“How did we even get here?” I heard this question come out like a bullet wrapped in frustration, sorrow, and fear; shot aimlessly into the open air, from clients seeking psychotherapy from me in the last month. Could it be a coincidence that my clients who are total strangers shared the same rhetorical question with me in our sessions?
All of them came from different backgrounds and have had different life experiences. Some of them were mourning the bereavement of their loved ones due to COVID-19, some were recovering from the infection, some were caregivers to their significant others or family members in recovery, and some had not been physically affected by the virus. Yet, all of them had the same question in mind. Another similarity amongst them was that none of them was expecting an answer. This bullet in their heart just needed a release.
This rhetorical question comes from deep seated emotions of grief. Grief, as per the American Psychological Association (APA) may manifest itself in forms of physiological distress, sadness, sorrow, confusion, yearning, obsessive dwelling on the past, apprehension about the future, remorse, and so on. If not addressed rightly and on time, this grief may lead to complicated grief, a condition more severe than the average loss-related life transition of depression and anxiety. Distinguishable from depression and anxiety, it is marked by broad changes to all personal relationships, a sense of meaninglessness, a prolonged yearning or searching for the deceased and a sense of rupture in personal beliefs beyond six to twelve months of bereavement. Complicated grief may become life-threatening through disruptions of the immune system, self-neglect, and suicidal ideations.
But the question remains, why are people who have not witnessed death or even had a positive COVID-19 infection in their family, experiencing grief? What makes total strangers ask the same question? The answer lies in the larger connection among them - the human connection!
The COVID-19 nimbus clouds have rained on all of us, albeit unevenly, everyone has been drenched. Grief comes from a sense of loss, and in this pandemic, everyone has lost. We have collectively lost our attachments.
According to John Bowlby, a pioneer psychologist in the area of attachment theory, human beings have evolved as social beings whose extended dependency on caregivers primes us for deeply rooted attachment bonds, not only in infancy, but also throughout our lives. We rely on these ‘attachments’ as a safe haven at the time of threat, and as a secure base for exploring the world. Starting with caregivers, we may develop attachments within various facets of life including our ‘self- narratives’. We script our own character with a certain social and personal identity, including job, status, relationships, cognitive beliefs. We base our current and future behaviour based on this perception of ourselves. Like an infant with its caregiver, we develop an attachment with our self-narratives. Sometimes sticking to these narratives may cause us to experience anxiety and distress, but loyalty to even our toxic caregiving narrative, may bring with it a certain sense of masochistic pleasure. We adhere to our narratives even though they might put us through excruciating distress because there is a certain sense of familiarity established with them that we are unable to let go of. According to Robert Neimeyer, an expert in the field of Grief, self-narratives may be disrupted when:
a. We encounter life events that are fundamentally incompatible with their plot structure, as in a violent or untimely loss due to suicide, homicide, a fatal accident, or a natural disaster.
b. When traumatic life events contradict the themes of our narrative, they may lead to ‘shattered assumptions’, a theory propounded by Professor of Psychology and expert in the field of trauma, Janoff Bulman. According to her, these shattered assumptions may call into question our basic assumptions i.e., of a world that is fair or predictable, the universe being benevolent, and the self as competent and invulnerable. The worldview’s primary function is to provide the individual with meaning, self-esteem, and the illusion of invulnerability, the shattering of which may provoke anxiety and physiological reactivity that is characterized by Post Traumatic Stress Disorder (PTSD).
COVID-19 with its fifty feet, humongous body covered in black thick fur, the head of a spider and ten large legs, as described by one of my clients in a visualization exercise, has not only separated innumerable persons from their caregivers, but has also separated all of us from our narratives. It has walked ruthlessly over the plot structure and themes of our narratives, leaving us with ‘separation distress’- making us feel like a child, lost in a fair. This is not just an individual experience of Grief; it is Collective Grief.
Coping with grief
Once we understand that our grief stems from the loss of control over our self-narrative, it is imperative to introspect which part of our narrative has been forcefully altered. For example, for Ray* (name changed), it was his narrative that hard work pays off, which was suddenly jolted. After years of giving his best efforts to his company, he was laid off. Arti*, after seeing the cascading deaths all around her, lost faith in her narrative of the world being a safe place. Jamil*, struggled to come to terms with not being able to save his wife’s life, a vow that he had made to her and to himself. Which plot or theme of your narrative do you find disrupted? The answer to this question could be the stepping stone to your journey of coping with grief.
Continuing bonds of attachments
Our attachments are dear to us, and the deepest pain comes from the thought of bidding them goodbye. However, does breaking attachments need to be perceived as excruciatingly painful endings, or can they be accepted as a new continuation of your narrative? Rather than bidding adieu, perhaps we could nurse our wounds with a new dawn, aiding them to grow in new directions of strength and resilience. This could mean that rather than saying ‘goodbye’, we say ‘hello again’, an idea propounded by Michael White, the founder of narrative therapy. For instance, you could write a letter to a lost job, someone you have loved and lost, or whichever aspect of your narrative you have lost, about what you have learned or gained from them and how that will forever remain of enduring value to you. This exercise could be performed recurrently over time. Maintaining continuity and reconstructing rather than relinquishing the bond can restore the attachment security that was challenged by loss.
