Updated: Apr 22, 2022
In A World Gone Half Mad With Grief And Outrage
“It’s our unexpressed sorrows, the congested stories of loss, that, when left unattended, block our access to the soul. It’s about how sorrow carves riverbeds in our soul, deepening us as it flows in and out of our lives.”
— Francis Weller, The Wild Edge of Sorrow
Mike Ko | Snoqualmie Falls, Snoqualmie, United States | Unsplash
Death & Dying & Our Grieving Ways
Opening up to the common wound
When the darkness all ‘round us is deep — in a world dangerously asleep, we suffer in such a world — we who’ve awoken to a different real. A separate reality.
This is not to judge the sleeping still resting within their comfort zone, but it’s harsh on those who wake up, like Neo, to the bitter truth of what this western world really is these days.
This is not to say we lived and died, exulted and grieved, differently in past lifetimes. Indigenous Celts, Norse and so on certainly had profound and deep rituals that reached into the very womb of the earth and the heart of the stars. But something dark happened in at least the past 200 years as we well know, and the good magic was slaughtered and the truth reviled. And thus resiled.
Yet still extant, the truth speaks from hidden places.
Although our almost unbearable sorrow may sometimes have no words, with no way to express the feelings, the swelling emotions from deep within, yet having a witness to hear, to listen to our grieving is endlessly and profoundly healing.
And so, we wait for the village to come to us as we suffer silently, or sob loudly, wailing or wordless in our grief.
And yet these days, it often does not come, our village simply does not come…
“I Grieve” | Peter Gabriel
The Shock of Grief
“To speak of sorrow works upon it moves it from its crouched place barring the way to and from the soul’s hall.” ― Denise Levertov
There's no doubt about it, the shock of grief places us in an altered state of reality perception. Grief is always around us, permeating the air we breathe and the environments our soul moves within.
Our soul has many powerful and deep longings in how we should live and how we could die, and why shouldn't we fulfil these?
The longing for love to surround us when we move into our period of transition, if we’re passing in a natural way and not through any violent wrenching accident that might takes us suddenly and unprepared.
We have that longing.
The longing for those of us who are left behind after such a loss to have a circle, a village, a tribe, a community, to hear us and for us to hear that we’re not alone, others are going through their own aching, painful emotions, finding it hard to be here but not wanting to go, such thoughts as these.
The building of a very new kind of relationship with the beloved one who has left us, rather than ‘letting them go’.
When someone else’s life ends so does ours — the life we once knew that felt so stable and solid is suddenly gone — our world pulled out from under our very feet.
We have another kind of ‘near-death-experience’.
Rachel Naomi Remen speaks of weaving the loss into and through our life, honouring and respecting the pain of our loss, no matter how large the loss or how small it may seem. And of not comparing the size of our losses, because all have experienced loss, everyone and all.
The need to find our own indigenous roots to succour us, and to believe that it’s not just the African or Native American who have such wonderful traditions, so too do the other indigenous communities.
It’s time for indigenous to mean all people, whether they feel they’re an alien from another world or from here from the beginning, ultimately we have all finally become indigenous to the earth.
Indigenous means ‘originating or occurring naturally in a particular place; native’. (Oxford Dict.)
Reclaiming our own Indigenous roots
“Indigenous peoples are the holders of unique languages, knowledge systems and beliefs and possess invaluable knowledge of practices for the sustainable management of natural resources. They have a special relation to and use of their traditional land.” — UN definition
Iwant to imbue these writings here with passionate com-passion — to somehow convey the urgency for this planet and ourselves to ALL see ourselves as indigenous — star-seeds, alien beginnings or not — for now we have all the earthly elements through and through our entire being, mind body and soul.
You may, as many do now, identify yourself with alien beginnings. But it’s seriously time to own our many lifetimes here. We are as old as the beginnings of time and matter, and yet even older still. We are as old as God. For that is our birth. Right.
We don’t need to learn how to be indigenous from the ancient stewards of this planet.
We ALL have an ancient heritage as deep and profound as the African or Native American. And sadly, often as bloodthirsty and violent, as well as spiritual and blessed.
However the ‘native’ people’s do have much to teach as many are still close to their rituals and medicine and sacred ways, where western man tore itself apart from this heritage.
But once you seek, you will find your shamans and prophetesses, priestesses and priests, medicine men and women, spirit dancers and sacred two-spirits — as an integral part of each and every culture.
