CAL MARITIMEHow to Cope with Loss, Grief, Death & Dying - Professionally & Personally
© 2002 Kirsti A. Dyer, MD, MS All Rights Reserved. E-mail: email@example.com
The California Maritime Academy - CSUM California State University, Maritime
SOC 210. Dying: The Final Stage of Living February 7, 2002
A sudden, accidental, unexpected or traumatic death shatters the world as we know it. It is often a loss that does not make sense. We realize that life is not always fair and that sometimes bad things happen to good people. The sudden death leaves us feeling shaken, unsure and vulnerable.
Common examples of sudden
deaths include: heart attacks, strokes, ruptured aneurysms, accidents,
post-operative complications, anaphylactic reactions (bee stings, severe
allergies), rapidly fatal acute leukemias, sudden infant death syndrome
and rapidly progressive infectious diseases such as respiratory anthrax,
certain pneumonias, Legionnaire's. Sudden deaths also include suicide,
homicide, natural disasters such as the Loma Prieta earthquake and human-caused
disasters such as the Oklahoma City Bombing or the September 11th
Special Problems for Survivors
Death due to a sudden or traumatic accident or disaster can raise a number of complex issues for the survivors. The grief process is often very different from an expected or anticipated death. Homicide, suicide, or exceptionally tragic events can cause reactions such as Post Traumatic Stress Disorder on the part of survivors and family members. Sudden loss or death creates special problems for the survivors. Many of these problems compound the grief response.
The grief response following sudden loss is often intensified since there is little to no opportunity to prepare for the loss, say good-bye, finish unfinished business or prepare for bereavement. Families and friends are suddenly forced to face the loss of a loved one instantaneously and without warning. This type of loss can generate intense grief responses such as shock, anger, guilt, sudden depression, despair and hopelessness.
A sudden tragic event shatters our sense of order and thrusts us into a world forever changed. Survivors of sudden loss may experience a greater sense of vulnerability and heightened anxiety. The safe world we once knew, no longer exists. We fear for ourselves, our family and friends. Survivors can become overwhelmingly preoccupied with thoughts that such a random act of violence might happen again.
Along with the primary loss of the person, families and loved ones may experience concurrent crises and multiple secondary losses: lost income, loss of home, loss of social status. The role the loved one held in the family is gone. It takes time for the family to reorganize. Family may be left feeling in a state of perpetual disarray with a lingering sense of unease and disorganization. Marital and other family relationships can become strained.
Additional problems arise if the grieving survivor was involved with the disaster or was physically injured. Memories of the accident or the disaster may dominate the person's mind. They may be taken up with feelings of numbness, unreality and fear. The bereaved person may suffer from "survivor guilt," wondering why they survived when others have died and believing that they could have or should have done more to prevent the tragedy.
The reaction to sudden deaths can be further complicated if the death is due to a violent act. If there is a trial, the grieving process may be unduly prolonged, stretching out to the time it takes for the trial. It may be particularly difficult on the family if the killer of their loved one is not be caught or goes unpunished.
Suicide is one of the most agonizing kinds of death for surviving spouses or family members to endure. This type of death can result in shame, anger and guilt if family members blame themselves, or are blamed for the death. Suicide is also one of the disenfranchised or publicly unacknowledged losses. Many times, it possible, the reason for a death due to suicide is hidden. The threat of social stigma contributes to family shame.
Families may feel unable to fully grieve and reach closure in situations when there is no positive confirmation of the death, when the physical body has not been recovered or if the body is available but the family is unable to view it. This factor can make it difficult to grasp the reality of the death has occurred as survivors continue to hope. Only when the reality is fully grasped can survivors move past the trauma to face the full realization and the pain of grief.
In public or particularly newsworthy events, survivors may also have to deal with intrusion by the media. As we well know the media can become an additional pain source—not respecting the families privacy, replaying tragic events—such as the explosion of the Challenger space shuttle or plane crashing into the World Trade Towers—over and over again. With criminal incidents families and survivors must deal with the police, investigators and lawyers.
