The essence of mourning and its different varieties and possible consequences

The state of template mourning consists of a kaleidoscope of feelings and sensations such as grief, sadness, a sense of loss, emptiness and pain. Typically, mourning occurs as a consequence of the death of a loved one – a family member or friend. It is a condition that occurs not only in humans, but also in other social animals – those that have a limbic system in the brain responsible for emotional reactions1. For humans, proximity to other people is a trigger for opioid receptors, which are responsible for pain relief. When a person is deprived of this special closeness, he or she feels a certain kind of pain.

Grief can express itself in many forms and take on different intensities depending on the person. Some people are in mourning for many years openly showing sadness and despair. Others suffer intensely, but for a short period of time. Still others seem to reconcile with their bereavement almost immediately – they abandon their sorrow and grief and take on new challenges and enter new relationships. Often the way the last group of people reacts raises doubts in their surroundings. People around them begin to become suspicious of the authenticity of the individual’s emotional state, believe that the person is hiding something or trying to avoid pain.

Due to the variety of ways of experiencing mourning, researchers wonder which types of mourning are within the norm and healthy response, and which are outside the norm. In 1993, psychiatrist Mardi Horowitz described the behavior of patients who experienced bereavement in maladaptive ways. According to his observations and interviews, these patients experienced intrusive thoughts about the deceased person, experienced strong negative emotions and feelings of avoidance. The European ICD-11 classification of mental disorders distinguishes a disorder called Prolonged Grief Disorder, which results from the loss of a loved one and is characterized by intense emotional pain2. The type of pain in question may consist of sadness, guilt, anger, denial, failure to accept the loss, a sense of acute loss, emotional numbness, difficulty engaging in social life and other activities. According to the above manual, in order to diagnose the described disorder, symptoms must be present in the individual for at least six months.

In the American DSM-V classification of mental disorders, bereavement is the body’s normal and predictable response to a stressor, which is the loss of a loved one3. The manual does not distinguish between adaptive mourning and mourning that constitutes a non-normative state. However, following the model of the disorder described in the ICD-11, the new version of the manual will include a unit called Prolonged Bereavement4. Interestingly, the current American classification proposes several mental disorders that can be diagnosed in an individual after the loss of a loved one. One of these disorders is the Great Depression – diagnosed two months after the loss of an important person and manifested by disturbed general functioning, suicidal and psychotic thoughts, slowed movement and a sense of utter worthlessness. The second such disorder is Post-Traumatic Stress Disorder (PTSD), which can be diagnosed after the sudden loss of a loved one, accompanied by such symptoms as unwanted and recurring thoughts about the loss, avoidance of circumstances reminiscent of the event, and excessive agitation.

Grief and sense of loss in the context of the Covid-19 pandemic

In the context of the Covid-19 pandemic, one can speak of two types of mourning.

First, many people go into a state of sadness, a sense of loss and grief after the actual loss of a loved one who died due to the coronavirus. What’s more, these people may go through mourning differently and in a more complicated way than people in pre-pandemic mourning. This is due to specific conditions resulting from restrictions imposed in connection with the global epidemic. According to researchers, factors that favor the development of maladaptive, complicated mourning are social isolation, elevated levels of anxiety and the loss itself of a sudden and unexpected nature5. As is well known, the global pandemic has helped intensify the above risk factors.

Secondly, a large group of people are experiencing a strange, hard-to-describe set of feelings due to the change in living conditions resulting from the introduction of new rules for operating in a pandemic. In an interview published by Harvard Business Review, loss specialist David Kessler describes how a significant portion of the population goes through six stages of grief during a global epidemic6. Kessler co-authored the book “On Grief and Grieving: Finding the Meaning of Grief through the Five Stages of Loss” with Elisabeth Kubler-Ross, founder of the website, and also works with people in professions that experience traumatic events and disasters. In the aforementioned interview, the specialist declares that people affected by the toll of a pandemic experience many difficult feelings, including grief and a sense of loss. The researcher realizes that everyone sees and feels that the world has changed – temporarily – but to a great extent. According to him, people feel a collective kind of sadness caused by the loss of normalcy and relationships with others, as well as fear of economic losses. According to Kessler, today’s societies experience several types of grief – including “expectant mourning” – feelings of uncertainty, anxiety and sadness about what bad things might happen in the future (they experience this when, for example, they think about the death of owning parents in the future). In today’s reality, people experience the state of being in a global epidemic feeling that something bad is happening – something they cannot see. According to the researcher, people perceive the pandemic as a kind of specter that robs them of their sense of security. According to him, in order to cope with disorienting feelings, people should recognize that they are experiencing a kind of mourning and understand its phases. The first phase of such pandemic mourning is denial (denial) – e.g., “Covid-19 doesn’t affect me, I won’t get sick.” The second phase can be referred to as the stage of anger (anger) – e.g. “They are forcing me to stay out of the house and give up my daily activities!”. The third stage is the so-called “bargaining” stage – e.g. “Okay, if I keep my distance for two weeks, the pandemic situation will improve, right?”). The fourth step is sadness (sadness) – e.g., “I don’t know when this will end, it’s so depressing.” The fifth phase was called the acceptance (acceptance) stage – e.g. “The pandemic is really happening. I need to determine how to proceed.” With this step, a person regains a kind of sense of control over the situation, which positively affects the mental state – it brings composure, calmness. Kessler adds another step to the process of dealing with grief. He calls it making sense of the situation (meaning). The researcher stresses that it is good to give meaning to a challenging context. Making meaning can be done, for example, by appreciating modern technologies that make it possible to maintain contact with people, or by paying attention to activities that the pandemic has triggered (such as increasing the frequency of walking).

