Grief and what to Expect

Everyone will suffer bereavement at some point but many of us have little idea how it will affect us until it happens and even then it may be confusing. Paul Williams from Cruse Bereavement Care looks at what to expect and where to find help.

People react to bereavement in a number of different ways. A lot of research has been done on the subject and this has resulted in a number of models of bereavement outlining the likely effects. Cruse Bereavement Care volunteers use the principles from some of these models in order to help those who are bereaved.

How might grief potentially affect those who are bereaved?

Some examples would include:

Behaviours eg routines and the way they relate to others

Physically eg they may become very tired or be more susceptible to physical illness

Mentally – eg they may find it difficult to concentrate or think clearly

Emotionally – eg they may have very strong emotions (such as anger, guilt, overwhelming sadness) and they may feel out of control or not strong enough for their expectations and the expectations of others

Practically eg financial worries

Some models of grief

Models are helpful because they can give a framework for us to see how bereaved people are grieving and then to consider how we can help them.

Colin Murray Parkes: Phases of grief

Many people who are bereaved will experience the following stages at their own pace:

Shock which may show itself in many different ways for example numbness or disbelief
Separation and pain which may show itself in waves of distress, intense yearning for the person who has died and feelings of emptiness
Despair which may show itself in depression, difficulties with concentration, anger, guilt and restlessness
Acceptance

J William Worden: Tasks of mourning

To accept the reality of the loss
To work through the pain of grief
To adjust to an environment in which the person who has died is missing
To emotionally relocate the person who has died and move on with life

Stroebe and Schut: Dual Process model

This model describes feelings and activities following a bereavement as being divided into Loss and Restoration
Both kinds of activities are very important for ‘recovering’ from a bereavement
When we are bereaved we may move back and forth between the two from the beginning of our loss
Loss activities would include grief work, intrusion of grief and denial or avoidance of restoration activities
Restoration orientated activities would include attending to the changes arising from the death, doing new things, new roles and identity

Principles of the work of Cruse Bereavement Care

Cruse’s aim is “to promote the well-being of bereaved people and to enable anyone bereaved by death to understand their grief and cope with their loss”

We offer a variety of services including face-to-face support in our local branches, group support, a National Helpline and very well used websites www.cruse.org.uk for adults and www.rd4u.org.uk for children and young people

Cruse’s working approach is person centred (based on the core conditions of Carl Rogers-see below) and integrative, which means that all our workers have knowledge of the various models of bereavement and the different helping and counselling approaches. In this way we can work effectively with all bereaved people.

The core conditions of Carl Rogers include respect and empathy.

Respect – The Cruse volunteer who holds this attitude deeply values the humanity of the client and is not deflected in this valuing by the behaviour or attitude of the client. It also means seeing the client where they are.

Empathy – The Cruse volunteer has the ability both to enter the world of another person as they tell their story and to communicate this understanding

How the bereavement models help Cruse volunteers to support those who are bereaved

Below are some brief recent examples of helpline calls and how the models have helped us to help bereaved people. The models equally help our colleagues in our branches who offer face-to-face support appointments.

A. “It’s three months now since my husband died. I ought to be over the shock”

She witnessed the unexpected death and was traumatised. She appeared to be experiencing a mixture of shock and disbelief (not unusual even when the person witnessed the death). In appreciating this she became less hard on herself and her perceived weakness in not coping better. She then wanted to have face-to-face support from Cruse.

This call showed the relevance of the Murray Parkes’ Phases of Grief (eg shock and despair and separation from the person who has died and the intense pain) and also had elements of the Worden’s Tasks of Mourning because the caller was beginning to work through the pain of grief but was struggling to accept the reality of the loss.

B. “My son died 10 months ago. I am so fearful of the anniversary. I am not even coping now”

Using the core qualities of respect and empathy enabled him to share what he was thinking and feeling. He explained that he was crying lots every day and he thought his wife was coping better and he felt inadequate. He also didn’t know whether he could continue living with the loss of his son.

He and his wife were still communicating well even though they were grieving differently. Also he was still working and keeping in close contact with his remaining son.

This seemed an example of the Stroebe and Schut Dual Process Model in that he was in the Loss Orientated sphere because the grief was still hugely intrusive. Also to some degree he was in the Restoration Orientated sphere because he was beginning to look to the future. He had ordered a headstone for his son’s grave and he was keeping his marriage together and continuing to work. However in looking to the future he was fearful of losing his precious memories of his son.

When we are supporting those who are bereaved we are using our core principles and qualities including respect and empathy and utilising our knowledge of the bereavement models to help the client in their own unique bereavement.

References:

Parkes CM, Studies of Grief in Adult Life, (Penguin, 1975).

Parkes CM, Love and Loss. The Roots of Grief and its Complications (Routledge, 2006).

Stroebe M, Schut H, The dual process model of coping with loss. Paper
presented at the International Workshop on Death, Dying and Bereavement. (Oxford, 1995).

Worden JW, Grief Counselling and Grief Therapy (2nd edition) (Routledge, 1991).

Cruse Bereavement Care: Helpline 0844 4779400

Email: helpline@cruse.org.uk

Website: www.cruse.org.uk and www.rd4u.org.uk

Has someone died? Restoring hope – a short but comprehensive leaflet – see:http://www.cruse.org.uk