Category: Grief

Grief is an expected intense sadness and misery in response to the death of a loved one, so the statement ‘Grief is a sign of weakness’ is one we disagree on. The passing of a person brings out emotions it is inevitable and affects all of us (part of human life). There is more to grief than just the internal feelings, there is spiritual, physical and social experiences.

Grief is a topic that is hardly spoken about in numerous homes, even though it is an important topic in our lives. It can occur in situations such as a job loss or a divorce. Grief is one of the most traumatic experiences. The experience of loss is shocking and it needs a process of grieving. When the death of someone is not accompanied with a process that allows us to express our feelings of despair and vulnerability, these emotions can be supressed. They can come back to us if we don’t find a way to acknowledge the loss that has taken place.

In this proposition we will discuss that people differ in their experiences of life and therefore they differ in their experience of death. The argument will be discussed reinforcing our position which is against the topic and the counter argument will also be discussed. The proposition contains points such as the five stages of grief (denial, anger, bargaining, depression, and receiving) which are necessary to release the tension and give closure (Louw & Louw, 2019:475). According to Kubler-Ross(1978) They don’t always occur in the same sequence. We will look how people differ in their experience of death.

Argument

Grief also known as bereavement is a way different people express their feelings to the loss they have suffered. Loneliness and depression are a normal part of the process of healing, not a sign of weakness. Grief is a naturally occurring emotion that affects almost every human being who has lost a loved one. In the process of healing, individuals are likely to develop continuing bonds. Continuing bonds are attachments maintained rather than relinquished, (Worden, 2018). In case of a widow or widower, it helps them keep healthy while still attached to the deceased. Continuing bonds contribute to positive mental health and lifestyle. It not having attachment issues but a way in which an individual can be able to come to terms of accepting the passing of a loved one. When my mother passed away, for a while I suppressed my thoughts hoping I would wake up from the dream but eventually I started accepting and keeping her as my imaginary friend and guardian angel.

Grief is a healing process which has stages, which you may encounter in any order and any number of times, (Buckley D). Kubler-Ross initially wrote up the different stages of grief, paying most of her attention on the negative emotions that people suffering from terminal illness go through before facing their final breath. There are five stages in all namely, Denial and isolation, rage, Bargaining, misery and acceptance. Grief is not a sign of weakness because when I was about to complete my 1st year of University, my mother passed away due to cancer she had been battling with for years. Grief is a universal experience, just like everyone who grieves, I did not see myself as weak but strong enough to face it.

Studies have shown that grief is part of nature that comes from a biological, cultural and psychological perspective, (Parkes & Prigerson , 2013). Grief does not have colour, age or gender. There are multiple types of grief such as absent grief, chronic grief and anticipatory grief. The disadvantage if grief is when one experiences chronic grief, an individual fall into depression and no longer functions in a normal way. Grief brings family and friends together who then offer support throughout the process. “Lean on me when you are not strong because we all need somebody to lean on, I will carry you always” is a song which means we find strength and healing when someone helps us carry the load and it becomes easier. In my personal experience, a support system helps the process of healing becomes effortless and easy rather than hard.

Counter Argument

As natural and as universal as grief can be, it also has its disadvantages. Not only can it have a negative impact on our physical wellbeing, but it can also negatively affect our mental health. As described in EveryDay Health, one of the most common early symptoms of grief is extreme tiredness, resulting in everyday tasks becoming too difficult to carry out (Dr. Sanjay Gupta). I have witnessed this for myself. A lady that had been working at a hardware store for the past ten or so years recently got fired. She did not take this loss very well, and in a short period of time she fell into a severe state of depression. She would isolate herself from everyone else, and sometimes she would refuse to eat. The after-effects were so bad that about two weeks later she suffered a terrible stroke that has now left her paralysed and unable to talk. As mentioned before, this is a great example of chronic grief. To support this example, EveryDay Health also mentions the fact that the emotional impact of grief is often described as “heartache” or “heartbreak”. As a result of increased stress during the bereavement stage, high amounts of the stress hormone are released which can then trigger heart problems. Grief also puts a huge strain on the body, with the heart being the most common target. GoodTherapy talks about how the loss of a loved one can increase a person’s chance of a heart attack, or the development of a broken heart syndrome. Grief can also lower a person’s immunity, making them vulnerable to infections, the flu and other diseases.

Having gone through the grieving process myself, I would have to agree with some of the points mentioned above. Not everyone who succumbs to grief will successfully finish grieving. Sometimes the number of negative events occurring right after one’s loss can trigger a more painful effect, hampering one’s progress to a healthier lifestyle. this may force a person into a horrible cycle of grief which could turn short term symptoms into more serious ones. Yes, grief can be particularly harmful, but this doesn’t mean that it is unmanageable. GoodTherapy states that building a healthy routine can be a step towards eliminating chronic grief. This means that old habits such as smoking and drinking would have to be replaced with a nutritious diet that can alleviate problems such as heart risks, digestive issues and sleep patterns. Exposure to mental health professionals, friends and family members, mental health awareness campaigns and initiatives, as well as books and other materials focusing on mental and physical health can also be helpful in avoiding the cycle of grief. A person can take control of their own lives and ultimately avoid the cycle of grief. Grief is a natural and healthy response to a certain kind of loss. It is something that many people have to go through, as stated in the Kubler-Ross stages of grief, in order to work their way out of the initial shock and pain of loss.

Conclusion

Its brought to our attention that people differ in their experience of the loss of a loved one. The argument states that grief is not a sign of weakness, but it is something that can make you even stronger and find peace. The attachment theory explains how people have different bonds to different people and so the difference in the intensity of your your grief does not make you weaker or stronger. The actuality that grief has a negative impact on your overall health should not destroy you as a person and make you feel weak it is a necessary procedure to regain your strength and move forward.

Grief is a normal and natural occurrence in life that can stem from various situations such as a loss of a loved one, a job, a move, or anything that causes a person to mourn. When a person experiences grief there is a variety of emotions that may cause the inability to carry on with normal activities. It may leave a person feeling numb and dissociated from life. Since grief is a personal experience and is a process that can not be controlled, it is hard to determine how long it will last. For some, it may last a couple of months and for others, years. Grief can occur in adults as well as children as it is not biased against age. (‘What is grief?’, n.d).

Grief usually ceases or the severity is lessened as time passes. However, when it is a constant and the intensity of it over time remains the same, causing a person the inability to continue and function normally, the grief may have evolved into Persistent Complex Bereavement Disorder (‘What is grief?’, n.d). This type of grief according to the proposed diagnosis criteria in the DSM-5 last more than 12 months in adults and more than 6 months in children (American Psychiatric Association, 2017). When this occurs the grief can trigger preexisting mental disorder or it can cause other psychiatric disorders to emerge (Kaplow, Saunders, Angold, & Costello, 2010).

Many studies have researched the impact grief has on adults after the death of a loved one, however, very limited studies have been conducted to include how children are mentally impacted after the loss of a loved one especially a parent. Statistical data shows that in the United States 1 in 20 children will experience the loss of a parent before the age of 18, and about 4% of children living in western countries will lose a parent during their childhood (Dyregrov & Dyregrov, 2013).

Currently, over 153 million children are orphaned worldwide (Children’s Statistics, n.d.). Grief in children after the death of a parent can be persistent and debilitating causing long term effects well into adulthood. Grief in 80% of children is usually resolved within a year of when the death occurred. The child is able to resume a life similar to before the loss. However, 20% of children who lose a parent during childhood will be severely impacted. (Stikkelbroek, Bodden, Reitz, Vollebergh, & Baar, 2015). The impact can depend on a variety of existing factors, such as the parent’s cause of death, the child’s current environment, and any existing mental health issues occuring with the child or in the family (Kaplow, Saunders, Angold, & Costello, 2010).

