Questions from stars on coping with grief caused by pandemic
(First of Two Parts)
The global pandemic has caused grief, panic and stress among people. We are groping in the dark because nothing this magnitude has ever happened before. The World Health Organization’s (WHO) Department of Mental Health and Substance Use has developed considerations to support the mental and psychosocial well-being of various groups during this crisis.
Since 2013, the EPCALM Adult Leukemia Foundation of the Philippines has brought together US and Philippine experts to help people understand grief as a process of healing. My good friend and cardiologist, Dr. Erlyn Demerre, is the founder and chairman of the board of EPCALM.
This columnist is one of the advocates of EPCALM together with Martin Nievera, Pops Fernandez, Anne Curtis, Jasmine Curtis, Tirso Cruz III, Angel Aquino, Kuh Ledesma, Heart Evangelista, Michael V, Vina Morales, Rovilson Fernandez, Tessa Prieto-Valdez and Top Suzara.
In 2018, EPCALM brought mental health first aid to the country and has been advocating for mental health since then. It has partnered with many organizations, to name a few, the Natasha Goulbourn Foundation (NGF) and the Philippine College of Physicians (PCP) to create awareness and reduce the stigma attached to mental health. PCP president Dr. Mario Panaligan, who is also a leukemia survivor and EPCALM advocate, has committed to making mental health a banner advocacy of the PCP and will work closely with Dr. Demerre, who is also the chair of the PCP Advocacy Committee.
Mental health challenges are on the rise due to the COVID-19 crisis. Some are sick and in isolation while many are grieving because they lost loved ones and livelihood. Recognizing the importance of mental health, the following celebrities have asked how to cope with grief caused by the pandemic. Dr. Demerre and Dr. Salvador Benjamin Vista from the UP College of Medicine and Philippine General Hospital (PGH) and an EPCALM advocate for mental health provided the answers.
Martin Nievera: There is a common feeling pervading among people nowadays that stems from COVID-19. Is this grief?
Dr. Vista: Yes, much of the discomfort we feel is grief. The world has changed and much of the world we knew before, is no more. This is loss. When human beings lose anything in life, big or small, our mind goes through a process of grief and suffers the pain of what we lost. We experience a painful rush of mixed feelings of shock, disbelief, anger and sadness.
Grief can occur personally, but also collectively. Personally, what we have lost are what we were used to as “our usual normal”: Immediate physical and emotional connection with others, a certain fearlessness when it comes to health, productivity and mobility, among others. These are but some of the personal losses that lead to the grieving process.
Additionally, if we look back in history, there have always been cataclysmic events that led to drastic and terrible change in the patterns of the world: Wars, political and economic upheavals, natural calamities and other pandemics. Collective grief was evident in all these.
Pops Fernandez: Are there other sources of grief? Are there different types of grief?
Dr. Vista: Indeed, there are many sources of grief, because grief results from any kind of loss. For example, during the ECQ (Enhanced Community Quarantine), we experienced a lot of these losses and hence felt the pain of grief. The most obvious is grief from loss of loved ones, the fallen victims of COVID-19, heightened by the inability to perform the normal grieving rituals because of disallowed gatherings for wakes and funerals.
Some had to postpone weddings and cancel school activities like graduation exercises. Many institutions in our society have discarded policies and practices like children going to school, working from home, religious worship and fellowship, among others, and are now trying to find suitable changes to battle the virus.
On types: Consciously or subconsciously, we ask ourselves the two questions, which encompass the predominant types of grief: First, we ask ourselves: Can I deal with this loss? This is Grief For The Loss. Secondly, we also then ask: Can I now live in the world without those things that are gone, and maybe the other things that I will also lose? This is Anticipatory Grief.
In other words, anticipatory grief applies to the uncertainty of future events. It involves much anxiety, as we worry about things that have not happened yet. For example, although death is the most certain final common pathway for every human being, the possibility of losing life and comfort for our loved ones and ourselves brings out deep anticipatory grief.
For this pandemic, what adds to the depth of the grief that many experience is the invisibility and uncontrollability of the enemy, the virus. It is a problem beyond our usual abilities to control, and therefore our attempts to control it (quarantine, finding treatments and vaccines, etc.) raises the probability of both success, which gives us hope, as well as failure. The latter makes us grieve in an anticipatory manner.
The phrase, “This is the new normal” is an attempt of our minds to transition, to change and to move forward, as the human mind, and spirit is inclined to do, from the pain of grieving and anticipatory grieving. It is one way that the mind transitions between the reality that was lost, to the unreality of the present and the future.
Jasmine Curtis: How do we deal with anticipatory grief?
Dr. Demerre: The key is to first accept that grief can occur and it has to be processed rather than ignored. Knowing that there are stages of grief can help us better cope. This will lead to our recognition and understanding of the stages of grief:
First stage: Denial. We would probably sound like, “Oh, we are okay. We will not be affected by the virus.”
Second stage: Anger. “You can’t make us stay home. We have work and activities to do.”
Third stage: Bargaining. “If I observe social distancing as ordered for the next month, things will be alright after, right?”
Fourth stage: Sadness. “I do not know when this will end…”
Fifth stage: Acceptance. “This is happening. I have to think of how to move forward.”
Acceptance is the key to moving forward and to be able to productively and intentionally make solutions towards more positive outcome. It is like saying, “Okay, I will comply with the ECQ. Stay home. Observe social distancing and hand hygiene. Wear a mask.” There is some degree of control that makes us see that the situation will get better if we do our part.
(To be continued)
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