Yours included. Whatever it may be.
The west forcefully turned its face and heart away from its own indigenous heritage, and others who remember have reminded us all by now. And it’s high time to turn back. To what is good.
To what truly feeds our soul and others and feeds the earth and the Spirits and our Ancestors.
Holding back the tears
“Depression is when your soul refuses for you to go any further until you have expressed all your sorrow, all your grief” — Weller
I’ve always seen some of the aspects of depression as an unconscious intention to hold a lid on a pressure cooker of emotions, which when loosened, release hot torrents of tears, anger and grief. The effort to hold this lid on such a bubbling cauldron of emotions is incredibly exhausting and debilitating.
But the fear of the pain, of what lies within, that it might be too unbearable for one soul to carry, is the fear that fuels that intention of avoidance.
And weeping and grieving is exhausting, the pain can feel overwhelming and unspeakable, but those who don’t allow such catharsis through, well, this can create ongoing emotional and physical health problems.
If the feelings are unable to be released verbally or through weeping, then metaphor is a wonderful tool — expressing deep and wrenching feelings through dance, art, writing — poetry and paintings.
These symbolic means of releasing powerful blocked emotions allow the natural flow to begin once more in what might be felt to be safer way by the individual, yet ultimately deeply therapeutic.
Solitude may be needed, as may the comforting arms or shoulder of a loved and trusted one, for a moment.
Yes grieving itself is tiring but it’s movement though us like a stormy river should not be dammed nor censored. Revelations arrive as the grieving is unlocked.
But this time of vulnerability holds a deeply innate medicine.
When tears and emotions are withheld, both the heart rate and blood pressure escalate, and the medicinal balm of tears return the body to a state of homeostasis, releasing a natural opiate from within our body’s system. This allows the person in grief to then rest and even sleep once more, as this internal numbing arrives after the release.
‘Some researchers have hypothesized that the release of stress hormones like leu-enkephalin [when weeping] may help regulate the body or bring it back to a homeostatic level.’ — Reena Mukamul
The weeping can be a turning point for a depressed person. But grief contains more than sadness, it holds our anger, despair, outrage, and other powerful reactions to the world. Are we grieving the loss of a loved one, or the dying of a world we love?
Is the grief we feel all about the person we have just lost?
Or does it hold all our griefs, brought together once more in a monumental realisation of what seem to be almost uncontrollable feelings? In truth our grieving is a labour of love, we give birth to understanding of what the soul really is, and what the body really is.
These realisations are awe-inspiring and terrifying — yet not.
And all these things are rememberings — because none of us are stupid. We know, so please don’t let anyone treat you like a fool, because you’re not, and such treatment is derogatory and a debasement of the majesty and grandeur of who and what you really are.
We’ve been ‘round the planet more than once, and even more than a few times.
Some of us choose to forget, but we need to appeal to our deep emotional and intellectual intelligence, our knowing and let the remembering begin. Of how it was, how it is, and how it could be again.
But the truth is we often don’t feel any immediate relief from weeping, for those who can, and in fact the opposite may feel true for a while, where we feel even more exhausted and dilapidated than before….
But just allow this process to continue in its own way and time-frame, as it is debilitating to grieve, but after a time, your energy will pick up again.
So the hidden metaphysical prescription within this process is this:
Give It Time.
Healing Circle | Artist unknown
Circles of Grief
“Tell me about despair, yours, and I will tell you mine.” — Mary Oliver, Wild Geese
Azul Valerie-Thome speaks of composting the grief into something that brings life once more. Her experience in these groups are of immense quality of connection and heartful openings that last and last way beyond the event.
Where we sit in circle and share what’s sitting heavily within our heart, the burdens of our soul.
Such communal grief-sharing groups can be held in the embracing warmth of darkness or in dimly lit spaces. And as Joanna Macy says, what people are most needing to hear is inside them — their own inner voice, their own inner knowing.
And yet as Valerie-Thome states with such heart, the human need is to not always be grieving alone, but to be witnessed heard and understood — identified with, even. In this, great healing is found.
In such a safe warm place, we can begin to tell the truth about our world — the world within us and without us — and my God we have such a right to grieve it all.
The outer world is all in such a mess, our inner world suffering so deeply. Why not weep for a time?
Michael Lerner, founder and director of Commonweal, speaks of a skilled and experienced person, someone who can skilfully hold the space, without attempting to do healing work and simply allow the talking stick to be passed around the circle and each one to be heard who has a need to be heard.
