Maté: Denial of own emotional needs and its connection to chronic illness

This lecture is presented on this site because it is a good argument for going to psychotherapy sessions that involve working through emotions and childhood traumatic experiences.

Gabor Maté’s message is an important one. As I write this reflection article, I am experiencing being in a situation which is teaching me an important lesson: I am forced to take a 5-day unexpected break from a hectic schedule I had created for myself. I had an accident. I fell from a deep flight of stairs and escaped with injuries that could have been much worse. Sitting at home nursing a swollen brow and black eye, I am reflecting on how I had wanted this time off for the last couple of months but did not have the courage to put appointments aside. I did not want to disappoint other people.

This accident was no accident but a warning. As a therapist, I knew what was going on in me, but I thought that the rest could wait. Wrong I was.

It is so easy to fall into the trap of self-denial because we are programmed to be so. Maté’s lecture, “When the body says no — caring for ourselves while caring for others”, hits the nail on the head.

Premature ageing due to the stress of taking care of others

2:30 DNA studies show ageing in people who live under pressure.

The preoccupation with the needs of others while neglecting the self is a risk factor for chronic illness.

4:20 A story of the personality of a woman who has breast cancer. She worries about her husband’s emotional state rather than dealing with her illness.

5:31 He reads obituaries of people who died too soon to illustrate the self-sacrificial and self-denying behaviour of people who have died from chronic illnesses.

Dealing with Anger

7:50 The dangers of suppression and repression of healthy anger leads to autoimmune disease and cancer, while going into rages, which is the polar extreme leads to heart disease.

The healthy way to deal with anger is to notice it, accept the feeling and talk to someone who is willing to listen about your anger feelings. Healthy way to deal with anger is crucial to health.

9:55 Mate describes a study from Australia of married women. Those that were unhappy in their marriages and could articulate them were better off physically than those who suppressed their unhappiness. The issue was not about happiness of the marriage but the ability to express the anger underlying.

Hanging on to roles society imposes on you, trying to please everybody, while forgetting to take care of your health can cause deterioration of health and death.

We cannot separate the mind from the body.

14:05 Mate explains to us about chronic illness and the current medical attitude towards these illnesses.

We cannot separate the individual from the environment

16:11 We are shaped by the environment. Environment is not only physical, but also the psycho-social environment. This means that the environment includes the people we live amongst.

To illustrate this, he cites studies where children whose parents are stressed are more likely to get asthma in polluted environment and other illnesses. This is known to be directly as a result of stress since asthma drugs are stress hormones themselves.

We cannot separate ourselves from the mental states of others in our society.

Talking about anger to someone is an important reliever of stress

19:10 Studies of breast cancer patients in Australia found that having a stressor in life AND being socially isolated made the subjects 9x more likely to have cancer. Mate explains that connection with another person, and talking to others about feelings of anger is instrumental to maintaining a healthy life.

Stress from anger is not only mental, stress is also felt in the body. In short term, stress hormones help to escape, long term stress causes chronic ailments.

Amyotrophic lateral sclerosis (ALS)

23:20 Maté explains the possible cause of ALS .

ALS is a neurological motor neuron disease, which strikes usually healthy people, and is fatal. Mate found these patients to have a personality tendency of denying their negative feelings, denying the experience of the self while having the overwhelming need to always be there for others-

27:03 He talks about the story and personality of Lou Gehrig. Gehrig’s name is the name for ALS. His personality of selfless ambition and helpfulness is typical of what Mate considers a personality that is typical of patients with ALS. Lou Gehrig had childhood trauma from growing up a child of an alcoholic.

These are caused by unconscious patterns. Not the fault of the patients themselves.

Unconscious self-denying behaviour is learnt from infanthood.

19:30 Mate tells us his own story of how unconscious factors affect how he too has a tendency of self-denial while trying to protect his mother.

Infants pick up on the stress of the mother and other caregivers. Infants learn to suppress their own pain in order to maintain a relationship with its caregiver. This infantile suppression becomes a memory that is recorded by and stored in the body. It is called trauma.

Making oneself lovable is done by suppressing feelings and denying own needs.

Mind and body are inseparable.

Personality patterns are learnt from infancy. These patterns translate into physical illness.

36:00 Newborns need to establish these patterns to maintain attachment to adults.

Emotional centers of the brain are attached to the hormone system, and the nervous system are connected to the immune system. These systems are connected.

38:40 Mate explains the phenomenon of “gut feeling.

How and why we give up our authentic selves as children

Children read and respond to gut feelings intuitively. Children are born with ability to intuit body language of adults accurately. As we get older, we begin to suppress this gut feelings, and rely on intellect.

41:40 There are 2 great needs of children. One is attachment to the care-giving adults. The other need is to be authentic. This is a need in order to function as an individual human being. In situations where we, as children have to sacrifice our authentic self, because this authentic self endangers the attachment to our parents, leads us to a pattern of having lost touch with our needs and feelings.

Our problem as adults is that we still stick to this need for attachment.

42:48 The Heart-brain Connection predictive activity.

Hence our emotional states is connected to our physical health.

Healthy anger is about knowing your boundaries and expressing it

44:45 Mate demonstrates what boundaries are and how boundaries can be breeched. He explains that healthy anger is necessary for us to communicate to the other that our boundaries have been crossed and to back off.

The immune system is linked to our emotions

The role of our emotions is boundary integrity. To keep out what is unhealthy, and let in what is enriching. The job of immune system has similar roles.

Autoimmune disease is a way of the body attacking itself.

To prevent illness or overcome illness, we need to exert who we are and to say, “no”.

Saying “no” may trigger fears about attachment, but we have to remember that we are adults.

If you are caring for others, you must demand support also for yourself. Ask yourself and reflect on this question: in what situations in your life is it difficult for you to say, “no”.

Methodology in the Study of Psychology

Scientific Methods in Psychology

Psychology has its roots with Newtonian scientists and physiologists, with the term psychology being popularized in the 18th century by mathematician Christian Wolff (1679-1754). Attempts at developing the study of psychology as natural science began with Johan Friedrich Herbart (1776-1841), who theorized that psychological processes could be rendered mathematically. He even developed mathematical equations to illustrate factors governing the threshold of consciousness. His theories were not followed up with empirical evaluations, and were thus not followed through. However, his theories was fodder enough for later psychologists after him, like Freud, who picked up on his idea of repression of ideas and cognitive equilibrium.

Psychology took shape in Germany as an academic discipline at the end of the 19th century with the establishment of an experimental laboratory at the University of Leipzig in 1879 by Wilhelm Wundt. This new discipline was characterized as physiological psychology. While acknowledging the presence of physiological and neuroanatomical processes, Wundt denied that these could reductively explain psychological principles. Wundt’s experiments had a lot to do with studies of sensation and perception, and few studies containing introspective reports. Many of Wundt’s experimental work are precursors of contemporary cognitive psychology. His principle of physical relations, in which he says, “Every single psychical content receives its significance from the relations in which it stands to other psychical contents” (Wundt, 1897/1902, p. 323) became the foundational principle of the Berlin School of Gestalt psychology of Max Wertheimer (1880-1943), Wolfgang Köhler (1887- 1967) and Kurt Koffka (1886-1941) (Greenwood, 2015).

Psychoanalysis

Freud, a doctor, had a background in neurology, which is very much inclusive of the discipline of psychology. While psychology is consumed with the study of human psychical structures and processes, Freud’s work was not entirely about that: his legacy lay in the process of understanding the psyche and not about explaining what psyche is itself.

Psychoanalysis is very much connected to the discovery of the unconscious (Ellenberger 2008), from the work of Mesmer and Puységur, and further back to traditional and religious spiritual healers, which in many parts of the world, is still the choice of patients seeking answers to their psychological problems. In my country, multicultural, and modern city of Singapore, for example, more than 35% of patients who sought psychiatric help, had first sought therapy from traditional healers (Lim and Poon, 2015).

The aim and methodology of research in both fields also tend to be dissimilar: psychological studies tend to be nomothetic in approach while psychotherapy as a science and more interested in the outliers adopt the ideographic approach towards research.

The Natural Sciences, Scientists and Philosophy

Research is important for the survival of any discipline. While there is no question of efficacy of practice of psychotherapy, and there are clients who experience healing with psychotherapy, these experiences need to empirical proof to be politically accepted. This is a phenomenon of human thinking today, where the distrust in the human experience of reality is overcome by reliance on algorithms of proofs.