Concerning children there is no clear definition of what Persistnat Complex Berevemnt is as compared to normal grief, as there is not separate proposed criteria in the DSM-5. However, children will express signs through their behavior. The symptoms go beyond crying or being sad, as these are typical when a death occurs. The symptoms are more severe. The child is unable to move past death and may exhibit intense feelings of anger, lack of concentration, nightmares, academic problems, and inability to make future plans. The reminder or memories are not of joy but are traumatic. There is no acceptance or reality of the loss. The child can not reconcile with the death or find meaning in it. It is also difficult to form or become engaged in other nurturing relationships with adults. The child experiences arrested development, unable to live the life that once was before the death occurred (Dyregrov & Dyregrov, 2013).

This type of bereavement also manifests differently depending on the age of the child. Preschool to school-aged children tend to exhibit signs by exaggerating fears, engaging in traumatic play, and aggression. They also tend to detach themselves from other adult caregivers. Adolescents will display or engage in risky behavior, can have suicide ideation, have the inability to recount the death of the parent, and are unable to plan or set goals for the future. (Dyregrov & Dyregrov, 2013). The longer the grief lasts the more likely the child’s cognitive, emotional, physical and social well-being will be impacted (Melhem, 2011).

Persistent Beremvent is most likely to occur in children that are predisposed to mental disorders, are from a lower socioeconomic background, or have grown up in a negative environment where drug abuse and criminal activity occur. Children coming from these backgrounds are more likely to experience separation anxiety, depression, and exhibit conduct disorder at a higher right after the death of a parent (Kaplow, Saunders, Angold, & Costello, 2010)

Family or personal history of psychiatric disorders are also more likely to cause the child to suffer mentally after a parent dies (Melhem, 2011).. Studies have also revealed how a parent passes can also cause long-lasting grief and psychiatric problems to occur. When a parent dies from external causes such as suicide, homicide or a sudden accident as compared to natural causes, the rate of suicide and depression severely increases. When suicide is the cause of death a child is 82 % more likely to commit suicide than a parent who died from natural causes. The rate is more significant when death occurs before the child reaches the age of 6 and males are at a higher risk than females. Suicide has been seen patients even up to 25 years after the parent’s death. (Guldin, et al., 2015).

Just as there is an increased risk of suicide due to external factors and existing problems, studies have also shown that there is a higher rate of 70 to 100% increase of depression when prior mental health issues and external factors are present. Hospital admissions are higher for men and women after the death of a parent even years after their parent’s passing. Depression rates also tend to be higher when the death of the parent occurs at a younger age compared to that of a teenager. Outpatient care for depression tends to be higher as well, 11% of females and 8.9 percent for males will seek out some kind of outpatient care for depression due to grief (Berg, Rostila, & Hjern, 2016).

The post-death family environment is also a predictor of a child’s mental health. A child is more vulnerable to suffering from depression when the surviving parent has a mental disorder such as depression or bipolar disorder. The caregiver’s mental well being plays a significant role in how well the child will cope. The increase in depression is likely when the grief for the surviving parent is still debilitating after 9 months (Berg, Rostila, & Hjern, 2016).

The way a child is allowed to grieve will also determine if the child will recover, or will have a negative lasting effect that will lead to mental illness. Children are often considered to be resilient and are not given the necessary care. Therefore they are often ignored or forgotten and left to internalize using their own coping mechanisms. When this happens children will have a delayed reaction to the grieving process. Another event or death can trigger grief, and the suppressed grief can manifest later in other psychological disorders such as depression or anxiety (Shortell, n.d)

The majority of children who have lost a parent are able to grief and resume normal life. However, those who can not due to other contributing factors have a higher risk of mentally suffering and have negative long-lasting effects (Stikkelbroek, Bodden, Reitz, Vollebergh, & Baar, 2015). In order, to combat the grief and help the bereaved child from becoming “stuck” in grief, there are a variety of interventions that may help, however, the research is lacking as to whether they are effective or not.

The first type of intervention is early intervention. Because children who suffer the loss of a parent have a higher rate of a mental disorder or lasting effect when certain factors are present intervention is key. If the death of a parent is eminent because of an illness allowing the child to seek out early treatment will be beneficial to their mental health. Children who already suffer from depression, anxiety, or aother mental health issues will need to begin the grief process earlier in order to not exaceberae their present condition (Kaplow, Saunders, Angold, & Costello, 2010).

Two additional types of therapy that are being explored in an ongoing research study that started in 2014 to find an effective therapy for children suffering from grief are Grief Help Therapy and Support Therapy. Grief help therapy involves attending 9 sessions and includes completing five parts in a workbook that includes Who died? What is grief? cognitive restructuring, maladaptive behaviors, and moving forward with loss? At the end of the nine-session, the skills learned are reviewed, summarized, and written down. The parents review the information from the workbook with the therapist and the child. The surviving parent will also receive 5 sessions that will focus on the child’s grief and not the problems of the parent. This will allow the continuation of therapy at home. It is also encouraged that the surviving spend more time with their child to develop better communication (Spuij, Prinzie, Dekovic, Bout, & Boelen, 2013). Support therapy also includes 9 sessions for the child and 5 for the surviving parent. It does not involve any workbook or homework. This therapy is divided into three sections. The first section identifies difficulties occuring in the child’s everyday life. The child is also encouraged to express these feelings in any way that is comfortable. Section two, the child and the therapist review the thoughts of the child and it is decided how these thoughts will be explored either through detail talk or play. In section three, the child and therapist speak or play out how they will say goodbye when therapy has come to an end. Counseling sessions with the parents are planned for every two weeks and solutions for helping the child at home are discussed (Spuij, Prinzie, Dekovic, Bout, & Boelen, 2013).

Another therapy to consider that has had success in treating other conditions in children and is empirically backed up by data and research plays therapy. A meta-analysis published in 2014, showed the effectiveness of this therapy in children 8 years old or less. When comparing pre-treatment and post-treatment symptoms the children had made a 50% improvement compared to those who did not receive play therapy. This type of therapy has proven to work in children because children thinking to tend to be concrete and they often have a hard time expressing their emotions verbally. Play therapy allows them to demstrote their feelings and emotions through their actions rather their spoken words (Lin & Bratton, 2015).

Lastly, a possible therapy to treat children with persistent bereavement is Music therapy. According to the American Music Therapy Association, “Music therapy is evidence and art-based health profession which uses music experiences within a therapeutic relationship to address clients’ physical, emotional, cognitive, and social needs” It is considered a safe treatment and can help people who are unable to communicate through spoken language. It tends to focus on the client and can be easily incorporated into treatment when proper training as occurred. Music therapy has shown to help mood, stress, anxiety, social skills, and overall quality of life in children and adolescents. There are limited studies but the current is evidence suggests that it is an effective treatment especially when combined with other forms of therapy. (Stegemann, Geretsegger, Quoc, Riedl, & Smetana, 2019)

Most children who lose a parent will recover and not have any long term lasting mental health effects. However, 20% of children and adolescents will be greatly impacted will be based on s limited studies showing a correlation between Persistent Complex Bereavement manifesting in children and adolescents when preexisting mental conditions exist, certain environmental factors, and the cause of death of the parent. When these factors exsist the child is more likely to suffer from depression, anxiety, suicidal ideation, and other mental health issues. More research is needed in this area to explore how preexisting issues can cause more mental health issues as well as interventions that are effective in treating grief when other factors are present.

