Words: Megan Hosking, Psychiatric Intake Clinician, Akeso Johannesburg, and Sandra Lewis, Head of Therapeutic Services, Akeso. Published originally in Mental Health Matters Magazine.
The loss of a loved-one is an intensely painful and devastating experience, and may often feel unreal. While grief and bereavement are experienced differently by everyone, there are some common aspects that may be helpful to understand, and to help one to eventually cope better with loss.
“It’s not only the passing of a loved one that leads to feelings of loss. People also experience grief in other events, for example when a relationship ends, or one loses a job or possessions such
as one’s house as a result of financial difficulties. These instances have become increasingly common during the current Covid-19 pandemic,” says Megan Hosking, Psychiatric Intake Clinician at Akeso mental health facilities.
The most widely recognised stages of grief were first described by Dr Elisabeth Kübler-Ross, who was a Swiss-American psychiatrist. While these stages are often presented as a linear process, it’s most important to realise they are not meant to create neat and tidy packages for emotions, and don’t necessarily follow in this order for everyone. According to Kübler-Ross, individuals experience each stage of grief and bereavement differently, and the length of time each stage lasts also varies from one individual to the next. A person who grieves may also move backwards and forwards between the stages of the grieving process.
The first emotion many people experience following a loss is a state of shock and denial. Things may not feel real or make any sense, and the reality of the loss will not yet have set in. Denial may result in a person carrying on with life as though the loss hasn’t happened, and they may not feel the emotions associated with the loss.
Anger can often feel endless; one may feel angry at others – the deceased person, one’s family, the circumstances, the health system, doctors, their employer, other people, and even a higher power. Feelings of regret and guilt (whether perceived or real) often manifest as anger against others who one thinks may have contributed to, or caused, their loss.
One may try to make arrangements, promises or bargain with others or a higher power to try and ‘reverse’ the loss, minimise one’s own sense of being harmed. This often happens when relationships end and one tries to get their partner ‘back’.
This stage is often where reality starts to set in and a person moves their attention to the present situation. One may feel intense sadness, want to withdraw from others or feel like doing nothing. Depression as a stage of grief is not the same as depression as a diagnosable mental health illness. A state of depression following the loss of a loved one or other significant loss is a normal and appropriate response, and often with time, will transition into a space of acceptance.
Acceptance does not mean that everything suddenly feels right again, or that you are completely healed or ‘okay’ with the loss you have suffered. This stage is more about realising that life without your loved one or in your changed situation is the way things are going to be, and learning to live with that – even though it will still hurt, and you may still feel intense sadness or feel the loss daily.
Losing a loved one suddenly, as may be the case with the current Covid-19 pandemic, can be very traumatic and is also often experienced differently to a loss following a long-term illness
or an expected loss. There is no time to prepare for the loss, and often one may not have your full support system around. There may be lots of questions about the loss, the circumstances leading up to it, and what happened, and feelings of shock may last longer.
It’s not uncommon following a sudden loss to experience strong emotional and physical responses, which can include: