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WHAT IS GRIEF?

The first step towards better interaction with a grieving person is a better understanding of grief. In this context, a grieving person refers to someone who has lost a loved one in a shocking or devastating manner. Suicide, homicide, or loss of a child or spouse at a young age are cases where the bereaved person is likely to need a lot of support in their grief. Interacting with a person who has lost a loved one in this manner may be difficult for others: the enormity of their grief may make you feel helpless. For practical information on how a professional should interact a grieving person, see Interacting with the bereaved.

Sources on the Internet: 

  • Hoitotyön tutkimussäätiö (2018). Äkillisesti kuolleen henkilön läheisten tukeminen. Hoitotyön suositus (online). Hoitotyön tutkimussäätiön asettama työryhmä. Helsinki: Hoitotyön tutkimussäätiö, 2018 (viitattu 4.9.2018). Saatavilla: www.hotus.fi.
  • Poijula, S. (2018). Suru. Soili Poijulan kotisivut (viitattu 9.11.2018). Saatavilla: www.soilipoijula.fi/tietosivut/suru/ 

Literature:

  • Dyregrov K., Dyregrov A. (2008). Effective Grief and Bereavement Support. The Role of Family, Friends, Colleagues, Schools and Support Professionals. Lontoo: JKP
  • Hedrenius S., Johansson S. (2016). Kriisituki. Ensiapua onnettomuuksien, katastrofien ja järkyttävien tapahtumien käsittelyyn. Tallinna: Tieotsanoma. Suom. Strellman U.  Original in swedish Krisstöd vid vid olyckor, katastrofer ock svåra händelser: att stärka människors motståndskraft (2013).
  • Itkonen J. (2018). Kun vauvaonni vaihtuu kuoleman suruun – Narratiivinen tutkimus kohtukuolemasta, lapsen kuoleman aiheuttamasta surusta ja selviytymisprosessista sekä kirkon tuesta. Helsinki: Helsingin yliopisto.
  • Poijula s. (2018). Resilienssi. Muutosten kohtaamisen taito. Helsinki: Kirjapaja.
  • Pulkkinen M. (2017). Surun sylissä. Suomalaisten kokemuksia menetyksestä. Helsinki: S&S.
  • Walter T. (2016). What is complicated grief? A social constructionist answer. Omega: The Journal of Death and Dying vol. 52, no. 1. 71–79.

Other sources: 

  • Poijula, S. (2018). Monikasvoinen suru. Lahden kesäyliopiston 14.11.2018 järjestämä koulutus ja koulutusmateriaalit.
  • Poijula, S. (2009). Traumaattinen suru – osataanko surevaa auttaa?. Pääluento, Surukonferenssi 2009.
  • Pulkkinen, M. (2018). Koulutusmateriaalit ja keskustelut.
  • Haastattelut ja keskustelut surujärjestöjen kokemusasiantuntijoiden kanssa (2018). Haastattelijana toimi Surevan kohtaaminen -hankkeen viestintävastaava Maiju Laitanen.

Grief following a sudden death of a loved one

Grief is more than sadness. The grief resulting from the loss of a loved one comes with a wide spectrum of emotions: it’s common to miss the person, to feel anger, bitterness, fury, guilt, anxiety, despair, loneliness, depression, hopelessness, isolation, agony, pain, helplessness, exhaustion, fear, terror, unsafety and shame. The loss may also come with emotions that are regarded as positive, such as relief and joy. Besides emotions, the loss affects a person’s behaviour and attitudes – and manifests itself as physical reactions in your body.

Life changes permanently with lossGrief is more than a disturbance to get over with – it’s a normal reaction to a heavy loss. The goal of a grieving person is not to ‘let go’ of their dead loved one, it’s to adapt to a life without their loved one. Time will bring new things into your life without breaking up your relationship with the deceased.

The most acute pain will ease with time, but you will never have to stop missing your loved one. Grief can bring about positive changes: the bereaved person may feel that their values have changed for the better. They may value life and people dearest to them more. On the other hand, if you lose your loved one to violence, you may feel permanently disappointed with humanity and life.

Not all bereaved people need medical assistance, but they all need compassionate interaction that treats their loss respectfully. Even the most devastating of losses does not always lead to clinical disorders.

The greatest risk factor in grief is not receiving help and support. Research indicates that support by a professional has a major impact on the wellbeing of the grieving person, both in the short and long term.

It is the professional’s job to encourage the social network of the grieving person to help them. The grieving person should also be encouraged to seek peer support and other professional help if needed. For many, the support of their loved ones and peers is most important.

“I spent half my life with my wife, and it was clear to me that the past was just as important as the future. Living with grief and loss is not a project that you get over in a year or five, or in any time. Loss has become a part of me, and I’m getting better at living with it. It doesn’t stop you from keeping on living or accepting new things into your life.”

Timo, expert by experience, Young Widows of Finland Association
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Myths about grief

“All the talk about phases creates unrealistic expectations and threats. If somebody is doing well, others may say, ‘just wait, the crash is right around the corner.’ The person will start fearing it and waiting for it, even though not everybody goes through a crash.”

Jenni, expert by experience, Child Death Families KÄPY

Different cultures, discourses and professional practices are influenced by conceptions of grief that are unhelpful to the bereaved. These conceptions are the result of a long legacy of research that sees grief as a temporary disorder and a process. In this view, grief goes through stages before reaching its destination. The task of a professional has been to help the grieving person move onto the next stage, or ‘onward’ in their grief. The idea is that the reactions will come sooner or later, and that they should pass by a certain time after the death.