Since the death was not anticipated, the deceased may have left unfinished business which the surviving family members may need to handle. These may be domestic concerns but could equally well be work-related or legal matters. Legal and financial affairs following certain types of death e.g. suicide, deaths in which the body is never recovered, may be complex.
The search for meaning of
the loss can challenge a survivors religious and spiritual beliefs. Sudden
losses in particular can precipitate an existential crisis as the survivor
searches for meaning. They start questioning their internal belief system
and values. Goals, plans and purchases which were important the week prior
to the event, abruptly seem trivial in comparison. Survivors are forced
to look at and re-evaluate life priorities.
Factors Affecting the Nature of a Sudden Loss
1. Natural vs. human-caused disasters
Traumatic Grief & Complicated Mourning
Tragic events can be much more difficult to recover from quickly, or at all, depending on the nature of the tragedy e.g. unnecessary or accidental death, rape, loss through natural disasters, death during war-time, unnecessary acts of violence.
Traumatic grief generally occurs when a death is:
Complicated Mourning is defined as a delayed or incomplete adaptation to loss or failure in the process of mourning.
The grieving process with
traumatic grief is complex, intensified demanding even more than a normal
response as the survivor struggles to cope with the loss and the aftermath.
Traumatic losses are the ones that often require counseling and professional
help from those knowledgeable in the field to help the grieving better
cope with the loss.
Human caused disasters such as the September 11th events catch us off guard. These acts are viewed as random acts of violence, can be more frightening than natural disasters, often perceived as " an act of God." Because the acts were committed by humans rather than being an "act of God" there is the perception that "We should have seen it coming," "We should have been more vigilant," "We could have prevented this event from occurring." It is difficult for us to believe that fellow human beings are capable of such atrocities. There are several differences between human and natural disasters that make the event even more stressful:
Sudden Death leading to the Unanswerable "Why?"
Trying to make sense of or understand sudden losses can be difficult. Survivors are left asking "Why?" "Why did this happen?" Yet events such as the September 11, 2001 tragedy and the Northridge earthquake were beyond anyone's control; they are a sudden, unexplainable loss.
It is human nature to want to answer the question "Why?" yet it may be difficult if not impossible to find an answer. Instead the question "Why?" is more of a plea for meaning and understanding. The thoughts of Rabbi Earl Grollman provide a useful perspective for coping with this difficult question:
Now death has shaken your faith, "Why?" "Why must life be one of sorrow?" "Why?" There are no pat answers. No one completely understands the mystery of death. Even if the question were answered, Would your pain be eased, your loneliness less terrible?Asking "Why" may in actuality be counterproductive, especially for the healing process. Perhaps it is better to ask "What can I do about it now?" "How can I help?" or "How do I pick up the pieces and go on living as meaningful as possible?" The following quote sums this up:
The three phrases that
I should let go from my mind, if I want to be serene
Basics on Coping for the Survivor
It is important for the grieving person to take care of him/herself following a sudden loss. He/she is dealing with an event that is beyond his/her control. One way of helping is to do things that help re-establish the person’s sense of control over their world. It is also important to focus on the basics the body needs for day-to-day survival:
Initially, be persistent and offer concrete help. A grieving family may feel so overwhelmed by the loss that they may not know where to start or what someone can do to help. Offer to prepare meals, help with child care, answer the phone, run errands, or help make phone calls or memorial arrangements. If the media is involved, it may be beneficial to run interference for the family.
After a few months, support is most needed. Be prepared to listen. Give the bereaved time to talk about their loss if they want. Ask how you can help. You can offer to take them to or go with them to a support group if it's feels appropriate.
Over time it helps to remember the grieving on the difficult days—anniversaries, holidays, the birthday or the death day of the person who died. People like to know that others still remember their loved one.
Sudden loss create distinct issues and problems for survivors. It also shares many reactions common to the grief process—being a process that survivors go through following a loss. Each type of sudden loss, whether a heart or a terrorist attack, leaves survivors bereaved, dazed and vulnerable.
Life is forever changed and very different following a sudden loss.
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