What is Grief and LossPosted on
What is Grief
Grief is a normal process to go through and everyone, at some point in life, will experience loss. Guidelines suggest that the ‘normal’ grieving time is approximately one to two months. It only becomes a problem when it becomes disabling and a person loses their ability to function in everyday life for an extended period of time – say six months or more. This can have a serious impact on motivation levels and the desire to carry on living. It results in broad changes to all personal relationships, a sense of meaningless and yearning, and a loss/upset in personal beliefs. The level of functional impairment is, therefore, an important symptom to consider when assessing grief related responses to loss.
The difference between complex and regular grief occurs in the brain – while complex grief sufferers are fully aware their loved ones are gone, they haven’t subconsciously integrated this information yet. When these conscious and unconscious notions collide, complex grief can result.Click To Tweet
As such, typical treatments for depression such as antidepressants are ineffective for complex grief sufferers. Counselling – talk and exposure therapy – is needed to help them process the loss subconsciously.
The symptoms of complex grief include:
- Intense longing for the
- Invasive thoughts/images of a loved one.
- Denial of the death.
- Imagining that the deceased is still alive.
- Looking for the person in familiar places.
- Avoiding things/circumstances that remind them of their loved one.
- Extreme anger/resentment over the loss.
- Feeling that existence is pointless/suicidal ideation.
The role of these symptoms is a natural coping mechanism, to process and understand the loss – in a similar way that self-harm can be used to cope with strong negative emotions. Note that this is a generalisation, as everyone is different and the role of these reactions will differ from person to person.
Determining the differences between Complex and Normal grief may appear easy, however, may not be clear to an untrained professional. Courses such as the CHC52015 Diploma of Community Services, CHC50313 Diploma of Child, Youth and Family Intervention or CHC51015 Diploma of Counselling will provide you with the skills to clearly identify the correct type of grief and individual is experiencing.
Disenfranchised grief is the result of a loss where there are no socially recognised ways to mourn. These socially ambiguous losses are effectively unsupported in the culture or community and thus public demonstrations of grief are not deemed appropriate because elements of the loss prevent public recognition. Some examples include:
- The death of a sibling you never knew
- The death of a pet
- The loss of a home/residence
- An abortion
- A celebrity death
It also covers more socially stigmatised situations, such as:
- A relationship breakup
- STD diagnosis
- Botched cosmetic surgery procedures
As a result of cultural norms towards loss, people dealing with grief in these areas may not qualify for typical grievance allowances, such as bereavement leave. This can result in a person not having sufficient time or outlets to grieve – the lack of understanding from others can often add to their negative feelings.
Typical reasons for grief, such as the death of a loved one, can even become disenfranchised once the ‘acceptable’ time allotted for mourning has passed. If we look at the Oklahoma City bombing of April 15, 1995, if parents were not “over” the death of their children after two weeks and resuming normal working life, they were diagnosed with post-traumatic stress disorder.
This type of grief can be hard because either people don’t understand, or the person grieving thinks that others will not understand. Basically, it is a feeling of grief when society, in general, deprives a person of the right to grieve. This is where you, as a counsellor, come in. As time passes, the grief often intensifies while, at the same time, the social support diminishes – making it more difficult for the client to integrate the loss into their life.
Cultural Reactions to Loss
Your background may also have an effect on the way you grieve loss and others’ interpretations of your reaction to loss.
Funerals are an important event to an Aboriginal person and may be nothing like the European funeral. An Aboriginal funeral may be a traditional funeral at the local church lasting the usual time – but it may also be a two-week long ceremony conducted hundreds of kilometres away. They involve a primary and secondary burial that can be months or even months apart and it is obligational to attend for the Aboriginal community.
In addition, when asked, “Who died?” they may look away and not mention the person’s name. This may be misinterpreted as them being deceptive; however, in many tribes, custom forbids members from mentioning the dead person’s name.
It is important that this extended grieving is not misinterpreted as complex grief if the client is of Aboriginal descent.