Having studied biochemistry and physiology, I do appreciate the process of scientific endeavor. Having a great interest in philosophy as well, I have meanwhile come to understand the sentiments of Kuhn (2012: 1962), that normal science is “an uneventful, presupposed set or unquestioned assumptions, which form the framework that governs how research are hypothesized, interpreted”—and I will take the liberty to add— funded. Natural science is part of humanity’s way of understanding “reality”, however, as Husserl (2012: 1931) points out, there is a natural human tendency to pool what we perceive of “the world about me” in order to find a “general thesis” or to form “common consent”.  Bearing philosophy in mind, we can see the progress of science with different attitudes. Empirical science is not an end, but a means from which humanity learns to understand its own nature, but hopefully.

Cognitive Neuroscience: Linking the Mind with Biology

Neuroscience can never be a standalone study: it requires engineering, the various fields of medicine and psychoanalysis in order to create and make sense of images derived from neuro-imaging. Their limitation is not unlike astronomers looking at the galaxy from satellite images. Looking at the brain in order to see the mind is like looking at one’s reflection in the mirror while trying to “see” the thoughts going on in one’s own head. Neuroscience may never really grasp the mind because the mind is bound by the first person observational perspective, and thus cannot be observed by multiple observers as matter can (Solms & Turnbull 2002). What neuroscience has done was to try to create maps of brain function on the brain; even this is limited because of what we understand to be the phenomenon of brain plasticity.

 

It is shown that the integrity of the structures above the brainstem, the extended reticular and thalamic activating system (ERTAS) – discovered in the 1950s by Moruzzi and Magoun— is responsible for presence of the global conscious state of an individual. Damasio (1999) interpreted this as an argument for seeing the mind and body as an inseparable whole. This is a monist approach, which is a rejection of dualism envisaged by Rene Descartes in the 17th century. Since the ERTAS nuclei centrally receive information from, and communicated with, the viscera, consciousness can be considered an embodied phenomena (Solms & Turnbull 2002). This is a perspective taken by philosopher, Merleau-Ponty, in his 1945 publication, Phenomenology of Perception (Merleau-Ponty and Smith 2012). For Merleau-Ponty, the relationship of the individual to the world is one of perception. It is through the body that one gets the perception. Perception is conscious and unconscious phenomena, because one can perceive something without being conscious of the perception, as with Weiskrantz’s (1986) Blindsight.

 

Benjamin Libet with his Nobel Prize winning findings leading to the idea of his Neuroscience of Free Will, demonstrated that there exists unconscious mental activity that decides the will to make a momentary action. This is shown by an experiment involving the physical movement (of a hand or part of the body), even before the individual is even aware of this decision.  In his experiment, subjects were wired up with EEG and asked to report the time in which they were aware of the urge to move their hands. The experiment indicated that the awareness of the urge existed milliseconds after initiation of brain activity that reflected this urge. Libet concluded that “the brain ‘decides’ to initiate, or, at least decides to initiate (certain actions) before there is any reportable subjective awareness, before such a decision has taken place” (Libet, 1985 p. 536).  He goes on to generalize that “if the ‘act now’ process is initiated unconsciously then conscious free will is not doing it” (Libet, 2001 p. 62).

Gazzaniga and Sperry’s split-brain subjects of the 1960s demonstrated the organized structure of the brain. In subjects where the left and right hemispheres of the brain were disconnected through severing of the corpus callosum, subjects showed almost normal functioning. These individuals, however, exhibited differences in behavior and abilities, which depended on which side of the brain got stimulated individually from the other and without the awareness of the other. Each hemisphere exhibited it’s own personality and its own way of cognitive operation.  This observation adds to the argument that the mind is linked to biology, and defeats the dualistic implication that there is a “spirit” somewhere operating biological machinery. Visual information that was no longer communicated from one side of the brain to another was perceived differently by different hemisphere, and the movement of muscles on one side of the body was initiated independent of the influence of the non-connected side of the brain.  This research provided for an interesting insight into the brain hemisphere function: it found the left hemisphere to be a dominant force in speech for language ability and the right hemisphere to be essential for visio-spatial tasks (among other interesting differences). These differences have extended consequence to the understanding of how human beings perceive the world, think and communicate.  The right hemisphere tends to perceive things as whole and has a sense for completing gestalts. It also tends to see things for “what it is”, at the present, and cannot interpret the ideas into language. The left-brain, however, takes the literal, static meaning of perceptions, and tries to analyze what it doesn’t fully understand into language. The latter phenomenon is also interpreted as “finding false memory” (Gazzaniga, 1998).