A group of people all weeping simultaneously, is an incredibly powerful experience of sitting together in the ashes of what’s been lost. It’s the balm for the common wound, the shared unspeakable agony.
There’s a powerful natural magic in speaking our despair. Once voiced, we don’t remain in that place, it shifts the energy. When we lose the fear of our own pain and suffering and that of others, and of the world — then we’re empowered and freed of its grip.
This is the beautiful paradox.
Grief is a harsh initiation, a very rough road, we feel ripped and torn by its jagged edges.
But know and remember this — we are the medicine. So — be the medicine!
Wandering in the wilderness: mad with grief
“All is welcome here.” — Azul Thorne’s sign for Grief Composting Circle
The First Noble Truth of Buddhism about life is Duḥkha (Sanskrit:दुःख; Pāli: dukkha) — suffering… there is so much suffering, this is the first Truth. Although some say this translation doesn’t quite convey the very subtle meaning of the word and prefer to leave it wordless.
And isn't this the very nature of true grief and suffering, a wordless feeling that cannot be described, and should not be, even.
Grief is a storm.
A firestorm, or tsunami. Either way we can survive it, though we feel we’re either burning or drowning, held down in the depths by its merciless dark taloned wings.
And in fact, your grief may not in this moment be about the death of a loved one, but the loss of your home in a real firestorm or flood, the loss of a loved and needed job, the loss of a friendship, a heartbreaking betrayal, a razor-sharp meanness — it’s any loss that cuts deep.
But death — the death of another takes us on an unasked for journey into the unknown and the unseen.
And the truth is we’re all destined for the Promised Land, but we need to take this rout to get there. And it’s terrifying.
Let’s admit it.
The spectre of our own mortality and forthcoming death, at some unknown date, time and way, rearing up in our face, is also a large part of our grieving for the very real loss of someone’s beloved presence from our life.
When I die…RUMI Armand Amar & Lévon Minassian — “Araksi artassouken” (The Tears of the River )
When I Die
when my coffin is being taken out you must never think I am missing this world don’t shed any tears don’t lament or feel sorry I’m not falling into a monster’s abyss when you see my corpse is being carried don’t cry for my leaving I’m not leaving I’m arriving at eternal love when you leave me in the grave don’t say goodbye remember a grave is only a curtain for the paradise behind you’ll only see me descending into a grave now watch me rise how can there be an end when the sun sets or the moon goes down it looks like the end it seems like a sunset but in reality it is a dawn when the grave locks you up that is when your soul is freed Have you ever seen a seed fallen to earth not rise with a new life why should you doubt the rise of a seed named human have you ever seen a bucket lowered into a well coming back empty why lament for a soul when it can come back like Joseph from the well when for the last time you close your mouth your words and soul will belong to the world of no place no time
~ Rumi ~
It’s visceral, it’s the smell of dust on the rain
“Tearless grief bleeds inwardly.” — Christian Nevell Bovee
Grief holds us and wants us to travel alone. For a time. The pain of grief is visceral, not purely emotional. At times you feel it travelling like ice cold glass through your veins.
Bringing up any old pain you’ve put to the side, anything you haven’t dealt with will arrive, along with the mountain of pain you’re already feeling, like iron chips to a magnet.
It all comes in like a howling wind that cannot be escaped.
And as the Earth and Heavens do when a great and humble soul leaves, they often put on a show.
When someone we love dies, the relationship is not over.
It just changes. We speak in different ways now. Silently from our heart. And they hear and answer in often surprising ways. They visit us in dreams, or connect through songs on the radio.
Birds fly suddenly beside us for a time as we travel on the highway. For some it’s butterflies.
You just know. Messages come.
And when someone dies suddenly, often part of the grief can be about the unresolved business in the relationship.
With seemingly any opportunity for any resolution gone.
But this is not really so.
Grief has its own time frame.
Never let anyone tell you how long you should grieve. Don’t let them pathologize your pain. It stays and goes in its own time. With no predictable rhythm or rhyme. We do not grieve in straight lines: grief denial anger acceptance.
It’s no linear process. We go around in crazy circles and cycles. We cannot see where the light is or even the tunnel.
But our life continues inexorably and we finally learn to laugh and live again. In our own way and in our own time.
A deeply personal process.