As Kessler says, the sense of grief is often accompanied by pervasive anxiety. Such anxiety is not adaptive and is different from fear, In the case of feelings of fear, the threat is real, and the emotion it evokes, although unpleasant, helps the person avoid a particular stimulus. Anxiety, on the other hand, is an emotion that arises not in response to a real stimulus, but as a result of abstract thoughts and imaginings. When people feel anxiety about a pandemic, disturbing thoughts enter their mind (e.g., “I imagine my parents will get sick from Covid-19”). The key to dealing with these thoughts is not to laboriously push them away, but to find imaginings from the opposite pole (e.g., “We all get sick sometimes, but that doesn’t mean everyone I love will die”). Destructive thoughts about the future can also be contrasted with objective thoughts about the present. This method draws from mindfulness philosophy and meditation techniques. When the mind begins to be filled with exaggerated negative thoughts about the future, it is worth directing one’s attention, for example, to the objects around one and their properties – the hardness of the table one is sitting at, the softness of the sweater one is wearing. Using this mindfulness technique, it’s worth breathing deeply and step by step realizing the reality by appreciating the positive elements of one’s situation (such as having food and livelihood, not being sick). Another way to cope with thinking about the sadness and suffering that may follow is to remove responsibility from yourself for events you can’t control by focusing on activities you can actually undertake (e.g., realizing that “I have no control over whether the person on the bus covers his mouth and nose while traveling, but I can wear a mask and disinfect my hands often”). Another important action you can take during this difficult time is to arm yourself with understanding and empathy toward others. A compassionate attitude toward an irritated or depressed person will not hurt anyone, and may even help an individual struggling with suffering.

Grief and sense of loss associated with the Covid-19 pandemic in adolescents

Adolescence is a developmental stage in which an individual is extremely vulnerable, and many aspects of his or her life undergo significant changes. Adolescents mature from a biological (changes in hormone levels), cognitive (changes in thinking and problem-solving processes), emotional (expressed, among other things, in engaging in risky behavior) and social (involves independence from parents and identification with a peer group) perspective. In addition, it is during adolescence that identity is formed exceptionally dynamically. Adolescents ask themselves questions like “Who am I?” seeking a stable, consistent and integral sense of self, different from the identity imposed on them by their family environment. The process of identity formation is particularly challenging for young people in the 21st century because of the multitude of available identities that can be adopted.

The above transformations of a child into an adult that take place during adolescence can be seriously disrupted by situations of loss. A young person who experiences a loss (whether of a loved one or an opportunity) must face not only the challenges of adolescence, but also a certain kind of mourning for the loss. Moreover, according to the researchers, young people seem to go through grief in a different way than adults. It turns out that teenage mourning is more likely to be misunderstood. Sadness, suffering and grief in response to loss during adolescence are seen as something that interferes with a young person’s search for identity and requires a teenager to radically say goodbye to a childish self-image in favor of a self-image as an adult.

Research supports the hypothesis that experiencing bereavement visibly disrupts adolescent development. Grieving adolescents who do not receive adequate support are more likely to experience difficulties in the workplace, have lower academic achievement and ambition than their peers, and appear more susceptible to physical and psychological disorders – such as depression.

In addition, the impact of bereavement on adolescents’ mental health is facilitated by the specific stage of neurodevelopment they are in.5 Adolescents are exceptionally intense in their sensation-seeking, as it is powerful experiences that are able to activate the “reward and punishment” system in their brains to an appropriate degree. As it turns out, the described system is involved in the process of mourning, which can become something like an addiction. Mourning people often return to memories associated with the lost person because these thoughts are pleasant. Unfortunately, seemingly positive memories are nowhere near reality. The profound discrepancy between pleasant fantasies and unpleasant realities causes great suffering for the bereaved. The described contradictions are often experienced by young people who have lost someone close to them. It is the young who tend to recall strongly pleasant memories of the deceased in order to activate the reward system.

Overall conclusions

The main purpose of the article was to introduce readers to the issues of bereavement and loss that often arise during pandemonium, especially in the context of young people. Bereavement can be understood in two ways – as sadness and grief after the death of a loved one, and as depression, confusion and a sense of loss caused by missed opportunities and dark visions for the future. Both the first and second processes follow a similar pattern (6 stages of grief according to Kessler). The conditions created by the Covid-19 pandemic and the associated constraints are conducive to the development of both types of mourning. Since a profound sense of loss, especially to a pathological degree, definitely deteriorates the quality of human life, appropriate steps should be taken to help society cope with it. Good practices for coping with bereavement can be the techniques proposed by Kessler, such as becoming aware of the happiness of the steps of the grieving process, mindfulness, or practicing thoughts from the opposite pole.

Literature cited

1 – WEINSTOCK, Louis, et al. It’s complicated-adolescent grief in the time of COVID-19. Frontiers in Psychiatry, 2021, 12: 166.

2 – PRIGERSON, Holly G., et al. Prolonged grief disorder: psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS medicine, 2009, 6.8: e1000121.

3 – BONANNO, George A.; KALTMAN, Stacey. The varieties of grief experience. Clinical psychology review, 2001, 21.5: 705-734.

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5 – MASON, Tina M.; TOFTHAGEN, Cindy S.; BUCK, Harleah G.. Complicated grief: risk factors, protective factors, and interventions. Journal of social work in end-of-life & palliative care, 2020, 16.2: 151-174.

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