bond or relationship we had with that person and the circumstances of the loss.

Can grief evolve into depression?

Grief is a process that makes the person connect with the emptiness and deepest sadness, which for a time "takes you away" from life as you lived it before in order to reestablish yourself and find a new meaning to help you move forward. Many people may confuse these states with depression, and in most cases this is resolved with the passage of time and the fulfillment of the tasks of mourning.

It becomes depression when the mourner cannot re-signify the meaning of his/her life, when he/she stagnates and continues to live focusing his/her attention on the person who is no longer there, when he/she cannot function normally in the different areas of his/her life, when the level of suffering does not become more bearable and the person continues to live with much discomfort even though a considerable amount of time has passed.

In these cases the intervention of a mental health professional would be necessary so that the grief does not become entrenched and lead to other psychological disorders.

What is the moment when a person should consider going to therapy to treat his or her grief distress?

As I mentioned earlier, one of the key moments to go to grief therapy is when a reasonable amount of time has passed and the person is still unable to restore his or her life, when the discomfort (guilt, despondency, anger, loneliness) overflows and he or she feels that he or she does not have the resources or sufficient strength to tolerate it.

It is also advisable to go preventively, that is, if you feel that, although little time has passed since the death, the help and accompaniment of a professional can help you to guide the grieving process, providing information about the process that you are going to live and offering you resources that will help you to alleviate the pain. Therapeutic grief work is very important and is key to helping the bereaved experience grief with less disruption.

Unfortunately, due to the COVID-19 pandemic, society has had to face new ways of experiencing grief. What are its characteristics or what makes it different?

One of the most frequently mentioned topics during this pandemic has been the mourning of family members who have lost loved ones whom they have not been able to accompany or give a dignified farewell.

The mourning for COVID-19 has brought us certain peculiarities that we must take into account. On the one hand, in some cases, especially at the beginning when we did not have sufficient means and information, there have been cases in which family members, professionals or caregivers themselves have been vectors of contagion. For these people, the feelings of guilt and anger are, if possible, much more pronounced, and can lead to complicated mourning.

Another characteristic of this grief is that it accentuates helplessness, feelings of guilt, fear, anger and loneliness. The mourners may feel intense discomfort because they have not been able to accompany their loved one, because they have not been able to offer them the help and attention they needed, because they have not been able to say goodbye, because they have not been able to receive the affection of other loved ones because they are confined. This experience has reminded us of the unpredictability of death.

Finally, I would like to emphasize the importance of farewell rituals and accompaniment in the last moments of life. In the stories of people who have not been able to say goodbye to their loved ones, we can appreciate how necessary it is to be able to say goodbye to the body to begin to accept what has happened and minimize the feeling of unreality, the funeral has a great value of repair both internally to begin to elaborate the death and socially, giving us the opportunity to talk about what has happened, what we feel in order to give meaning and to receive the affection and closeness of the people who love us and constitute our support network.

The fact that family members have not been able to do so, or have done so quickly and with very few relatives, has been one of the dramas of this pandemic.

If you would like to purchase the book Grief and Resilienceyou can do it in this page.