Healing the pain of bereavement

Coping with grief caused by the death of a loved one can be a long and painful process. Although most Indonesian communities frown on open displays of emotion, counselors and the bereaved tell The Jakarta Post contributor Prapti Widinugraheni that confronting and undergoing the process of grieving are essential for people to accept the death and be at peace with themselves.

JAKARTA (JP): For the grieving, one of the hardest things to do is to be honest with themselves and admit their pain.

But it is the first thing they must do in starting the process of healing their hurt, says Andar Ismail, an associate professor of Christian education at Jakarta Theological Seminary and a pastor at Samanhudi Indonesian Christian Church Jakarta.

"Many people don't admit that they are grieving, they pretend that they aren't. They smile, talk about other things and won't cry. It's like having a wound on your arm, and the way you are trying to heal it is by covering it with a sleeve," he says.

Honesty is essential and should not be hindered, even by the consolation taken from religious or cultural beliefs.

"Religious and nonreligious people alike must be honest with themselves. By quickly consoling oneself with words like 'I must be grateful because the deceased is now with God', the bereaved is resorting to 'cheap' consolation," he said.

Many people are unaware of the psychological damage caused by these forms of consolation, which are conditioned within society and religion. Dyah Astuti, 32, a typical middle-class Indonesian, lost her father to a heart attack in 1996, her father-in-law in mid-1998 and had a stillbirth later that year.

"When my father died ... I only cried softly because from a very young age I was taught to be close to God and believe that if you die, you go to a happier place and so I should be thankful. The first thing I did when he died was pray and I felt a bit better."

The first time she started feeling depressed was when relatives around her started crying -- and she found herself taking on the role of comforter for others.

"It was particularly difficult for me because as an eldest child, I felt it was my duty to give strength and consolation to my mother, younger sisters and grandmother, all of whom were very close to my father. So there I was, consoling people when actually somebody should have been consoling me."

Dyah's way of handling the situation is nothing unusual in Indonesian society. Society, culture and religion often lead people into thinking that grieving is a sign of weakness, so they maintain a front of being strong.

"Grief is not a sacred thing. Leading a happy life does not mean you always have to be bright and cheerful. It is also knowing that you can be sad. Imagine if you could not be sad -- you would be like a stone," said Andar.

Sharing

Apart from being honest with themselves, grieving people must dare to share their grief with others, but Dyah has found this hard to do in the case of her father's death.

Even now, five years on, she still has not completely overcome the depression from his death and only finds solace through her baby daughter, born three months ago.

After talking at length, she finally admitted there was something about her father that only she knew. But she refuses to reveal the information or talk about it with anyone.

Experts agree this is extremely unhealthy. Opening up and sharing grief is crucial in the healing process. While this may be easier for grieving people who are generally open and expressive, Andar says it would also help to have people around the bereaved who are willing to listen and who do not discourage conversation on the topic.

Experts said the reaction of people dealing with the death of loved ones can be summed up in several stages, although they may not necessarily go through all the stages, or follow the same order.

Psychologist Monty P. Satiadarma says these stages involve:

* an attitude of disbelief, denial and an unwillingness to accept the fact of the death;

* a feeling of anger, which in most cases is evoked by a feeling of being "left behind" by the deceased, or, in some cases directed toward God who is seen responsible for the situation;

* an expectation to be able to bargain, primarily with God, by promising to do something as long as the deceased can be brought back to life, or as long as an incident leading to the death could be altered (usually this starts with the words "if only ...");

* depression, first arising from a feeling of helplessness and later from the feeling of loss and, sometimes, from a feeling of self-created guilt (such as feeling that the deceased would not have died if he or she had been taken to the hospital sooner);

* acceptance of the death, which is the healthy final stage indicating that the bereaved person is ready to go on with life.

Psychologist Agustin Sukarlan said that if this last phase is reached then the bereaved person is healed.

"At this stage, grieving individuals can see the death as a test of life which they have passed and which has strengthened them. But if they are stuck at the depression stage, then special support, counseling or medication may be needed."

Interestingly, she said the Javanese tradition of slametan (thanksgiving ceremonies) for the deceased may, consciously or not, relate to these stages. Ceremonies are held at three, seven, 40, 100 and 1,000 days after the death, which more or less match the time frame for the stages of grief listed above.

"The way these slametan are held implies that we are dealing with God, but at the same time gaining moral support and prayers from neighbors."

Healing

Counselor Liena Suwito says the degree of grief and the time needed for healing depends mainly on the emotional relationship between the bereaved and the deceased during the latter's lifetime. The closer the relationship, the greater the feeling of loss.

"Some people repress their feelings and find it difficult to share their grief with others," she said.

Counseling may be needed in such cases because behind the facade of sadness, there may still be unexpressed feelings of regret, guilt, anger or the presence of unfinished conflicts. Counseling should help do away with such negative feelings and replace them with reconciliation and forgiveness.

Agustin warned that people who should be grieving but act like nothing has happened should be of concern to those around them.

"He or she might be having a delayed response. The person may pretend to be strong, but later end up excessively depressed. This is much more unhealthy mentally."

Another aspect determining the degree of grief, according to Monty, is the process of dying. A chronic illness may prepare family members better in dealing than a sudden death.

Experts agree there is no scientific proof that men and women react differently when faced with the death of a loved one. But in many cases society, culture and religion require that one gender -- usually the male -- act "stronger".

"In many Indonesian societies, it is taboo for men to cry in public. Thus, males have more difficulty in handling sadness in this sense," Monty said.

This is physically unhealthy, he points out, because tears contain toxins that should be released from the body. This secretion is part of the body's natural defense system which is triggered every time a person is faced by a "life-threatening situation" -- in this case it is the stress and unpleasantness that comes with grief.

"Many people are mistaken.: It's important to cry and should not be seen as weakness," Andar said.