 

McGilchrist (2012), in his book, The Master and His Emissary: The divided brain and the making of the western world, weaves this idea of how the neurophysiology of the human brain shapes the way society thinks and how this leads, and has led, to the evolution of the human brain structure itself. McGilchrist, in my opinion, created a clever use of the two hemispheres of the human brain, and it’s structural asymmetry, as metaphor for humankind’s intellectual conflict with regards to the philosophy of science.

Clinico-anatomical methods of brain study developed in 1861 by Pierre Paul Broca, who studied the brains of patients suffering from aphasia. This method is still relevant today for studying brain function. For studying aspects of the mind and consciousness, only humans make reliable subjects. In the era of imaging, however, the researcher does not need to “wait” for subjects to die in order to find out the location of lesions in the brain that caused the symptom.

While we are still in the dark about what makes brain matter consciousness, there is much progress made in the study of perception, memory, emotions and processes like dreams. A field of study that I have recently found to be very interesting is work on psychedelic chemicals on the brain. This branch of research had suffered three decades of governmental ban. The effect of psychedelic drugs is now being studied with brain imaging technology, fMRI. A notable study was done by Carhart-Harris et al. (2011) on psilocybin—a hallucinogen found in hallucinogenic mushrooms. The studies demonstrated the effect of the substance on the blood flow to the region of the brain associated with the Default Mode Network or DMN, a highly connected part of the brain.

Carhart-Harris et al. (2010) in a paper entitled, The default-mode, ego-functions and free-energy: a neurobiological account of Freudian ideas, explored the notion of Freudian constructs regarding the ego and id, as having “neurobiological substrates”, and demonstrated the theory that Freud’s descriptions of primary process are consistent with the neurophysiological changes in the DMN during hallucinogenic drug states.  The DMN has also been implicated in processes involving self-judgments, recall of autobiographical memories, mental simulations, mind wandering, and daydreaming.  (Bruckner et al. 2008 & Northoff et.al., 2006). To further demonstrate the link between the DMN and ego function, Ino et al. (2011) found brain activation at the DMN during activity of autobiographical memory retrieval.

Neuro-imaging techniques have given scientists tools to observe changes in brain activity dynamically. The development in the understanding of brain activity has grown exponentially with improvement in imaging technology. Technology, however, still requires psychoanalytical concepts to make sense of what is being recorded by technology. Whether neuroscience proves or disproves a psychoanalytic concept, it still uses psychoanalysis as a template from which to base its understanding of the images.

Bibliography

Bruckner, R, Andrews-Hanna, J & Schacter, D. (2008). The brains default network: Anatomy, function, and relevance to disease. Annals of the New York Academy of Sciences 1124, pp.1-38.

Carhart-Harris, R. L., & Friston, K. J. (2010). The default-mode, ego-functions and free-energy: a neurobiological account of Freudian ideas. Brain, awq010.

Carhart-Harris, R. L., et al. (2011). Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. . Proceedings of the National Academy of Sciences of the USA. Vol 109 no. 6. 2138-2143.

Ellenberger, H. F. (2008). The discovery of the unconscious: The history and evolution of dynamic psychiatry. Basic Books.

Greenwood, J. D. (2015). A Conceptual History of Psychology: Exploring the Tangled Web. Cambridge University Press.

McGilchrist, I. (2012). The master and his emissary: The divided brain and the making of the western world. Yale University Press.

Merleau-Ponty, M., & Smith, C. (2012). Phenomenology of perception. D. A. Landes (Trans.) NY:Routledge.

Northoff, G., Heinzel, A., Greck, M., Bennoihl, F., Dobrowolny, H. & Panksepp, J. (2006). Self referential processing in our brain: A meta-analysis of imaging studies on the self.  Neuroimage, 31(1), 440-457.