References

1. Addressing grief and fostering resilience in children by Lanise Shortell. (n.d.). Retrieved from http://www.icpcn.org/addressing-grief-fostering-resilience-children-lanise-shortell/.
2. Berg, L., Rostila, M., & Hjern, A. (2016). Parental death during childhood and depression in young adults – a national cohort study. Journal of Child Psychology and Psychiatry , 57 (9), 1092–1098. doi: 10.1111/jcpp.12560
3. Children’s Statistics. (n.d.). Retrieved from https://www.sos-usa.org/our-impact/focus-areas/advocacy-movement-building/childrens-statistics.
4. Dyregrov, A., & Dyregrov, K. (2013). Complicated Grief in Children—The Perspectives of Experienced Professionals. OMEGA – Journal of Death and Dying , 67 (3), 291–303. doi: 10.2190/om.67.3.c
5. Guldin, M.-B., Li, J., Pedersen, H. S., Obel, C., Agerbo, E., Gissler, M., … Vestergaard, M. (2015). Incidence of Suicide Among Persons Who Had a Parent Who Died During Their Childhood. JAMA Psychiatry , 72 (12), 1227. doi: 10.1001/jamapsychiatry.2015.2094
6. Kaplow, J. B., Saunders, J., Angold, A., & Costello, E. J. (2010). Psychiatric Symptoms in Bereaved Versus Nonbereaved Youth and Young Adults: A Longitudinal Epidemiological Study. Journal of the American Academy of Child & Adolescent Psychiatry , 49 (11), 1145–1154. doi: 10.1016/j.jaac.2010.08.004
7. Wardecker, B. M., Kaplow, J. B., Layne, C. M., & Edelstein, R. S. (2017). Caregivers’ Positive Emotional Expression and Children’s Psychological Functioning after Parental Loss. Journal of Child and Family Studies , 26 (12), 3490–3501. doi: 10.1007/s10826-017-0835-0
8. What is grief? (n.d.). Retrieved from https://www.mayoclinic.org/patient-visitor-guide/support-groups/what-is-grief.

The process of grief and loss has been in existence since the earliest days of life. The development of new cultures and religions has influenced the way in which grief and loss is practiced and viewed in different communities. Specifically, one of the world’s oldest religions that influenced a new style of grief and loss is Judaism which was introduced about four thousand years ago. Jewish grief and loss styles are built upon their unique development of beliefs in religion, death, and spirituality. Judaism has immensely developed since its initial introduction and has many factors that influence their traditions with bereavement.

The creation of the Jewish religion began with followers believing that there is one God who unveiled Himself to the historic figures of Abraham, Moses, and Hebrew prophets. As Judaism was introduced in the world it also introduced the Tanakh. This is the known Jewish sacred text. The first five books of the Tanakh are known as the Torah which defines laws for people of the Jewish faith to follow and also explains the origins of the Jewish religion (History.com Editors, 2018). Judaism holds many denominations including Hasidic, Reconstructionist, Humanistic, Messianic, however, the three most prominent in today’s society are Orthodox, Reform, and Conservative Judaism. Although there are many denominations, most share the main beliefs God has made a covenant with followers, communicates to them through prophets and rewards good deeds while also reprimanding for wrong-doing (History.com Editors, 2018), holiness is attained through following the laws laid out in the Torah, as well as their beliefs upon death and rituals carried out after one has died.

Judaism holds many beliefs and assumptions that influence their views of death and the afterlife. Followers of the Jewish faith believe that there is one God who holds life and death in His hands and that if death were to occur it would be a part of His plan. It is also demonstrated that, “… the notion that the soul will live on and that resurrection awaits is a cornerstone belief in Judaism” (Rubin, 2014, p. 83). God plays a major role in all Jewish views in the afterlife in which He is seen as the overarching power as well as the arbitrator of life. (Rubin, 2014). Traditional Judaism teaches that once an individual passes on, the deceased’s soul continues to the afterlife and faces judgment from God. However, no single teaching has been declared definitive and there are still mysteries to be learned about the afterlife.

As for children they can participate in post-funeral rituals if they want, however, it may seem a bit inappropriate by others. Shiva is the period of mourning right after the funeral where individuals stay in their homes for seven days but, “Children may go back to school for some period if both parents and child make this decision together (Grollman, p. 33). Therefore, it is not essential for them to seclude themselves in their home to grieve but can go back to their normal day to day schedule. The dying process is seen to be a public event while the grieving process is a private one. In a Jewish individual’s last days of life, people close to them gather around to say their last goodbyes and pray over them in this transition from life to the afterlife. “…may wish to recite the last confessional, the Vidui, with the help of family, friends, or a rabbi” (Wolfson, 2005, p. 7). Surrounded by family, close friends, and a rabbi may aid an individual in passing on peacefully.

As for the grieving process, immediate family members typically mourn the death of a loved one privately in their own home but do accept the condolences from friends and the community. The first week that is observed for mourning after the burial, members of the family do not prepare food for themselves but do accept it from the community. Comforting survivors of the bereaved is highly valued in the Jewish religion. “Judaism understands that we are a community of mourners. At a certain point in our lives, we all become bereaved.” (Wolfson, 2005, p. 324). Comforting those currently in mourning is seen as a mitzvah, a religious obligation, and in return prepares others for any future bereavement experiences one may have. As for the social stigma surrounding death and dying in Judaism, there isn’t much. Death is seen as a natural occurrence in life and in fact, “Judaism rejects the denial of death. It asserts boldly and truthfully that we are formed from dust and to dust we shall return…” (Wolfson, 2005, p. 4). Furthermore, there is not much stigmatization around those who are grieving but even if there is, modern Judaism followers understand that it should be eradicated. “Grief must be viewed, according to modern psychology… as a therapeutic process that nature itself has provided to help the mourner face up to and accommodate himself to his loss” (Matz, 1964, p. 350). Therefore, there is not much negative association surrounding the topic of death in Judaism.

Cultural death practices such as body preparation after death, viewing, funeral arrangements, and rituals in Judaism are similar among most denominations. Upon death, the cultural body preparation of the deceased is known as Taharah. In this process the body is washed by members of the family, men wash male family members while women wash female family members. Then, purification of the body occurs, “… by fully submerging the body in a “mikvah” (ritual bath) or by pouring a continuous stream of water over the body” (Jewish Funeral Traditions). The ending of this act ends the purification ritual.

After Taharah is complete, the deceased is then dressed for burial in his/her everyday clothing. “Adult males usually wear a talit (a prayer shawl) and a yarmelka (a head covering). Others are buried in tachrichim (plain shrouds) to emphasize equality in death” (Grollman, p. 30). The deceased should be buried as soon as possible meaning within a few days of death. The family plans the funeral usually making it as simplistic as possible. Extravagant decorations or settings are not to be made and even “… flowers are generally not part of the Jewish funeral” (Grollman, p. 29). Initially, funerals mainly occurred in the home, however, now they are usually carried out in a synagogue, the Jewish house of worship. Jewish traditions do not execute viewings of the body or wakes in the burial process as it is against Jewish law unless it is requested to be done so in private. Instead, the family will participate in ritualistic events such as keria. Initially this act involved tearing a piece of clothing but has been changed to tearing a piece of black ribbon to symbolize mourning. “The torn garment or black ribbon is usually worn after the funeral for seven days and for some, thirty days” (Grollman, p. 32).

The first seven days of mourning after the burial are known as Shiva. In this time, the family of the deceased stay home and mourn for their loved one. Many rituals are carried out during this time in which “… some may wash their hands, which…symbolically indicates that our hands are clean of death… a light, or shiva candle, is kindled and remains burning for the entire seven days… The practice of covering mirrors [is held to inhibit self-reflection]… The bereaved recite the Kaddish prayer “May God’s name be magnified and exhalted…”, a pledge of rededication…” (Grollman, p. 33). After the first seven days pass, the next thirty day period after burial is recognized as Shloshim. In this time, mourners typically transition from their mourning process back to their normal living. However, cheerful social events are to be avoided out of respect to the deceased and the bereavement process. In addition, other practices like grooming, such as shaving or cutting hair, are to be not carried out during this time.

After the family-centered grieving rituals of Shiva and Shloshim are practiced, the period of bereavement for mourners is typically expected to have ended. Children who lost a parent are expected to conclude mourning twelve months from the day of death. Friends and communities of the bereaved seek to help comfort them in their mourning. Although these set periods for bereavement are given in traditional aspects this does not mean those of the Jewish faith cannot continue grieving the death of loved ones. Modern views of Judaism seek to aid those who are in bereavement through counseling and grief support groups. Jewish views on support groups are seen through a religious scope as they are typically offered by local Jewish community centers or synagogues which are carried out by a rabbi. Grief is religious-focused and is seen as stages that involve ranges of rites and passages. Through reflection and adaptation, “…its purpose is to promote personal growth and reintegration into the community”… and “In bereavement… Judaism teaches how to give expression to one’s sense of loss, how to regain one’s composure, one’s zest, indeed inspiration for one’s own life and that of future generations” (Gerson, 1977, p. 272). Contemplation, improvement, and different outlooks on life following bereavement is expected, however, Jewish followers also acknowledge that while they can cope with grief they don’t leave it behind which is demonstrated through their celebration of Yahrzeit, the anniversary of their loved one’s death.

