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The saying goes that only two things in life are truly assured: death and taxes — but despite its inevitability, part of the human condition is to ignore the reality of death. That is, until we are confronted by it and then we are frequently ill-prepared. In the fast-paced 21st century, we strive to live life to its fullest, sometimes squeezing out drops of happiness without thinking of the consequences. We eat unhealthily, persist with lethal habits, and drive as if cars have no potential to kill. But sooner or later we have to face the fact that life is a finite gift. In 1969 Elisabeth Kubler-Ross postulated five phases rief in her book On Death and Dying. u1,6 Altho these phases are not infallible and each person reacts to the feelings of loss and bereavement in their own ways, psychologists agree that our responses to bereavement follow a common pattern. This generally progresses from denial to anger, bargaining and depression, eventually ending with acceptance and a feeling of closure. Dr Farheen Majid, a psychologist at Life Entabeni Hospital in Durban explains:'It is common for one to go through the process, come out of it and then regress into one or more of the phases due to a trigger such as a birthday or anniversary. Recovery from these five stages follows a predictable course, if grief is dealt with properly: Not all grief comes from death — feelings of mourning typically also occur after a divorce, retrenchment, relationship break-up, leaving a
familiar environment or being diagnosed with a terminal illness — but whatever causes the feelings of grief, people tend to go through a similar process before reaching resolution. Once the person has passed the denial phase and has come to terms with the irreversibility of the situation, the healing can begin. With children it is particularly important to explain that death is permanent and that no amount of anger or bargaining can bring the person back. Feelings of abandonment, especially after the loss of a parent, are common and these emotions need to be explored with openness and honesty, allowing the healthy expression of pain in a supportive environment.
Helping someone through the mourning process can take the form of either emotional or physical support, or both. At the beginning, it helps to give assistance with practical matters, whether dealing with funeral arrangements or helping to organise child-care and work commitments, says Dr Majid. Once the initial shock has passed and the person has come to terms with the finality of the loss, they may just need a good listener, she adds.Talking about their loved one, telling stories about their life and looking at photographs all help to keep the memories alive. Expressing emotions helps to facilitate the healing process and leaning on friends and family in times of crisis strengthens
remaining bonds and reminds the bereaved that they are not alone. Counselling and support must take place within the appropriate cultural and spiritual context, and practical support from the community can be helpful.There are many ways in which religious beliefs can bring us comfort and reassurance, points out Dr Majid. 'Many people say spiritual beliefs help them to cope and find constructive meaning in death. Belief in the natural cycle of life and the omniscience of a divine, higher being that we all ultimately return to offers comfort and reassurance to many of those who have suffered a loss: Before a feeling of acceptance is achieved, there is usually a period of depression which can last up to a year. Statistics show that 50 percent of bereaved spouses meet the criteria for major depressive disorder at some time during the first year. Depression ass_ ated with grieving is not an illness in i and therapy is not essential, but pr pation with suicidal thoughts, feelings of lessness and psychotic symptoms ar signs that thedepression is becoming clinical and the sufferer should seek help. These symptoms most often occur when the person has a history of mental illness or when they have lost someone to a violent act or suicide. In these cases and in others less serious, a clinical or counselling psychologist can help facilitate the grieving process, enabling the patient to move beyond their grief through the use of psychotherapy and, if necessary, medication, says Dr Majid. A psychologist can also refer you to a support group which provides members with information, reinforcement for positive change and a chance to help others. Knowing you are not the only one going through tragedy can help to lessen feelings of abandonment and promote a sense of belonging. A support group can also be a cost-effective method of approaching complications arising from bereavement, although access to professional counselling is available in both the public and private sectors. Other avenues of support include Lifeline, the South African Depression and Anxiety Group (SADAG) and Compassionate Friends. Google can also guide you to material that resonates with your specific state of mind — this is a good way of
Once the person has passed the denial phase and has come to terms with the irreversibility of the situation, the healing can begin
finding additional resources when you do not feel ready to share your pain with outsiders. There are a few (in most cases, ancient) cultures that actually celebrate death as a natural part of the cycle of life. In autumn, Mexicans celebrate the Day ofThe Dead when the community comes together to pay tribute to passed family members and ancestors. Ritually remembering and celebrating the lives of the dearly departed is considered an important part of the grieving process. Maintaining a symbolic
connection to them through honouring their interests or talking to them in a meditative space can also lead to acceptance. 'Although therapy can be helpful, everybody mourns in different ways and the pattern of these responses depends on many factors, from who or what you have lost to individual personality traits and external factors such as family support and spiritual beliefs', says Dr Majid. Allowing the pain and trusting the process are important to the healing process. In the end, perhaps the only comfort is that life goes on inexorably — and in that basic fact lies hope; hope that with the changing seasons and through noticing the small glories of existence, we will come to understand that this too shall pass.
For psychologists and other healthcare professionals at Life Healthcare hospitals, email general.information@ lifehealthcare.co.za or fax 086-500-7535 or use the doctor search function on our website: www.lifehealthcare.co.za.