Each individual may face many threats of loss or loss in the natural course of life. The loss of a loved one, the end of a close relationship, the loss of an organ, the loss of a job, and the loss of some intellectual/abstract values such as homeland/independence/an ideal can be given as examples. Unfortunately, we have been experiencing losses in many issues during the pandemic process we have been experiencing for the last few months. However, we can say that death is the most painful loss experienced by the individual due to the fact that it is an end and is irreversible. For this reason, the main point of this article is this point of loss.
In every period of life, individuals face the normal grieving process after a separation and loss. Grief is a multidimensional and difficult process that concerns every aspect of the life of the individual who has lost. But it is not a disease; It is a normal reaction to loss.
In the literature, there are three different concepts that reflect the process experienced after the loss of a loved one at different levels (individual, social and situation-specific). It is observed that they are often used interchangeably, but they are conceptually different from each other. Losing life; It is an objective expression of the situation that the individual is in because of the loss of a loved one. It reflects the social or external component of the process. Mourning; Defines a time of grief and sadness over someone’s death. Grief represents the cultural side of loss and includes conscious or unconscious cultural responses. Mourning; In individuals experiencing loss due to death, it reflects adaptive responses to that loss. Grief includes unfinished plans, wishes, dreams, and fantasies about the bereaved. The common point of all these concepts is that they are subjective reactions of the person.
“Mourning” for the person we lost is a natural process that must be experienced. The person may protest this loss during the grieving process, some disruptions may be seen in normal functions (such as self-care, working, family and social relations), and some mental problems may be experienced. In order for a person to continue his life in a healthy and functional way, he must complete the grieving process. At this point we can look at Worden’s Model of Grieving Duties.
In Worden’s Model of Grief Tasks, instead of conceptualizing the grieving process as a process consisting of certain phases, the basic tasks that must be fulfilled in order to adapt to the grieving process are defined. According to this model, the four tasks of the grieving process are defined below;
Accepting the reality of loss: It is the full confrontation of the person who experienced the loss with the fact that the lost person is “dead and will never come back”.
Working through grief and expressing emotions : The pain caused by the loss of a loved one is both physical and emotional pain. Accepting and living this pain is both a difficult and important task.
Adapting to an environment where the deceased is not present : Lost persons are unaware of the deceased’s role in their own lives until a certain time has passed since the loss. For this reason, the grieving individual has to adapt to the loss of the roles he assumed in the life of the deceased and the change that this creates in his sense of self. How the individual accomplishes this basic task will determine the outcome of the grieving process; It is either a progress towards making sense of the changes in the individual’s life and redefining the purpose of his life, or a pause in which growth stops and he is condemned to a dilemma that he cannot solve.
Emotionally reorganizing relationships with the deceased and moving on with life : The grieving individual has to prevent the mourning process from negatively disrupting future life plans and activities by creating an appropriate memory formation for the deceased. In other words, rather than ending the relationship with the deceased, it is the ability to place the memories and thoughts of the deceased in a suitable place in his emotional world and continue his remaining life. This stage is the most difficult task in completing the grief.
Grief is a different experience for each individual in the life cycle. For this reason, different grief reactions can be given in the face of loss. At the end of the natural process that develops after the loss of a loved one, individuals restructure their lives through new bonds and relationships. Thus, grief can become a tool for growth and development. On the other hand, if the process is reversed, the grieving process cannot be completed and results in significant impairments in the individual’s functionality.
pathological grief; It has been defined as the gradual deterioration of the individual’s functionality in the social and professional life areas, despite the passage of at least six months after the loss. They are pathological reactions that develop when the individual is stuck in one of the normal stages of grief and cannot complete the grieving process. Grieving is now replaced by stereotypical repetitions and stagnation of healing. The pain after loss deepens and intensifies.
Intense feelings of guilt, loneliness, inability to process past losses, and previous physical or mental problems may hinder the normal grieving process. In this process, unexpected, exaggerated, very prolonged reactions or unresponsiveness may develop instead of normal reactions. Symptoms are often related to denial and individuals avoid acknowledging the reality of loss. In this process, it is imperative to get help in order to complete the bereavement in a healthy way.
