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Mourning

Writer's picture: analuciamarseniseanaluciamarsenise

Mourning is a complex process of crisis and adaptation to loss, and can occur in different situations: mourning a relationship, the death of someone significant, a phase of life, a job, among others. In this brief article, I will focus on grief related to death, unfortunately a need that is more emphasised in the face of the countless losses resulting from the pandemic.


Death is a natural phenomenon and is addressed and portrayed by different areas of knowledge and art, essentially because it is the great fact of existence: one day, everything ends and we must therefore ‘enjoy life’ and every moment. Although we are rationally aware of finitude, we are not often emotionally prepared for it and often what could have been done in the present ends up being postponed until, faced with the impossibility of accomplishing plans, many are plagued by guilt. How do you deal with the death of a loved one with whom you haven't made peace, for example? How do you go on with life plans that were meant to be lived together? Who will look after me now? These are some of the countless questions that can distress the bereaved. We are attached to those we love and in the face of loss, part of us is also lost. Who to be, how to be, how to live now?


The death of a person has a different weight for people depending on the existing relationship (grandparents, parents, children, siblings, friends, etc.) and these differences must be taken into account, however, regardless of the context, the grieving process requires going through different phases and tasks: The phase of accepting the death, the phase of elaborating the pain of the loss, the phase of adapting to a world without the person and a phase of reinvesting in oneself and one's life.


The phase of accepting the loss is the difficult phase of confronting reality and the fact that the deceased person is not coming back. Some people may end up denying the loss, trying to keep the person alive by constantly talking about them or acting as the person, if alive, would have wished. Some keep the deceased's belongings intact, not accepting the radical change that has taken place. These ways of proceeding prevent the person from working through the emotions of their loss and, consequently, readjusting to the world and life. It is very important, after an initial phase, to decide on a direction for the deceased person's belongings, as well as, when talking about the person, to try to use vocatives and verb tenses adapted to the new reality (e.g. my late husband, such a ‘person was’). The funeral, among other rites of passage, are of the utmost importance here, as they are a symbolically and emotionally charged way of saying goodbye. Such rituals also allow for public recognition of the loss and social cohesion, increasing the bereaved person's social support.


Unfortunately, this pandemic has made it impossible to carry out farewell rituals in a number of cases, which can be very damaging to the grieving process and mental health. An alternative way of dealing with this situation would be to carry out a personal ritual, such as writing a farewell letter and burying symbolic objects of the deceased. The burial of such objects can take place in a meaningful place and be accompanied by the planting of a tree or flower, which can symbolise the passage from death to rebirth (if it makes spiritual sense to the bereaved) or simply a process of eternalising the legacy the person left for others.


The phase of dealing with the pain of loss requires experiencing the most diverse emotions arising from the grieving process. It is normal to feel a wide range of emotions (anger, guilt, sadness, anguish, relief, helplessness, despair, fear, anxiety), sensations (shortness of breath, tightness in the chest, emptiness in the stomach, feeling of depersonalisation, weakness, dry mouth, lump in the throat), cognitive changes (illusions of hearing or seeing the person, disbelief, confusion) and behavioural changes (sleep and appetite disturbances, tendency to forget things, dreams, social isolation), with no specific timeframe for returning to ‘being well’. However, if small situations trigger overwhelming, incapacitating suffering that ends up impairing an individual's day-to-day functioning, this could be a complex bereavement that requires specialised psychological intervention in bereavement.


The essential thing at this stage is to express what you feel, regardless of other competing difficulties that may cause the person to oppress their emotions or put them off, as failure to do so and emotional avoidance can lead to the development of psychopathologies, as well as behaviours such as substance abuse. Seek help, maintain specific and trustworthy contacts for moments of grief and, if necessary, it can be very important to undergo psychotherapeutic counselling to deal not only with a variety of emotions, but with everything they can mean given the history you had with the person who died. The relationship with the person could have been bad, dependent or marked by ambivalence and unresolved conflicts. Such complex relationships could therefore elicit emotions such as guilt, guilt for feeling relief; avoidance of talking, thinking or feeling negative emotions related to bad aspects of the person and the relationship, leading to a consequent unrealistic idealisation of the person or also a devaluation of the person and the loss in the name of reducing the real pain felt, among others. The important thing is to review the history of the relationship with the person, the real emotions felt, in all their valences and intensities, thus giving body and realistic meanings to what was experienced. Resources used in this phase can include revisiting memories, visualising photos and videos, significant objects and searching for materials that allow the identification of thoughts and emotions (positive and negative) associated with the person who has died. This not only allows emotional expression, but also the identification of conflicts with the person who has died, which can lead to the confirmation or restructuring of unrealistic or distorted beliefs associated with the previous relationship and which end up affecting the emotional reaction.


The phase of adapting to a world without the person is a phase made possible when the need to invest in dealing with the pain of the loss has already been reduced, so that energies can be invested in learning skills and new ways of being. Without the previous emotional elaboration, new difficulties would emerge, such as inattention, lack of energy, reduced reasoning and problem-solving skills, among others, which would affect the person's adaptation to the new reality and, consequently, their self-concept and self-esteem.


