Fragile Pieces

The majority of bereaved people eventually manage to get their lives together, and find that life is again meaningful. They realize that even though there will be no-one to replace their loved one, they will have new and fulfilling relationships with others and will develop new interests and hobbies. But some people are either unable or unwilling to end the grieving process. They find themselves locked into a cycle of excessive and chronic despair, guilt and anger.

As you might imagine, given the varied nature of people’s circumstances, the process of grieving is not necessarily straightforward. Its normal progress can be disrupted by a variety of factors including the unspeakable nature of the death, the attitude of the people around the bereaved person, and a tendency, when people lose their partner, to distort the dead partner’s qualities.

In rare cases, the suddenness, and sometimes violence, of death can create a crisis of such enormity that it can take a great deal of time for grief to be resolved. Murder, being burned to death, dying in a car or plane crash, or as an innocent bystander or victim of terrorist attack are examples. The facts, and the magnitude, of what has happened may go so far beyond the experiences of those who are left that they cannot cope. Fear, incomprehension, vulnerability, and an intense anger at anyone (or a god) who may be responsible, are probable emotional outcomes. In addition, if your loved one was murdered, or killed themselves, the stigma can be so strong that it can lead to even more protracted grief. The questions commonly asked by neighbours or acquaintances, for example: ‘Why didn’t you do something?’ or ‘Didn’t you know they were going to kill themselves?’, can stir intense feelings of guilt and shame.

It doesn’t always end with only coming to terms with the death itself. The aftermath of such horrors in courtrooms, with officials, the police and the media can be as stressful and traumatic as the appalling events themselves. In these circumstances, it is likely that you would benefit from help by professionals who will provide an environment and support system for you to begin a full, healthy resolution to your grief. Refer to the Resources section at the back of this book for addresses of useful organizations.

Unsatisfactory Support

However, in more normal circumstances, one of the main reasons for an abnormally lengthy period of grieving is the lack of the right kind of support from friends and family. Some relatives and friends, with the best of intentions, don’t allow the bereaved person to talk about the death of their loved one. They fall silent when this ‘difficult’ subject is broached because they don’t want to risk ‘upsetting’ the bereaved. They forget that it is probably next to impossible to get more upset than the bereaved already is.

Other sets of family and friends go to the other extreme. They lavish excessive attention on the bereaved for an extended period that sometimes prevents them from starting work again or from renewing their old interests and friendships. They might insist: ‘Not yet. You’re not ready yet.’

This over-concern, while again undertaken with the interests of the bereaved at heart, unfortunately prevents the healthy and steady maturation of the grieving process. It goes against the advice of psychologists, who suggest that the most productive and supportive climate for the bereaved is one where they are able to acknowledge and express their feelings. During this process tears will fall, but this isn’t a case of getting more upset, it’s just a part of the process of recovery. And instead of smothering the bereaved with attention, it would be more appropriate for the bereaved to be encouraged to find practical solutions to the difficulties they face in returning to ‘ordinary’ everyday life.

Bereaved Partners

There are also issues that arise in the recovery period that relate specifically to bereaved partners. It sometimes happens that over time the image they have of their deceased partner becomes so distorted that it interferes with the successful formation of new relationships. In effect, the deceased partner is ‘sanctified’ by the surviving partner. They habitually compare any new person they meet with an almost angelic figure who is all of the best aspects of their loved one, but without any of their less attractive features. More often than not, this comparison is conducted negatively: ‘Ah, but my wife/husband/partner would never have done this. She/he was so kind, thoughtful and giving. I’ll never meet anyone as good as her/him.’

While we would all like to remember our loved ones with the greatest of affection, it can be necessary, in order for the surviving partner to move on, for the ties with the first partner to be worked through and discussed in an objective manner by both parties in the early stages of a new relationship.

There can be severe emotional problems for older people after their partner dies. Some adjust very well to death, but in cases where partners have been together for many years, day-to-day living can be difficult. One reason, apart from loneliness, is that older couples are often mutually dependent, and the lack of support after a death can lead to chronic self-neglect. Why bother? time and life seem so pointless now. This reaction is common if one of a couple had to care for their partner for many months or years before they died. Tied to this is the burden of guilt at feelings of relief in seeing a partner’s misery coming to an end. This is not to say that most who wish their partner dead are motivated by hate – quite the opposite – but it’s characteristic of carers of the long-term ill to have such thoughts.

