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March 18, 2011

Bereavement and Grief: What to do?

It has been a week since the quake and tsunami news began. Thousands of people have been killed by this disaster, more are on the way… and now I hear that my Japanese relative just committed suicide. That relative was not living in the affected area. His suicide is seemingly not connected to the tsunami deaths -why choose to kill yourself when so many thousands are visibly struggling for their own lives? It is hard to make sense of this, but my research and academic background is actually helping me walk me through these horrific times. Writing this article, with the help of notes that I have taken over the years, will help me heal my own wounds, and I hope it will provide information and motivation to people who are in need of psychological support -the kind of support that often comes last, or does not come at all, especially here in Japan.

Many of us are currently going through what is called survivor's guilt. It is somewhat comforting to be able to put a label on it, isn't it? That being said, I still feel depressed. This article is about bereavement, grief and some worthy counseling procedures, for adults and for children. Children's feelings are often lost in the mix when there is so much turmoil in the world. I hope this article will help adults notice potential problems with children and help alleviate them.

What is bereavement? Grief? What can we do about it?
Grief is a reaction to a loss. It can be a real loss or an anticipated loss. This is inclusive of the distress that we may feel when people have died or are dying. By understanding the function of our grief, we may arrive at some relief. However because such grief is often overwhelmingly powerful, simple words of consolation can easily be grossly insufficient. Bereavement is identified as being deprived of life or hope.

According to J. W. Worden in Grief Counselling and Grief Therapy (1988) we go through:

Phase 1. Numbness
Phase 2. Yearning
Phase 3. Disorganization and Despair
Phase 4. Reorganized Behavior

However, the phases overlap greatly and are not necessarily formed in a stair-like progression. Another way to look at the phenomenon is by looking at 'tasks' (Leick and Davidson, Healing Pain: Attachment, Loss and Grief Therapy, 1991):

Task 1: Accept the loss as a reality (intellectually and emotionally)
Task 2: Address the emotions and deal with them as they are encountered
Task 3: Acquire new skills to make a new lifestyle possible
Task 4: Put energy into making new relationships possible

Again, the progression is not stair-like and it is normal to have to go back and forth between the tasks. If you are not feeling yourself, try these tasks. They may help you get through your struggles.

These are some signs of typical (normal) grief:
-numbness
-yearning and anxiety often alternating with depression
- preoccupied with thoughts of the dead one (or the cause of death)
-insomnia
-anorexia
-irritability
-social withdrawal
-headaches

Now, although some of us have lost loved ones in this tragedy, many of us perhaps have not directly lost a loved one, yet both groups will commonly feel guilt. As I stated earlier, a feeling of guilt is considered natural. Knowing this can help alleviate the problems that may arise from these feelings.

Why do we naturally feel guilty? There are several theories, but perhaps it is sufficient to say that as humans we find it difficult to be logical when it comes to death. In the struggle to find logic in death we inevitably arrive at questions regarding our own actions --"Did I do something to cause this?", "Could this have been my fault?", "What could I have done differently?". These are common questions that race through our minds even if we 'know' that the questions may be absurd. However illogical these questions may be, the process alone seems to be able to bring up our guilt levels. This is especially true if you happened to be harboring negative feelings toward the deceased at the time of death. In our current situation here in Japan, other (absurd) questions may arise such as, "Is global warming to blame?", "If I conserved more energy, could I have prevented this?". Again, although these questions may in fact be absurd, the natural questioning process alone can help bring upon feelings of guilt. Remember: In the brain, imaginary occurrences can conjure up the same emotions as real occurrences -the same places of the brain light up!

Letting go of the grief does not mean that you don't care anymore. Let your brain relax when it can.

What can we do about the children?
Death is a topic that children need to talk about -but many adults do not take the time to discuss death with children. Let's try to do something about this. If a child looses a family member or a friend, they need to discuss it. Don't let them go at it alone. Think about it - where does a child's concept of death come from? It comes from their immediate context. More specifically, children observe adults and acquire the emotional reactions that they witness. Children draw inferences from adults' reactions.

