Dealing with complicated GRIEFBahamas Psychological Association members encourage people to talk rather than internalize feelings
When someone dies who was ill, people mourn but the intensity of the loss might not be as greatly as when there is unexpected death, according to members of the Bahamas Psychological Association (BPA). They say complicated grief occurs when there is an unexpected or violent death, suicide of a loved one, lack of a support system or friendships, traumatic childhood experiences, such as abuse or neglect, childhood separation anxiety, close or dependent relationship to the deceased person, being unprepared for the death in the case of a child’s death, the number of remaining children and, lack of resilience or adaptability to life changes.
In the wake of the Labour Day tragedy in which four women were killed, and 24 people, including children were injured, when a truck lost control and plowed into participants of the march celebrating Sir Randol Fawkes Labour Day, President of the Bahamas Psychological Association, Clinical Psychologist Dr. Wendy Fernander encourages people to talk about it, rather than internalize their feelings.
Tami Patrice Gibson, 48; Dianne Gray-Ferguson, 55; Kathleen Fernander, 51; and Tabitha Haye, 41, were killed as they were marching with the Bahamas Financial Services Union (BFSU).
The psychologist, who is president of the Bahamas Psychological Association, said while she doesn’t think people ever get past loss, she said they have to live one day at a time. She encourages talking about the victims, their memories and what your relationship with them was like. Doing so she said allows for the start to develop coping strategies and skills.
“We have to acknowledge that it has happened. Coping begins first with an acknowledgement that this incident happened, so when we recognize that then it allows us to move through the process of shock. And I think the whole country was in shock at the news … everyone’s trying to process the news and what would contribute to it, and all of that. And there will be varying theories as to what happened. So first there is the acceptance that this happened, but now where we are really is that we are in shock, so it’s going to take us awhile, and some people are going to get through it more quickly than others.”
The psychologist says memorialization of victims is encouraged and for people to find ways in their personal lives, or as a community, to memorialize the persons lost.
“It may be individual families, or at work, they can make a board, write a note, put some kind of symbol that says I remember the person. So we move from shock to acceptance and memorialize them so that we hope an incident, a tragedy like this doesn’t happen again. Barrington [Brennen, BPA counseling psychologist and executive council member] and I met with one of the victims’ coworkers and they are still expecting her to walk in the door at any moment, and the same thing when we met with families [on Sunday].”
Over the weekend, Fernander and members of the BPA provided initial psychological support for two families, and said they would be continuing to provide services to facilitate the recovery process during this week, reaching out to all persons impacted directly by the tragedy.
They are also reaching out to the people who were injured and are in hospital, and their families. Fernander said a BPA counselor has also been assigned to work with the vehicle’s driver and his family.
Signs and symptoms of complicated grief include extreme focus on the loss and reminders of the loved one; intense longing or pining for the deceased; problems accepting the death; numbness or detachment; preoccupation with your sorrow; bitterness about your loss; inability to enjoy life; depression or deep sadness; difficulty moving on with life; trouble carrying out normal routines; withdrawing from social activities; feeling that life holds no meaning or purpose; irritability or agitation and lack of trust in others
When the above signs and symptoms are present, BPA members say it is best to talk to someone.
When the following symptoms are evident —intense pining or longing for the deceased that occurs daily or is distressing or disruptive; trouble accepting the death; inability to trust others after the death; difficulty moving forward with life; excessive bitterness or anger related to the death; feeling emotionally numb or detached from others; a feeling that life is now meaningless; a belief that the future won’t be fulfilling; or increased agitation or jumpiness — BPA members say it is wise to seek professional help from someone who is trained and knowledgeable about grief and loss.
“These symptoms can cause numerous complications — depression, suicidal thoughts or behaviors, increased risk of heart disease, cancer and high blood pressure, anxiety, long-term impairment in daily living, post traumatic stress disorder, substance abuse, smoking or nicotine use. Some of these complications may not only require psychological help buy medication assistance,” said Brennen.
Whether it’s the recent holiday tragedy, or any situation for which counseling is provided, the psychologist said after introducing themselves, they ascertain whether the person was present at the scene, or where they were when they heard the news. She said they then ask them to speak to them about their memories of the deceased and to use one word to describe that person. They also find out whether anyone has slept since the incident, or whether they had eaten since it happened.
