Problems

There are several problem situations with the expression of grief that may cause the helper anxiety, but are not dangerous.

Acting out. This is difficult to distinguish. But some people do enjoy being carried away by an enthusiastic expression of grief, to the point where it is being used as a safety valve that prevents the tension building up for the expression of a less socially acceptable emotion—usually anger, but sometimes joy (a hidden pleasure that the mourned person is out of the way). Unless you are a counsellor or therapist, it is not up to you to decide whether the emotional expression you are witnessing is this kind of acting out. But, of course, you have a right to evaluate your own involvement in the situation. If you sense something phony or unreal in the person's grief, you may not feel like helping. On the other hand, the acting out may turn into a more genuine expression. A long period of wailing may not get anywhere, but if it turns to sobbing, the feeling is real. A rule of thumb is to follow the basic principle of taking the person seriously. Follow the progression of the emotion, at least for a while.

Self pity. Like acting out, this may try your patience. Since self pity is a normal part of grief, it can be encouraged at first, but if it continues for a long time and you feel yourself getting angry, it may be worth at least getting some of your anger out briefly. This may bring out any underlying anger in the person as well. Don't use your own anger manipulatively. Be yourself, and be guided by your own feelings. But remember that if you are in an EFA situation, you owe it to the other person to restrain your own feelings if they threaten to take up more space than the other person's.

Freezing. See the earlier section on distress. This may be a serious condition. If several attempts at contact with a person who is seriously frozen do not work, leave the person alone. Don't become angry—the freezing is often covering grief so acute and deep that the person cannot share it without opening feelings of disintegration or dying. In some cases, a stubborn freezing contains elements of angry provocation—the person is waiting for you to make angry attempts at contact so that self-pitying crying or anger can be justified by your actions. If you sense this, don't take the bait. But again, if you do not know the person well, it is best to play safe by taking them seriously.

Where you feel the freezing covers a serious grief or pain, you can give passive support by remaining near the person and being available for whatever they may need. If you occupy yourself quietly with your own business, rather than attack the person with incessant smothering attention, he or she may thaw out and ask for something.

Endless hysterical sobbing. Where sobbing involves convulsive movements of the chest, a full discharge of the emotion will eventually occur. In cases of severe loss and mourning, the sobbing will only stop when the person is exhausted. Cover the person with a blanket, or put them to bed. Infinite patience is needed.

Choking. If the person's throat becomes seriously constricted, accompanied by choking sounds, encourage them to turn the choking outward; they can take a towel, or your arm, in their hands and 'choke' it by twisting their hands hard and maintaining the pressure while breathing in and out. This action tends to release the constriction in chest and throat.

Emergency. See the section on panic in Chapter 5, Fear, for any situation where the person is agitated and mobile while being self-destructive—for example, running around the room and crashing into objects. Self-destruction in grief is usually aimed at either the head or the chest area, where the pressure of emotion bursting toward discharge is too great. The person may, even while lying down, attempt to bang their head against a wall, as if breaking the head open will relieve the pressure. Or they may tear at their clothes or skin in the region of the heart where they feel bursting sensations, as if they could tear open a way for the pain to come out. If there is no medical help immediately available and the person is beginning to do themselves physical damage, you are justified in taking serious measures:

—Restrain the person physically. If it is difficult to hold them still in a protective embrace, try to maneuver them to a bed or the ground and hold them lying down on their front. Lie over their back with your chest if you can do this without exerting a crushing weight.

—If the person is silent but struggling, try to encourage them to yell; this will provide an exit valve for the energy that they feel as bursting. Pinching the cheeks firmly between the fingers and thumb of one hand may provoke yelling, and does not cause damage.

—If there is a period of calm in which the person is able to accept your instructions, ask them to stick one finger down their throat until they gag. Have them do this several times. They will probably not vomit, but the gagging relieves the anxiety and the bursting feelings.

—Try to channel headbanging toward a soft surface, such as a pillow. This is better than trying to stop it.

—If the person is tearing at his or her clothes, make sure they are loose around the neck.

This is short term emergency. In some cases a long term emergency occurs, especially where mourning after a death or a personal loss continues over several months. The person may become exhausted from days of sobbing, the muscles may ache, and there may be no appetite.

This is a difficult problem. In certain primitive societies, mourning is institutionalized and there is a tradition of support from large numbers of friends or relatives and of help and sharing in discharges of grief. In our technological society, mourning tends to be treated as something which should be eliminated. Tranquilizers are used as a kind of chemical surgery of such 'negative' emotions as anger, fear or grief, although unfortunately cutting these emotions out of the organism cuts out much of the capacity for joy and pleasure as well. Some people go onto tranquilizers after a death or separation or marriage break-up, and never come off them. Others, when they do come off after some months of tranquilizers, seem to be haunted by feelings of emptiness and guilt. Or else they plunge again into the emotional crisis which the tranquilizers leave temporarily suspended. A similar situation occurs for many mothers after childbirth in which extensive anesthesia has been used: the person has existed or survived through an event rather than lived through it. Post partum depression (or rage) is routine.

Thus, our society does not provide a good context for longterm emotional support. (Such a context, for example, might be 'half way houses' for people in emotional distress, in which they could share their emotions with other healthy people without being diagnosed as ill.) Unless such support is available, the person may have to seek or be referred to medical help—which means, in effect, chemical help. You may feel guilty about encouraging a person in this direction, but you have to honestly assess your own capacity to help. If continuing emotional support of another person in distress threatens your own emotional health, you should feel free to try to find others to share the task with you. You can either let your own emotions emerge, or you can restrain them. Of course, restraint is often necessary and not harmful (see Chapter 5 on Anger). But continuing restraint does not eliminate an emotion. It simply turns it inward. The danger of long-term care for someone else is that you may feel consumed by repressed anger and frustration. No matter how much you love a person, you must be able to take at least some breaks for yourself. If they love you, they will understand this in spite of their own distress.