Practical Problems

There are many practical problems for someone who has been bereaved in old age. Perhaps chief among these is loneliness, but there are other anxieties including concerns about health, possible financial difficulties, and issues of security. Here are a few suggestions to deal with these particular issues:

• Loneliness The loneliness after bereavement in old age can be intense. It doesn’t help that in Western society, where the extended family rarely lives together and may be quite widely scattered, widows and widowers almost invariably find themselves alone, and may become dangerously isolated. The sense of longing and loss is a feeling that some believe they can never get over. The only way to overcome loneliness is to work at it. Don’t expect it to be easy. It won’t be. Early on it may also seem as though to have fun is somehow disloyal to the memory of your partner, but there may come a time when instead of becoming distraught, and wistfully reflecting: ’1 wish she/he was here’, you might begin to enjoy the activity itself without guilt and smile, and think: ‘Yes, she/he would have liked this too.’ Lack of money or mobility also can make things difficult, but if you have some extra cash to spare you could think about going to evening classes at a local college or joining one of the extracurricular classes at a university. Some local councils subsidize such courses, and so they can be fairly cheap. The range of studies is huge; there’s everything from learning how to upholster furniture to becoming computer literate or learning a new language. And, of course, it’s a very good way of meeting people. If you’re more mobile you could join a rambling club, a bowls club or a choir.
• Health Some researchers have concluded that elderly widows and widowers are more likely to suffer illness or die soon after a bereavement. A few put this down to a loss of will to live, or more simply put, a broken heart. Others suggest that any increase in visits to doctors in the six months after a bereavement can be put down to tension or anxiety, or symptoms of illness that were ignored just prior to their partner’s death. Whatever the case, living by yourself is certainly difficult. Without a companion there doesn’t seem much reason to get up, eat properly and get out and about. There are potential health risks in this. Simple things can help: eat properly balanced meals; make sure you exercise regularly; keep warm.
• Money Money doesn’t need to be tight for you to take advantage of any benefits that you might be entitled to. State grants or credit are not charity. If you are not very mobile or have medically-documented physical problems, you may be eligible for financial support. There is no shame in taking it. Similarly, if your partner served in any of the armed forces, you may be entitled to a sum of money as the widow of a war veteran.
• Security It’s a fact that most elderly people who have lost a partner are women. Women tend to live longer than men, and also to marry older men. By the age of seventy-five two-thirds of women have lost their husbands. Many women in this position, probably quite rightly, feel threatened and physically at risk. If you haven’t already done so, install a chain on your door, and a fish-eye peephole, so that you can check on people who are calling. Put locks on all of the windows. Always ask to see the cards of any officials or workmen. If in doubt, call up their offices to be quite sure that they are legitimate. (Get the numbers from the telephone directory; any number you get from the person at the door might simply put you in touch with an accomplice.) Don’t be put off by people complaining that you’re being ‘difficult’; you’re just being safe. You could consider getting a dog. Get to know your neighbours, and let them know when you’re going away so they can keep an eye on your place. A telephone is an essential tool in keeping in touch with officials and friends. Think seriously about getting a phone/fax machine, or a computer with a modem and e-mail (if you haven’t got one already) as this makes communication easier.

Remember that your life still counts even though the death of your partner may have slightly shifted your perspective at present. You still have the right to make choices and decisions, to be treated decently and with respect, and to have control over what happens to you. Being older can make it a little more difficult, perhaps because in Western society the elderly aren’t valued as highly as they should be, but it is completely possible.

One way of starting to take control is to get organized. Arrange what you’re going to do the next day each evening. This could be a part of a regular (possibly weekly) routine involving getting out for a walk every day with a purpose other than getting some fresh air, such as getting your pension, going to a class or an exhibition, or posting letters. Get some exercise, be curious and active. If you aren’t so mobile, ask relatives and friends to help with things you can’t do yourself. Alternatively, contact an association that represents elderly people for information and assistance.

Coping with a death that was self-inflicted is extremely difficult. It seems to be beyond question that the stresses on a family where a death is a result of suicide are greater than those imposed by most other forms of death. A great deal depends on the age of the person who takes their life, but in all cases the reactions of family members and friends are likely to be harsh and complex.

Stresses

In addition to dealing with the range of emotions that all the bereaved have to cope with, the families of a suicide face other extreme stresses. Typically they include:

• Denial In common with those who have become bereaved under less tragic circumstances, the families of suicides find it difficult to accept that their loved one has died. Yet, more than this, it’s not unusual for them to deny that the death was due to suicide at all. If the suicide was a teenager or young adult, his or her father tends to take it very badly. Of all of the family members it’s fathers who typically deny the fact of suicide the most. Even when they become more accepting, they commonly rationalize the act of suicide. Instead of recognizing in the tragedy any internal family problem or other unreleased pressures, outside factors such as drugs in society, the company that the suicide kept, and the breakdown of society as a whole are blamed.
• Shame There is such stigma attached to suicide that one of the most powerful emotional reactions to an act of suicide within the family is shame. Registrars are routinely asked to falsify death certificates by grieving family members who don’t want the truth to emerge publicly. Even within the family there is often a conspiracy of silence to keep the dread secret. To neighbours and acquaintances, the death is passed off as an ‘accident’.
• Guilt The guilt in the aftermath of a suicide is unlike the regrets and guilt associated with other forms of death. Instead of bitter regrets over a catalogue of actions or arguments, you might feel almost overpowering guilt not only for what you feel you should have done to prevent the suicide, but also for what you might have done that contributed to its happening. The guilt of parents whose children have taken their own lives may be extreme. Western society holds that they are responsible for the upbringing of children, and with the suicide they are deemed to have failed as stable, nurturing parents. Similarly, adult children may feel overwhelming guilt if their elderly, recently widowed parent died by suicide. They will inevitably feel they should have visited them more often. Partners of suicides may feel a peculiarly acute form of guilt since they more than anyone should have ‘seen the signs’.
• Fear A darker, and perhaps more disturbing, reaction to suicide is the fear that it can unleash. Primarily, this is the fear of self and of an individual’s impulse to self-destruct, but in addition it is the fear that someone else in the family might take their own life.

Perhaps more tragic, and very real, is the constant fear that people outside the family will discover the fact of the suicide and almost inevitably interpret it in such a way as to negatively affect the family’s social standing. There seems little doubt that someone who dies as a result of an accident, illness, old age or even violence is more likely to be viewed with sympathy than someone who takes their own life. The act is often interpreted by others as a shocking and violent end to a tragic story of rejection or abuse by (usually) the suicide’s father, and is symptomatic of a dysfunctional family.

These perceptions are increased if the suicide act of your loved one required some determination and energy, such as hanging, as opposed to a more passive end through taking an overdose of pills. Furthermore, even if there are mitigating factors, such as the proven psychological instability of the suicide, these tend not to alter an outsider’s interpretation of events.

Of course, not all of the difficulties of terminal illness relate solely to the patient. Friends and family are also affected. If you have been aware of the nature of your loved one’s illness, you will have been anticipating their death. It’s only natural, but it makes an already distressing ordeal all the more demanding. This is because in anticipating the death it’s likely that you will have been feeling guilty at thinking about the practical issues of how you will live your life after they are dead even while they are still alive. It seems as though you’re being disloyal in letting go before you’re supposed to.

But, again, this is to be expected. There is an inevitable conflict between looking after someone who is dying, and the need to reorder your life. It’s a pre-death reshuffling of roles that happens when people recognize that someone they love is dying that is similar to post-death grief. However, the two processes shouldn’t be confused, in the sense that in anticipating what happens after the death you will somehow subsequently grieve less. There isn’t a fixed amount of grieving that takes place when someone dies. You’ll just grieve differently, that’s all.

It is significant that the death of a child is not just the tragedy of stillbirth, cot death, or illnesses or accidents that take the life of a young girl or boy, or adolescent. A child is a child at thirty or forty to the parents of that adult. And when adults die there is often a parent, or parents, left to grieve.

The death of a child is especially brutal because it’s untimely, in that it upsets the concept of a ‘natural’ order of life and death wherein parents die before their children. For this reason alone, perhaps, there is no greater grief than the grief following the death

I of a child. It’s a crushing upset from which many people feel they do not fully recover. This is especially true if the death is accompanied, as it often is, by intense feelings of guilt, regret and failure.

Death of a Fetus or Newborn Baby

While the loss of a child throws up unique issues whatever the child’s age, there do appear to be special problems associated with the death of a child during pregnancy, or soon after birth. If your child died a very early death it’s likely that your feelings of being somehow at fault are intense. This may be because parents are parents, and the duty of parents is to be able to provide for their children. In a sense parents are the ones whose duty it is to ‘fix’ it so that their child will have a safe environment in which to grow up. Sadly, parents simply cannot fix everything. Miscarriage, stillbirth, neonatal death and cot death (otherwise known as Sudden Infant Death Syndrome or SIDS) are often wholly unpredictable. They are therefore unpreventable.

Nevertheless, the shock of saying goodbye to a dear child before having said hello is devastating. This sense of loss and aloneness may be amplified by the staggeringly insensitive and unhelpful comments of others. Choice among these are: ‘Don’t worry. You can have another one’, or ‘I know it’s sad, but it’s not as if you really knew the baby’. The expectation of those who have not suffered such a loss seems to be that the bonds of parenthood are somehow more valid if the child who died was at least a toddler, or boy or girl of primary school age. The reality is different. Attachment to a child usually begins even before it is born – a mother is likely to recognize her foetus as an individual.