On Monday, during visits with families and co-workers, Fernander said they found out that more than half the persons they had visited hadn’t eaten since hearing the news, and a good majority of them hadn’t slept. She said they informed them that while this was normal, they would prefer that they start to eat a little food, because not doing so could drive them into unhealthy eating.
“We counsel them regarding sleep hygiene and the importance of eating, and we encourage them to talk about the person, but to also take time to grieve. If they feel like they want to cry — to grieve, to write a note if there was something they wished that had said and didn’t say. But more importantly, to take a moment to allow themselves to grieve — to not feel like they have to be a super person, to not allow themselves to put on a stiff upper lip and pretend as if it hasn’t happened. And while we have to go on, we have to also allow ourselves to grieve and come out on the other side of the grief a healthier person, but we can’t do that if we don’t allow ourselves to grieve. I think what has happened is that we typically like to make grief something that’s abnormal, but it’s a very normal process, anytime you’ve suffered a loss.”
She said moving forward means putting one foot in front of the other, and thinking of how the deceased would want you to move on in their death.
“It forces us to look at our own mortalities. But it also says to us, how do we live our lives moving forward? How do you make a difference as a result of what has happened? Our time on this earth is brief, so it’s incumbent on us to ensure that we live a life that’s meaningful,” said Fernander.
“For me it’s important to remember that every person who comes into your life, they leave a piece of themselves behind as they go, so it’s important to remember that. It doesn’t matter who the person is, it doesn’t matter what kind of person the person was, they leave a piece of themselves behind, and then too what happens for the survivor is it forces them to look at their own mortality.”
Brennen encourages sensitivity and understanding when someone is grieving. And to avoid saying things that can cause further pain like “God knows best”, “just pray about it”, “snap out of it”, “don’t cry” or “don’t talk about it anymore.”
“These are myths and unrealistic expectations when grieving. Just be there for the person. Allow them to grieve. Encourage them to talk about their loss. Encourage them to cry and feel their pain. This is best for recovery,” said Brennen.
Families impacted by the Labour Day holiday tragedy that they were unable to reach, Fernander said can contact her at 525-2600 or BPA counseling psychologist and executive council member Barrington Brennen at 477-4002. The BPA is comprised of psychologists who work in the public sector, private practitioners, and at the University of The Bahamas.
As BPA members reach out, Fernander said she’s found that Bahamians are becoming more open to grief counseling, but she said their response has always been the result of an organization or workplace reaching out to them, and not so much persons walking in seeking assistance.
“Typically they don’t walk in. Barrington and I went to homes of persons [on Sunday], and we went to workplaces [on Monday] and we anticipate that we will be going to other homes and other workplaces in the coming days. But no, people aren’t readily willing to accept counseling/intervention for whatever reason,” she said.
Signs and symptoms of complicated grief
- Extreme focus on the loss and reminders of the loved one
- Intense longing or pining for the deceased
- Problems accepting the death
- Numbness or detachment
- Preoccupation with your sorrow
- Bitterness about your loss
- Inability to enjoy life
- Depression or deep sadness
- Difficulty moving on with life
- Trouble carrying out normal routines
- Withdrawing from social activities
- Feeling that life holds no meaning or purpose
- Irritability or agitation
- Lack of trust in others
When these signs and symptoms are present it is best to talk to someone. However, when the following symptoms are evident, it is wise to seek professional help from someone who is trained and knowledgeable about grief and loss.
- Intense pining or longing for the deceased that occurs daily or is distressing or disruptive
- Trouble accepting the death
- Inability to trust others after the death
- Difficulty moving forward with life
- Excessive bitterness or anger related to the death
- Feeling emotionally numb or detached from others
- A feeling that life is now meaningless
- A belief that the future won’t be fulfilling
- Increased agitation or jumpiness
These symptoms can cause numerous complications. They include: depression, suicidal thoughts or behaviors, increased risk of heart disease, cancer and high blood pressure, anxiety, long-term impairment in daily living, post-traumatic stress disorder, substance abuse, smoking or nicotine use. Some of these complications may not only require psychological help, but medication assistance.