Communities and a positive support system are always essential in grieving the death of a loved one. In Judaism, community can be found where the synagogue is. When Judaism began to first be practiced, the holy Temple was built in order to have a gathering place for everyone to worship. However, it was destroyed and later on a second Temple was built in its place but was also destroyed eventually. People began to turn to their local synagogues as a place to gather and practice their beliefs with others in the community. The practice of Sabbath is performed which is acknowledged as a day of rest and prayers that begins Friday afternoon and ends Saturday night. “On the first Friday after the funeral, mourners go to the synagogue and publicly recite the Kaddish prayer” (Maltz, 1964, p. 346), and is done so every single week on Sabbath for the rest of the year following the death. After this is done they also will recite the Kaddish prayer on Yahrzeit for years and years to follow to commemorate the dead where each time they will light a candle. In addition to joining at the synagogue to remember their loved ones, close ones mourning the death of a loved one may also meet with a rabbi to discuss their feelings of grief and how to move forward with life. Therefore, the synagogue acts as a place of community for the bereaved where they feel comfortable to express their emotions, struggles, and questions about religion and death, and ultimately a place where there is no judgment surrounding the grieving process.

Grief and loss can be experienced in any number of ways by individuals. Different cultures or religions can influence the way communities experience the grieving process by having unique rituals, beliefs or lack thereof about death and the dying process, views on grief counseling, and resources to aid with the bereaved. One religion, in particular, that has influenced the grief and loss process is Judaism. Followers of Judaism have naturalistic views of death with cultural-specific rituals, perspectives, and healing processes. Overall, mourning in Judaism can be seen as a rite of passage in which individual growth after experiencing bereavement is attained.

Grief is a combination of what one feels and what one thinks when a loss or separation has occurred. These feelings often arise after the loss of a person, event, status, relationship, pet, etc. Grief can occur after a divorce, loss of a job, loss of a pet, or any multitude of events. It even occurs when a 12-year-old has his bicycle stolen. Frequently one thinks of the death of a loved one as a grief event, but grief occurs on other life-changing events also. A stolen bicycle could be a life-changing event for a young boy or girl.

Consider a coin as an example of the relationship between love and grief. A coin always has more than one side. The images may be missing, but both sides still exist. Love would represent one side of the coin, and grief would represent the other side. In other words, love and grief are two sides to the same coin. The decision to grieve is not made at the time of loss, but rather, the decision whether to grieve or not grieve is made at the time the relationship is born.

One cannot decide not to grieve at the time of the loss of someone or something but can only decide how to express the feelings and thoughts that are occurring. Grief is the opposite side of the same coin that contains love. One cannot have one of these two without the other.

There is an old truism in funeral service that relates to the value of a funeral. It is “a joy shared is joy increased while grief shared is grief diminished.” This truism is true. When one has a personal record (low round in golf, largest fish caught in one’s life, receiving an engagement ring, graduating from college, etc.) and a personal milestone in one’s life occurs, one’s joy increases by sharing the event with family and friends. A similar effect is when one shares a loss or painful event. Often one hears that “you will feel better to get it off your chest.” Sharing a sad or bad event will help diminish that event and seems to make one feel better. So it is with funerals: Friends and family come to share what may be the worst day of our life, and by sharing, by simply being with us, the sadness and grief one feels is diminished. Therein lies one of the intrinsic values of a funeral, and that is the reason that different cultures around the world gravitate towards having similar customs when dealing with the loss of family and friends. Funerals are said to be too personal to be private. Even friends need an outlet to share their grief at the loss of someone special. A funeral should not be reserved only for the family but should allow the community to come together to share in the loss.

Most of us do not relish the thought of visiting a friend or family member who has experienced the loss of a loved one. One does not know what to say to make them feel better or what to do. I remember watching my Dad meeting with a family who had experienced a loss of someone. “Mr. Sam” was the consummate funeral director. He was genuinely kind and caring and strived to help the family cope with the many details in an unassuming manner. I have seen him sitting at a kitchen table pre-dawn, waiting to help the family move through the different steps required to begin the funeral process. Sometimes he would sit there in their home for 30 or 45 minutes without saying anything. Eventually, someone would say, “Mr. Sam is here.” At that point, my father would begin to speak with the family. His manner and his voice were soft and caring. Questions that had to be asked, information that had to be obtained were always gathered in an unassuming manner and always respectful. Never would “Mr. Sam” be assertive or in any way aggressive. He would never say, “I know how you feel” or other clichés that developed to help the speaker say something “helpful” to the family. Those clichés seldom, if ever, make anyone feel better. This may be the reason that in many cultures, food is delivered to the home of the family. Of course, the food is needed for the family and friends gathered, but more importantly, it allows one to non-verbally express their care and concern. Flowers serve the same purpose. One can express their feeling without having to find the words to do so. So these traditions are really for the benefit of the visitor as well as the family.

Resolving grief is a process and not an endpoint. The time required varies from individual to individual. Many feel that one never resolves grief, but rather one comes to the realization that these feelings are normal and will become an acceptable part of our future life. Memories of the deceased move from being very painful to becoming comforting and joyful. This is a process that occurs over time and indicates that one is moving through the grief process towards the acceptance of the loss. This is a healthy transaction. Hope and a renewed self-worth continue to grow during this process. The painful memories are slowly replaced by memories that result in joy when being recalled. Around this time, one begins to want to talk to others about the deceased and the good times that they shared.

Introduction

Losing a loved one can be a tailspin of emotions, a feeling of lack of control in one’s own life, and a chasm in the normalcy of daily life (Harden, Holding onto Motherhood during the Grief Process, 2018). According to (McCroby, 2018) grief is a serious of stages with a predictable start and end which involves every dimension of our lives – spiritual, psychological, physical, and social. Grieving is an encompassing process that can be observed from the biological through the interpersonal and personal to more broadly levels of discourse (Robert A. Neimeyer, 2014). This assignment is based are the vignette of a woman named Gail. She is a 38-year-old married woman who presented to the mental health services via referral from her GP in relation to severe throbbing headaches, difficulty falling asleep, fitful and disturbing sleep, upsetting dreams and poor appetite. The vignette highlights that Gail is married with two children with suggests that she has support. Gail’s feelings of guilt and sadness emerged in the last month when her late sons high school class graduated. Throughout this assignment I will outline theoretical perspectives that establish Gail’s delayed grief reaction. Also, in this assignment I will include the appropriate tools used in completing a mental health assessment I will also highlight the interventions used to help Gail.

Theoretical Perspectives to Loss and Grief

Feelings of loss and grief can be experienced after we lose someone or something, we care about like; the death of a loved one; loss of a relationship; loss of a pet; loss of a job; a change to your way of life; or loss of important possessions. This can make a person experience a wide range of emotions which can trigger a dip in their mental health. One of the worst life events that can occur is the loss of a child. According to (Asuman Buyukcan-Tetik, 2017) losing a child is a major stressor and it has severe effects on the physical and psychological wellbeing of the parents that are bereaving. It takes time to adjust and to learn to live our life without that person, thing or way of life. While grief is a universal and natural response loss, the process is unique to each person. A person who is grieving will experience a variety of distressing thoughts and emotions which can include anger, guilt, loneliness, sadness, relief even sometimes happiness as the griever comes to recognize the permanence and magnitude of the loss. (McCroby, 2018). According to (Videbeck, 2009) there are lots of different responses to grief which are; spiritual responses, cognitive responses, physiological responses, behavioural responses and emotions responses. It is clearly evident that Gail experiences these responses. For example, she worries about her two children and their safety, she is feels guilty for the death of he son which is an emotional response. Gail states that she feels “useless” to her family this shows the spiritual response. Gail presented herself to her G.P with “severe throbbing headaches, difficulty falling asleep, fitful and disturbing dreams when asleep, and poor appetite”, this highlights Gail’s physiological responses that she is presented with.

