Grieving at a social distance

It was a day I would never forget. I passed my online viva; although it was a sign of the socially-distanced times we live in due to coronavirus (COVID-19), it was still a time to celebrate after years of hard work training to be a counselling psychologist. A few hours later, I received the news that a dear relative in New York, United States had passed away from COVID-19. Other relatives in New York were also seriously ill or had lost their lives to this disease. Everything I achieved earlier in the day faded into insignificance. Normally I would have booked the soonest flight, but as with the rest of the world, being in lockdown meant we were all in our homes grieving at a distance by means of video communication technology such as Zoom and Skype. 

Although it is a process we all must go through at some point in our lives, we are in unchartered territory when it comes to grief. All cultures place an importance of being surrounded by loved ones and religious and spiritual leaders in mourning (Keeley, 2017). However, unlike loss in normal conditions, government rules on lockdown and social distancing of mourners have disrupted funerals in nearly every culture and faith. In order to limit transmission of the virus, many people cannot attend wakes, cremations and burials (World Health Organization, 2020); these are now broadcast online. Thanks to technology, the bereaved still have a shared experience of mourning in their homes. But we are also dealing with our own personal challenges of prolonged quarantine while in grief. Despite being digitally connected, it is still easy to feel powerless and disconnected wherever in the world you live – it’s not the same, but it’s all we have for now.

Freud’s (1917/1957) paper Mourning and Melancholy outlines that the pain of mourning comes from separation of our internal attachment to the deceased. As we mourn, it is generally agreed that we go through several stages. Popular examples are Kubler-Ross’ (1969) five stages of grief: denial, anger, bargaining, depression and acceptance, and Parkes’ (1965) states of numbness, yearning, searching, disorganisation, despair and then reorganisation. Although it is debatable whether all these stages occur and whether they occur in succession, they speak of mourning as an initial resistance which eventually leads to re-evaluation of a new relationship with the deceased. But the lack of a physical experience with other mourners and the body itself can be confusing to navigate. Families who are coping with several losses at the same time can also feel anxious, yet separated from the experience of mourning. Although we have become increasingly reliant on technology to maintain some form of human connection, how does an individual come to terms with loss without experiencing that they are physically gone? At this point in time, we are not sure… and it is normal to feel this way. 

‘Successful’ mourning assembles the concept of loss while maintaining a meaningful connection and the ability to re-engage with daily activities and connect with others (Shear, 2012). But this process is not always smooth, especially in these unsettled times. Complicated grief is a form of prolonged bereavement marked by distress in accepting and making sense of the loss (Currier, Holland, Coleman & Neimeyer, 2006). It is the Melancholy in the title of Freud’s paper. It feels as though time has stood still, and the individual cannot see a positive future without the deceased. Funerals are thought to normalise and collectivise the grieving process (Giblin & Hug, 2006), but without the real-life experience of a funeral, individuals may find it difficult to integrate the significance of the death into their self-narrative. Seeing your loved one’s funeral on a screen might feel unreal, as though it was happening to someone else. The deceased can feel present in memories and through reminders in everyday life – a photograph, a song, a birthday or anniversary, a shared hobby or a favourite film or TV programme. But when the constant news and social media coverage generates feelings of anxiety and unsafeness, we then worry about ourselves and other loved ones, especially those who are far away. Opportunities to make sense of the loss may be overwhelmed, and mourning can become static. Safety and security are considered to be fundamental human needs (Maslow, 1968). No-one knows when this pandemic will be over, but while some people will rejoice immediately at re-engaging with life, those experiencing loss may need more time before they feel safe enough to create a ‘new normal’ without their loved one.

Many people, especially frontline workers, are facing unprecedented levels of pressure to stay rational and steadfast while putting their lives at risk, often while experiencing their own personal struggles and bereavements from the pandemic. Despite some mental health practitioners having the option of working online, they also face similar personal challenges. Psychological support has never been more essential, but there is a dearth of an evidence base on grief and mourning in relation to COVID-19, as it is a novel disease. When I have worked with grief in the past, it has mostly involved helping clients to develop and re-integrate a new relationship with the deceased. But where circumstances are unsettled beyond control, this may need more time. A back-to-basics approach of creating a safe, supportive therapeutic space, establishing trust and being empathic, patient and respectful with clients can always serve as an anchor when we are unsure. We as practitioners must also be especially kind to ourselves in these difficult times. Acknowledging our own fears and doubts, monitoring our own wellness, and seeking professional and personal support by whatever means possible all remain important. It is not a sign of weakness or incompetence to say, 'I don’t know'. Client or professional, we are all learning as we go along in navigating a socially distanced world. There is one thing about grief which still stands – there is no time limit, nor is there a right or wrong way.

- Angelina Archer is a Counselling Psychologist in-Training / Doctoral Candidate at the University of East London

References

Freud, S. (1957). Mourning and melancholia (1917). In J. Strachey (Ed.). The standard edition of the complete psychological works of Sigmund Freud (Vol. 14, pp. 243–258). Hogarth Press.

Giblin, P. & Hug, A. (2006). The psychology of funeral rituals. Liturgy, 21(1), 11-19.

Holland, J.M., Currier, J.M., & Neimeyer, R.A. (2006). Meaning reconstruction in the first two years of bereavement: The role of sense-making and benefit-finding. Omega-Journal of Death and Dying, 53(3), 175-191.

Keeley, M.P. (2017). Family communication at the end of life. Behavioral Sciences, 7(3), 45.

Kubler-Ross, E. (1969). On death and dying. The Macmillan Company.

Maslow, A.H. (1968). Toward a psychology of being. D. Van Nostrand Company. 

Parkes, C.M. (1965). Bereavement and mental illness: Part 1. A clinical study of the grief of bereaved psychiatric patients. British Journal of Medical Psychology, 38(1), 1-12.

Shear M.K. (2012). Grief and mourning gone awry: Pathway and course of complicated grief. Dialogues in Clinical Neuroscience, 14(2), 119–128.

World Health Organization. (2020). Infection prevention and control for the safe management of a dead body in the context of COVID-19. Retrieved April 20, 2020, from https://apps.who.int/iris/bitstream/handle/10665/331538/WHO-COVID-19-lPC_DBMgmt-2020.1-eng.pdf.