The complexity and simplicity of the experience of grieving

EDITORIAL

The complexity and simplicity of the experience of grieving

Profa. Dra. Regina Szylit Bousso

Professora Livre-Docente do Departamento de Enfermagem Materno-Infantil e Psiquiátrica da Escola de Enfermagem da Universidade de São Paulo - USP - São Paulo (SP), Brasil. Líder do Grupo de Pesquisa CNPq: Núcleo Interdisciplinar de Pesquisa em Perdas e Luto.

"To spare oneself from grief at all cost can be achieved only at the price of total detachment, which excludes the ability to experience happiness."

Erich Fromm

Grief is a natural and expected reaction to the rupture of a bond; it is a process of preparing for a significant loss, which does not apply only in the case of death, but also to other situations of irreversible deprivation, such as separations or retirements. It is not considered lost when there is no interest in what has been lost. Thus, its meaning is determined individually, subjectively and contextually by those who experience it.

Grief is a consequence of the experience of loss that happens when our lives are affected by the termination of a relationship, a project or a dream. It signifies an intense emotional suffering caused by loss, a profound sadness, a dynamic, individualized and multidimensional process through which the individual traverses.

Since the early work of Freud⁽¹⁾, grief has been studied and there has been a great evolution in the manner of understanding this experience. The most recent conceptualization of this mystery that pervades our human condition is to consider it as an inevitable life experience, unpredictable, unrelated to the stages previously presented, neither resolvable nor likely to be "overcome", but as an event that becomes part of life in unique ways, changing over the course of life, and itself being life-changing. It consists of a normal and expected process of transformation and redefinition of the relationship with the lost person, a task that allows for its preparation⁽²⁾. Thus, it concludes with a "resolution", with the return to normalcy, but with the incorporation of loss into the life of the grieving person, so you can follow on with life with a continuous connection to the deceased, but which allows one to continue to move forward with life.

Currently, scholars no longer work with the concept of phases of grieving, which risks unfair and biased assessment of the person's condition in a generic way, ignoring individuality. It is a process of transformation of the relationship with those who died, which it is important to note, can not be simply eliminated from the life of the bereaved; it is not only more physically present, but the grieving person continues with a different relationship from that which existed before. The development not only depends on the working through the loss, but also the ability to disregard it⁽³⁾.

Among the peculiarities of each case, there are a number of factors involved that may complicate or extend the mourning. A violent or sudden death, or one with much suffering or that reverses the natural order of things - children who die before their parents, for example - tends to aggravate this painful process.

Coping well with grief is signified by the ability to face the feelings evoked by the loss, the new reality that it imposes, and also to have moments of avoiding pain and returning to life. The realization that the beloved will not return brings about melancholy, and the grieving person needs time to accept the reality of death, transform the relationship with the lost person, and develop their own identity without that person. Everyone experiences the grieving process in his/her own way. Every time someone remembers her loss, she may return to intense feelings of sorrow, tears coming to her eyes again, but soon thereafter she can find comfort.

Thus, experiences of grief have been studied by researchers. Little known, yet, are interventions that can be offered by nurses to assist individuals and families to walk with less pain through these sad experiences.

All that we can say about the care of the bereaved is that this relationship requires sophistication and that it is harder to articulate than the apparent simplicity of the available models of care. They are relationships that enable attention to the individuality of the griever, to guide them during this difficult situation, helping them to realize that, sometimes, what can give them the most comfort is, ironically, that from which they may flee - talking about their loss.

Grieving alerts us to the work of caring for the suffering of others, the work to reconnect the mourner to the deceased, work that requires the ability to relieve suffering through love and affection. This requires shared effort with the bereaved to help him/her get somewhere safe where he/she can find compassion, trust, faith and refuge, but where he/she can also grow, give meaning to life and move on. Working with the bereaved means supporting them to oscillate between loss-oriented coping and the guided restoration of life⁽³⁾, recognizing that memories do not arise only in difficult times, but also alternate with joyful emotions. In my opinion, the therapeutic effort should help to give meaning and hope for a new life, independently, without the loved one.

Perhaps in the heart of those who care, there is a place of refuge and growth that is cultivated by those who have faith, who love and are not afraid to work with pain and suffering, and the willingness to support those who are experiencing them.

REFERENCES

• 1. Freud S. (1917 [1915]). Luto e melancolia, In Freud S: Obras Completas de Sigmund Freud, Rio de Janeiro: Imago; 1996. vol 14 - p.269-91.
• 2. Parkes C.M. A Historical overview of the scientific study of bereavement. In: Stroebe M. et al., Organizador. Handbook of bereavement research: consequences, coping and care. Washington DC: American Psychological Association; 2001. p. 25-45.
• 3. Stroebe M, e Schut H. Meaning making in the dual process model of coping with bereavement. In: Neimeyer R, Organizador. Meaning Reconstruction and the experience of loss. Washington DC: American Psychological Association; 2001. p. 55-73.

Publication Dates

• Publication in this collection
  01 Aug 2011
• Date of issue
  2011