Bereavement is the process of moving from not wanting to accept a terrible reality to being able to accept it. For that to occur successfully many things need to happen. Above all, a person needs to let out their grief. Everyone’s different in how they do this with some being more public in their grieving and some more private but generally the more grief there is, the less chance there’ll be of becoming stuck in bereavement or of grief coming out ‘sideways’ – for instance in bodily symptoms.

The stages of bereavement

The stages of bereavement are well documented and widely known. They’re similar to the stages that a dying person goes through and are not a neat progression. That’s because we’re not machines and our emotions, like life itself, are messy. So the stages will jump around and repeat.

Firstly there’s denial where the fact of a death feels so alien that it’s impossible to take it in. Even years later we may find ourselves on the point of telling the lost loved one something, momentarily forgetting they’re not there. Then there may be anger. Doctors and nurses, for example, may become targets of anger for a perception that they didn’t do enough to save the person who has died. Guilt for one’s own perceived failings may also be present. ‘If only I had said, if only I had done’ or ‘if only I hadn’t said or done’ are familiar refrains. It’s important to recognize guilt as a symptom of bereavement and to try to keep it in proportion.

The next stage is depression which, while it may be the longest stage for some people, also marks the beginning of acceptance which is the final stage and the aim of bereavement. Acceptance means what it says but it doesn’t imply ‘getting over’ the lost person or forgetting them. Often people never get over someone and certainly don’t forget but with time they do find a way of living with the loss and of taking up the reins of life once more.

Other features of bereavement

An obvious dimension of bereavement is the need for countless cords which bind us to the loved one to be broken. Each time that happens it’s accompanied by pain. There’s also the huge adjustment to being permanently deprived of someone’s emotional nourishment. Small wonder that bereaved people are in some sense searching for the person they’ve lost. It’s not uncommon to mistake someone in the street for the loved one and to literally run after them. Neither is it uncommon to sense the loved one’s presence or to hear them around the house. If they’re invited out, a bereaved person may also be restless and want to go home for apparently no reason. Again, it’s about wanting to be near the person who has gone, as is a need to talk about them to others, perhaps going over repeatedly the chronology of events leading up to their death. So it’s important for those around the bereaved person to be willing to listen.

Taking someone into ourselves

Related to this desire to be close to the lost loved one is the need to take them into oneself and to become like them in some respects. This is called identification and it can take many forms. Accident and Emergency departments are familiar with the phenomenon of a person coming in complaining of chest and left-arm pain which, upon investigation, has no physical cause. ‘Have you lost anyone recently?’ a doctor may ask. ‘Yes’, the person replies, ‘my father died of a heart attack’. Or else a widow may find herself watching the Cup Finals that her husband used to love or taking on other behaviours and traits that he had. On occasion someone may even take over the work that the dead person used to do and make it their own.

Identification happens as a way of working through a loss. If the person becomes part of us, we don’t have to lose them altogether. They become a sustaining internal presence. But in healthy grieving, there’s also space eventually for investment in new relationships. A balance can be struck between the inner world and the opportunities and challenges of the outer world.

A healthy outcome to bereavement

Although there’s no distinct end point to grieving, if all goes well a time will come when significant healing has happened and it’s possible gradually to re-immerse oneself in the daily flow of life. Outward signs of this may be giving away the departed’s clothes, re-arranging the house or having it decorated or perhaps moving house altogether. Other signs may be buying new clothes for oneself, making new friends, going on holiday and undertaking new activities. Although, as I’ve said, bereavement is a continuing process, these things are indicators that a point has been reached where the whole life with the lost person has been assimilated and all of it is available, the early days of the relationship as much as the latter days.