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Martha (Marti) Barham R.N., Ph.D.
Four Quadrants / Common Questions
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Unresolved grief is often an unwelcome companion. Let us explore the psychology of grief by first understanding the psychology of loss. Loss is not a stranger to any of us. We have all known grief throughout our lifetime, whether it be the loss of a friend, parent or pet through death or separation. Many of us have experienced a divorce and recognize the loss of expectations, hopes and dreams. The goals prior to marriage often include having a family, hoping to share the mutual responsibilities of teaching and raising the children, perhaps putting them through college. A divorce shatters that dream. The realization of hopes parents have for their children often falls short. Many parents, while the child is yet an infant, fantasize the child's career. The child's career choice in adulthood may be very different, triggering grief within the parent.
The hopes we have for ourselves in a job endeavor may never come to pass. We may never climb the career ladder. If we have, however, dealt with loss, if we have expressed our grief to lessen the pain, anguish, hurt or disappointment, we will move toward resolution. Resolution or acceptance of loss is merely the acknowledgment that the situation exists. The purpose of the natural emotion grief in the human being is to ensure this occurs.
The grief process often includes the expression of the four other natural emotions: anger, love, jealousy and fear. Natural anger provides the impetus to bring about change. A change we wish, want or hope for. When we do not like the way our car runs, for example, we take it to a mechanic for repairs.
In repressed grief, distorted anger is frequently noted resulting from our inability to alter circumstances. Often this is expressed in an act of revenge, holding grudges or in bitterness toward the one we hold responsible for the loss. When someone we love has a terminal illness, when someone we cherish has died, when we've had a loss we cannot change the situation. What is the transformation we would initiate? Our desire is to reinstate situations as they once were.
Fear is a natural emotion. We are born, however, with only two fears, the fear of falling and the fear of loud noises. These perpetuate caution, helping to ensure our physical safety. Natural fear triggers our nervous system to react to impending danger as in the case of unexpected noise or the confrontation with an abyss. What then is the difference between panic and fear? We have all watched a child going down the slide for the first time! The child would never experience the thrill of going down that slide if at the top of the ladder the child only felt panic. Panic blocks the ability to reason and when encountered over a period of time, manifests as hysteria or shock. Natural fear warns the child to back away and decide it was not quite time to meet that challenge. Observing others going down the slide, natural competition and curiosity provides the impetus for the child to walk up the ladder. The natural challenge of the experience stimulates them to move toward going down the slide. Natural fear protects the body and ensures evaluation and safety. Watching others go down the slide reinforces the inner knowing, "I can do it.'1 It is a simplistic but effective form of thinking, "It didn't hurt you, maybe it won't hurt me."
Once we are familiar with the psychology of grief, we need not be an expert in the counseling field to handle a grief situation well. Using our own naturalness, we can reach others. Let us remember we are health professionals secondly. Primarily, we as human beings can reach out and touch the heart of another. Sometimes this must be supplemented by the expertise of a health professional if the involved feelings are of an intense degree. Long before there were psychologists, psychiatrists, therapists or nurses, there were "friends". People able to listen and say, "Yes, I understand." Most of all they say, in a non-verbal way, "I have every confidence in your ability to handle the situation."
Four Quadrants
Every human creature is born with four aspects or quadrants of the personality structure - a Physical, an Emotional, an Intellectual and a Spiritual component. The Physical part encompasses our body and includes the five senses. The five senses teach us of our environment while the body is the vehicle allowing us to relate to each other. As we grow, our Emotional aspect plays a great part in the socialization process. The Emotional component, namely the five emotions mentioned previously, enables us to relate to each other and also ensures our interacting one with another. The Intellectual aspect or our mind helps us to evaluate and correlate our actions and to problem solve. The Spiritual Quadrant, awakening and expanding in adolescence, ensures we know there is an aspect of us that lives forever. You may want to call this core a soul, nirvana or spirit.
The human species, dramatically at adolescence, recognizes this awareness and actively seeks answers to questions besieging men through the ages. Where did I come from? Where am I going? What am I looking for? What is my purpose? We seek what we call destiny. As we grow and mature, particularly after middle age, more and more emphasis is placed on - Where am .1 going? What is the purpose to life? Time passes. Indeed our body has served us well. During the time frame in which we approach death, we begin to put less emphasis on the physical body. Every individual on some level knows death is pending and is aware the natural deterioration of the body is taking place.
