Coping with bereavement

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Christopher Hall is chief executive officer of the Australian Centre for Grief and Bereavement, and previously worked as a psychologist with the Victorian Department of Education.

For too long, we have suffered from a narrow definition of grief.

We've viewed grief largely as the human response to death but grief is really the human response to change.

It's a multifaceted response that involves our emotional life, our cognitions - the way we think about ourselves, the world and our relationships, as well as the impact of grief on our bodies, our relationships, our spirituality and even our broader frameworks of meaning.

It may be a change that is unwelcome, an adverse life event such as a loved one's death or a floundering relationship.

It may even be a welcome change, such as adjusting to a new work culture or moving to a new location.

Change is a fundamental part of life.

It plays a central role in the work of psychologists, as we help our clients adjust to change or transition.

1. Theories about grief

People often refer to Kubler-Ross' 1969 model of grief which suggests that people go through five emotional stages - from denial through to anger, bargaining, depression, and then acceptance.

While this cookie-cutter model brings a sense of order to a complex process, it has been widely rejected for failing to reflect people's own unique experience of grief.

Freud's initial work suggested that the task for bereaved people was to say goodbye and let go - a process of breaking emotional bonds. We now acknowledge that grief is different for everyone. Bereaved people do not tend to break emotional bonds, instead, they continue these bonds with the deceased.

2. Keeping the connection

Much of psychology's work is in how people can maintain a connection to the deceased and their relationship, while not preventing them from living fully in the world. We move from a relationship of physical presence to a relationship of memory.

This continuing bond can manifest in a variety of ways. It may be that they remember the person on their birthday and light a candle.

It may be that they keep that relationship alive through raising research funds, a foundation in their memory, or even pursue a change to legislation. The therapeutic task is no longer about getting the person to say goodbye, it's about developing a new relationship with the deceased.

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3. The grieving process

Grief has been described as the price we pay for love. We know that in bereavement, grief will often come in waves. People can waver between the intensity and the pain of grief and finding times where they find comfort in activities that might provide some avoidance of the loss. We all have different ways of grieving.

For some people, their grief is private while for many, it's instrumental - they grieve through action. Grief is a process that can potentially last a lifetime. Grief is not about arriving at a point of closure, where all business is done and dusted.

In many ways, it is a loss that will be revisited throughout life. Seven per cent of bereaved people will develop complications in their bereavement experience that will benefit from professional engagement.

These are often, but not always, people who have a particular way of relating in the world that makes change difficult for them and people who experience deaths that are sudden, unexpected or traumatic.

While grief will always remain with us, we expect that around the six-month mark that people will begin to feel that they are able to manage their way in the world more effectively.

If they are still significantly struggling, we may advise them to seek additional support.

4. How others can help

The silence or inaction of others following a bereavement can add to people's experience of grief. It's important that people surrounding the bereaved person be courageous and proactive. Offers of assistance can help, as for many bereaved people, a significant stressor are the day to day demands of living, particularly after the death of a partner.

5. Coping with grief

It's imperative that people take good care of themselves physically and get plenty of rest. Seek out those things or activities that provide you with some degree of comfort or relief.

These could be activities such as walking, yoga or meditation. They may consider joining a support group and meeting with other people who've had a similar experience or simply find company in supportive friends.

People grieve in the way that they tend to live their lives. Some people will find that returning to work or being occupied in activities is beneficial.

For many people, it's about finding some kind of meaning in the loss, reflecting on those questions of why and how, and thinking about how the person changed their life. It's often about creating a brand new normal - a new life, in the wake of that event.