I have researched two theorists who in my opinion help to further understand the suffering and pain behind Gail’s loss. These are Kubler-Ross’s stages of grief and John Bowlby theory on Attachment.

Kubler-Ross’s Stages of Grief

Dr. Elisabeth Kubler-Ross developed a frequently used model of bereavement, in the “stages of grief” in her landmark book on Death and Dying in 1969. Kubler-Ross (1969) provided a foundation for an understanding that readily translated to the public (Harden, 2018). The model is described in a five-step linear process that consist of denial, anger, bargaining, depression and acceptance (Harvard Mental Health Letter, 2011). The five stages of grief are;

• Stage 1- Denial: a person may be in a state of disbelief, shock, numb.
• Stage 2- Anger: Frustrated outpouring of bottled up emotions. Irritation.
• Stage 3- Bargaining: seeking in vain for a way out. Reaching out to others, telling one’s story.
• Stage 4- depression: final realisation of the inevitable. Overwhelmed and helplessness.
• Stage 5- Acceptance: finally finding the way forward. Exploring options, moving on.

Bowlby’s Theory on Attachment

John Bowlby was a psychoanalyst who researched the effects of separation between infants and their parents. The theory itself highlights the bond that is formed between a mother and their kid. From the vignette it is clear that Gail is attached to her son and that they had a strong bond with each other. This gives us the understanding of the grief that a mother would experience if they were to lose a child. Bowlby projected that grief and loss is incited through separation. During Bowlby’s work on attachment, he and his colleague Colin Murray Parkes noticed for stages of grief.

1. Shock and Numbness- person feels that loss in not real or that it is impossible to accept it.
2. Yearning and Searching- the person is very aware of the void in their life and may try and fill the void with something or someone else.
3. Despair and Disorganization- now accepts that things have changed and cannot go back to the way they were before.
4. Re-organization and Recovery- faith in life starts to come back, build new goals new patterns Ans new habits in life.

Nursing Assessment

For the nursing assessment to be holistic, Gail’s needs must be focused on. These needs include her biological, social and psychological aspects and including her spiritual and cultural needs. To obtain the important information that is required for the assessment the nurse will interview, talk and listen to the patient. The nurse will also use assessment tools to gather the relive information. A nurse’s toolbox is overflowing with various patient assessments, each of which is designed to help you in providing safe and evidenced based care. The tools that I have decided to use while assessing Gail are the Depression Anxiety Stress Scale (DASS) and the Birchwood Social Functioning scale. The DASS is a 42-itern test that aims to capture here dimensions of namely depression, negative emotional state, stress and anxiety (Andrew C, 2007). Another scale that would also be beneficial while assessing Gail is the Beck Depression Inventory, which is a system that measures characteristics attitudes and symptoms of depression. This system would be helpful because according to the vignette Gail is experiencing feelings of “sadness” and “guilt”.

The nurse will use the biopsychosocial approach to assess Gail. The biopsychosocial approach provides a background for the current assessment of symptoms and behaviours and includes a review of the patients current and past history. It stresses the importance a systemic, comprehensive perspective in functioning and human development and puts emphasis on a holistic integration of psychological, sociocultural and biological factors when attempting to understand human psychology (Lari Meyer, 2011). For example, Gail’s feelings (emotional response), changes to Gail’s body (physiological), her beliefs and values (spiritual response), her thoughts (cognitive responses) and how she behaves (behavioural responses). Its states in the vignette that Gail has no history of depression however the nurse would still conduct an enquiry regarding Gail’s background history. The nurse would also assess her safety in relation to suicide ideation, intent or plan to self-harm and death wish. The common assessment tool (CAT) is generally used in the Wexford Mental Health Service. This helps the nurse to obtain all the relevant information that is needed for example background information, information about the client, presentation, previous admissions, medical issues, early life, substance use, safety, and much more.

There are three components that are involved in the nursing assessment. These are: adequate perception regarding the loss, support while grieving for the loss and coping behaviours/techniques during the process.

Perception

The first step of the assessment conducted by the nurse is to evaluate Gail’s perceptive of her loss. This step is important as it highlights to the nurse how the patient is feeling, how they are affected by the loss and how they’re thinking. The nurse will ask the client questions in order to gain insight. To gain a clearer understanding on how the death of her son has changed Gail’s life the nurse would ask open ended questions like” how does this loss make you feel” or “do you feel the loss of your son has brought despair and negative thoughts upon you”. Gail could also use this opportunity to clarify with the nurse any concerns she may have. The nurse can help Gail to understand that each person has a unique grieving process. Another important assessment is to inquire into what the individual believes about the process of grieving (Videbeck S. , Mental Health Nursing , 2009)

Support

While grief is a natural process, many people benefit from the support and guidance of other people. It is highlighted in Gail’s vignette that she is married with two other children. These are the people who can help and support Gail through this tough time. They can help in meeting her spiritual and emotional needs. It is important that as a nurse we help Gail to identify these people as her support network and encourage Gail to accept their love and support at this time of need. According to (Videbeck S. L., 2009), assessment of support systems can provide the person grieving with the awareness of the people who are there for them to reach out to for security and love. By highlighting to Gail, the importance of have a support network, the nurse could advise Gail to reach out to her family and friends and ask for their support.

Coping Mechanisms

Coping mechanisms are the strategies people often use in the face of stress or trauma to help manage painful or difficult emotions. The nurse will assess the persons coping behaviours by the behaviours of the person. The use of effective communication is important and crucial in this step of the assessment in order to see how Gai’s behaviour reflects on her coping mechanisms. Asking Gail more comprehensive questions will allow the nurse to identify how the death of her son has impacted her life which will gain insight to Gail’s thoughts. Coping can be impacted by several factors and forces such as ones cultural/spiritual background, perception of death, past experiences with losses, level of social support and intrapersonal relationships.

Identify outcomes

When the assessment is completed, the nurse will set realistic goals for the individual. For example, the nurse will collaborate with Gail to set goals that are achievable. Examples of goals that would be determined for Gail are;

• Avail of the support from family and friends.
• To accept the loss of her son.
• Practice coping mechanisms for when anxious or depressed.
• To feel less guilty.
• And lastly, to work with the interventions suggested to her.
• Identify her own strengths and weaknesses.
• Utilize effective coping mechanism.

According to (Alan B McGuire, 2015), an essential component of psychiatric rehabilitation is goal setting.

Tools for assessment

Two tools which I have chosen are the Sainsbury assessment tool and the Depression, Anxiety, Stress Scale (DASS) assessment tool. I believe these two tools will help aid in the assessment of Gail’s needs. Assessment tools are frequently used in psychiatry in an attempt to assess the patients mental state and in term should determine the management of the service user. (McPherson, 2005)

Sainsbury Assessment Tool

The Sainsbury risk assessment is an initial risk assessment tool for primary care mental health. It is an important part of a complete mental health assessment. According to (Stein, 2005) risk assessment must cover the risk of harm to others, risk of neglect and the risk of suicide. This assessment is included in the CAT initial screening assessment which I have already mentioned above.

DASS Assessment Tool

The DASS is a clinical assessment that measures the three related states of depression, anxiety and stress. It contains 21 questions. This assessment tool helps the nurse to develop a treatment plan and assess symptoms severity or treatment progress. I believe in my opinion that this tool is more focused in helping with Gail’s assessment as she shows signs of distress. It measures the negative emotional states of depression, stress and anxiety.

Intervention and Management of Grief and Loss

No parent is prepared for their child’s death. Parents are simply not supposed to outlive their children. The death of an older child or adolescents difficult because children at this age re beginning to reach their potential and become independent individuals. It is evident that Gail is experiencing the common grief reactions e.g intense shock, confusion, disbelief and denial. The grief experienced after losing a child has been described as the most difficult and deepest sorrow that parents and mother (Kateja Raitio, 2015). For Gail the death of her child has caused immense suffering upon her.