Hungry Souls and Angry Ghosts
“The Lord said: It is the men of sinful actions actuated by their previous misdeeds who become ghosts after death. Please listen to me, I shall tell you in detail.” — Garuda Purana, Vedas, verse 2.22.
Buddhist, Taoist, Hindu, Sikh, and Jain texts all describe wrathful demonic entities who are certain dead folks cursed with an insatiable and ravenous hunger or thirst, tortured and tormented with cravings to be ever unsatiated. This manifestation of such an evil afterlife for them came about through their misdeeds in life, and is karmic in nature, according to these scriptures.
Dwelling in dim and shadowy realms they obsessively seek the type of food in accordance with their karmic debt, their hunger never to be fulfilled.
In Japan the Jikininki are cursed to eat corpses and the Gaki to eat fecal matter, and in Christian lore, the Grigori are tormented creatures with no mouths, displaced souls eternally wandering and seeking nourishment they can never devour.
The Chinese spirits of certain dead ancestors become Hungry Ghosts ‘compelled to return to the earthly realm during the seventh month of the Chinese Lunar Calendar in August. These ghosts can eat human food, and offerings of cake, fruit and rice are commonly left out for them, while amulets are worn and incense is burnt to protect against those with evil intent or insatiable need.’ (Heaphy)
The living are warned about these wandering dead spirits whose intent can be to steal the Chi — the life-force — of the non-vigilant and unsuspecting human.
Their relentless cravings are spoken of as never able to be satisfied, and can also be intent on stealing the actual body of any weak-willed human — kicking out the residing soul, in order to possess it and live within it. They’re not immune to feeling frozen by icy cold or burnt by scorching heat, so it seems their existence is an eternal hellish torment.
The difference between the damned and these suffering creatures is that they dwell in the world of the living, whilst the damned are confined to dank subterranean domains.
The Hungry Ghost in Buddhism is an analogy, a symbolic representation of those who are ‘following a path of incorrect desire, who suffer from spiritual emptiness, who cannot see the impossibility of correcting what has already happened or who form an unnatural attachment to the past.’ (Heaphy), and can also indicate a seemingly uncontrollably addictive nature, including drugs and alcohol and so on.
The Western Hungry Ghost arrives with the thinning of the veils in the time of Halloween, when not only do the souls of our beloved loved ones come through, but this crack between worlds can also allow in more malicious spirits with evil intent.
Placing candles to guide the loved ones back home is also designed to repel and ward off the more nasty spirits that might seek entry.
But all is not totally lost for these sad and broken creatures — they can be saved and it’s the living who can help them in this way.
Offerings made to them in ritual, including pouring water on their graves can assuage their terrible hunger and thirst, and this loving kindness can eventually lead them to the light once more.
The 5 Gates of Belonging | Azul Thome
Francis Weller: The Five Gates of Grief
Francis Weller spoke at the Minnesota Men’s Conference in 2013 about The Great Forgetting — being ‘suffused with the sorrows’ of the ‘earth grief’, but in the sad cultural expectation of us grieving alone, ‘we fall into the two great sins of the culture — amnesia and anaesthesia’ — of ‘forgetting and going numb’.
He breaks down the roots of the word ‘anaesthesia’ into its origins of ‘without beauty’, where the things that would usually attract us into life have lost their quintessential attractiveness — and we lose our taste for life…
And thence the loss of real grieving becomes a vacuous emptiness rather than an experience of encountering ‘beautiful and strange otherness’. Our soul craves the sacred majesty of deep grieving and is thwarted by this cultural short-circuiting.
We anticipate, yet do not allow ourselves to accept nor admit what we desperately wish for and need to receive.
The exuberant and wonderful familiarity of our existence on this planet, which comes about through the multitudes of other lifetimes here, is damped down by the mockery of the sacred with which all milestones are now greeted.
Powerful milestones, which in past times were recognised and beautifully ritualised, are instead mocked and scorned, losing their validity and becoming a travesty in the eyes of the mockers.
Our grief then also becomes a shameful thing — to be buried away in the deepest recesses of our psyche — hidden and completely ignored. We need to grieve the loss of loving of our own lives, just as much as we grieve death, for it’s one and the same thing, in so many ways.
Yet the numbness and the forgetting. .. how could this hidden pain not then fester and become an illness, a disease of the soul?
Yes, this is where many now go. Medicating the pain, shutting down the cultural shame. And then the entire culture becomes ill. For the body and soul always seek to relieve itself of any internalised pressure and pain.
But it’s not always that way.
