My wife walked into the nursery at 8:00 A.M. on a beautiful sunny Sunday morning wondering why she hadnít heard any noises. She found our six month old daughter, Terese Nicole Reece dead in the crib. I was at a local church conducting a class on parenting. My wife called the church and I left a shocked classroom of people to rush home. Numbness, shock, horror, disbelief, fear, confusion, bewilderment--the whole montage of emotions. Our lives changed forever by this inexplicable, mind shattering event.
The police and paramedics did what they could. Then the coroner came. He walked upstairs, and then down again. My last memory was of him carrying my child out in a maroon satchel. He never said a word. I, my wife and two remaining children were left standing at the curb. We did not have a clue about what to do next We muddled through the next week with the help of my graduate professor and his wife---Dr. Jim Oakland and Helen.
Funeral arrangements, viewing the body, the funeral all seemed sureal and done in a haze. I remember my wife going with her mother to view Nikie. I didnít go, my defenses were massing to repel this unbearable catastrophe. I did manage to get to the funeral home and view the body. It was sitting on the floor, a white box with what appeared to be a small doll. Surely not my child. Denial, avoidance and numbing were holding back the torrents of chaotic emotions, too overwhelming to feel all at once.
I set about to regain control of my world. I dismantled the nursery in one day. I went back to work and school, a flurry of activity to restore mastery and order to my world. The lid fastened securely, my rage on a short tether, my despair knowing no bounds. I could not verbalize, or articulate to anyone my experience, not even to my wife. I became frozen, wooden, unable to feel any grief. I remained that way for 20 years. My wife handled her grief differently, we withdrew, didní talk. She went her way, I went mine. An ocean of sorrow flowing between us; unacknowledged. My emotions came out symptomatically, colitis, insomnia, irritability, rages, compulsive spending, over working, and over eating.
And now, 30 years later, I am a psychologist who specializes in trauma and bereavement. Recently I have been working intensely with individuals who have had life changing incidents; traumatic losses which have radically changed their lives. In the process I have run into people with a variety of losses from which they have had difficulty recovering. One woman put it very succinctly. I lost my husband to AIDS, and I had a miscarriage, I have just realized that I do not know how to mourn.
This woman is not alone. Few of us know how to mourn, and because of this most of us have many unmourned losses. How can this be when loss is such a large part of life, and death occurs so frequently? There are over 20 million new bereavements every year. Over one third of these are likely to result in complicated bereavements. The social and psychological costs of these unmourned losses is staggering.
Time after time people tell me their stories. A woman begins to have flashbacks, memories, and images of her mother who died 16 years ago. A man who is alcoholic is has images of his mother and father who died 30 years ago. A man sitting in a meeting gets a strange look in his eyes. I had been doing a lecture on Bereavement. He said, ďI donít know where this is coming from, but I just realized that when I was twenty, my mother died, and now I am forty, and I never mourned her passing. There is a unity to all of these stories, a common theme: delayed grief, complicated mourning, unmourned losses, all leading to unhealed wounds.
Let us look briefly at the problem, some of its causes, and try to develop an understanding of some ways to deal with loss. First of all, there are numerous losses which are not in necessaruky related to death. The loss of a career. Being suddenly transferred to a job in another city. Your best friend moves away when you are seven. Someone steals your car. You go through a sudden and unexpected divorce. Abortions, miscarriages, all of these losses cause psychological wounds. Every loss is accompanied by grief. Grief is merely the total constellation of psychological and physical reactions we have to a loss.
When a loss is sudden, overwhelming, and exposes us to threat, horror, death, and we experience intense fear, helplessness or horror then we are likely to have been the victim of a traumatic stressor. This stressor, the specific circumstances of a death, are critically important in determining the course of events to follow. If the death was sudden, or unanticipated, violent or mutilating-suicide-homicide, random and or preventable, if the deaths were multiple and at the hand of another, and the bereaved was personally exposed to the horror or death, this equates to the death being traumatic and equals a high risk for complicated mourning.
Complicate, unresolved, or delayed mourning is defined as a compromise, distortion, or failure in one or more of the stages of mourning which may lead to a lack of resolution or accommodation to the loss. Unmourned losses lead to a variety of psychological symptoms: you may experience anxiety regarding your death or be preoccupied with the death of others, you may be chronically restless, tense and irritable. There may be blocks and avoidance in anything having to do with the event. You may have intrusive, unwanted recollections and flashbacks. You may increase your intake of substances to regulate your feelings. Relationships with significant others may be marked by increased conflict, rage, and or withdrawal. You may experience deadness and an inability to feel any loving feelings. You may have chronic feelings of emptiness, loneliness, isolation and alienation from others. There may be chronic sadness and persistent crying. And finally, you may develop numerous illnesses which are stress related. If you have any of these symptoms or several, as is the usual case, there is a strong probability that you have some losses in your life with which you have not dealt. We are now back to the original problem. I don't know how to mourn. I may recognize that I have had several painful, life changing losses in my life but I donít know how to deal with them. ďIsnít it best if we just forget about them and move on with our lives. Whatís the point of dwelling on these things?Ē
The problem with unmourned losses is that they cause problems. People with unmourned losses frequently have what I call dead zones. These are areas where they are unable to remember, or feel certain kinds of feelings. Their relationships usually suffer. They have damaged self-esteem from these losses. And they do not seem to be able to experience any joy in living. I felt empty, dead, and unable to experience any loving feelings for years. I blamed it on my wife. We divorced. I was still unable to feel.