Weiskrantz, L. (1986). Blindsight: A case study and implications.

Wundt, W. (1902). Outlines of Psychology. (C.H, Judd, Trans.). Leipzig: Engelmann. (First Published in 1897).

Optical and Auditory Illusions

The human brain is not merely a receptor of qualia, like a microphone or camera. The brain processes raw data received from the environment, and converts this data into perception. Sensory data gets converted into meaning via areas in the posterior cortex of the brain called the association zones. Perception is a function of consciousness, and how we perceive a sensory stimulus is learned. The learning process involves memory function (Solms and Turnbull, 2002).

The split brain experiments of Gazzaniga gives us clues to which side of the cortex is responsible for creating illusions. The work of the right hemisphere is more apt at turning shapes into forms and melody from notes because it has the tendency to create wholes from parts. This is the basis of our optical and auditory illusions.

Artists and psychologists throughout history have been fascinated with the use of illusions.  The latter, in fact, use illusions often instinctively in order to render 3 dimensional objects onto 2 dimensional spaces. One notable artist and painter is Josef Albers (1888-1976). Albers famous series, Homage to the Square, is a beautiful study of color interactions. He presented color theory as a way to offer illusion of depth, space and temperature. Commonly found on buildings are also trompe l’oeil paintings that have 3D effects, accomplished with the clever painting of drop shadows as illustrated in figure 1.  With the simple grey shades, we perceive the shape as sticking out of the paper.

 

Figure 1 (Picture by Nicole Helbig)

Notable researchers of optical illusions have studied various forms of optical illusions. Some of these illusions, like the figure-ground puzzles allow the eyes to see two different motives on the same picture, but at different instances, depending on where one’s focus of the picture lies. A famous example is Rubin’s vase, developed around 1915.  Rubin discovered the first phenomenological laws of figure/background articulation (Albertazzi, 1999). The figure is seen to become differentiated from the background in an alternating manner because of the chromatic contrast between the shapes. The lines in which the figure and ground are clearly separate and provide the contrast.

Gestalt psychology was developed during the time of the First World War.  The major contributors at that time were Kurt Koffka, Max Wertheimer and Wolfgang Köhler.  Their premise is that objects are perceived within an environment in their context. In other words, we perceive parts and pieces and perceive these as whole “gestalts”. Similar objects are also seen as groups, rather than discreet pieces.

 

Kanizsa triangle

The Kanizsa triangle is an example of a figure that forces our minds to create phantom shapes that were not illustrated on the diagram because our minds perceive the missing shapes nevertheless. Figure 2 is my attempt at recreating such an optical illusion.

Figure 2

Müller-Lyer created a simple, but clever illusion consisting of a stylized arrow. Lengths of the line that make the central part of the arrow can be seen as longer or shorter than the other, depending on whether the ends of the arrow have sharp points pointing outwards or inwards, even though the lengths of both arrow lines are similar.  This kind of optical illusion, unlike the figure ground puzzles, cannot be willfully “unseen”.  Researchers like Berry (1968), however have found evidence that optical illusions like the Müller-Lyer illusion do not get seen by peoples of cultures who have not the exposure to certain rectilinear.  What we infer from this phenomenon is that perception, like culture, is learned.

Auditory illusions are interesting because we may often be exposed to them unawares. I had some difficulty distinguishing from the sample of African music played in class which notes were really played and which were auditory illusion created by “a fast running sequence of sounds in disjunct intervals” (Kubik, 2010). It is hard to imagine that one is hearing that which is not really there, and that the sounds are the product of our perception. Most incredible about this piece is that the instruments are traditional instruments played by hand.

Other popular audible illusions have been created with electronic instruments. Audible illusions, like optical illusions, come in various forms.  Some examples are Binural beats, where by two pure tones are played in each ear leading the listener to perceive an illusionary third tone.  Risset’s rhythmic effect is used often in modern day disco-techs. Named after Jean Claude Risset (b. 1938), the beats give the impression of being in perpetual acceleration.

 

Bibliography

Albertazzi, L. (1999). Shapes of Forms: From Gestalt psychology and phenomenology to ontology and mathematics 275. NY: Springer Science & Business Media.

