Grief Counselling

Grief Counselling

There is not a word to adequately describe what it feel likes when you hear the news that someone you love has died. What happens next is a roller-coaster of emotion and experience impacted by the attachment bond with the person who has died, the meaning of the relationship, the circumstances of the death, and your psychological, physical and spiritual perspectives.

What does it mean to grieve?

It is your inner response to a loss, the way you integrate the reality of the death of someone significant to you.   (You may also grieve when you experience any other significant loss such as a relationship, employment or loss of physical function.)

There is no one right way to grieve.

The experience of grief and loss is a personal journey that is as unique as those encountering it.  Much has been written about stages and phases of grief as attempts to make sense of the varied impacts and experiences of people facing the loss of significant people in their lives. These approaches can be helpful as you try to regain a sense of wellbeing following such a loss.

There are three core tasks of grieving. 

  1. The first is to confront the reality that the person has died and will not be coming back.
  2. Then, the grieving person needs to experience and manage the emotional suffering caused by the grief.
  3. The final task is to find a way to change the relationship with the person who has died from presence to memory.

Sometimes we know that a person’s life is coming to an end and other times death comes unexpectedly. There are some differences about the resultant grief reactions to consider, and some understanding of the factors for different scenarios will provide a framework for thinking about your reactions to grief.

Coping with Grief and Loss   

It is normal for you to have some good days and then other days when the grief is overwhelming.  Sometimes you may not be able to function whilst other days you may seem fine. When the grief reaction starts to ease you may be overwhelmed with guilt and shame at “moving on”.

How counselling can help.

Everyone deals with loss differently, but sometimes it is overwhelming and you can feel very alone. However you are impacted by your loss, counselling can be a supportive and helpful way to assist you to effectively process your very personal and unique responses to grief and loss.

Heather is an experienced counsellor helping people through grief and loss.

Different Types of Loss

Anticipated death

When you become aware that death of someone you care for is a likely outcome or that it is inevitable an anticipatory grief response may commence.  This may come about due to an extended illness, disability, severe accidental injury, terminal diagnosis or ageing or decline of an elderly person. There will be a wide range of losses that may occur over time, such as loss of cognition, memory or personality, awareness, independence, identity or stability.

The range of common grief responses may result from this awareness: sadness and pain, anger, depression or anxiety.

You may also experience weariness or exhaustion with being a care-giver, and the stress of anticipating the death and the uncertainty about when that might occur.  Hence you may live for an extended time in a state of hyper-alertness that can be both physically and emotionally exhausting.

However, anticipating a death provides opportunity for preparing for the loss. There is time to reflect on what life without the person will be like.  You can choose how to best use the remaining time with your loved one, to prepare for the future and attend to unfinished business.

For some people experiencing anticipatory grief can reduce the symptoms of grief following death, but this is not so for everyone.  Again, there is no one right way to grieve.

Sudden, unexpected or traumatic death.

A sudden or unexpected death can be a traumatic experience, shattering your sense of safety and security.  Everything changes in an instant, and leaves you shaken to the core.  The experience of grief in such circumstances may be very different to an anticipated death, and may result in severe reactions such as Post Traumatic Stress Disorder or compound the grief response.   Shock, anger, guilt, depression and hopelessness may be severe.

Unexpected death immediately plunges family and friends into a world that is forever changed.  Your sense of security and safety may be significantly impacted resulting in vulnerability and heightened anxiety. The shock of the death of your loved one may result in a numbness and unreality that persists for a long time. This is a defence mechanism that helps you manage overwhelming emotional reactions.   Becoming afraid that such a situation might happen again to someone you love may occupy your thoughts.  Only when the reality is fully grasped can you move past the trauma to face the reality and pain of grief.

Relationships within families can be shaken when someone dies unexpectedly.  The role held by the person within the family is gone, and it takes time for the family to reorganize.  Hence relationships within the family may become strained. When someone dies unexpectedly there may be unfinished business within the family that needs to be handled.  This may be about relationships or conflicts, work-related matters, financial concerns, or property issues.

When there is an unexpected death there will be involvement of legal and medical authorities. Often these processes are difficult, time consuming and lengthy. They add to the layers of issues that require attention and are often confronting and distressing, perhaps forcing you to consider difficult realities about the one who has died.

The nature of the death will impact the meaning of the loss, whether an act of violence, suicide, accident, or medical issue.  Preventable deaths often result in questioning about how the death may have been avoided, and guilt or anger towards those responsible or those perceived to have contributed towards the death may be intense.  The age and life stage of the person who has died is another important factor that gives meaning to the death, and can cause great pain and suffering. This is linked to the psychological expectation of life and death. A child, a parent, someone recently retired, an elderly person; is it fair, acceptable? Is it part of the natural order?

The impact of an unexpected death will affect people differently. These include psychological factors such as the nature of the relationship, meaning of the loss, strength of attachment or unresolved conflicts. The coping styles of individuals, behaviour patterns, self-esteem, needs, attitudes and beliefs are factors that also impact the grief response.  Past or current experience of   mental health issues may significantly influence the individual’s capacity to deal with the grief process, and monitoring by a health professional is recommended.  Another factor that may contribute to a difficult grieving process may be past experiences of loss.

Making sense of the loss may challenge religious or spiritual beliefs and result in an existential crisis. Belief systems and values may be questioned, and life priorities may be re-evaluated.  Often people emerge from grief with clear intent about what they want out of life, or how they will change their life to achieve important goals. Others may be affirmed in their beliefs.