The normal grief process is a fluid process that most individuals can resolve without the intervention of healthcare professionals (Waller A, 2016). However, when grief is prolonged, and the grief-stricken individual is unable to reconcile the grief and adjust to life without their deceased loved one, psychotherapeutic interventions ore warrant (Wittouck C, 2011). With the guidance from the nurse Gail would be encouraged to make and identify changes which will benefit her with the grieving process. They will discuss different interventions that will aid Gail to manage the dis tress she is experiencing. Gail’s care plan will be based on the information gathered in the previous carried out assessment. The Multi-disciplinary team would discuss Gail’s case and recommend the most suitable interventions that she may use. They will discuss Gail’s short, medium- and long-term needs. A recovery plan will be developed for Gail and achievable goals will be discussed with Gail. Setting goals will help Gail in the recovery process.

Due to Gail’s anxiety, depression and her insomnia pharmaceutical drugs may be suitable for Gail. The use of drugs to treat Gail is very effective but other interventions should be taken into consideration too. Two interventions that I believe would be appropriate for Gail are Anxiety Management and Cognitive Behavioural Therapy.

Anxiety Management

Anxiety is a common feeling that everyone experiences at some stage. It can be a normal emotional response to many stressful situations. Anxiety is also a natural, understandable emotional response that can help us prepare for challenges. Anxiety Management is a detailed programme for stress related problems. It is offered to people who have difficulties with anxiety and want to learn more about how to manage it. It consists of six sessions which can be group or individual where clients learn about how their anxiety and how it can affect them. Anxiety is a normal reaction to stress which can be describe by different characteristics for example difficulty concentration, fatigue, restlessness, tremors, and sleep disturbances (Marcia Astres Fernandes, 2017). Gail can reduce her anxiety by learning how to cope with her stressors.

Cognitive Behavioural Therapy

Cognitive Behavioural Therapy is psychosocial intervention that aims to improve mental health. It focuses on challenging and changing unhelpful cognitive behaviours and distortions, developing personal coping strategies that focus on solving current problems and improving emotional regulations. CBT uses an evidence-based approach to aid clients to cognitively revaluate their interpretations neutralize their emotional and psychological responses to present stimuli through systematic desensitization process and awareness building (Amy H. Gaesser, 2017). CBT has been shown to be effective in treating anxiety, depression and a wide range of other disorders (Magnus Olason, 2018). It can take up to five to ten months to complete a course in CBT. Improving Gail’s emotional and cognitive behaviour will benefit her as it will allow Gail to become more involved in her treatment.

Conclusion

At some stage in our life we all experience death and grief, it is an inevitable part of life. Unfortunately for Gail she has experienced the tragic loss of a child which no parent should experience. The grief that Gail is experiencing is affecting all her human dimensions, her health and wellbeing and making her everyday life more difficult. Understanding the grieving process and the theories of loss can provide us with the knowledge to utilise frameworks in order to deliver the most appropriate care which is specific to Gail’s case. Throughout this assignment I have mentioned theoretical perspectives regarding the grieving process and the most suitable interventions and management for Gail. It is very important for Gail to utilize the discussed interventions for her to participate in the road to recovery. As psychiatric nursing students, our role is to guide people in similar situations who are going through difficult and emotional periods in their life, to manage their individual grief and support them with any difficulties they may face during the way, which will improve their quality of life.

Grief is a part of your life that is lucidly unavoidable no matter the age of the person. When someone is grieving it can be over multiple different reasons. Many people think of death when someone states they are grieving but this is because many people have already experienced it and can relate to the grieving process themselves. Even though it is unavoidable from happening, there are ways we do get through it. These steps are known as the four-component model, and it helps to show how people go through the grieving stages. However, many people also begin to grieve when they are dying. Elisabeth Kubler-Ross explains her theory on dying based on the stages that many people go thought when they are dying. This also helps the family and peers of the person who is dying.

It does not matter what age you experience the meaning behind death and bereavement, but you will notice the differences between the meanings of them through out your lifespan. According to Cavanaugh, R. V. K. J. C. (2015) bereavement is a state and condition in someone’s life that is caused by the loss of an in did all from death. This is another word for the grief and mourning based on the meaning of life between culturally. During the life span of individuals, we all have different experiences on dying and bereavement at each point of our life. For children, the levels of cognitive development help them determine and learn how to cope with death. This is based on the the behaviors that are being demonstrated on the way they grief on the death. For adolescents, they are little different in the understand of death. Many adolescents have a problem comprehending and making sense of death and this causes them to severely react by bereavement. This age will need more of push to let out feelings about the lose of someone because they tend to bottle them emotions up.

Adults deal with death a little more than any other age, on a different emotion level. As a young and middle ages adult, they may experience harder and more intensified feelings and emotions towards death. This is because they may have developed an attachment to that person who has passed. This also is a hard feeling time because many individuals will experience the loss of their parent will they are in their midlife age. This is a time where adults have a harder time adjusting and dealing with emotions and must learn to challenge their own humanity that is being affected. The feelings become very complex to cope with when someone in the middle-aged life loss a parent of a child of their own. The induvial will begin to remove adulthood and all the important aspects that come with that person because it hurts to have things around. However, the older adults usually are less concerned and nervous about death and deal with it much better than any other age. This relates more to their self and they still will mourn and cope differently after losing a child or their partner, but the relationship will influence the way that older adult’s grief and cope with the loss.

For a middle aged induvial they way that are affected by death can been shown by the four-component model to the grieving process at their life. This model demonstrates the four ways that individuals understand death according to Cavanaugh, R.V.K.J. C. (2015). For an individual they may nub and shocked and want to be left alone. This normally happens right after the death of someone. This is the beginning of the adult taking in the lose of the person and wondering why and how it could happen. The next thing that will happen is classified as yearning and scratching. This is the next phase and shoes the variety of emotions and confusion on what is really happening. Many people suffer the most in this phase and it is because it does not seem real and they wonder what could happen. The other stage is considered the initial acceptance phase. This is when someone is beginning to be disorganized and despair the loss of the person. This is when the person may feel weak and being to see that it is not a dream and reality is what had happened to the person.

In my adolescent years I had lost my grandpa due to cancer. This was in the year 2012 and it took me about 5 years to finally process the loss of him being real. During the being of the time when we knew he was going to die, my mother told me its best to get everything out that I need to emotionally. This was a hard time for me because he was the man who raised me to be the way I am today. When he died in hospice, I was extremely numb to the world. I did not want anyone talking and reaching out to me at that moment. I was the last one in the room and was shocked that I was the last one who he grabbed before he went off into the light. I questioned during this time why It had to happen to him and why I had to lose such a good man so early in life. This made me extremely sad, anger, disappoint and unimportant over the days of coping. IT did not really hit me that he died until a week later and this was the hardest time for me. I started the whole cycle over of weakness, numbness, being shocked and did not want to be messed with. I ended up having to get medical help to get me out of the grieving depression that I had drifted off too. This helped me cope and get out of the emotions I was in and she even helped me realize that we all die one day, and we must take each day like it is our last. This is what opened my eyes to reality, because I know my grandpa would not want to see me looking like a puff fish in the face over the loss of something.

Now death is not always about grieving. Elisabeth Kübler-Ross had a theory that is based on five stages that individuals go through about dying. The first stage is known as the denial stage. Denial is normally how many individuals get through the loss of someone. An example f denial in someone’s life would be if a doctor called you about blood work and said you had a serious disease; you would be in denial about it and assume it was a mix up of patient records. This stage is also when someone is in shock. The second stage is anger and this is when people begin to live back in their normal reality world. This stage is where many questions and emotions begin to submerge. An example of anger in this stage would be asking why this happened to me and why it could not be someone else. This is to help you bind with reality and focus on the reality of what is going on. The third stage is bargaining, and this is when individuals beg or try to make a deal with a higher spirit about what had happened. The best example for this stage is someone praying to their God and asking him to bring them back and/ or take them instead. This is the time where you question if it were your fault and how you could have changed it. The fourth stage is the depression stage. This is the most accepted form of grief in any aged person. You begin to feel down, sick, emotionally unstable, and may not want to be interacted with. Normally when someone loses someone close to them their depression kicks in and they may wonder what the point of living is if they are not around. Many younger females deal with this after a first break up so its not always about death when it comes to grieving. The last stage is known as acceptance. This is the stage you want and need to get to when you are grieving. You will begin to stabilize your emotions and understanding on what had happened. The best example for this stage would be accepting the loss of someone by saying: it is okay that my dog died, instead of my dog died but it’s okay. This shows that you have acceptance the difference and the loss of the animal close to you.

