The central
theme in bereavement is LOSS; but not loss in a general sense. It is
the specific, personal loss of a loved one through death. It is a final exit of a loved person from the
physical space where all forms of previous interpersonal contacts become impossible
again. This picture attempts to capture
in graphic terms the impact of this loss on the human mind and the consequent
activation of the coping mechanisms. The
involuntary emotional and behavioral reactions to this loss are often described
as grief while the traditional, voluntary ,social expressions to this loss is mourning which may overshadow all the other aspects of bereavement especially in Africa.
It is normal for
human beings to express this involuntary grief reaction by an initial phase of
shock, protest and disbelief followed by preoccupation with the thoughts of the
deceased, which is often characterized by searching for other intrusive
thoughts about the dead. As a process of
resolution, there is a stage of reluctantly accepting the reality of the loss,
which is followed by outright rejection of attitudes of guilt or self-pity with
respect to the deceased.
Where adverse bereavement- related symptoms persist for more than 6 months
or when there is the absence of expected grief symptoms or the avoidance of
painful symptoms within the first 2 weeks; a situation of abnormal grief
reaction ensues that require psychiatric consultation. The human cognitive
template has valuable recordings of memorable interactions with the loved one
that cannot be switched off as can be done to a television. To view the human
mind at that mechanical level is to have a poor understanding of how the human
mind functions. The grief reaction state may come out in close resemblance to
depressive illness except that guilt and suicidal ideations are not free
floating if they ever exist as they will always be in the context of the
deceased. There are usually no associated feelings of worthlessness,
hallucinatory experiences or prolonged functional impairment. The grief reaction may initially appear mild
until the one year anniversary when manifestations may become more intense. To mask this; some may take to alcohol and
substance abuse.
Frank stress reactions to the
loss especially when the death is sudden, unexpected or violent may present
with re-experiencing and flashbacks of the circumstances of the death of the
deceased. Folks with previous history of psychiatric illnesses may be more
prone to committing suicide following bereavement. There is a demonstrable higher rate of
hospital admission and increased medical consultation among those bereaved
especially if they are parents, children or spouses in relation to the deceased. The women may present more with frank psychiatric
disorders while the men would develop more medical complications because of
bereavement if they do not remarry. Some
of the subtle but potent factors that can facilitate complications of bereavement
are social and emotional isolation, absolute loss of social role, unemployment,
financial hardship and loss of supportive social networks. Some bereaved
individuals may have low self-esteem, ambivalent or dependent relationship with
the deceased or previously unstable personality profiles. The women especially become more vulnerable
and destabilized following bereavement just as men show less acceptance of
their loss and turn to other romantic relationships sooner.
Mourning as a conscious, voluntary socio-cultural
facility could have a creative and profound positive impact on the grief
reaction by ameliorating factors that can get it complicated.
In Africa where
a widow is viewed more as property of
the deceased husband and by extension of the extended family; prospect of
remarriage is usually marred by family gossips and persecution as obsolete
cultural practices whereby a sibling of the late husband may be expected to take over the widow of his late
brother without her consent. Properties acquired jointly are oftentimes seized
by the extended family if she does not comply with the family directives. Some
mourning practices can take several months, which may foster social isolation,
loss of self-esteem and disconnection from supportive social networks and means
of livelihood. Both religious and cultural practices should ensure that those
who harbor guilt feelings following the death of their loved ones are reassured
so that they can have enhanced mental capacity to bear the loss rather than wallow
in self-pity. Memories of our loved ones can be devoid of pain when we
immortalize them with projects that can serve the good of the community
especially the vulnerable ones. As a consequence of suicide bomb attacks, air
disasters, increasing road traffic accidents and reduced life expectancy
generally; there is definitely an increasing population of widows, widowers,
orphans that would require a robust social welfare program from our government
at all levels because their bereavement would have taken a negative toll on
their socioeconomic standing.
Dr. Adeoye Oyewole
adeoyewole2000@yahoo.com
+234 803 490 5808 (WhatsApp only)
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