In natural development of the personality structure, the Physical Quadrant is the first to develop and the Spiritual Quadrant the last to fully expand. However, if this growth process is interrupted by a life threatening disease or terminal illness causing rapid deterioration of the body, Spiritual awareness automatically and prematurely awakens. This is why many people observe dying children as so very wise. It is as if they have found answers adults have been seeking. Lo and behold, these children have found it. Where? Where else I Within themselves.
The following are some commonly asked questions about the grief process.
QUESTIONS - How does the fear of losing life fit in with natural fears? My example is - you answer your door and a man is standing there with a gun pointed at you -~ wouldn't that be natural fear? Yet it is not related to noises or falling.
ANSWER - We are born with two fears, the fear of falling and the fear of loud noises. These manifest automatically when someone comes up and touches us unexpectedly or we approach the edge of an abyss. They are natural protective devices assisting us and our body in maintaining physical life. These are not learned but are innate responses present at birth. Another natural protective device, our physical survival aspect, ensures the body clings to life. Danger evokes within us the response to fight or flight. We have learned in childhood that a gun can be dangerous, as we have learned of other dangers in life.
In reply to the question of the man at the door with a gun, the physical sight of the gun representing danger triggers the adrenaline flow as we evaluate quickly how we are going to handle the situation. If panic takes over, we find ourselves not using our best judgement. At that particular moment in time, we need our intellectual capacity to help us quickly evaluate, process and decide what our next step should be. No one can give you a pat answer of what to do. It would depend on who is in the house with you, etc., or who the man was. Was he indeed there to turn the gun upon you? Was he looking for someone else and happened to knock at the wrong house, only to move away from you and to move next door? What would your next step be as soon as he turned away from your door? Assessment supported by good judgement would supply the answer of how to handle the situation of danger.
QUESTION - What role does the feeling of guilt about how one treated a loved one play in accepting the loss of that person?
ANSWER - Guilt is not a natural response, it is learned. Before one can deal with the natural emotion, grief, the unnatural response of guilt must be evaluated. Oftentimes, we find the seat of guilt lies in the "shoulds" we have put upon ourselves. It can be associated with the claims ("shoulds") put upon us by society or those we put upon others. First, we must accept our responses toward the dying individual. If, indeed, we feel in our evaluation, we have not carried out those actions or interactions that would have been within the realm of possibility, before we can move into the act of self-forgiveness we must acknowledge our behavior to ourselves. In doing this, we then begin to accept our own humanness and move toward the quality of grief. This allows us to grieve not only for the loss of the loved one but for the loss of the interactions that were missed.
The guilt response can be correlated to individuals who as children did not have a positive parental relationship or one less than the degree they desired. As adults, there can be great emotional spaces between themselves and the parent. When a parent dies, an adult may experience guilt feelings, reflecting they did not call mother or father, visit them, or they were not the child the parent had hoped for.
Until one can look at what stimulates adult behaviors, one cannot begin to deal with the natural grief. The child we were, knew there existed the essence of a relationship that could have been, a promise of what might have been and never was. What we grieve for then, is the relationship that never unfolded and now never will be.
QUESTION - Can you give any suggestions of how one might tell a child about death or, explain why a dead body does not move?
ANSWER - Each individual needs to share from their own point of view when a child asks about death. Be honest, perhaps saying, "This is what I believe." The child learns people look at death differently and yet there is often a sameness about the beliefs. A natural response of a child to death was shared by a grandmother. This woman remembered hearing at a previously attended seminar on separation and loss that a child is never too young to attend a funeral. She insisted her granddaughters be allowed to visit the funeral home when the other grandmother unexpectedly died. The girls, five and seven, approached the coffin together. Their grandmother walked behind them. The youngest reached up and touched the body, withdrew her own hand quickly saying, "She is cold and hard!" The older sister looked at her with dismay, "What did you expect? She is just like the snail shells we find at the beach after the snail has crawled out." The grandmother said nothing. Later, she asked how she might have responded. There was no need for a response. The child had given a beautiful symbolic expression. A comment both meaningful and accurate. What more could anyone add!
Children accept death as a natural part of life, until they learn otherwise. All behavior is learned. If our attitudes about living and dying are not positive, we can choose to change them. Each of us can reclaim our lost naturalness, however, a measure of humility is required to admit change is necessary. Oh - to be as little children!
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