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It was 1890’s Britain, a mother of a young boy, like many mothers of upper social class in that time, believed that parental attention and affection would spoil her child. She instructed her housemaid to raise the child almost exclusively, which the attendant did, with great passion and dedication. One day the housemaid left her job and the boy felt a deep sense of loss, a loss which he would later describe being as tragic as losing a mother. Little did John Bowlby know at that time that he would grow on to be among the first people to describe in detail what it means to be attached to someone and more importantly what happens when we lose that attachment.

He wrote that as we get attached to a person, we create a model in our mind based on our personality and our past experiences; it’s like we create a shared world in our minds about how our relationship is and we predict our future with that person based on the shared world, a world in which we and the person we are attached to contribute. When we lose our attachment figure, the equilibrium is disrupted, the shared world is shattered, we no longer receive inputs from the other person and our mind is forced to go through an entire process of readjusting to the new reality. The response we have while we are going through this process is called grief. While any kind of loss can lead to grief– a breakup, a divorce or even a loss of house, we shall talk about grief in the context of the death of a close loved one. 

What Happens to Us?

When we lose someone, we first protest and then search to somehow keep the attachment bond the same. As we lose hope and the attachment bond diminishes, we despair for a while and eventually readjust our lives around the recognition that the lost person will not return. Although we ultimately learn to accept the reality of death, we keep seeking symbolic ways of keeping the memory of the deceased alive. What we go through while we deal with grief can be divided into 5 distinct stages namely:

STAGE 1: SHOCK AND DENIAL–– This has not happened, its all a lie. Things are just like they were before.

STAGE 2: ANGER–– Why me? How can this person leave me and go? How can God do this to me?

STAGE 3: BARGAINING–– If only I had done things differently, I would not have lost this person.

STAGE 4: DESPAIR–– Why go on at all? What’s the point of going on without this person?

STAGE 5: ACCEPTANCE–– I will miss the person who left but I will move ahead, I will live on.

Contrary to popular belief, we do not go through the stages in any specific order, in fact, we move in-between stages to and fro. Sometimes we get stuck in one stage for months and many a time, we skip past a stage.

For How Long?

The time a person is allowed for grieving can vary for different cultures. In most societies, the individual suffering from grief is expected to return to work or school in a few weeks, to establish equilibrium within a few months, and to be capable of pursuing new relationships within 6 months to 1 year. Research suggests that the bereavement process does not completely end with this time period and certain aspects may persist indefinitely. It is common for a person to relive the original grief each year during the anniversary of the dead and in some cases when the grieving individual becomes the same age as that of the deceased person at the time of their death. This is called the ‘anniversary reaction’ and it tends to become mild and may last for a few hours to a few days.

Is it Normal?

Just like it is perfectly normal to be happy when a child is born in the family, it is perfectly normal to mourn the death of a loved one and in fact, it is necessary. Only after we go through the process of grief can we thoroughly move on. However, some times we can get stuck in the middle of the process and this is called pathological grief or complicated grief. We remain angry at the individual for leaving us; we remain angry at a higher power for making us suffer and perhaps the most dangerous of all– we remain angry at our self. This anger stems from the guilt we feel, the guilt of not doing enough for the deceased person, the guilt that perhaps if we would have done things differently, the deceased person might just be alive.

Although clinical depression can occur in grief, they are not one and the same thing. In grief, the sadness is reactive and only concerning the dead individual whereas, in depression, the sadness is more pervasive and persistent, and related to topics beyond that of the deceased.

Some Mourning Rituals Across the World

What Can Be Done?

Ever since mankind existed, every culture has its own rituals concerning the dead. These complex cultural rituals that the grieving people participate in is called mourning. These rituals help us go through the different stages of grief and are extremely useful in helping us process our new reality. The funeral and burial service acknowledge that death is real and final, the breaking of ‘chuda’ by women in some cultures, though symbolic, helps her break through denial. The rituals like serving food to family and friends on death anniversaries garner support for the bereaved, encouraging tribute to the dead, uniting families, and enable community expressions of sorrow. Encouraging the grieving people to take part in the social customs and rituals has shown to help them deal with their loss. The Diagnostic and Statistical Manual of Mental Disorders states that grief should only be treated if it lasts for more than 1 year or if clinical depression is diagnosed and the grieving person wants to kill him or herself.

Coping with the loss of someone or something we love is one of life’s biggest challenges, often leading to intense pain and discomfort. Understanding that it is not only normal but necessary will help us deal with it better. Also, we do not need to completely forget the deceased person, and there will be times when we will miss him or her and that is perfectly okay as long as we have reinvented our lives and accepted the reality. After all, experiencing grief is universal yet extremely personal.  

 

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About the author

Dr Adnan Kadiani has been fascinated with the workings of the human mind since a very young age. This led him to take up psychiatry as a speciality after completing his MBBS and he is currently practising therapy oriented psychiatry in South Mumbai. He has a deeply felt interest in teaching and research. Childhood adversities and domestic violence are his primary research interest topics. When not working as a mental health specialist you would find him travelling, understanding different cultures, talking to different people and enjoying the various cuisines of the world.

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