Berry, J. W. (1968). Ecology, perceptual development and the Müller-Lyer illusion, British Journal of Psychology 59 (3): 205–210,

Kubik, G. (2010). Theory of African music (Vol. 2). University of Chicago Press. p.107

Mundy-Castle, A. C. (1966). Pictorial depth perception in Ghanaian children. International Journal of Psychology, 1(4), 289-300.

Solms, M., & Turnbull, O. (2002). The brain and the inner world: An introduction to the neuroscience of subjective experience. Karnac Books.

 

Transcultural Orientation of Psychology

History of has shown us, that it is not so easy to study psychology transculturally because we tend to see the world through the lens of our own culture. The study of psychology with the emphasis on culture makes for interesting work; in fully understanding another culture, we have little choice but to become more aware of our own culture.

Hudson in the 1960s created simple illustrations on cards to study children from “unacculturated groups” in South Africa who had no exposure to children’s literature familiar to the western world, to see how the children interpreted the images (Hudson, 1967). He learned from experience working with the children that what we take for granted in the form of looking at 2 dimensional drawings while being able to understand the perspectives and interpreting the images as 3 dimensional representations, children who have not learned to see these images simply have no comprehension of them.  Mundy-Castle used the same cards, and the on a separate group of children in Ghana, and made some interesting observations from that as well.

Cicero (in 45BCE) Rome defined cultivation of the soul. In the Middle Ages “cult” is used to mean religious forefathers. By the 18th century, anthropologist, Johan Herder (1744-1803), defined culture as the point of separation between man and nature. He elaborated that language is the adaptation tool of the human species, which is used to pass information down from one generation to the next. Language is something we use for learning.

Studies in neuroscience and cultural anthropology demonstrate that culture is learned. How we perceive the world is how we make meaning to whatever reaches our senses. We learn from our culture through the process of socialization.  This starts with upbringing and continues for life through a lifetime of learning.  The learning process is possible through language.

Edward Sapir (1884-1939) and Benjamin Lee Whorf (1897-1941) mentioned that all our thinking is language. This idea is quite similar to Jacques Lacan’s (1901-1981) famous essay, the agency of the letter in the unconscious, that the unconscious is structured like a language (Lacan, 1977). Lacan’s idea is somewhat different because he talks about the “unconscious” and not thinking, and he mentioned that it is structured “like” but not necessarily is, language.  We are faced then with the dilemma of distinguishing between “what we think” and “how we think”.  What seems more plausible, deducing from split-brain studies, is that the right hemisphere thinking is linked to what Freud calls primary processes, while the left hemisphere does the work of the language driven super-ego (Galin, 1974). This would then be contrary to the idea of Lacan.

It is true that we do not know everything about our own culture. Even so much of what we inherit of culture is through upbringing. Throughout life we adapt to changing cultural environment and evolve culturally through a learning process called “enculturation”. This process happens naturally due to influences to the socio-cultural development of our time.

Culture is a dynamic situation that each individual lives with, and every aspect of our lives is culture, and this includes inherited and adopted customs and practices, laws, symbolism, food, technology and taboos. As psychologists or psychotherapists, we have to be aware of our own culture glasses when working cross-culturally.  We also cannot overlook the ever-changing cultural environment in which we live in, and how technology and new habits shape our lives, environment and relationships.  Sherry Turkle (2012), in her book, Alone together: Why we expect more from technology and less from each other, brings us to the awareness of how we are relying more of technology to get through with the boredom of life. Boredom and loneliness play a key role in our growing dependence on technology. The goal of psychotherapy in this instance is to find the root of these emotions.

Bibliography

 

 

Cicero, M. T. (45 BC). Tusculanes (Tusculan Disputations). pp. II, 15.

Galin, D. (1974). Implications for psychiatry of left and right cerebral specialization: A neurophysiological context for unconscious processes.Archives of General Psychiatry, 31(4), 572-583.

Hudson, W. (1967). The study of the problem of pictorial perception among unacculturated groups. International Journal of Psychology, 2(2), 89-107.

Lacan, J. (1977). The Agency of the Letter in the Unconscious.

Turkle, S. (2012). Alone together: Why we expect more from technology and less from each other. Basic books.