Therefore, grieving is not always related or connected to the death of someone or something. As we age, we may experience death and other failures that make you grieve. A lot of younger girls go through break ups and lose of friends. But mainly once we get older, we learn to accept that things will change, and that death and grieving is part of nature and how we are programmed. Regardless is we cope and heal differently than someone we know; we will make it through the stages of grief and learn how to get over heartbreaking things faster and more woke than we would have if we have never experienced the emotion rollercoaster. These stages of coping and grieving help to stabilize you and help you through the loss of someone easier because you have other hands to reach out to when you need the guidance and shoulder to lay on.

References

1. Cavanaugh, R.V.K.J. C. (2015). Human Development: A Life-Span View. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource.com/#/books/9781305480636/

Loss, death, grief, pain is an impactful subject for the romantics. Death and loss are not only of human beings but death can also be of the abstract notions. Grief and pain are also felt on the loss of any feeling, emotions or loss of imagination. Grief was different for the romantic poets.

Coleridge’s “Dejection: An Ode” is an autobiographical poem in which he laments over his loss of creative imagination. To him imagination was a natural gift which when was taken away from him gave him permanent unhappiness and a constant grief. When he lost the ability to imagine he not only lost his ability to create poetry but also the ability to enjoy life. The magical and the beautiful objects of nature do not impress him the way they used to do before he lost his creative imagination. This causes deep pain and grief in the poet. He remains unaffected on seeing the beauties of the world which is a matter of pain for the poet. Grief is an abstract notion one can feel it in different ways and on different things. It usually occurs on the loss of something and in Coleridge’s case it is because of his loss of creative imagination. Creative imagination once lost cannot be stored therefore the poet also lost his power of joy in the world. In the state of grief everything seems to be dull to him as nature and beauty have lost all their charm to him without his imagination. For Coleridge, his grief is connected with his loss of poetic inspiration. Coleridge suffers from pain which cannot be seen and nothing from the outside world can heel it and his pain is dull at the start but becomes deep as time passes. When he looks at the stars and does not feel the same joy as before he laments as his heart gets full of grief. The beauty of sky does not attract him does he grieves and nothing from the outside world can help him heel. To him nature becomes dead and lifeless. Coleridge’s grief is over his loss of his inborn ability to imagine. For him grief is in the loss of his abstract feeling because of which the world and nature have become dull and dark. They no longer attract him. Thus he is left to lament all through his life now.

In “On Another Sorrow” Blake describes the love of God for his creation and the world. Blake describes the expression of human sympathy as a reflection of God’s compassion for his creation and the world. ‘Bird’s grief and care’ refers to an image of God’s continual benevolent care for His every creation. According to Jesus, even the most insignificant bird is fed by him. ‘Hear the woes’ means that possibly the sorrowful person’s song will be transformed into a positive melody. He observes himself as having the same kind of love that God does for all of His creation. He appears to wonder over God’s ability to hear and see grief. The emotion presents itself in the smallest of creatures and infants. Directly or indirectly, He is connected with everyone. The innocent perspective allows youth to think that simply feeling pity for someone or listening to their problems is a good enough solution. With experience they will learn that in order to help a sad person, you have to take some sort of action. Just as the speaker is unable to sit beside someone suffering and not comfort them, so too is God. God’s pity comes to all those who suffer.

For William Blake grief is in the seeing other people in pain. He feels that how can someone stay calm or happy when he finds others in trouble or pain. At least we should try to calm the person if we cannot help them. Grief can be over anything but we should help and calm others at their time of pain. Even God cannot see other’s in pain and we humans should also do the same. Pain is not only limited to human beings it is also in animal. Seeing people in grief makes the poet lament and grief as well. His grief is not based on his loss of something but on seeing other’s in pain and in difficulty he feels the pain. Blake becomes restless when he sees other’s in grief. He says that a father and a mother cannot see their child in pain and weep with him in his pain. If this is found in humans to be sad with others then how can their creator be in relief on seeing others in pain. We should have faith in God that he will lessen our pain and this time shall pass.

Shakespeare’s Hamlet is a play about a tragedy that invokes many different ideologies about the meaning of loss and how it goes hand in hand with both madness and grief. Hamlet, throughout the play, portrays the underlying theme of madness and the loss of his father triggers his insanity and he quickly starts to stray farther and farther from reality causing him to ponder suicide and seek revenge, which then sparks concerns from the people around him. It is evident that Hamlet loses his sanity in the play because of the loss of his father and the grief he felt for him, causing him to have delusions and see the ghost of his father, which drives Hamlet to avenge him by killing his uncle, Claudius. Although the theme of loss is clearly depicted in Hamlet, the character, many other characters in the play have experienced a loss of either madness or grief, characters like Laertes, Gertrude, and Claudius. All in all, it is seen that the theme of loss is prominent in the tragic play, and it causes many internal dilemmas within the characters, most notably, Hamlet. It is made abundantly clear that Hamlet was going mad since the beginning of the play when he allegedly saw his father’s ghost and after that, his madness seemed to progress to the point where he cannot distinguish appearance vs. reality. Although, in the beginning, Hamlet had a plan to act insane, so that he could confirm the ghost’s claims about Claudius being the one to murder his father, King Hamlet, it ended with him going crazy and eventually led to his death.

The first indication of Hamlet’s madness was when he was talking to the ghost he says, “haste me to know’t, that I, with wings as swift, as meditation or the thoughts of love, May sweep to my revenge,” (Shakespeare, 1.5.62) which indicates he is in a hurry to find out and seek revenge rather than ask questions like a rational person would, which informs us that this is all in his head because his delusions are forms of his subconscious tasking him with a deed and fulfilling his suspicions. Later on, it is clear he is growing mad and unstable because of his indecisiveness to act on killing Claudius, we see this when he watches Claudius confess, he says,” Now might I do it pat. Now he is a-praying, And now ill do’t. And so he goes to heaven. And so I am revenged, That would be scanned,” (Shakespeare, 3.3.190) which shows just how confused and dazed he is and how his indecisiveness matches the uncertainty of sanity inside Hamlet’s head. As time passes by in the play we see Hamlet kill Polonius and not express any grief towards the murder and Gertrude says, “Mad as the sea and the wind when both contend Which is the mightier. In his lawless fit, Behind the arras hearing something stir, Whips out his rapier, cries, A rat, a rat. And in this brainish apprehension kills The unseen good old man,” (Shakespeare, 4.1.212) when talking to Claudius about the death of Polonius, she says he is gone mad and the fact that Hamlet feels no grief indicates his mind is lost and he has become obsessive with revenge that his mind sees no grief. At this moment we see that he is truly mad and that will be one of his fatal flaws that leads to his downfalls and the downfall of many other characters, like Ophelia and the tragic deaths of the others at the end of the play.

