Psychological Assistance to Relatives of Suicides - Essay Example

?Coping with Suicide: A Real-Life Application of the Kubler-Ross ‘Grief Cycle’ Introduction Scholars have discovered that the length of bereavement differs extensively. There are also conflicting perspectives on which reactions to bereavement are most successful. A number of scholars, like Elizabeth Kubler-Ross, support stage-oriented models of bereavement. This paper discusses Elizabeth Kubler-Ross’s five stages of grief and afterward applies these five stages to suicide, in particular, to Lucy Bennett’s documentary film about suicides in London’s subways, One Under. Elizabeth Kubler-Ross initiated and questioned previously traditional assumptions and practices of dealing with bereavement and death, and gained recognition among health care professionals, the bereaving and the dying, which possibly suggests the degree of inhibition and denial that had previously typified traditional perceptions of the issue (Fall, Holder, & Marquis 2004). As mentioned, the five phases of Kubler-Ross’s grief cycle was created originally as a paradigm for assisting and supporting dying patients in coping with bereavement and death. Nonetheless, the notion also gives ideas and support for accepting the new realities of change and trauma, and for assisting other individuals with emotional coping and change, regardless of the reason (Cavaiola & Colford 2006). The work of Elizabeth Kubler-Ross has presently become tantamount to emotional adjustment to grief or loss, and counseling. Elizabeth Kubler-Ross, a psychiatrist, released in 1969 one of the most celebrated works in the field of psychology, On Death and Dying. The book introduced the five phases of grief, namely, Denial, Anger, Bargaining, Depression, and Acceptance (DABDA). More popularly known as the ‘grief cycle’, Kubler-Ross did not plan this model to be an inflexible chain of chronological or structured stages (Grover & Fowler 2011). It is a paradigm or a model, not a process per se. In other words, individuals do not encounter all of the five phases at all times. Several phases may reappear. Several phases may not be encountered at all. The switching of phases is not a sequence. The five phases are not identical in their experience and outcome. Individuals’ grief is unique (Grover & Fowler 2011). Therefore, the Kubler-Ross model recognises that there exists a distinctive behaviour of spontaneous emotional reactions which individuals experience when trying to cope with trauma, loss, bereavement, death, and so on. The paradigm claims that individuals have to overcome their personal struggle to cope with grief, after which there is normally acceptance of reality. The five ‘grief cycle’ phases are discussed below. First phase is Denial. This phase helps grieving individuals endure the loss. This phase is characterised by denial and shock. Everything becomes unbearable and worthless. Numbness comes in. Shock and denial enhance the chances of surviving the loss and of successful coping. Denial helps in moderating the overwhelming power of grief. Denial is subtle. It is a natural way of allowing only the things that a grieving person can deal with (Lord 2000). As this person comes to term with the loss and begins to probe deeper into his/her emotions, s/he is unwittingly embarking on the process of coping and healing. Strength is regained, and the denial is starting to disappear. However, as this person continues, all the emotions s/he is rejecting start to appear (Doka 1996). Second phase is Anger. This phase is vital to the process of healing. A grieving person should be eager to experience anger, although it may appear never-ending. The more this person genuinely experiences it, the more anger will start to weaken and the more successful is the coping process. It is normal to feel neglected and forsaken (Grover & Fowler 2011). Anger is a force and it can serve as strength, providing momentary order to the emptiness of grief. People are normally more acquainted to controlling anger than experiencing it. Feeling angry is simply another sign of one’s passion (Grover & Fowler 2011). The third phase is Bargaining. Prior to a loved one’s death, a person may be willing to sacrifice everything for the life of his/her beloved. The grieving individual bargains with God. After the loved one’s death, bargaining may become a momentary agreement. A bereaved person bargains with God for his/her recovery from the loss. Grieving individuals may become entangled in a muddle of ‘What if...’ or ‘If only...’ images (Doka 1996). Guilt usually comes along with bargaining. The ‘if only’ visions compel someone to unravel inadequacies in one’s self and what a person ‘believes’ s/he could have acted out in a different way. A grieving person lingers in the past, attempting to bargain his/her way out of the pain (Doka 1996). The