Pukning Pothasang : Bereavement

Dr. Mona Nongmeikapam *

Have you ever lost someone very dear? I recently did. The heavy numbness in the heart and the angry denial in the mind that comes with the passing away of a close person is, unfortunately an emotion all of us are familiar with.

Bereavement and grief are terms that are often used synonymously. Bereavement refers to the state of loss and grief means the reaction to that loss. Losing someone to the cruel hands of death is never easy and trying to be there for people who are undergoing the process of grief is almost as challenging. Perhaps understanding a little more about the process of Bereavement will facilitate with coping, if not lighten the grief in any way.

There are five medically accepted stages of grieving. The first one is Denial. One can never be ready for death. It is just too abrupt, just too final and oh so terribly cruel! It takes anyone a certain amount of time to absorb the shock and acknowledge the fact that someone so dear and so vibrant and alive is gone forever.

Next comes the Anger. The inexplicable, uncontrollable wrath- and who bears the brunt? Anyone around, inanimate defenceless objects but above all, the person who is bereaved! Why me, why to my family......................I could have done this, this shouldn’t have been done this way................why? How?

Several unanswered questions and a huge void masked as Anger. Then the bargaining begins. Don’t we all just love a good bargain?

And what won’t we give up in exchange of a dear one? Anything........ You name it, perhaps life itself. There lies the tragedy. All our pleas and bargaining fall on the deaf ears of cruel fate!

Needless to say, the next stage to follow is Depression. The degree of pain and the depth of hurt vary, depending on the relationship with the deceased, the circumstances preceding the death and various other factors. Then steps in the human resilience- the undeniable inner strength. Although unfathomable in the beginning, we somehow pick up the broken pieces and move forward unto the final stage of Acceptance.

Helping one attain acceptance are the other weaker family members whose responsibility now befall on one’s shoulder, a good support system and our own personal day-to-day responsibilities.

What is to be done?

Kapchasanu! (let them cry it out) All lot of our ritualistic ceremonies are actually straight out of a textbook of Psychology! Asiba Hangba chatpa (relatives and friends offering condolences), the daily Lairik Taaba (spending some time each day remembering the deceased and the Lord), spending time with the close kin fondly remembering the last few days and sharing one’s anguish more or less comprises the steps under Grief Therapy.

Medications and professional help?

Grief reaction is entirely a natural process and you never treat something natural. One can only stand by and let the stages of grief get over by themselves, offering support when sought and letting the bereaved get on with the process of grieving.

Medications are refrained from, unless the bereaved individuals are severely sleep-deprived and may need an occasional prescription of non-benzodiazepine sedatives or a rare anxiolytic to offer them temporary respite. But because of the high abuse and dependence potential of these drugs, they should be used only when recommended by a trained Psychiatrist who has interviewed the individual at length.

When does the grief process become complicated?

Bereavement although considered to be a natural process of life can turn complicated in about 10-15 % of affected individuals.

o Chronic grief reaction: The normal grief reaction is taken to be that starting within 2 months of the death of a close one and not persisting beyond 2-3 months thereafter. When the symptoms persist beyond six months and is classically characterised by bitterness or the idealisation of the deceased, it is said to be complicated. This usually is seen when the relation with the deceased was extremely close or dependent or in case of lack of reliable support system.

o Hypertrophic grief reaction: This is usually encountered after a sudden or unexpected death. The grief process is exaggerated and the affected individuals may adopt several maladaptive coping methods including withdrawal.

o Delayed grief reaction: The grief process is filled with denial, anger and guilt.

o Posttraumatic stress reaction: This usually follows unnatural or violent deaths. Despair, flashbacks and preoccupation with the circumstances leading to the death are few of the symptoms that may be seen in this case.

These are complicated grief reactions and need immediate attention from mental health professionals.

Losing somebody close is never easy but like every challenge given the right and timely support, this trying times can also be tided over. There are support groups, help-lines; we can seek professional help in the form of Grief Counselling.

Many find solace in the time-tested ritualistic practice of mourning specific every culture and religion but all meant for the same purpose: bidding our farewells and some form of closure. As for me, I console myself of my grief remembering a quote from the Bhagwat Gita: "For death is certain to one who is born...thou shalt not grieve for what is unavoidable."