The background to the death, when it occurs in the hospital, may be cloudy. Mothers are often sedated. They may not be given the option of holding their dead child, as some hospitals continue the practice of routinely cremating foetuses and the stillborn, even though many foetuses are well formed by twenty-eight weeks. Mothers may feel particularly bereft if they have no token to indicate that their baby existed at all. It is natural and comforting to cherish a lock of hair, a photograph or an inky foot- or handprint on a piece of paper. They may have nothing except the memory of a small white coffin, and a short, sad service just before the burial or cremation of their child.

All of this can cause ,specific patterns of grief in parents whose children die very young. In addition to thoughts of anger, guilt and depression there is often a profound sense of ‘what might have been’. Linked to this are private fantasies of what the child could have achieved. This can add to feelings of being detached socially, and from reality, which in turn fuel fears of going slightly crazy.

It’s not too surprising, therefore, to find that couples find it difficult to talk to each other about the death of their baby. But there is a further problem in that fathers are unlikely to have formed as strong an attachment to the baby as the mother at the earliest stages. As a result, marriages after a stillbirth or SIDS death can suffer severe trauma.

Clearly, recovery after the early death of a child is by no means easy, but there are positive steps you can take which will help to rebuild your life:

• Hold the baby If possible, and the doctors agree, hold your baby. For a few minutes look upon your child as having been born; cradle the baby gently in your arms, and caress him or her. This might seem a strange thing to suggest, but it is important for mothers to form a final attachment with their baby, and for fathers to be given an opportunity to develop an emotional bond with their child. This provides a sensitive and very human closing to life that will serve as a small, yet significant, memory that will sustain you in grief. Take photographs, ask for a lock of hair, or a print of your baby’s hand or foot.
• Help plan the funeral The funeral provides an opportunity to say goodbye to your baby. Normally, hospitals will provide such a service free for foetal deaths and neonatal deaths. They use the services of a contract undertaker for a specific cemetery. Remember that you are not obliged to accept these arrangements if you believe they are unsatisfactory for any reason. It may be that you disapprove of the cemetery itself or the style of service it offers. If the thought of a white coffin is too harsh a container for a child that has not tasted much of life, you could consider using something that has altogether less jarring imagery and connotations. This could simply be a soft shawl or shroud, or other cloth. Ask if you can personally place the body in the grave; you can ensure that it is a ‘natural’ position. Choosing a private ceremony might also mean fewer restrictions on the placing of tokens of love, such as teddies and dollies, by the grave. In making a private arrangement you could think about buying an adult grave so that you can be buried with your child when you die.
• Remember Naturally, you will want to remember your baby. However, the best way to remember your baby is not to succumb to the temptation to make a shrine out of a nursery that you might have prepared in anticipation of your baby’s birth. There will come a time when you will have to reappraise the value of keeping hold of what could have been, and remember your baby in more healthy and positive ways. These may include simply looking at what photographs or other remembrances you may have, and openly (without bitter regret) talking with your partner of what hopes you had for your child. But more than this, you could add to the memory of your child by giving gifts to organizations that help needy children throughout the world. You could choose significant dates such as Christmas or the birthday of your child to do this.

Recently, it seems to have become more difficult for people in Western society to grieve, and to accept death and bereavement. This is probably due to the changing mores concerning death that have occurred during the twentieth century. For example, it is now not always necessary for people to wear black at a funeral or for a minister to give an address in a church. And more elaborate and formal expressions of condolence – such as the wearing of a black armband – are largely no longer observed. Despite the loss of these cultural supports, people who have recently been bereaved are nonetheless expected to cope. Often they are expected to show their grief for only a very short time, despite evidence to suggest that it can take much more than a year for a bereaved person to start to reconstruct their life. This apparent lack of sympathy may be because people tend to confuse grief, which is the period of readjustment that a bereaved person needs in order to respond to death (or, perhaps less coldly expressed, the period during which their love is not able to let go), and mourning, which is the short period of time during which we make a social acknowledgement that the person we love has died. The period of mourning in modern society is relatively short and is more or less over within a few days or weeks of the funeral.

However, where grieving is concerned, the length of time and the intensity of the period are fairly unpredictable. They depend on your personality, how close you were to the person who died, the previous experiences you’ve had of death and the way in which your loved one died. Following the sudden death of my wife Shirin, I was told by a friend of a friend, whose husband had died after eleven months of marriage, that it was six months before she found she was able to start to laugh again at the trivia of everyday life. But she didn’t tell me that it was going to be a year before I would be able to control bursting into tears at any time of day, or in any place, whether cooking a meal for myself, sitting in my car at a set of traffic lights, or working on a text for a lecture. For some, it can take years.