Many cultures still embrace their very old elders, the dying, the sick and the disabled as a sacred part of everyday living.
Youssou N’Dour | I Bring What I Love | Griot
A Return To Grace
Whilst still here with us, beloved Elder Sobonfu Somé spoke of embracing our grief, and the urgency for us all to develop a new relationship with our ways of grieving, and that the future of our world depends greatly on the manner in which we handle our grief.
She said that “positive expressions of our grief are healing. However, the lack of expression of our grief or its improper release is what is at the root of the general unhappiness and depression that people feel, all of which lead to war and crimes.”
Sobonfu spoke of healing the grief of our world through consciously building spaces to grieve — “grief rooms and shrines in public spaces where people can go to grieve.”
She believed and taught the world that communal grieving — openly and publicly grieving — is an incredible way to open up to a profound level of healing, through the “validation, acknowledgement and witnessing” such an experiential sharing of pain and suffering can offer.
Her husband, Dagara Elder Malidoma Somé believes the role of grief and sacrifice in ritual life, particularly many days of water rituals, “simultaneously cleanse and pacify, while drawing people down from their daily lives into a kinship of ancestors.”
Wisdom Film | Elizabeth Kübler-Ross | “Unconditional Love”
“I’m going to dance in all the galaxies.”
Ilearnt decades ago about Kübler-Ross’s Stages of Grief. How Grieving is not linear but mostly haphazard, yet still has clearly defined phases within the chaos of pain. We don’t always go through all those stages — and she was the first to say this — but we may identify with much of what she says. It all made sense and still does.
A great pioneer of her time, working in palliative care she noticed many things.
And with her innate sensitivity and thoughtfulness, and her great spirit and intellect, she wrote these insightful thoughts and observations down to educate and teach the world.
Speaking yet of sadness, hauntings, dreams, isolation, and healing, she outlined the 5 Stages in somewhat this way (with my own interpretations added in):
It didn't happen. I see them everywhere, in a car just now, then walking on the other side of the street. I know it was them. Someone’s not telling the truth. It’s some sort of awful and weird conspiracy designed to totally do my head in. It’s a sadistic game someone’s playing with me. They’re hiding from us, from me anyway. They’ll be home soon.
Dear God what have you done?! It’s not the right time! It never will be! What?! How could they?! How could they leave us and at this particular point in time?!! What were they thinking?! Thoughtless! Heartless! What about me?! And anyway it’s all a damn lie! It’s the damn truth! It’s this! It’s that! It’s everything but!
Dear God — if I don’t do this thing again, or I drop that habit, or I don’t think such angry thoughts, sometimes even a little murderous but not really about them, will you bring them back to me? I promise! I promise I’ll be good! I know you took them from me because of me! Because of something I did or thought, or you think I might have thought even if I didn't! But I didn't mean it! I’m really really sorry! Please believe me! You can bring them back now!
Nothing I do will ever bring them back. That last conversation we had, or didn't have. .. damn I stuffed up our last ever opportunity to make things perfect between us…I should leave this planet too as I’m not fit to remain. I shouldn't take up space here, they should be here, not me. I’m useless hopeless good for nothing…nothing will ever feel good again. This pain will never go away. I just want to curl up in fetal position inside a woolly blanket in the dark and hide away forever. Maybe that will make it all go away. This unbearable grief. This pain will never end. It’s a life sentence.
Well, I’ve cried and sobbed ‘til my mind went numb and my head felt soggy. I’ve wept ‘til kingdom come and back again. I even screamed in the car with the windows up and the music turned up loud. I punched the pillows on my bed — no one gets hurt that way. I wrote them letters, then I burnt the letters and sent them out to sea. With flowers and candles. I know now they’re gone and not coming back, but — I call and call, and sometimes they reply. In their own way. And often they don’t.
I’m settling. The wrenching agony is shifting. I felt the sun on my face for a brief moment today and the breeze against my skin and in my hair, ruffling my blouse, and something shifted, even momentarily. I let myself feel ok for a second. I even laughed (a little) guiltily at a joke. I’ve made a little altar for them with all white things — their photo in a frame with white shells around it, a sweet white candle, a glass of scotch for them(I know they’ll like that!), a lovely white rose, with a beautiful white lace cloth underneath it all. I light the candle and talk to them there. I even feel heard sometimes. Maybe I will be ok again. Maybe I will.