My client who lost her mother also was molested by her step-father. She suffered from depression, was frequently angry and impatient with her children, and had chosen an abusive and alcoholic man for a husband. My client who lost both his parents at an early age became an alcoholic as a means of dealing with his unmourned losses.
The point I am making is that when we do not deal with our losses, they create major distortions, disruptions, and often result in our psychological development stopping at the date of the loss. I have one client who experience a major traumatic loss of a child at the age of 20 and since that time has been married three times. She also responds to her depression by being addicted to cosmetic surgery. She hates herself so much she compulsively seeks to change how she looks through surgery. And this is another red flag: compulsive reenactment of trauma related themes.
One client reacts to female rejection-- his mother was abusive, and then died of Multiple Sclerosis when he was young--by going on a rampage of gambling, drinking, and womanizing. He dramatically acts out his feelings of hurt, anger, abandonment, and rage through this cycle.
Again, knowing and recognizing the problem is one thing, what can be done about it? This is the first step, recognition of the symptoms. This is difficult, because typically, complicated grief is caused by persistent avoidance of any and all reminders of the event. Nevertheless, by becoming aware of the potential meaning of our symptoms we have taken the first step toward mourning our losses. And this is the major struggle in bereavement, one part of us wants to defens, avoid, and not feel at any cost. The other part is seeking growth, healing, and restoration of wholeness. This can only be done by feeling, grieving, and facing the problem. Intrusion, denial--a difficult tug of war.
This step can be facilitated by keeping a journal of feelings, images, and those unwanted thoughts. By writing these down we are beginning to take the fear out of them. They also serve as the messenger and are trying to tell us where the pain is that needs healing. Another technique for helping focus on the losses is to create a loss inventory. This is done by dividing your life into ages, or decades. Some do it by dividing it into childhood, adolescence and adulthood. The divisions will be natural when you begin to write down the losses. Write them down, and then write about how they affected you and what you did about them. Then think about how it changed your life.
This process transitions you into the next phase of bereavement: connecting the feelings, memories and images. This is often a very painful part of bereavement because we have disconnected the feelings because they were too painful at the time. Do not expect to accomplish this all at once. Be patient and do it at a pace that allows time for reflection, integration, and healing. One client is creating a picture storybook of her family and losses.
The third step is what I call reconciliation. Often times there are mixed, ambivalent, and conflicted feelings about our loved ones and losses. We need to make sense of what happened, accept the event, relinquish the loved one, and find new ways to live. Sometimes, rituals of healing can be very helpful. A few years ago, my two adult children and I went to the gravesite, located the head stone and stood there, confronting the ghost which had haunted our lives. We put our arms around each other and faced the loss which changed their lives as much as mine. Finally, we must rebuild. This may take the rest of our lives, but it involves restoring our self-esteem, dealing with the effects of the losses, and undoing any destructive, distortions which may have been due to our avoidance. Every loss must be mourned. One of my clients who lost a son to a drug overdose is discovering that she not only lost a son, she lost her good friend, she lost the future. ďI will never see him get married, have children, or get his dream job.Ē
In summary, losses are a part of life, traumatic, life changing losses often create problems over a long term if they are not mourned. Each loss presents a unique challenge to our capacities to mourn and accommodate to the pain. Bereavement is a process, it is not a series of stages we go through in a predictable fashion. Bereavement is an active process, each personís losses and grief are as unique as their fingerprints. If we are to live, we must learn to mourn. The reward will be healing and wholeness, not only of yourself, but of your relationships, and your whole life. Avoidance, denial, and repression deaden us, in order to feel fully alive we must live with awareness and embrace the suffering which will lead us to transformation and a new and different self.
In addition to these numerous opportunities to work with victims of disasters, trauma, and abuse, he is himself the survivor of traumatic bereavement. He and his wife lost a 6 month old daughter because of Sudden Infant Death Syndrome. These experiences have left him with a special knowledge of trauma and have resulted in devoting his professional life to the study, research, and development of effective recovery programs for a broad spectrum of individuals with life crises.
Currently Dr. Reece is finishing his next book, which is designed to help people survive and recover from traumatic and life changing experiences. He also writes a monthly column for L.A. Steps For Recovery, a widely distributed publication for the recovery community. As the founder and executive director of The Stepcare Institute, Dr. Reece has built a distinguished career as therapist, author, educator, lecturer, and consultant. He is noted for his sense of humor, relaxed presentation style and skill in facilitating learning experiences.
Dr. Reece has written a book: Trauma, Loss & Bereavement which details the effects of trauma and has many helpful self-tests for recognizing the effects of trauma, stages in bereavement, and complicated mourning. The book may be purchased for $20.00 For details check out his web page www.stepcare.org or call to order at 626 355 2407