What does Bereavement vs. Grief mean?
Bereavement is to feel desolate and alone as a result of a death/loss. Grief is the deep mental anguish arising from Bereavement. There are two types of Grief: Normal and Pathological.
There are obvious losses, such as the death of a loved-one or a break-up. Not so obvious are the losses of a job, money, health, etc. There are also losses related to aging, such as losing the ability to perform at a job, which is felt as a loss of self.
In order to understand grieving the loss of self, it is extremely important to differentiate between the spirit and the sense of self. The spirit is you; it is your essence and personal energy. Your energy and your genetic DNA formed the beginning of you and what you perceive as self.
But What Makes Up Our Idea of Self?
There are nine general factors that contribute to your idea of self. How you see yourself is based on what you see, along with what others see. Gender is a major factor of self. When you were born, your gender affected the way your parents interacted with you; a Brain Injury did not affect this. Race is also a factor. When you walk into a room people notice the color of your skin, and their reaction affects how you feel about yourself. Body type is also a factor; you judge yourself and others judge you by your physical appearance. This can be affected by the medications you take or an injury to your brain stem that controls your weight.
Another factor is physical and/or academic abilities, such as being graceful, artistic, strong, musical, etc. Some people are good at mathematics, while others are good in the arts. Either way, a Brain Injury can dramatically affect this area.
How we cope with life is another factor. Some people cope well and are resilient, while others are emotional and allow things to get to them. When you are born, your basic personality is intact; a Brain Injury can change that.
Our ethnic background truly affects many aspects of our self; from the food we like, to our sense of humor, to how our skin may tan, etc. A Brain Injury does not change our ethnic background.
Relationships are extremely important. Are you a son or daughter, a father or mother, a brother or sister, a niece or nephew, a husband or wife, a grandparent, friend, or cousin? Are you a stepmother or stepfather? Are you a half-brother or half-sister? Brain Injury does not affect relationships.
Along with these aspects of the self is the role or job we perform. We all have a role or job we identify with, which makes it a part of who we are and how we see ourselves.
Over time, you will eventually be able to look in the mirror and accept yourself by saying: “this is me.” This means that you have a sense of self.
What is Grieving?
There are two types of Grief: Normal and Pathological. The type of Grief I am referring to is the Normal process; which is a healthy part of relieving sorrow and giving meaning to loss.
What is Meant by Loss?
Loss is the essential element of creation. If you gain something, you lose something else. There are obvious and not so obvious losses, including the loss of self. At several points in our lives we will have to relinquish a former self-image and move on.
Eric Erikson and other leading Developmentalists have described the successive stages of life. Modern research suggests that there are normal, predictable stages of adult development. There are numerous variables that cause people to go through these stages in drastically different ways.
As one gets older and proceeds through life, there is a natural mourning process for the former self. The stages of grieving the self are similar to mourning for the loss of others. This process is sped-up in a personal disaster, such as when an individual experiences a close encounter with death.
Numerous scientists have written about the “healthy” grief process, such as Bowbly, Engel, Lindeman, Parkes and Kybler-Ross. Healthy grief is often more prolonged, pervasive and can take more complicated forms.
Symptoms of Healthy Grieving
- Attempts to regain the loved one (bargaining)
- Acceptance or resolution.
The “typical” grief response includes denial, anger, bargaining, disorganization, depression, and acceptance or resolution. The first reactions are often shock, numbness, bewilderment, and a sense of disbelief. After a few days, the numbness turns into intense suffering, which includes an overwhelming feeling of emptiness. A grieving person may have dreams or hallucinations of how they used to be. Next comes a period of despair, as the grieving person slowly accepts the loss. The dominant feelings are sadness and inability to feel pleasure. Tense, restless anxiety may alternate with lethargy and fatigue.
Biological Impact of Grief
Research has shown that loss affects the health of the grieving individual. Some physical symptoms common with Grief are sleep disturbances, loss of appetite, headaches, back pain, indigestion, shortness of breath, heart palpitations and even occasional dizziness and nausea.
The grieving person may alternate between avoiding reminders of their prior self and cultivating memories. Some desperately seek company, while others may withdraw. Sadness is mixed with anger towards a variety of people, including doctors, friends and relatives. This anger is often directed inward to the extent that there is a wish to be dead. Frequently the motives of people who try to help are suspected, and the grieving person may alienate their friends, relatives or therapist. A common change in grieving is for the bereaved to withdraw from leisure and social activities.
Grief and Depression
Grief and depression have many features in common, including guilt, anger and physical symptoms. However, a bereaved person usually shows more changes in mood and has moments of normal cheerfulness. If you have ever been to a funeral, you have seen people crying, and then laughing about fond memories. This is not seen in a depressed person.
A bereaved person rarely has pervasive feelings of worthlessness. People who have been depressed before are more likely to respond to Bereavement with chronic grief.
The process of Grief consists of the emotional energy of the grieving person directed at the images and thoughts of how they used to be, therefore, none is left over for other activities.
Eventually, through constant review and reliving of memories and feelings, the energy is gradually turned outward again. How one displays Grief through behavior and emotions depends on culture, gender, age, and religion.
The solidification of the real self does not truly occur until adulthood. Men tend to gain their sense of self through their work, job or profession. Since the women’s movement in the early 70’s, women also derive their sense of self from the work, job or profession they do, rather than from their social duties.
The overt display of the normal Grief reaction is often vastly different in men and women. Men tend to not express their feelings openly, because their friendships are not lifelong relationships, but are frequently associated with specific, fixed time periods or activities.
Women’s friendships are usually long lasting and are based on their social roles as family caretakers. This role is seen in almost every stage of their lives.
Also, cultural leeway is granted to men and women to display anger and grief differently during bereavement. Men are usually given greater leeway to be overtly angry, while women are permitted to display sadness more openly.
However, some angry outburst may have an organic basis, often referred to as the organic personality. This is a result of a brain-injury. It is the impairment in a person’s ability to make the necessary adaptation to his or her world in the service of discharging tensions and satisfying needs.
Thus, some organically impaired people are unable to tolerate even small changes in environment or routines. Others cannot sustain close relationships because this usually involves tolerating some degree of frustration of immediate needs. They may appear overly demanding, clingy, or childish. Still, others cannot bear the loss of function caused by brain damage, such as the ability to express themselves through language, to process information as efficiently as they used to, or to perform a task they had been accustomed to doing.
Grieving the loss of self due to injury includes earlier definitions, perceptions and images of self. For most young and middle-aged men and women, work provides one of the fundamental sources of meaning to life, whatever the nature of that work may be. To many people their job is their concept of self. Consequently, the loss of ability to work can have a demoralizing effect, and is perceived as a loss of self.
Common reactions to such loss are the stages of denial, anger, depression and eventual acceptance. If the cause of the loss has been a life-threatening danger, the person may experience a high death anxiety, with arousal and excitement generated by this. Often the person relives the situations over and over again through brief and intense memories, with emotion attached to them. These effects are called Post Traumatic Stress Disorder.
In the early stages of recovery there is a pervasive mood of helplessness. Often, the brain-injured person is waiting for the doctors or therapist to “make them better.” However, depending upon the deficit, this may never come about. Dr. Diane was told she had to learn to live with her right hand tremor. As a guitarist, she had to deal with another aspect of loss.
Brain injury causes an acceleration of the stages of the life cycle, and thrusts the brain-injured person into a normal grief reaction. The stages of grief are often not apparent in individuals with brain injury, because they are masked by the neurologic symptoms, called Post-Concussive Syndrome.