fourth phase is Depression. Meaninglessness surfaces in this stage, and grief emerges on a more intense level, more profound that one could ever think of. This depression seems eternal. It is vital to realise that this phase is not an indication of a mental health problem. It is the normal reaction to a major loss (Payne et al. 1999). This phase is quite frequently viewed as abnormal: a condition to be remedied, something to recover from. A loved one’s death is an extremely depressing event, and depression is an apt and natural reaction. It would be abnormal to not suffer from depression after the death of a loved one (Payne et al. 1999). Basically, depression is one of the numerous crucial phases in the healing process. The fifth phase is Acceptance. This stage is usually equated to the idea of being ‘okay’ eventually after a major loss. But this is not true. Most individuals do not eventually become ‘all right’ about a loved one’s death. This phase relates to the acceptance of reality of a loved one’s death and realising that this sudden reality is a lasting one (Grover & Fowler 2011). A grieving person will in no way become accustomed to this new reality, but sooner or later acceptance comes in. In fighting this new reality, many people initially desire to bring back the life they once had before a loved one passed away. Nevertheless, sooner or later, through gradual acceptance, a grieving individual realises that s/he cannot sustain the past unbroken. The bereaved individual should learn to readjust his/her lifestyle and responsibilities (Grover & Fowler 2011). Rather than rejecting one’s emotions, s/he listens to his/her thoughts. A grieving person may begin to build and rebuild relationships. This person tries to regain the life s/he once had, but this cannot be achieved until one have allowed grief to take its natural course. Applying the Kubler-Ross Model to the Effects of Suicide The documentary film by Lucy Bennett, One Under, demonstrates how an individual experiencing grief goes through the ‘grief cycle’. The film suggests train drivers who witnessed a suicide encounter an array of emotional and psychological responses. It reveals the personal experiences of Tube drivers with suicides in the London’s busiest subways. Even though particular reactions seemed to impinge on the professional life of the Tube drivers and other witnesses of a suicide, others were more common, natural responses after distress. Grief responses were revealed. Several confirmed that they were ‘obviously shocked’. Some also revealed having to relive a number of traumatic responses from the past because of the suicide. Denial Most first-hand accounts showed feelings of shock and disbelief toward the end of a suicide. Most Tube drivers disclosed being ‘untrained’ or ‘unprepared’ in suicide situations. One driver recounted how he acted unprepared after a suicide: “I jump down to the track... maybe a pump of adrenalin... I looked at the track and I was kinda hoping that he is still alive since I am barely doing 10 miles an hour.” The driver chuckled after, which suggests the possibility that he knows how absurd he reacted to the situation. Another Tube driver showed denial and disbelief of the suicide he witnessed on Christmas Day: “It was very different. I don’t want to really talk about this. It is far far worse than anything. It was terrible... it was Christmas Day.” The frequently stated responses range from being ‘shocked’ and ‘I wasn’t able to recover immediately from the effect’ of the suicide. Accounts showed denial that suicides are real and can occur. Debbie, a widow of a man who committed suicide in the subway, expressed an initial reaction of denial. She said that when her husband, John, texted her about taking his own life it “seemed unreal” and that John “is not that kind of man.” She doubted that John can commit suicide since “he is funny and kind.” She also expressed disbelief of her sudden reality: “I am a happily married middle-age woman and all of a sudden I lost someone who supported me with everything else.” Anger This reaction was a major issue disclosed, either toward the person who committed suicide and their selves. There was resentment against the person who committed suicide for giving up on life’s struggles and for disregarding the possible impact of their actions on the lives of others. A Tube driver said “suicide is unfair.” He added that “a driver cannot do anything about it. I became scared to drive a train for a period of time.” Another Tube driver admitted that he felt ‘anger’ in the beginning, and eventually added that witnessing a suicide is “so so sad.” He said that “I was just angry... why that day?” The forced adjustment that these witnesses have to undergo and the selfishness of the act of suicide seem to produce this anger. There were remarks, particularly Debbie’s, indicative of anger