David Kessler, who co-wrote On Grief and Grieving with Kübler-Ross (now deceased), now says his own understanding has evolved even further since that initial time of such illuminating insights, but also feels their original teachings were often greatly misunderstood. This is the risk all ground-breakers take. The reactions they get from the ignorant.
He needs to know how many their teachings really helped. How they helped ground so many in their great suffering, and to understand a little of the confusion chaos and pain they were going through. And helped them to get back into their skin again, and their feet on the ground, if you know what I mean here.
Providing, very much so, a warm bright light at the end of the dark blackness of a seemingly endless tunnel. And a way through it all.
Yet I think he does know. As does Elisabeth.
Kessler now talks of a Sixth Stage of Grief, and it’s interesting that Rachel Naomi Remen also speaks of this in a separate work — that of ‘Finding Meaning’ in what’s happened. And this is NOT the trite New Age saying that ‘everything happens for a reason’ type of meaning, she’s quick to point out. It’s about stumbling through the darkness and grasping handholds where we can until we manage to bring in some meaning from it all.
I will not place an interpretation on this 6th Phase — of Finding Meaning in the terrible losses. For it’s up to each and every one of us to reach this place in a powerful inner understanding not coloured by the words or thoughts of others.
We deepen and our heart breaks over and over ‘til we find some measure of peace or even grace within the outrage of the loss.
TAKE ME HOME — Home Funeral & Death Midwifery by Sacred Crossings
The Sacred Passage End Of Life Death Doula
These gorgeous heartful midwives of our passing — we must honour and respect their vocation, for it’s a sacred and blessed calling.
They approach what’s still a taboo conversation for many in a fearless, and yet open-hearted and warm way.
The shock most of us would experience if receiving a terminal prognosis (and we all have an eventual terminal prognosis at some point — no-one gets out of here alive, as they say) and yet having the time to prepare and plan for a a graceful transition as possible, in all the ways we might hope for — is all available and here for us all now.
The Death Doula, or End-of-Life Doula, arrives to bring emotional, physical and psychological support (medical support is not one of their roles). This can be in hospital or at home.
So — now we have these dear Doulas to love us through our transition and open the door to being surrounded by love, rather than sadly alone in our last hours.
What else could we wish for?
Well we could wish to be able to paint our own eco-coffin in any way we please, and our ashes to be sent to sea in a flotilla of flaming lotus candles, or our body to be the place for the roots of a new tree to embrace.
We could wish for sweet music to be lightly playing as we pass — with live muso’s or via technology.
We could open the windows and curtains to a feel breeze on our skin, and the sun on our face if we so desire. We could choose our favouritest floaty light clothing to enhance our emptied body with grace and beauty.
We can pass with our hand being lovingly held and our tears acknowledged as we go through to the next world.
Our soul naked and sacred yet clothed in light.
It’s all there.
Pathologising Our Pain
I received this urgent missive via email a few years ago — a deeply concerned message from a panel of psychotherapists who work in the grief and loss field, about the psychiatric ‘bible’ DSM V’s new inclusion of the pathologizing of grief to a mental disorder, from a natural process that has its own time and its own reason…
‘The caution here? Be wary of physicians or other medical professionals who rush to prescribe anti-depressants to address your grief. Here’s a better prescription: Mourn the death of your loved one in your own way. There’s no prescribed formula. You may cry; you may not.’ (excerpt)
I am writing with some sense of urgency (not bad news) to both inform you of an outcome from my work group (International Work Group on Death, Dying and Bereavement) in Canada and to ask you to ‘come on board’ with the distribution of this information.
As you may know, DSM-5 was released on May 22 and in it there remains some disturbing, misleading information re bereavement.
In essence it enables, even encourages the diagnosis of depression 2 weeks after the death of a significant person.
We have seen that the drug companies have continued to fund the ‘research’ and stand to make between 100–500 billion .. yes billion, from the sale of drugs which will be inappropriately prescribed. I was fortunate enough to be in a work group with 10 very esteemed and learned colleagues, the names of whom all appear at the bottom of the attached op-ed from us.
As a small group we worked for 5 days on the topic ‘The Pathologizing of Grief’ and realised we could do nothing to redirect the flow set in motion by the drug companies, we also realised we have little influence on those most likely to prescribe the medications (who, after all, are doing what they believe and the drug companies and quasi research is telling them is best).
So we decided we are best to clarify the issue, empower bereaved people and hopefully invite the media to take up the issue.