This is a phase of learning new skills, often previously assumed by the person who has died, and it can require a lot of time, effort and support. Seeking help from a social and support network is of paramount importance here. In this phase, personal plans and projects are also reflected on and redesigned, and there can also be a deep investment in self-knowledge and in reflecting on one's own life. In addition to the crisis of adapting to the loss, this phase can end up involving existential crises, so therapeutic counselling is recommended to facilitate the tasks of mourning.


The phase of reinvestment in oneself and in the world is possible not only because of the previous processes, but because the person has developed, throughout their grieving process, a repositioning in their emotional life of the person who was lost. The person who died is still alive in a way, but in memories, learning and experiences, no longer occupying a central place in the person's life, without, however, meaning that they have lost their importance. Here, the capacity to love is restored and openness to life is strengthened.


These phases represent a guide to the grieving process, but it is essential to emphasise that they don't always occur in a linear fashion and can reappear, and often there are attempts to move from one phase to the next without the previous one having been properly resolved. Patience and affection with oneself is very important in the grieving process, allowing and accepting the normality of any moments of greater vulnerability. After all, losing someone you love is more than a loss, it's the need to reinvent yourself.


DEMYSTIFYING A TABOO: BEREAVEMENT IN CHILDREN



The concept of death evolves throughout life, but for a child, even if they don't understand it, they already experience the fear of loss and the end of a bond. In this way, children feel the loss and must also mourn!


Unlike the child protection function that some positions believe they favour by silencing the subject of death in front of children, avoiding talking about it or expressing their own emotional pain close to children, such positions only end up frustrating them, because children are also dealing with loss, but they feel confused by the reaction of others and are afraid to express themselves. That's why it's essential to involve the child in the grieving experience and show a willingness to listen and support them in their emotions and fears.


Bereavement for children is complex, not only because they have verbal and emotional limitations in understanding and expressing how they feel, but also because they have a lower tolerance for suffering. Children can feel very alone and do not receive comfort from other children, so their grief can be facilitated if they know what is happening and if they have the support of adults who are emotionally available to support them. The process of supporting children's bereavement is favoured by playful activities, such as themed games and symbolic rituals. These include the ritual of leaving a letter/message to a relative and planting something in their honour.


Also regarding childhood grief, when very young, children are unable to distinguish between what they think or are and reality, having a very self-centred understanding of the world. As a result, the death of someone significant, especially a relative, not only generates feelings of fear and helplessness but also leads to guilt: the child feels they have been abandoned because they are undeserving of love. It is essential to reassure them that they are loved, that it is not their fault, and that other family members will continue to care for them. Furthermore, children's understanding of what is said to them is very literal, so death must be explained in a clear and direct manner (e.g., "the body has stopped working"), avoiding euphemisms or abstractions that will only confuse them. Older children may also experience great fear of further losses, becoming very controlling of reality and compulsively worried about the wellbeing of loved ones. Children may also exhibit hyperactivity, euphoria, or feelings of detachment.

In adolescents, the understanding of mortality often leads to significant disengagement from reality. It is advisable for both children and adolescents to receive psychological support during grieving processes, as unresolved grief can contribute to the development of future disorders.


Finally, I reiterate the great need to talk about death and express feelings. If you are grieving or know someone going through it, do not hesitate to talk or ask about grief, and seek or offer help. We are in a time of great social difficulty, and it is crucial that we support each other’s wellbeing and mental health.



Course Support Material focused on Psychological Intervention in Grief (MDC Psychology and Training):


  • Bowlby, J. (1960). Grief and Mourning in Infancy and Early Childhood. Psychoanalytic Study of the Child, 15, 9-52.

  • Bowlby, J. (1980). Attachment and Loss: Loss, Sadness, and Depression. Basic Books: New York.

  • Coralli, B. (2012). The Collective Silence: Death in the Present Day and the Discomfort it Causes. Retrieved from www.psicologia.pt.

  • Engel, G. L. (1961). Is Grief a Disease? A Challenge for Medical Research. Psychosomatic Medicine, 23, 18-22.

  • Kübler-Ross, E. (1969). On Death and Dying. Macmillan: New York.

  • Lima, F. F. & Carvalho, L. V. (2009). Children and Death. Brazilian Society of Psycho-Oncology.

  • Melo, R. (2004). Grieving Process: The Inevitable Path in the Face of Death's Inevitability. Retrieved from http://groups.ist.utl.pt/unidades/tutorado/files/Luto.pdf.

  • Pedro, A., Catarino, A., Ventura, D., Ferreira, F., & Salsinha, H. (2010). Children's Experience of Death and Grief in Childhood. Retrieved from www.psicologia.pt.

  • Walsh, F. & McGoldrick, M. (1998). Death in the Family: Surviving Losses. Artmed: Porto Alegre.

  • Worden, J. W. (1982). Grief Counselling and Grief Therapy. Springer Publishing: New York.

  • Worden, J. W. (1998). Grief Therapy: A Manual for Mental Health Professionals (2nd Ed.). Artes Médicas: Porto Alegre.

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PSYCHOLOGIST AND PSYCHOANALITIC PSYCHOTHERAPIST Ana Lúcia Senise

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