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Death, Dying and Bereavement

This is a rough guide of common issues for NLP practitioners to consider when working with issues around bereavement and death. It is not inclusive.

  • Affluent, white middle class, nuclear families tend not to have the extended support networks that working class and ethnic groups more often possess.

  • With the developments in modern medicine and diagnostics, a person who does not even feel unwell may learn that they have a terminal disease/illness. This is a relatively new phenomenon where previously the diagnosis may have come an explanation of a complex set of symptoms. The diagnosed person may have some difficulty telling other people about their diagnosis, especially when the first few react with disbelief or comment on how well the person looks.

  • Where illness has been long and distressing, the surviving relative may feel a complex set of emotions, often beginning with relief. It may be some time before bereavement (sense of loss and longing) sets in - if at all.

  • People respond to the death of a parent differently to that of a child, and differently to that of a spouse.

  • Some people will respond to the death of a pet (esp. cat or dog) as they would a child.

  • The "speed of death" can profoundly affect how the surviving people are affected, as can the mode of death. Where there is particular suffering involved, for example being trapped in a burning building etc, trauma in surviving relatives can be particularly high. Where there is a perceived "purpose" to the death (the "heroic death") perception is often quite different.

  • A sense of injustice can exacerbate problems, i.e. where the person died in a war zone that the survivor has political objections towards, or there was a motiveless crime etc.

  • Where the death resulted from a crime, often details horrifying to the relative will be revealed openly in court and heard by the survivors.

  • Where the survivor attempts resuscitation (increasingly common) they will often replay micro-details of "if only I hadthen he would still be alive." Self-blame and self-recrimination etc is common. Reassurance that "you did everything you could" generally fails and often makes the survivor feel an increase in guilt.

  • Death may occur following particular bad spell in the relationship - the survivor may have thought, "I wish he was dead" or wotnot during this time. Guilt may be high as the argument or disagreement was never given closure. Later, with reflection, the survivor may conclude that they were in fact in the wrong during the difficult times and unable to do anything about it now, suffer a depressive reaction to this.

  • When there is the death of an infant, or a child is stillborn, problems occur for some time after as interested but as yet uninformed parties enquire how the baby is doing.

  • Other people's reactions can be difficult to deal with. For example, one young female colleague of mine received a phone call at work to inform her that her husband has been killed in an accident at work. Six months later, on her first day back at work, an older and well meaning colleague said, "Well dear, at least you are young enough to get remarried."

  • Following death of a spouse, financial burdens can be enormous, especially where there is little in the way of family or social support. Thus the surviving spouse may not only have lost their partner, but faces losing their house and job etc. and experience a change in role as they become recipients of welfare, main child carer and so forth.

  • The dying person often has a problem with visitors who present a number of reactions. Some people (mostly men) take the role of being the morale booster and tirelessly joke etc, others will find endless reasons to stay away or avoid the whole situation, and so forth. Endless "Get Well Soon" can soon become annoying. One patient of mine wrote a note on the end of her hospital bed that read. "I am dying, so I won't be getting well soon, and please don't ask me how I am doing."

  • The feeling of helplessness in others around the dying person can be enormous and can become troublesome. Whilst the diagnosed person may be doing well to come to terms with their own dying, others will clutch to hope that "well, maybe they'll be able to do something" or "maybe they've got the results wrong or something" and so forth.
  • Death can be put into a number of categories:
  1. Expected death - where the person has been ill for a long time and death is expected by everyone.
  2. Unexpected death - where death is not expected, this can be sub-categorised further:
a. Accidental
b. Catastrophic medical event i.e. cardiac event, aneurysm etc
c. Suicide
d. Murder
  • Where the death carries a large media interest, i.e. murder of a child, the surviving relatives can find themselves catapulted into the limelight. They may find themselves having to give media statements, will have to contend with journalists, photographers etc. Yesterday they were a normal parent, today they not only have the death of their child to come to terms with, but they are now a household name and featured all over the news and media.

  • Even years later, the survivor will encounter scenarios where another person may enquire, "Do I know you?" where the initial event itself is forgotten. The survivor finds themselves in difficult positions whereby they may not wish, or it is inappropriate to say, "My child was murdered"