The pharmaceutical companies complain about how much they spend on research yet they spend 19 times their research budget on advertising and persuading health practitioners to prescribe their drugs, in spite of the data to the contrary.
The article is reprinted below. If you are concerned about bereavement becoming diagnosis and treated as an illness, I invite you to read it, consider it (and the wealth of knowledge and concern shared by the authors) and, if you agree with the content, please distribute it as far and wide as you can. Email it to friends and colleagues, copy it for conference attendees, use it for discussion groups amongst concerned professionals.
Mal Mckissock OAM Bereavement Care Centre
This statement was developed by a workgroup at the meeting of the International Work Group on Death, Dying and Bereavement in Victoria, British Columbia on April 28 — May 3, 2013. You have full permission to translate the document into other languages, and to distribute it via websites, blogs, the media, and other venues. It is our intention that the message be shared widely:
When does a broken heart become a mental disorder?
Rarely, if ever.
But don’t tell that to the American Psychiatric Association, which has just released its fifth version of the Diagnostic and Statistical Manual of Mental Disorders.
The DSM is a catalogue of mental disorders, hundreds of them, each trailing a listing of symptoms.
The manual informs selection of a diagnosis, which is required by U.S. insurance companies for reimbursement for mental health care.
There’s a major change in the newest version, DSM-5, with serious implications for the millions of people who are coping with the death of a child, spouse, parent, friend, or other loved one.
But first, a quick glimpse at the history of this publication, often referred to as the bible of psychiatry. The very first edition, published in 1952, didn’t even refer to grief, considering it an accepted and normal reaction to the death of a loved one.
The third edition added an exclusion statement under Major Depressive Disorder, referred to as the “bereavement exclusion.” Under this exclusion, a diagnosis of Major Depressive Disorder could not be made for a full year after a death.
They recognized that normal and common reactions to the death of a loved one could look like symptoms of depressive disorder, for example, sadness, disturbed sleep, lack of concentration, changes in eating, and loss of interest in things that were once pleasurable.
In 1994 the 4th version of the DSM reduced the bereavement exclusion to two months after a death, and this new version removes the bereavement exclusion completely, meaning in effect that anyone can receive a diagnosis of Major Depressive Disorder two weeks after the death of a child, parent, spouse, friend, or anyone.
Why does this matter?
For at least three reasons:
First, normal reactions to the death of a loved one will be easily misclassified as the mental disorder depression.
Grief is not the same experience as major depressive disorder. It is not an illness to be treated or cured.
It is a healthy response to a painful reality that one’s world is forever altered, and will never be the same. Absorbing this loss, and adapting to all the changes it unleashes, has its own unique course for every person, and will not be stilled or stopped by quick fixes or simple solutions.
Death is a life-altering event
But grief is not a pathological condition. Second, antidepressants are commonly and frequently prescribed. There is a strong likelihood that newly bereaved people will qualify for a diagnosis of Major Depressive Disorder just two weeks after a death even though their reactions are normal.
Antidepressants have not been shown to be helpful with grief-related depressive symptoms, and there is accumulating evidence of long-term negative effects of being on antidepressants.
We need to ask why psychiatry is pathologizing grief and therefore making inappropriate pharmacological treatment easier.
And we should not overlook the self-interest of pharmaceutical companies who see a new and substantial market for antidepressants, currently a multi-billion dollar industry.
Third, about 80% of prescriptions for antidepressants are written by primary care physicians, not psychiatrists.
We have the expectation that physicians, as well as psychologists, social workers, and clergy, to whom many of us turn for help after losses of all kinds, have professional training, solid research backing, and supervised experience to guide them. Some do, but in fact, a considerable majority of practitioners with these degrees have no professional training at all in responding to the bereaved.
The caution here? Be wary of physicians or other medical professionals who rush to prescribe anti-depressants to address your grief.
Here’s a better prescription:
Mourn the death of your loved one in your own way.
There is no prescribed formula. You may cry; you may not. Your reactions will be shaped by many things: the relationship you had with the deceased, your personality style, and the support or lack of support you receive from others.
Push aside those who tell you to move on, that every cloud has a silver lining. What one person finds comforting might not work for another.
Find friends and family who understand, and with whom you can share your experience.
If they won’t listen or help, or if their help is not enough, search for support groups through your local hospital, hospice or community organizations.
Don’t be afraid to seek professional help, but if you do, ask about the person’s training, qualifications, and experience with grief, loss, and bereavement.
