Bereavement in times of pandemic

In a pandemic situation, pathological grief is more frequent, but it can be treated.

The death of a loved one is one of the moments in everyone's life when the human need for contact is most evident.

There is no one right way to go about the grieving process and no right time frame to do it.. For example, the unexpected deaths or in complicated circumstances (accidents, suicides, missing persons), usually originate more difficulties in the elaboration of the mourning.

But what is grief?

There are many articles and information about what is grief and its phases, here I would simply like to emphasize that grief is a normal process that we go through when we have lost a loved one and in which we have to adapt to a new reality. It is important to emphasize the normality of grief in the grieving process.We live in a society that has very little tolerance for discomfort.

We cannot avoid the emotional Pain we feel when we have lost someone important in our lives, there are no shortcuts or tricks to avoid suffering. Understanding the process and accepting it is the beginning of emotional healing that can lead to turning grief into an enriching experience and personal growth.

The normal process of grief is not a diseasebut the development of acceptance of the loss. Dejection and sadness are the usual emotions. Each person feels this experience in his or her own way and experiences the intensity of grief subjectively. Family and friends may share the expression and manifestation of grief, but not what is actually felt, let alone its magnitude.

The normal grieving process becomes a roller coaster of emotions in varying degrees. You go from disbelief of the death to irritability, to fear, to frustration or confusion, all of which are normal, natural and healthy. It is also common to feel anxiety, tachycardia, nausea, tiredness, headaches, disinterest, and the desire to cry.. Facing these emotions and feeling the pain is the key to overcome grief, avoiding suffering by taking drugs or consuming alcohol and drugs is a big mistake.

When grief is complicated

In recent years there has been much research on what are those risk factors that cause complications in the natural grieving process, which is known as complicated grief. This type of grief is one whose intensification reaches the level where the person is overwhelmed, resorts to maladaptive behaviors or remains steadfastly in this state without advancing in the grieving process towards its resolution.

The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM 5), calls it persistent complex grief and is characterized by continuous longing for the deceased, accompanied by intense grief and frequent crying and worrying about the deceased or the manner of death. These symptoms should continue for at least 12 months since the person's death (6 in children), although this criterion must be relativized, as each person is different. What is important is the level of suffering of each person and whether he/she considers him/herself stuck in it.

Types of complicated grief

One of the world's experts on bereavement, J. W. Worden, proposed a distinction between four types of complicated bereavement:

Chronic grief

Symptoms persist for yearsOne of the most prominent aspects of this type of bereavement is that the person experiences a sense of incompleteness.

Delayed grief

In this type of grief, the characteristic symptoms appear months or even years after the death of the loved one. Sometimes it happens when the suffering is too intense, or when conditions force the person to stay strong and postpone their grief..

Exaggerated grief

Worden speaks of exaggerated grief when the symptoms are excessive and practically prevent the person from living a normal life.

Masked grief

Problems, such as drug, drug or alcohol abuse, are manifested and the person is unable to cope with them.The person is unable to recognize that they have anything to do with the loss suffered.

Differences between normal and pathological grief

What differentiates pathological bereavement from normal bereavement are the intensity of the symptoms, the duration of the reaction and the appearance of some symptoms that do not occur in normal grief, such as hallucinations or delusions.such as hallucinations or delusions.

In the initial phases of complicated grief, physical symptoms such as insomnia, fatigue and/or weight loss usually predominate, but with time, emotional and psychological symptoms such as anger, rage and anguish, as well as hopelessness or death wishes, become more intense and frequent.

Mourning in times of pandemic

Tributes, funeral rites, and farewells are an important part of the healthy grieving process.. Throughout human history, the need for a physical time and space, often shared, to show the loss has been evident.

In the horrible circumstances that plague us today, where our family and friends die in the distance. Where a very short period of time elapses between diagnosis and death that prevents us from preparing to mourn. Where we cannot give a last kiss, a last look, a last hug.

In these circumstances it is normal that we can be blocked by the guilt of "I should have done, I should have done, I should have done" type of guilt. of the type "I should have done, or said something else" or that anger ("damn government, they did not do everything necessary in the hospital") or a deep sadness ("I will never stop suffering"), prevent us from moving forward in the rethinking of our life without the loved one.

In these cases, it is possible that we may develop pathological grief and it is advisable to seek the advice of a grief therapist.

How to cope with delayed grief

Finally, I would like to recommend some very useful guidelines for coping with the loss of a loved one in these circumstances.

Perform farewell rituals.

You can prepare a virtual meeting via Skype or WhatsApp and organize a farewell, even if you cannot be together.

Agree on a time and make a tribute to that person by telling anecdotes, writing on your social networks, telling anecdotes, writing on your social networks, and so on.You can also write on your social networks or, for example, light candles at the same time. You can create a group or make a page for that person and everyone can write what they feel, upload pictures and share their feelings.

It is important to include people with functional diversity and children in these rituals, explaining to them in a clear and simple way what they feel.It is important to include people with functional diversity and children in these rituals, explaining the situation in a clear and natural way, valuing the age and abilities of each one, and how they can participate.

If you don't feel strong enough to share the loss together, it is your right to do it more intimately or by yourself. Write a poem, journal or letter telling how you feel or what you would say to the person. You can also draw pictures if you can't find the words. Do it the way that makes you feel best.

Create a space in a room for the memory. Choose a photo, decorate it as you like, with candles or flowers or even objects of that person. Whenever you need it, go to that corner and express yourself. Tell him/her what your life will be like from this moment on, remind him/her what things you liked and say goodbye if you need to.

Practice self-care

Having explained the roller coaster that we go through in a grieving process, we must take into account the fact of not "losing ourselves" in this process.

Take care of your diet and your rest times.. Try to keep your schedule and listen to your body, if you need to slow down, do it, allow yourself to recover, but do not give up.

Practice exercise, find an occupation such as cooking, reading, meditating and take advantage of a ray of sunshine on the balcony or window.

It is normal for feelings of sadness or anger to surface, if you need to be alone or contact with people who make you feel good, do it.. You will probably receive calls from many people to express their condolences and interest in you. Give them guidelines and schedules.

Seek help to manage your emotions, either from family and friends or, if necessary, from professional bereavement psychologists. The telephone lines provided by the state (health center, red cross, police, etc.) can also be of great help.

Finally, avoid overloading yourself with information that will "contaminate" you, look for activities that will relax you.Don't make too many important decisions and don't demand too much of yourself.

Allow yourself time to heal

Remember that this situation will not last forever and that, when all this is over, you will be able to say goodbye in person with all your loved ones.

Conclusion

In this article we have wanted to highlight the importance of carrying out the grieving process as naturally and smoothly as possible to avoid, as far as possible, a possible later complication.

It is well known that in special circumstances like the ones we are living, there is a higher probability that the natural grief becomes pathological, so everything we can do to help the bereaved is a good idea.So everything we can do now to cope with this process will help us to prevent a possible disorder. If you see that this situation is becoming too complicated for you or your loved ones and that the resources available to you are not sufficient, do not hesitate to seek the help of a bereavement psychologist.