 

 

Experiences of Grief after a Loss of a Loved Person

What does a person go through when he/she loses a very dear person? This person could be a parent, spouse, child, friend or even pet.  Every person’s experience is unique, because every relationship is unique. In order to understand what people may go through after the death of someone special, here is a questionnaire that I found.

How is the experience of grief described?

This is a set of questions that one can reflect upon when accessing the grief experience.

Since the death of your loved one, how often did you:

      1. Think that you should go see a doctor?
      2. Experience feeling sick?
      3. Experience trembling, shaking, or twitching?
      4. Experience light-headedness, dizziness, or fainting?
      5. Experience nervousness?
      6. Think that people were uncomfortable offering their condolences to you?
      7. Avoid talking about the negative or unpleasant parts of your relationship?
      8. Feel like you just could not make it through another day?
      9. Feel like you would never be able to get over the death?
      10. Feel anger or resentment toward your loved one after the death?
      11. Question why your loved one had to die?
      12. Find you couldn’t stop thinking about how the death occurred?
      13. Think that your loved one’s time to die had not yet come?
      14. Find yourself not accepting the fact that the death happened?
      15. Try to find a good reason for the death?
      16. Feel avoided by friends?
      17. Think that others didn’t want you to talk about the death?
      18. Feel like no one cared to listen to you?
      19. Feel that neighbors and in-laws did not offer enough concern?
      20. Feel like a social outcast?
      21. Think people were gossiping about you or your loved one?
      22. Feel like people were probably wondering about what kind of personal problems you and your loved one had experienced?
      23. Feel like others may have blamed you for the death?
      24. Feel like the death somehow reflected negatively on you or your family?
      25. Feel somehow stigmatized by the death?
      26. Think of times before the death when you could have made your loved one’s life more pleasant?
      27. Wished that you hadn’t said or done certain things during your relationship?
      28. Feel like there was something very important you wanted to make up to your loved one?
      29. Feel like maybe you didn’t care enough about your loved one?
      30. Feel somehow guilty after the death of your loved one?
      31. Feel like your loved one had some kind of complaint against you at the time of the death?
      32. Feel that, had you somehow been a different person, your loved one would not have died?
      33. Feel like you had made your loved one unhappy long before the death?
      34. Feel like you missed an early sign which may have indicated to you that your loved one was not going to be alive much longer?
      35. Feel like problems you and your loved one had together contributed to an untimely death?
      36. Avoid talking about the death of your loved one?
      37. Feel uncomfortable revealing the cause of the death?
      38. Feel embarrassed about the death?
      39. Feel uncomfortable about meeting someone who knew you and your loved one?
      40. Not mention the death to people you met casually?
      41. Feel like your loved one chose to leave you?
      42. Feel deserted by your loved one?
      43. Feel that the death was somehow a deliberate abandonment of you?
      44. Feel that your loved one never considered what the death might do to you?
      45. Sense some feeling that your loved one had rejected you by dying?
      46. Feel like you just didn’t care enough to take better care of yourself?
      47. Find yourself totally preoccupied while you were driving?
      48. Worry that you might harm yourself?
      49. Think of ending your own life?
      50. Intentionally try to hurt yourself?
      51. Wonder about your loved one’s motivation for not living longer?
      52. Feel like your loved one was somehow getting even with you by dying?
      53. Feel that you should have somehow prevented the death?
      54. Tell someone that the cause of death was something different than what it really was?
      55. Feel that the death was a senseless and wasteful loss of life?

Finding the Answers

The questions, answered in the affirmative within the first 2 years of loss of a loved one, reflects the natural response of grief. After a longer period of time, the feelings should subside. If feelings of grief develop into depression, seeking counseling can be a life saver.

Seeking a balance in allowing oneself to grief, and then to slowly move on with living a life without the loved one is an act of taking responsibility for one’s own survival. That is a matter of individual choice, and freedom. Finding resources to survive loss is part of the act of responsibility. A good resource one  can achieve for oneself is to find someone who would listen. This person may be in the form of another family member, friend, counselor, priest or psychotherapist.

Bibliography

Barrett, T. W., & Scott, T. B. (1989). Development of the grief experience questionnaire. Suicide and Life-Threatening Behavior19(2), 201-215.