Recently, as I was walking in the hills I entered into conversation
with a stranger. At first we spoke of
the steepness of the hill we were climbing. And then, as we walked along
together, he asked if I knew that someone’s ashes had been placed in the corner
of the field further along our path.
This was news to me even though I had passed that spot many times. He said he would show me the place - so I
followed him - and there, just as he said, tucked beneath the wild gorse was a
small stone plaque on the ground with a name and the words: “he loved these
hills” engraved upon it. “I always pause
when I pass here” he said thoughtfully.
And we did.
As I bent over I noticed from the plaque that the man had
been born on my brother’s first birthday.
I also noticed that, had he still been alive, he would have been my age. That thought stayed with me long
afterwards. “You must have met his
widow”, he said, “She walks a King Charles Spaniel”. It was strange to think that I had, as I then
realised, spoken to her in passing on many occasions and had been unaware what
she was going through – how her husband had been so very ill for two years –
then died.
It seems to me that this is where grief and loss are best
placed (and left) – within the everydayness of life itself, and not seen as a
medical condition to he treated. I say
this as this week I read an abstract of a report entitled: “Complicated grief
and related bereavement issues for DSM-5”. I read in this report: “Sometimes acute grief can gain a
foothold and become a chronic debilitating condition called complicated grief …
Hence, some bereaved people need to be diagnosed and treated”. I sometimes wonder whether people who write
such lines have had much to do with people outside of a clinical setting and
mindset. Surely grief is not an “it”, a
“condition”. Accuse me of semantics if
you like - but first, allow me to explain.
Grief (not just with death, but also through the loss experienced
with the end of a friendship) includes a multitude of fluctuating responses - some
more apparent and others perhaps more subtle - at any given moment: these
inevitably influence our feelings, moods and inability to continue life just as
before. Many variables will influence
our personal experiences of grief (I say “experiences” as grief is
surely not a single experience, let alone a “condition”).
These variables might include, for example: the depth of the relationship to the person
who is missed; whether or not there are unresolved conflicts (perhaps
intensifying regret and a sense of guilt); the time spent together (different,
but perhaps equally devastating for the young partner who has just got engaged
as for the one separated after 50 years together); whether the death was sudden
or the end of a protracted illness and much suffering (where there may also be
a strong sense of ambivalent relief too); whether an elderly person who has had
a full life has died or a young child who has been robbed of the opportunity
for a full life.
So grief is a response, or rather, a spectrum of changeable
responses: certainly not a fixed “condition”.
And the way I experience and express (or even have difficulty
expressing) my grief is integral to who I am and will, albeit subtly, vary in
intensity and expression. I am not, as
you will have guessed, enamoured with simplistic notions that try to reduce the
complexity of human emotions and behaviour to neat categories or stages.
Is there then a point at which grief can be deemed
pathological - “complicated grief” that is a “chronic debilitating condition”
that needs to be “diagnosed and treated”?
In our culture it would usually be a doctor who makes this decision: call
me naive, but I wonder why, as I can’t see that grieving is a medical
condition. Ah you say, but we have to
intervene (a word used time and again professionally to justify statutory
actions) as the person may resort to suicide.
As shocking as this may sound, suicide may be a reasoned - and in the
circumstances, a reasonable choice - though not in keeping with our cultural
preoccupation with forever trying to look young and hoping to postpone the inevitability
of our death.
To decide that so-called “complicated grief” needs to be
treated with so-called antidepressants seems to misunderstand grieving. Antidepressants might (I say ‘might’ as
people respond in varied ways to this family of drugs) give a person some
distance from their emotional pain, bearing in mind people sometimes speak of a hazy detachment
when taking these drugs. Is that really
the answer? You may think so. I am not sure detachment (and disengagement
emotionally) are the best ‘medicine’ when you may be feeling more alone than
ever.
I began to understand grief quite differently when I lost someone
very dear to me. At that time something
died in me too – and without a doubt, I was never to be the same
again. I realised for the first time
that the experience is not simply mental but affects us in every way – for me
it was very much a physical heart-rending experience too - and the depth of
pain was beyond my previous comprehension (or current wish to remember). I then took to walking many a mile in the hills
here that I so love - not primarily then for the scenic beauty - but I had to have
expression for that tormenting energy within me. Earlier today, whilst walking with Boris my dog
I stopped at the plaque of my unknown companion who also loved these hills. For me life goes on. And yet, I am still counting the years since my
devastating loss - in a few months it will be 15 years. “Complicated grief”? Certainly complex.
Might it not be preferable to consider how it is for a
person in their darkest moments of grief rather than on considering how we can “treat” that
person? This takes time - considerably
longer than giving out pills - but being with that person, taking time, not
intruding, not being the professional here to help you - but mindful of the
other person. We might then recognise
that the person does not have a medical condition but perhaps a deep sense of
isolation and aloneness, shattered dreams and dashed hopes, fearfulness and a
loss of courage to face life again. Can we
really “treat” these aspects of a person’s life? I think not.