An individual’s social, cultural, ethnic and spiritual beliefs all have a profound effect on how they react to death and loss. As a counsellor, if these beliefs are significantly different to your own, it can be difficult to relate to your client and empathise with their position. Consequently, it is important to educate yourself about the different cultures in your community and their belief, by establishing networks with them.
Cultural competence is a continuous practice. The first step is knowledge and the second is awareness.
Culture is really important and unconsidered by most therapists. An extreme example is Schizophrenia – in the Western world, it is one of the most debilitating disorders; in other parts of the world, it is revered (e.g. shaman). So, the grieving process can be massively impacted depending on social, cultural factors etc. This might mean grief looks very different – the importance is that the behaviours function the same way. On a basic level, think gender differences – a female might cry, whereas a male may not but this doesn’t mean one is grieving and the other is not. Imagine how Buddhists may differ to Christians following the death of someone. You can imagine that there are vast differences between people based on these factors – some of the behaviours may even be strange or harmful (starvation, self-harm, hallucinations) – but, in dealing with grief, it is important to be sensitive to individual differences.
Developmental levels should be considered also – think about how age may affect the grieving process. A child will grieve differently to an elderly person and to middle-aged persons, as their outlook on life is completely different. Exposure to death for an elderly person may have numbed the effect somewhat, whereas a child may be new to the concept. With the older generation, it may also elicit the facing of their own mortality; a child may not understand the severity of the situation and only grieve at a later time when they are able to process the events. This can result in them ‘acting up’ later in life.
Certain cultures may view public displays of grief as unacceptable and this may contribute to the build-up of emotion in a client, making it hard for them to express their emotions; however, other cultures view the public expression of grief as vital.
Within each culture, individual reactions will differ also – this can be down to their personality, their closeness to the deceased or their role in the mourning process.
The ideal situation is to become ‘culturally competent’ – that is not only being culturally sensitive but also able to engage with clients from different cultural backgrounds.
Failure to do this may result in the following:
- Misinterpretation of a client’s reactions
- Causing offence to the client, creating a barrier to effective counselling
- Inability to offer appropriate support and support networks
Once you’ve established this information, you should then seek to use available resources to find out more about their beliefs.
These can include:
- Community/religious leaders.
- Family members (of the client).
- Colleagues familiar with your client’s cultural beliefs.
Ethnicity is not merely the colour of someone’s skin. Moreover, it refers to the culture a person identifies with. So, even if a person is white and of Australian descent, but they grew up in Tokyo, Japan, they may identify and consider themselves as “belonging” to Japanese culture.
The Oxford Dictionary defines it as “relating to a population subgroup (within a larger or dominant national or cultural group) with a common national or cultural tradition”.
In a counselling context, therefore, you must not make assumptions based on appearance alone. Just because someone looks like they are from somewhere e.g. Asia, does not mean they are from there or that they identify and comply with that culture.
Simply whether your client is male or female can affect the way they grieve. In some societies, males are taught not to show emotions such as sadness, loneliness and depression, as it can be perceived as a ‘weakness’. When a loved one is lost, this can result in a build-up of these emotions, with a no appropriate outlet to vent them – they may even deny their feelings of grief.
Spiritual differences can affect the societal consensus about death – whether it is viewed as a negative or positive outcome. Note that spirituality doesn’t merely refer to religious beliefs – it is a broader concept that means something different to each individual, but that which gives their life meaning.
Let’s look at the Mexican and Hispanic Day of the Dead – where death is celebrated and families leave gifts and food on the graves of their deceased loved ones’ graves. In Ecuador, they even have a picnic on the grave of their loved one, when they are initially buried.
Compare this to the traditional funeral, where it is a much more sombre affair, where attendees grieve through remembrance of the deceased’s life and crying. This can be followed or preceded by a wake.
From this, it is understandable how people’s perceptions of dying can vary greatly.
This article was written by Wendy Webber, the Australis College Head of Faculty for Community Services and Counselling. For more information about our range of courses that could assist in the areas of grief and loss review the following courses CHC52015 Diploma of Community Services, CHC50313 Diploma of Child, Youth and Family Intervention or CHC51015 Diploma of Counselling or call 1300 887 991.