A hidden and suffocated physical wound may never heal. It requires air, light, care, and medicines to repair. Emotional wounds are no different. Every individual has their own way of grieving, just like their unique narrative. Psychologist, Elisabeth Kubler-Ross has described in her grief model, the different stages of grief one may find themselves at namely - denial, anger, bargaining, depression, and acceptance. For instance, Radhika* who lost her romantic relationship during the pandemic, stayed in denial for the longest time, thinking that they will get back together soon. Later, there was anger towards her partner and the pandemic, how both these factors had no consideration for her emotions. Radhika also had phases when she tried to bargain with the universe that she would trade anything to get her relationship back. Hurt and disappointed, she had a long period of endless breaking down and sadness. And, after a long natural battle with grief, she finally accepted the sense of loss.
Each individual may not necessarily go through all these stages of grief, and perhaps not in the given order, and that is okay. However, whichever stage you may find yourself at, what is required is for you to embrace your emotions sans judgements and to let yourself soak in them. This may fill your mind with questions, thoughts, and overwhelming emotions. Feel free to pour them out in creative ways concurrent with the theme of your character in your narrative. For instance, if you identify yourself as a talker, then talk your heart out to your significant others or a professional. If you are a writer, write; painter- paint, dancer- dance to the hitherto beats of your grief. Express!
Search for meaning
“Life offers purpose and meaning, but does not promise fulfilment or happiness.” Victor Frankl’s logotherapy, and his experience at the Nazi concentration camps is a big testament to his quote. It echoes that life may throw unprecedented traumatic events at us, however, these events may also be doors opening for us to discover new meaning and purpose, whether we wish to explore it or not, is our ‘free will’, as Frankl terms it. Those who dare to open these doors and explore the hidden meanings behind them, may find it to be an efficient way of coping with grief, in finding new directions to their narrative. Some helpful ways to do this may be to
reflect on what could be the different interpretations of your loss;
how this loss may have affected your direction in life; and
how in the long run you imagine you can give meaning to this loss in your life.
These, as Frankl suggests, may be ways of exercising your free will and taking ownership of your life story.
Is it okay to be okay?
Shyamoli*, was grieving the loss of her husband of 23 years, she was speechless when I asked her this very question, “Is it okay for you to be okay?” Her narrative of being a loyal and devoted wife, perhaps held her accountable to her protracted grief, which she was unable to overcome after six months of her husband’s demise. Similarly, Ibrahim* who finally got a month’s time with his wife and two-year-old daughter, after being let go from his job, felt that he was betraying himself while answering my question, “have you found any unsought gifts in this grief?” Because the idea of being a stay-at-home father was at loggerheads with his narrative of him being the provider and protector of his family.
An important aspect of coping with grief may include looking at the self in the mirror and saying, “it is okay for me to be okay,” and reflecting on:
-the unsought gifts this grief may have gifted you with,
-what lessons have this loss taught you about yourself and others, and
-has this difficult transition deepened your gratitude for anything which you’ve been given?
The child lost in a fair
While we strive to continue writing our self-narrative with the help of the above perspectives, the separation distress experienced by the child in us, as if we are lost from our parents in a crowded fair, may bring us pangs of anxiety and panic. In different people, it may be seen in two different dimensions depending on their dominant attachment styles :
a. Attachment anxiety: This may be often expressed as dependency and over-activation of the attachment system. For instance, even as years pass by and the child in us grows up, we may have trouble acknowledging a loved ones’ unavailability causing us to feel panic and anxiety. To compensate for the anxiety, we may often find ourselves desperately and constantly seeking support from others.
b. Attachment avoidance: This may be expressed as the deactivation of the attachment system and emotions in general. For instance, in this case, the child over time tries to consciously avoid loss and failure by avoiding intimate relationships in order to reconcile with the internal model of her loved ones’ absence.
As we journey through this phase of grief, it is imperative to take care of the child in us and to provide them with secure attachments. Grief is a difficult and time-consuming journey that can neither be travelled alone by avoiding support as seen above in the attachment avoidance style, nor by overindulging in it as in the attachment anxiety style. So, as we prepare ourselves for this journey, striking a healthy balance between giving and receiving support from the self, as well as others, maybe an effective mantra to embrace. Remember, overcoming grief is a journey and not just a destination. And the perfect journey involves just the right number of companions - not too many, not too less.
Akhila R has a Master's in Clinical Psychology from Tata Institute of Social Science (TISS), Mumbai. She is a Practicing Psychotherapist with six years of experience. Her therapeutic interest lies in working on areas of Grief, Trauma, Relationships, Personal Development, and Mental Health concerns.