such as “suicide is a real desperate act.” Quite a few feelings personal incompetence were also revealed. For instance, as stated by a Tube driver at the final parts of the film, “I want to be in control of my emotions.” Being a man, the driver obviously resents the task he has to confront, that is, face the emotional pain of the families of those who committed suicide in the subway and avoid showing any hint of emotional weakness in the process. He said, “When I see the families it upsets me... I saw that and nobody else did.” A few drivers admitted that they felt emotionally and psychologically weak after witnessing the suicides. Bargaining There were some statements reflecting feelings of regret. Some said they would do anything to regain the normal life they had before the suicide incident. Some thought that they could have done something that may prevent the incident and they wanted to go back to that particular time and responded differently to that situation. Some realized how good their life is before the suicide incident and longed for the reversal of the trauma. For instance, Debbie said: “You would wonder for a long time what you could have done differently.” She also expressed regrets for failing to understand John before: “He provides care for adults, which could be tough sometimes. He has very high standards. He was just exhausted... now that I kind of understand... all the wrong things happening at the same time.” Depression Some of the Tube drivers displayed anxiety after the suicide incidents they witnessed. They revealed experiences of alarmed and unnerved reactions, difficulty focusing and sleeping, frightening recollections of the suicide, and anxiety over the possibility of being abandoned or isolated. For instance, the driver who witnessed a suicide on Christmas day said, “I have a huge breakup with my marriage. I kinda lost it. You cannot sleep. You keep thinking of the bodies. I have nightmares.” Debbie felt the same thing when he learned of John’s suicide. She was ‘distraught’. Other terms that came out of the interviews showing signs of depression are ‘terrifying’, ‘panic’, and ‘losing everything’. Acceptance An ultimate issue was acceptance, revealing feelings of relief and forgiveness. Acceptance was mostly expressed by Debbie: “I knew that I have to face reality.” “Running can make me good than any chemical can.” “I am fitter than I used to be.” “I don’t have that choice; that choice was taken away from me.” Even the person who knew Debbie confirmed that she was “overly relieved” and “all the anguish and anxiety are disappearing.” Discussions and Conclusions Nevertheless, abrupt loss, like suicide, is distressing, with consequent disturbing emotions and thoughts and avoidant behavioural patterns. Alongside avoidance were disturbing responses and psychological alterations, which involved feeling anxious, insecure, and apprehensive, both professionally and personally. Particular issues, defence mechanism, culpability, professional inadequacy, self-blame, anger, and disclosed adjustments in behaviour, were enclosed professional responses. These revelations were akin to professional responses from findings of mental health practitioners who work with suicide. Most Tube drivers and others who witnessed suicides in London subways perceive the incapacity to thwart the suicide incident as sign of incompetence, and quite a few feared criticisms, opinions, or blame by other people. Further sentiments of culpability for the actions they carried out resulting in the suicide were disclosed, with experiences of guilt and seclusion afterward, particularly in instances where organisational assistance and support was absent. Nevertheless, finally accepting or coping with the suicide required both defence for their responses and decisions and acceptance of the suicidal person’s actions. Therefore, as suggested in the above discussion, the Kubler-Ross ‘grief cycle’ is more of an ebb and flow paradigm, not a linear one. References Cavaiola, A. & Colford, J. (2006) A practical guide to crisis intervention. Boston, MA: Houghton Mifflin Company. Doka, K.J. (ed) (1996) Living with grief after sudden loss: Suicide, homicide, accident, heart attack, stroke. Pennsylvania: Taylor and Francis. Everly, G.S. (ed) (1995) Psychotraumatology: Key papers and core concepts in post-traumatic stress. New York: Plenum Press. Fall, K., Holder, J. & Marquis, A. (2004) Theoretical Models of Counselling and Psychotherapy. New York: Brunner-Routledge. Grover, R. & Fowler, S. (2011) Helping those experiencing loss: A guide to grieving resources. California: Libraries Unlimited. Lord, J. (2000) No time for goodbyes: coping with sorrow, anger and injustice after a tragic death. California: Pathfinder Publishing, Co. Payne, S., Horn, S. & Relf, M. (1999) Loss and Bereavement. Philadelphia: Open University Press. Read More