In order to understand whether the grief can be completed in a healthy way and to look at the process in a little more detail, it may be useful to look at how the psychoanalytic theory handles the phenomenon of mourning and how it separates the phenomenon of mourning and melancholy. The similarity between the emotions, behaviors and roughly observable expressions of a bereaved person and a melancholic person was remarkable in the last century as well as today.
What we see when we observe a bereaved person is as follows: He is a stagnant person who is unhappy, dejected, sad, has lost interest in the outside world, lacks pleasure, has no ability to love anything other than the object he has lost. We accept it as “normal” as it is. Because we know and can explain why; The beloved object no longer exists. The libidinal investment in the object has not yet been abandoned. With the continued investment, the object continues to exist for a while, at least on a spiritual level. With the gradual withdrawal of the investment, the mourning process is completed and the self returns to its former state.
What we observe in a melancholic person has the same appearances in the bereaved person. He is also sad, sad, stagnant, has lost his ability to love and care, that is, he is also exhibiting a life of loss. But sometimes the sense of loss is not recognizable or identifiable. It can be a state of awareness of loss, but as Freud said “Knowing who you have lost and not knowing what you have lost in that person” in question. The difference does not end there: the melancholic person has begun to see himself as worthless and insignificant. In addition, feelings of guilt and expectations of punishment sometimes approaching the level of delusion are seen, the ego is inhibited. At this point, Freud defines the difference very nicely: “In mourning it is the world that has become poor and empty, in melancholia it is the self itself.”
An important question arises here: How does object loss turn into a loss of self? Freud says that in the self-directed criticisms of the melancholic, which we can find exaggerated and which draws our attention, when we listen a little carefully, the features related to an object that we think should be loved nearby, even if it is hidden among the words, is seen. So everything that devalues he says about himself is basically about someone else. The libidinal investment attracted is not directed to another object and is taken into the self. The libido could not be released and was used to identify with the abandoned object. In other words, the abandoned and lost object has been taken into the self in a sense. Therefore, the loss of the object is experienced as if it is related to the self.
In identification, the basic mechanism is to resemble the object by incorporating the features of the object into the self, that is, by incorporating it. Thus, with the inclusion of the abandoned or lost object, and therefore with identification, the object becomes a part of the self, and the loss of the object turns into a loss of self. So the melancholic loses from within.
Although we have understood how object loss is experienced as a loss of self, there is a second question waiting to be answered; This part will be incomplete if we do not answer the question of why the object-identified self is treated so cruelly. At this point, we need to meet again with another basic concept in psychoanalytic theory; ambivalence. Bivalence is a word we use to describe a situation where both love and hate feelings coexist on the same object. The ambivalence is manifested by the frustrations associated with both the need for it and the failure to meet the expectations in relation to the object; an affect whose origins can be traced back to the mother-child relationship in the early stages of life.
We can assume that disappointments experienced in relation to object relations in melancholia trigger such ambivalence. Thus, after the object was given up or the object was lost, ambivalence became active and the attack on the object began. However, since the identification with the object is realized with the mechanism we have just mentioned, that is, the object is included and becomes a part of the self, so sadism is directed towards the self.
Since the grieving process is unique to the person, how it will be handled and how the person will experience this process differs due to many points such as personal story, personality organization, closeness of the lost person, and how the loss occurred. For this reason, I think it may be useful to separate the ordinary process of grief at which point it is necessary to receive psychological support. In general, when you experience more than one of the following items, getting support from a mental health professional can help you have a healthier process;
When the person denies or suppresses the loss for a long time, as at first
Reacting too heavily and emotionally when talking about the loss
Running away from everyone and everything that reminds them of the loss
Talking about the person who died after a long time, using the present tense language as if he were alive and really feeling that way
Resisting to keep the lost person’s belongings/room for a long time
Constantly bringing up the issue of the missing or talking about it as if it never happened
Difficulty performing daily life functions after loss
Engaging in behaviors that may harm self or others, such as substance abuse, alcohol abuse, violence
avoiding processes such as going to the cemetery, religious rituals