We grieve as deeply as we love. We can get off track with love, and we can respond to our grief in ways that aren’t healthy, or don’t serve us well.
But let’s not make love, or grief, a mental disorder.
This document was written by a group of concerned professionals in response to the release of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders ( DSM-5).
Thomas Attig, PhD, Professor Emeritus in Philosophy, Bowling Green State University
Inge B.Corless, RN, PhD, FAAN, Professor, MGH Institute of Health Professions, Boston, MA
Kathleen R. Gilbert, PhD, Executive Associate Dean, Indiana University School of Public Health, Bloomington, IN
Dale G.Larson, PhD, Professor, Department of Counseling Psychology, Santa Clara University, CA
Mal McKissock, OAM, Director of Clinical Services, Bereavement Care Centre, Sydney, Australia
David Roth, Executive Director, Puetz-Roth Funerals and Grief Companions, Bergisch Gladbach, Germany
Donna Schuurman, EdD, FT, Executive Director, The Dougy Center for Grieving Children & Families,Portland, OR
Phyllis R. Silverman, PhD, Scholar-in-Residence, Women’s Studies Research Center,Brandeis University, Waltham, MA
J. William Worden, PhD, ABPP, Psychologist, Laguna Niguel, CA
We would like to acknowledge the International Work Group on Death, Dying and Bereavement (IWG) for the opportunity to develop these ideas. This statement represents the opinions of the authors, not the opinions of the Board or membership of the IWG.
Thank you for taking the time to read this. We are seeing far too many bereaved people diagnosed as depressed and treated with medication. It’s time for action.
Mal Mckissock OAM Bereavement Care Centre
Where it’s up to now (DSM V)?
DSM 5, published in 2013, still includes a condition of Persistent Complex Bereavement Disorder (PCBD) codable as a “severe and persistent grief and mourning reaction” in “Other Specified Trauma- and Stressor-Related Disorder” 309.89 (F43.)
This was seen to be the most controversial change from DSM-IV to DSM-5.
The deep concern is of the pathologising of persistent grief and the over-prescribing of anti-depressants when other non-medical options might be available. I myself have seen enough real psychosis in my professional life and work to not be anti-meds for certain psychotic disorders, and yet, this (new in 2013) diagnosis beggared belief. It went against all rational and humane thinking.
Yes bereavement and grief can precipitate a depressive episode. It’s my very strong belief that depression is NOT a life sentence, and should not be painted as such in the medical profession.
We can see there are many who support this belief beside me, and we’re still battling to overturn the bizarre pathologising of a powerful grief and loss process that could be approached in so many other ways.
So many other ways.
So where are WE are up to now…what needs to still happen? This is the $64,000 question we need to answer and address through our ongoing and powerful commitment to positive change of opening, and continuing to open, the dialogue about natural death and grieving processes being fully integrated into all our global communities.
Homecoming is almost always the end of every ritual, every suffering, every painful initiation. And if it’s not, it should be. It signifies a very significant milestone reached, a historic landmark moment, a sacred cairn of rocks marking this most notable place on your remarkable journey.
Homecoming is the warm spiritual embrace at the end of such an initiatory journey.
Yes. Death is an initiation too. Our most momentous initiation of all. It’s freedom from earthly suffering and the final liberation. It’s our very real Return to Grace. To Love. To Truth. And to God.
Wisdom Film | Thich Nhat Hanh | “The End of Suffering” | The Great Bell Chant
REFERENCES & RESOURCES
‘Un-Mothered’ We have not ‘lost’ our mothers. We say that to be polite, but in truth, we have become un-mothered. medium.com Home - EKR Foundation Learn more about the Elisabeth Kübler-Ross Foundation on our home page. The EKR Foundation is a volunteer-based… www.ekrfoundation.org www.un.org › esa › socdev › unpfii › document The Bereavement Exclusion and DSM-5: An Update and Commentary The removal of the bereavement exclusion in the diagnosis of major depression was perhaps the most controversial change… www.ncbi.nlm.nih.gov
Mads Schmidt Rasmussen | Unsplash
Copyright 2020 © Julie Von Nonveiller Cairnes. All rights reserved.
I first published this in MEDIUM on Jun 16 2020, and on FB a few years prior....
None of my messages are about other people (ie 'celebrities' and so on) - no matter what they might think - these come from me, to you my friend, for your soul upliftment