Let's look at cognitive development for a moment -this is my specialty. Children below the age of around six don't really understand finality, so death is quite on the same level as 'not available now' to them. Such young children may cry over deaths at funerals, but it is probably because the context facilitated the response, not the deeper actual understanding of the consequences of death. However, after around the age of 10, children begin to reach the level of cognitive development when they can understanding abstract concepts. Unfortunately, this level of intelligence marks the beginning of a deeper/darker understanding of death - it makes the death more haunting and menacing for the child. Avoidance of the subject, or deflection of the child's questions helps establish a taboo within the child and the non-information, or deliberate dis-information provided by adults may remain as misguided manifestations (harmful myths) within the child that may last way into adulthood. It is important to realize that children are necessarily egocentric. I don't mean egotistical. I mean egocentric -their cognitive development has not reached a level that allows them see themselves from an outside perspective. They are the center of their universe. What does this lead to? It often leads them to blame themselves for the deaths that they have witnessed. Sadly, if a parent verbally blames a child for the death of a loved one, the child will readily believe it. Because children do not have the mental capacity to understand adult concepts, they automatically believe in 'magic' - anything that happens that they don't understand basically seems to be happening by this magic. Anything they can imagine is basically real to them at some level, so, in this gullible state, any reasoning/rationale provided by us 'all-knowing' adults is often readily believed and is incorporated into their own belief systems. The things we say shape our children. This is why we must be responsible for what we tell our children, especially in highly emotional times, because as we all know from experience, highly emotional times carve our memories the most vividly. Now is the time to set things straight with our kids.

How should we talk about death with children?
Children usually accept authoritative statements. It helps them understand the world. Unless it was a suicide, counselors are often trained to make it clear to the child that 'the death' was:

-unwished by the person
-not the responsibility of any living person

and that the dead person:

-did not wish to go
-was sorry to leave the family
-had no choice
-does not feel grief now

By making these points clear, psychiatrists report that there were fewer and briefer behavior problems, less health problems, and less academic problems for the children. Of course there is no guarantee, but the counseling procedure seems sensible to me and I therefore recommend having similar conversations with your children -even with your classroom children if you teach kids. I recommend this because you may be the only adult that has the knowledge and motivation to provide the children with the guidance that they may be lacking.

In conclusion, I admit that writing this article has helped me heal my own wounds. It is helping me with my own bereavement and grief. We may never know why my relative took his life, but I cannot dismiss the possibility that the quake and tsunami disaster was a catalyst for his suicide. It is my hope that by publishing this article, I can help others help others in dealing with their bereavement and grief. I am especially concerned with the children of Japan. Please pass this information along to parents and teachers of children that you know that my have been affected by this unfolding atrocity. I pray that we can be of some help to them.



« Kinky neurons in your brain! (or, Why should emotions be center stage in the classroom?) | Main | Maslow, your feelings, and the tsunami »

Comments

Thanks for this, Robert. In a few hours I'll get on a plane to come back to Japan (have been in the USA for TESOL). I arrived the day before the earthquake and do feel guilty about not being there to support my wife and son during the hardest times.

I live in Sendai, the epicenter. Am thinking about my students, many of whom I'm sure will have PTSD. Most books recommend "talk therapy". Culturally, not sure that is a real option for most Japanese. Comments/suggestions anyone?


Hi Marc,

Glad to hear that your family is safe. It must have been hard for you, being so far away.

Yes, I believe that talk can be a good way to help people thought this, but as you say it may not be easy in the Japanese culture. My suggestion -and what I have been doing all week- is starting off the sessions by having the kids draw pictures (of the news). I find that children, and adults actually, can be more prepared and open to discussion when some form of art is involved early on in the process. It seems to help them move to a cognitive state more conducive of discussion. After they finish their artwork, they share their work with each other and I ask them questions about the art and then naturally move into questions about their feelings and concerns. Sometimes the students go into those areas without any leading from me.

Kids learn from our actions and reactions -they associate our reactions to events and largely soak up what is presented to them - so I try to be calm and understanding when they talk about the disaster. It is my hope that this calmness and understanding can help them through this time.

Peculiar article, just what I needed.

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