Current research into grief does not support this stage model. Grief is very personal and the way it manifests itself depends on several factors: the individual resources of the bereaved, social support, the bereaved person’s relationship with the deceased, and the circumstances of the death. Although we can see many similarities in the experiences of the bereaved, it’s impossible to set limits or time frames to grief. When helping a bereaved person, the help should be based on the person’s needs and on respectful, humane interactions.

Myth: grief is work

Different discourses and conceptions promote the idea that the bereaved person has to work on their grief to get over it.

In reality, you can’t perform grief

You can’t heal or get over the grief faster by ‘working on it’ more. Not everybody reacts to grief the same way. The lack of strong emotions or reactions is not a problem, or a sign of ‘not having worked on it’.

Myth: Grief progresses in stages

The misconception of different stages of grief is very common and far-reaching. However, current research into grief and the personal experience of the bereaved do not support this stage model.

In reality, grief is personal

It’s true that grief often involves the initial shock and the following period when the incident stops feeling unreal and becomes concrete, eventually becoming less painful. However, no description of grief applies to everybody. The way everybody adapts to grief is very individual. Often, the stage model of grief does more harm than good. The idea of grief as stages may feel suffocating or dismissive to the grieving person.

Myth: Grief has a time limit

The world around you may expect the grief to end sooner or later. People may view you letting go of your loved one as the goal of grief and the inevitable conclusion to grief.

In reality, grief changes shape

Particularly in case of sudden and tragic losses, the grief never completely ends, although it will change shape. Your relationship with the deceased will not end in death; it will continue to change throughout your life. Your loss will become a part of your life story.

Myth: You should not disturb a grieving person

Finnish culture in particular often emphasizes the idea that the bereaved should be allowed to grieve in peace.

In reality, interacting with and supporting the grieving is important.

Interacting with a grieving person may feel difficult at times, which leads people to think that the bereaved should be allowed to grieve in peace. While it is true that some mourners need more time alone than others, the bereaved should never be left alone. At the very least, you should ask how they are doing and what kind of help they need. Even if the grieving person does not need help immediately, you should approach them regularly and even after a long time, as their needs and experiences may change. 

Myth: The concept of grief is permanent

For a long time, the concept of grief has been divided into distinct stages and examined through the lens of overcoming one’s grief.

In reality, the world and concepts of grief are vast and changing.

Grief is studied across various disciplines, broadening our understanding of both grief and how to interact with the bereaved. Experiential knowledge is also extremely important when examining grief, as every instance of grief is individual regardless of studies and research. Breaking down the myths related to grief and examining grief in a comprehensive way is helpful for both the bereaved themselves and the professionals who work with them. 

Common reactions after the death of a loved one

Many bereaved people are concerned about their reactions and may even be afraid that they’re a sign of ‘going crazy’. Because of this, it’s comforting for them to hear that many other people have gone through the same things, and that the way they’re reacting is completely normal, considering the situation. However, it’s important to acknowledge that everybody’s reactions are unique, and the lack of ‘normal’ reactions is not worrisome or uncommon.

Common acute reactions

  • Shock

  • Disbelief

  • Sense of incomprehensibility; it just doesn’t feel real

  • Concept of time changes

  • Bodily reactions: trembling, shivers, dizziness, palpitations

  • Numbness, lack of emotion or reactions

  • Some people can maintain their ability to function despite the shock – but they may still need your help!

  • Some people have no recollection of the events related to the death or news of the death

Common long-term reactions

  • Strong sense of loss and longing, emotional pain

  • Feelings of guilt

  • Clear recurring memories of events related to the death

  • Trouble concentrating, memory issues

  • Trouble sleeping

  • Irritation, feelings of anger

  • Anxiety, sensitivity

  • Physical symptoms, illnesses

  • Deeper appreciation for close and good relationships

  • Change in life values

  • Desire to change the society and/or help others who have gone through the same thing

No matter how strong or distressing, emotions related to the death of a loved one are normal. If the grief feels unbearable or the bereaved person is self-destructive, they should be directed to a trained professional immediately.

Grief is not a sickness, but it can make you sick

Trauma, depression, complicated grief, prolonged grief…?

Strong and distressing physical and emotional sensations are normal after the sudden death of a loved one. The bereaved person will need crisis support and extensive social support following the death. Medical assistance, however, is rarely needed.

The loss may lead to inability to work, and a medical diagnosis is needed for sick leave. Because of this, reactions stemming from grief are sometimes misdiagnosed as depression. This problem is well known within health care, and Finland is about to adopt a diagnosis of prolonged grief or complicated grief. According to some estimations, 10% of the bereaved require a medical diagnosis.

Although grief can manifest itself very strongly, you should never dismiss the feelings of a grieving person. A heavy loss can lead to physical and mental illnesses, such as depression and post-traumatic stress disorder. If the bereaved person appears to need professional help, they should be forwarded to a competent professional. This evaluation can be done by a psychologist, while a doctor can make the diagnosis and prescribe psychotherapy.  The most important thing is to consider the person’s feelings: offer help to those who need it. Don’t pressure the bereaved person into getting better more quickly.

Signs that the bereaved person may need professional help

  • Their grief feels constantly unbearable

  • The person is preoccupied by painful memories of the death and can’t think of anything else

  • They have strong, recurring fears of new disasters

  • Painful and constant self-blame, feeling of worthlessness

  • Strong and constant thoughts of anger and revenge

  • Prolonged lack of functional ability that disrupts the person’s life or prevents them from getting help

  • Inability to take care of one’s children

  • Total inability to talk about the deceased or the death

The most important thing I want the professionals to understand about grief is that you should not try to heal grief. A professional can support a bereaved person with their grief, but they must not carry a burden of whether the bereaved person will be “healed” of their grief or not. Grief is not a sickness.

Minna, expert by experience, Young Widows of Finland Association
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