Among the loss of his sanity, Hamlet has also witnessed the loss of the loved ones around him and the theme of death goes hand in hand with the theme of loss. Death is a prominent feature in the whole play, it is seen when Ophelia and Polonius die, it is seen when many of the characters conspire to kill another, Hamlet with Claudius, Claudius with Hamlet, Hamlet with Rosencrantz and Guildenstern, and the death of King Hamlet by Claudius was the beginning of the end and what set the motion for the events to come that quickly lead Hamlet to insanity and madness. After Claudius’ coronation, Hamlet still seems to be mourning his father’s death and when Gertrude asked him why he is mourning, we got to see how King Hamlet’s death affect Hamlet. ” Seems, madam? Nay it is. I know not seems. Tis not alone my inky cloak, good mother, Nor customary suits of solemn black, Nor windy suspiration of forced breath, No, nor the fruitful river in the eye, Nor the dejected havior of the visage, Together with all forms, moods, shapes of grief. That can denote me truly. These indeed seem For they are actions that a man might play. But I have that within which passeth show, These but the trappings and the suits of woe,” (Shakespeare, 1.2.24) is the perfect example of the last time Hamlet felt pure sadness, which is indicated by his black clothing that is ridiculed by his mother, Gertrude, that he is upset and he clearly states how his clothes are just a hint at the grief he is truly feeling, we don’t see this type of grief again because he has lost that part of him by being obsessed with murdering his uncle, Claudius, this is proven when he stabs Polonius and does not feel any remorse or guilt and all he says is, “Thou wretched, rash, intruding fool, farewell. I took thee for thy better. Take thy fortune. Thou find’st to be too busy is some danger. Leave wringing of your hands. Peace. Sit you down. And let me wring your heart. For so I shall. If it be made of penetrable stuff, If damned custom have not brassed it so. That it is proof and bulwark against sense,” (Shakespeare, 3.4.198) he mistook Polonius for somebody else who may have been important and he does not care at all that he stabbed him.

In conclusion, it is evident how the theme of loss can mean loss of sanity, could mean loss of a loved one and could also be intertwined with other themes such as death, madness, and appearance vs. reality and the impacts they had on Hamlet and the rest of the cast causing them to all tragically die in the end and for Fortinbras to take the kingdom, which had been one of the reasons Claudius killed Hamlet’s father, King Hamlet, in the beginning, which, in turn, was the reason why Hamlet went mad and like a domino effect they all came tumbling down one by one after that one death (that started with King Hamlet). This can be considered quite ironic because the reason Claudius wanted to kill King Hamlet was so that he could take his throne and his wife and have everything his brother had and in the end they all tragically died and Fortinbras descended the throne. This proves the detrimental effects that the theme of loss can have on a person, how it makes you mad and sparks other themes of the play.

Introduction

The experience of grief is as universal as the human condition itself. However, the intricacies and manifestations of this emotion can differ vastly across individuals, cultures, and societies. In the American context, a nation renowned for its ethos of resilience, grief is often viewed as an obstacle to overcome rather than a process to endure. This essay will explore the many facets of grief, its impact on the individual and society, and the paths to healing and acceptance in the United States.

Understanding Grief: A Multifaceted Emotion

At its core, grief is a natural response to loss. It is a potent mixture of a myriad of emotions, from sadness and longing to anger and guilt. While it is often associated with the death of a loved one, any significant loss – a job, a relationship, or a cherished dream – can trigger this profound emotion.

The Complexity of Grief

Grief is not a linear process but a complex, multifaceted journey. In America, we commonly refer to Elisabeth Kübler-Ross’s five stages of grief – denial, anger, bargaining, depression, and acceptance. However, this model only represents one facet of the grieving process, and it’s critical to understand that everyone’s experience with grief is unique and multifaceted.

Grief in the American Society

Cultural Perspectives on Grief

In the United States, the societal approach towards grief has traditionally been influenced by the country’s dominant cultural values of self-reliance, resilience, and positivity. With its inherently painful and disorienting nature, grief can appear at odds with the American ethos of moving forward and overcoming adversity. Consequently, grieving individuals often feel pressure to quickly resume their ‘normal’ lives, potentially bypassing or suppressing the intricate grieving process.

The expectation for rapid emotional recovery can lead to the harmful concept of ‘closure,’ suggesting a definitive end to grief. Grief is not a linear process with a neat conclusion; rather, it is a winding path marked by peaks and valleys of emotion that may change but never truly ends.

Moreover, public expressions of grief in the U.S. are often governed by unspoken rules and time frames. For instance, the funeral ritual offers a structured, socially acceptable space to mourn, but the grief experienced beyond such confines can be deemed uncomfortable or inappropriate. It emphasizes the need for greater empathy and understanding towards the complexities and duration of grief.

Grief and Mental Health

The recognition of grief’s profound impact on mental health has become more prevalent in the U.S. over the past decade. Grief can trigger various mental health issues, including depression, anxiety, post-traumatic stress disorder (PTSD), and complicated grief disorder (CGD). Consequently, mental health professionals and researchers have emphasized the importance of seeking help during the grieving process.

Additionally, there’s been an encouraging shift towards a more compassionate perspective on grief in the American healthcare system. Healthcare providers are gradually moving away from pathologizing grief towards understanding it as a normal, albeit challenging, human experience. This shift has paved the way for more comprehensive and supportive care for those grappling with loss, marking a significant development in the American societal understanding of grief.

Grief in the Age of Social Media

The advent of the digital age and the rise of social media have dramatically reshaped the landscape of grief in American society. Platforms like Facebook, Instagram, and Twitter have become spaces for collective mourning, where expressions of grief and condolences are shared broadly. This public display of grief can create a sense of community, providing solace and support to the bereaved.

However, the portrayal of grief on social media also presents challenges. The performative aspect of social media can lead to pressure to grieve publicly and in ways deemed socially acceptable. This phenomenon, termed ‘grief policing,’ can intensify the grieving individual’s emotional distress, adding another layer of complexity to the modern American grief experience.

Moreover, digital memorials and virtual funerals have transformed traditional mourning rituals, particularly amid the COVID-19 pandemic. While it allows for collective mourning when physical gatherings are impossible, it raises questions about the authenticity and depth of digital expressions of grief.

Paths to Healing: The Journey Beyond Grief

The journey beyond grief is inherently personal and distinct for each individual. It is a path marked not just by pain and loss but also by healing and growth. The journey begins with acknowledging the grief, a step that can be profoundly painful but essential for processing the loss.

Professional support such as grief counseling or therapy can be instrumental in navigating this path, providing tools to understand and express emotions. They can help reshape the narrative around loss, transforming it from an insurmountable obstacle to a part of the individual’s life story.

Moreover, community support, whether from grief groups or loved ones, provides solace and understanding. Shared experiences can lessen isolation, fostering a sense of connection and mutual support.

The journey beyond grief is not about “moving on” or forgetting; it’s about learning to live with the loss, integrating it into one’s life, and finding meaning beyond it.

Community Support and Grief Groups

Community support plays a pivotal role in the grieving process. Grief can often feel isolating; connecting with others who have experienced similar losses can provide much-needed understanding and solidarity. Across America, various community-based grief groups have emerged, offering a range of support options. These include in-person meetings, online forums, and specialized groups catering to specific types of loss. These platforms provide a safe space for individuals to express their grief, share personal stories, and gain insights from others’ experiences. In an increasingly connected world, such communal platforms are essential in fostering a sense of belonging and facilitating healing in the wake of loss.

Embracing Grief as a Process

Understanding grief as a process rather than a hurdle to overcome is vital in navigating the complex healing journey. Contrary to the societal pressures for rapid recovery, grief is not a singular event with a distinct end but an evolving experience that ebbs and flows over time.

Embracing grief involves acknowledging the pain, expressing the emotions associated with the loss, and gradually adjusting to the new reality. It’s about honoring the person or aspect of life that has been lost and allowing that loss to become a part of one’s personal narrative.

In essence, embracing grief involves cultivating patience, compassion, and self-awareness. By recognizing grief as a testament to our ability to love and connect, we can see it not as an enemy to be conquered but as a transformative journey towards healing and growth.

Conclusion

Grief, in its vast complexity, is an inherently personal experience that challenges our resilience and confronts us with the deepest aspects of our humanity. In American society, where the pressure to “move on” is pervasive, it’s crucial to validate grief as a profound, multifaceted process that necessitates time, patience, and compassion.

The growing awareness of grief’s impact on mental health, the role of therapeutic interventions, and the potential of community support groups indicate a promising shift in attitudes towards grief in the United States. As we navigate the landscape of grief, we must endeavor to foster a society that permits open, compassionate conversations about loss and provides support for those on their healing journeys.