Grief Responses

Whether the death of a loved one is unexpected or anticipated an understanding of some common aspects of grieving can be helpful as you experience a range of emotions and try to make sense of the loss you have experienced.  Seeking the support of family or friends and taking care of you during this difficult phase of life can be a helpful strategy.

Counselling can be another beneficial strategy to aid your grief journey. Heather is an experienced and supportive counsellor who can provide you a safe environment in which to address challenges you may be facing.

Shock and Disbelief

When you first hear about the death of someone close to you the initial reaction may be a sense of shock and disbelief.  You might find it hard to think clearly and need to hear the news repeated to allow the reality to set in.   It’s too hard to accept and so to deny the reality of the situation is a common response.  It enables you to cope with overwhelming emotions. This is a defence mechanism that buffers the immediate shock. It is a temporary response that holds you through the initial period of pain.

Sometimes there is a complete denial that the loss has occurred. It might feel like you are on ‘auto-pilot’, and later you might not be able to remember specific details of what you did immediately after you heard about the death.

Pain and Guilt   

Initial shock is often replaced with unbelievable pain. Acute mourning begins with the acknowledgement and acceptance that the loss has occurred.  You wonder how you will ever bear the truth that someone you loved has died. You might have feelings of guilt about your relationship with your loved one, or be remorseful about missed opportunities. You may find yourself focussing on difficulties in the relationship and find yourself considering what you should have done or should not have done.  These thoughts might cause great anguish and despair, and you wonder how you will ever get through the pain and distress.

Anger

Feelings of anger are commonly experienced, and you may become angry and upset with family and friends, medical staff, or other people who are also experiencing the loss.  You may feel enraged at the world and the injustice you feel. You may feel anger towards the person who has died or resentful of the pain they have caused.  If you have had a difficult relationship with the person who has died you may be ambivalent about their death, or feel enraged that they have left you with painful memories or unresolved conflicts.  Then you might feel guilty for being angry.

Feelings of helplessness and vulnerability are common, and a natural response is to try to regain control. You might find yourself focussing on what could have been done differently.  If only certain things had happened the death might have been avoided.

Fear and anxiety

The physical loss of the person who has died can instil a fear of being alone or in particular situations without them present. There may be a fear about passing the hospital or the place where the death occurred.  Some fear that they might never feel any different and can’t imagine how they might experience joy or pleasure again.

Anxiety can impact a grieving person in a variety of ways. An immediate response may be concern about what has happened to their loved one and existential and spiritual questions may become important.    Is there an after life? Is there a God? How could this happen? Will I see my loved one again? Conflicting emotions of anger, resentment, peace or hopefulness may be confusing.

There may be anxiety about how you are going to manage life without the one who has died and the practical implications of the loss may seem insurmountable.  There may be an anxiety about forgetting the one who has died, not being able to recall their smile or the sound of their voice.

Depression, reflection, loneliness

When denial can no longer be maintained and the reality and finality of loss is evident, depression may result.  Depression amplifies the range of emotions experienced resulting in a sense of helplessness or hopelessness. A general flat mood pervades all of life and leaves one feeling hollow, empty and alone. Withdrawal, isolation, and fatigue are common symptoms.  Perhaps you might not be able to see joy or hope anywhere in your life and feel like life is not worth living.

The distinction needs to be made between normal depression of grieving and other forms of depression. Your GP or a counsellor are a valuable resource to help you through this.

Resolving the loss and acceptance

Being able to accept the reality of the death and letting it be is not the same as forgetting the person.  Rather it is like constructing a different ‘frame’ for the person, finding a way you can comfortably live with the memories and essence of the one who has died.  This requires psychological reintegration.

An important task in the grief journey is learning to find a way of living with the void created by the absence of the person, to redefine who you are without the presence of the one who has died. This requires some acceptance of the loss and finding ways of managing without their physical presence in your daily living. This is usually a gradual process, with a return to activities of daily living and reduction in preoccupation with thinking about the person who has died. Part of this process is moving between memories of the person who has died, both good and bad. Recurring thoughts and reminiscing about them is a normal part of dealing with the reality of the loss. Over time, this preoccupation will gradually lessen as you adjust to a new reality of life without them.

Complicated Grief

Grief turns your world upside down and you need to find a way of learning to live in that world that is forever changed.  There is no time frame on grief, but sometimes you may become concerned about yourself or how someone you know seems to be struggling with their grief. Perhaps their grief seems too severe. Perhaps it seems prolonged.  Maybe you notice other changes in behaviour or emotional responses that seem to be out of character.

There are some indicators that may alert you to a difficult grief response.  These may include the following:

  • Suicidal thoughts and intention
  • Severe and ongoing emotional distress
  • Severe mental disorganization
  • Withdrawal from usual social or work activities
  • Self-destructive behaviours
  • Deep feelings of guilt, regret, self-worth
  • Violent outbursts of rage
  • Symptoms that imitate those of the person who die

If you become concerned about yourself or someone else it is essential to seek the support of your GP or a qualified mental health professional familiar with grief.

Heather is an experienced counsellor providing sensitive and caring support for those experiencing grief. Counselling will provide the help needed for you to manage your grief and learn how to embrace life again.

There is no time frame for finding a way to accept and deal with the reality of your loss.  Everyone has their own experience of grief and you are unique in how you are impacted by the loss of the one who has died. You may feel like you are through the worst of the pain and then be unexpectedly surprised by another deeply painful memory that impacts you.  This is the nature of grief and the cost of connection.