A few words about mourning

Studies have shown that seeing, for example: a photo of an ex-partner after a breakup, activates the part of the brain responsible for feeling physical pain (the thalamus is a relay station, the site of modulation of pain and sensation). If love is released by dopamine and oxytocin, the loss of this will trigger cortisol, meaning nervousness, fatigue, weight fluctuations, moodiness, headaches, nausea. Bereavement, therefore, is a process of psychological, social and somatic reaction to loss and its consequences (loss - separation, divorce, conflict, health, fitness, youth, possessions, natural disaster, death).

According to psychotherapist Martina Mueller, sometimes the first obstacle to working through grief is beliefs about accepting the loss. Coming to terms with the loss of a loved one - especially a child - seems like a betrayal to that person, a sign of not loving him or her, and the pain experienced sometimes gives the feeling that he or she is not completely gone from one's life. The trauma of a pregnancy loss has a huge psychological impact though often marginalized by those around you. Despair, guilt, loss of confidence and self-respect are the immediate consequences. Long-term, however, the experience of miscarriage affects emotions in the next pregnancy, increases the likelihood of postpartum depression and can disrupt bonding with the child born in subsequent years. The researchers found that such psychological impact was not related to the length of the pregnancy before the miscarriage - the loss of an 11-week pregnancy can be just as painful and traumatizing as the loss of a 25-week pregnancy. Loss in the case of missing persons, on the other hand, is very difficult to work through. Insecurity, fear, anger, guilt, grief and faith in finding and returning a family member are all mixed together. Often the family cannot find solace for decades.

Different reactions to loss:.

1. Cognitive sphere (changes in thinking - denial, confusion in the head, difficulty focusing, concentrating, feeling lost, being in another world, feeling of the presence of the dead, hallucinations).

2. Emotional sphere (experiencing strong emotions that are difficult to control, confused, conflicting feelings, stupefaction, helplessness, relief),

3. The realm of the self and a sense of identity (I have lost a part of myself, so who am I without this person),

4. Social, material sphere (change in life situation, new role, so new behavior patterns, responsibilities and lifestyle changes, financial problems may occur),

5. Spiritual sphere (questioning the meaning of life and faith),

6. Physical sphere (feeling of exhaustion, worse mood, health condition, severity of somatic complaints).

Mourning phases and duration:.

The sense of loss is always experienced specifically for a given person, and although it has a course and its duration (it closes in a period - up to 4 years - its length is influenced by rituals, interpersonal ties, lifestyle), everyone experiences mourning differently (even if the death occurred under identical circumstances to someone else). At the moment, the phases of experiencing mourning (denial, anger, bargaining, depression, acceptance - they don't occur in succession, so they can't be called phases, some don't occur at all) are being abandoned, as well as the naming of the 4th phase as depression, because it raises a lot of doubts and inattention to the development of clinical depression. Sometimes what we observe are the defense mechanisms that occur, which help or hinder the bereavement experience (suppression, denial, denial, projection, rationalizations, selective processing of information, magical behavior/magical thinking, self-reliant attitude, escape into dreams, splitting the disease area).

What can be done:.

It is important to remember that there are no good, bad, normal or abnormal reactions, behaviors and emotions, because it is a traumatic situation. Thus, the mourning process resembles extremes. Accompanying, listening, showing understanding of different behaviors, emotions, giving space to show them, sometimes silent presence, asking for help with daily chores, avoiding advice ("take it easy", "don't cry") are the best ways to show support in this difficult situation. It is also necessary to be attentive to the symptoms of depression - because bereavement may resemble it, but not every person will have it. It is assumed that the first 3 months are the most difficult, and if the symptoms of depression persist after this period - you should seek help from a professional (you can do it earlier, as psychiatric help is indicated for disorders of sleep, appetite, concentration, attention, constant anxiety, apathy, fatigue. The psychiatrist will also check whether the symptoms appeared before, regardless of the occurrence of bereavement, and will be able to diagnose clinical depression).

What are the indicators that mourning is ending.

ceasing to avoid contact with memories, objects, or places that evoke the memory of the deceased person, a realistic image of the deceased person (not idealization or belittling), making attempts to find myself in social roles, regaining control over my own life, turning towards life, searching for meaning, making the experience of loss part of one's life story, thinking about what "I" would do/do in a given situation, what my needs are, instead of what the deceased person would want me to do/do, or what I can do to meet his/her expectations. In Poland, not much is said about bereavement, but as in other countries, there are social patterns and expectations and rules about specific behaviors towards death (e.g.: showing respect, accompanying suffering, condolences, funerals, wearing appropriate clothing). The lack of such behaviors is perceived negatively by society or loved ones, so the lack of permission to experience mourning "in one's own way" can promote the occurrence of complicated, atypical mourning. It can also occur in the absence of expression of feelings, or their inhibition (deferred mourning, blocked mourning), when the death occurred violently (suicide, murder, disaster), when the relationship with the deceased is ambivalent, when there are difficulties in accepting help, there is a lack of support in the environment, there are difficulties in daily functioning, there were already adaptive difficulties, or there is an accumulation of various losses. The natural process of coming to terms with the loss of a loved one generally closes within 1 to even 4 years. It is very important to say goodbye to the deceased. It allows you to believe, to be sure of the situation. It also helps to experience bereavement later, as a closed, after-settlement process. However, if a person escapes from experiencing painful feelings, realizing the fragility of human life, the collapse of the myth of immortality, experiencing emptiness and loneliness, losing a sense of security through avoidance (stimulants, focusing on various ailments in the body, throwing oneself into activities, withdrawing from most relationships or living exclusively in the past) then acceptance and a renewed life in which there is room for joy and satisfaction may not occur for many years. Therapy helps to recover from a painful loss (group therapy covers about 14 months or longer, as it is important to pass anniversaries, holidays, birthdays, etc. without the deceased, individual therapy does not cover a specific duration)

Magdalena Shafie - psychologist, psycho-oncologist