Anxiety, Stress and Personality Development - Research Paper Example

How anxiety, stress and personality development can influence the emotional experience of the bereaved Bereavement can be defined as the various reactions, or behaviour patterns, of individuals, to a large extent directed by the emotions felt to the experience of great loss. People meet bereavement in differing ways, but in every case there will be a degree of anxiety and stress, depending upon the personality of the individual, their intellectual and emotional development and their particular situation, both as an individual and as a member of wider society. Mourning is the term used to describe how people behave as a result, and how this is affected by the norms of the particular society of which they are a member. According to the National Cancer Institute ( 2011) how people grieve and behave as a result will depend upon a number of factors. The group list these as:- • Whether or not the person was expected to die at that point or not, i.e. how much notice the bereaved person had in order to prepare themselves, to say their goodbyes, to make arrangements. The circumstances will also affect this , for example if a person commits suicide or is murdered this is obviously more traumatic than if someone very elderly just fades away peacefully. • The bereaved person’s personality. People with higher levels of self- esteem tend to cope in a more controlled way than those with low self-esteem. It has also been found that people who feel in control of life cope better than others. • Their religious faith or lack of it. This may depends not so much on belief as whether or not they regularly attend a place of worship as to the fact that if they do so they will have a strong social support system in place. • Their gender. It is felt that men do not cope as well as women after the death of a spouse. Again this is thought to be because women tend to have better social support systems already in place. • Their age. Young people tend to grieve intensely and may develop health problems. On the other hand they often make a quicker recovery, again due to the amount of social support they receive. • The amount of support available to them. Restricted social support tends to produce more problems, as Clute points out with regard to those who have underdeveloped systems of support. ( Clute, 2007) . The loss of someone close can be devastating. People deal with this in many different ways. Anxiety is a natural response - part of humanity’s ‘fight or flight’ response to difficulties. As described by Worden, the biological response to loss is aggression. (2002, page 9) It is a heightening of senses as described by Mind 2012. This reflex results in high levels of adrenaline being released which causes several physical results – an increase in oxygen levels as the heart rate rises in an attempt to get oxygen where the body feels it is needed in order to flee danger. There is a corresponding reduction in appetite as blood is moved away from the digestive system into the muscles. The person can become twitchy, making nervous movements and refusing even necessary food, perhaps even becoming nauseated. They cannot concentrate or relax, so this physical difference makes an emotional impact. Death, even if it was expected, means a loss of control. This will be particularly profound in someone who already has little control over the situation and its implications upon their future. This is about more than death. The person feels out of control, in particular of their own future. They may have been quite dependent upon the deceased person. They ask themselves many questions to which they don’t have answers such as :- How will I cope? What about money? Where did he put the insurance papers? How do I tell the children? Can I carry on living here? Anxiety can be a learned response. In other words if people we are close to are anxious, we are more likely to be so ourselves. In Judaism there is a long developed practice of simply sitting with a bereaved family. Not flitting around, not talking very much, simply sitting. This is a religious duty and is done whether or not they were close to the person or merely an acquaintance. (Avelim, 2011).This is the group’s way of lessening any anxiety, yet so often the response of the majority is to do things. This could be organising a wake, informing all those who need to know, sorting out necessary paperwork, even clearing out the person’s wardrobe, or arranging the sale of their house. perhaps because this means less time to talk , and so softens the emotional impact. It could also be that this gives a sense of being in control to some extent. Other’s react in a rather different way – perhaps refusing to really accept their bereavement. This often involves becoming very isolated, avoiding social situations and such things as preserving the person’s belongings exactly as if they were about to walk back into the room. Queen Victoria’s reaction to the loss of her beloved consort is a typical example. She withdrew from public life for many years and did all she could to preserve Albert’s memory( BBC 2012) . Reactions among the elderly bereaved include loneliness, low moods, excessive tiredness, poor quality of life and cognitive dysfunctioning. Social status may change as income disappears. Women may feel that their status was linked to their husband’s position in society, and with that ‘borrowed ‘ status gone they face a huge change in their social circumstances. Stroebe et al ( 1999, page 473) point out that in relatively small and unassimilated groups , as can occur in the United States, social and medical support may be limited because of cultural barriers. Stroebe et al ( 1999, page 470) discuss coping mechanisms and cite Kaminer and Lavie 1996) as describing how Holocaust survivors repressed their memories in order to be able to carry on with their lives. The Normal Grieving Process Grief at a loss normally progresses through certain distinct stages, although not all scholars are in agreement on this topic ( Shroebe et al, page 5, 1999) . Psychiatrist Elisabeth Kübler-Ross defined what she felt were the various stages of grief. This was based upon her work with the terminally ill, but can be applied also to bereavement. At their simplest these stages are most commonly defined as :- • Shock and disbelief. The person finds it very difficult to accept the reality of the death. This is particularly so if death is very sudden and unexpected as after an accident. According to Ireland ( 2011) this can have a positive effect in that the blow of loss is softened , at least for a while. Ireland sees this as a natural process, and not harmful as long as it does not cause either mental or physical damage. • Anger. This can be aimed at the person who has died. ‘Why did he have to do this now?’ even if that person had no control over their own life and death. • Searching. Looking for evidence that the person is still alive – half recognising him in a crowd for instance. • Guilt. Perhaps they feel they could have done more, or they may feel guilty about their anger. They may feel out of control if the person dies in the care of others, as so often happens in hospitals and they feel that they could have done more. If for instance a child dies from an inherited disease these feelings of guilt can be particularly strong. If one person is a survivor in a car crash, or a natural disaster. they can feel immense guilt, even if the incident was not their fault • Sadness. Very akin to depression, but the negative emotions are not experienced in such a consistent way. • Acceptance. The gradual return to normal life. The person comes to fully realize what has happened and is at peace with this To reach this stage can take a very long time - a year or more would be a minimum in most cases. ( WebMed 2009) This means that the person has gone full cycle, going through the many activities which make up their lives, but without the person who has died – holidays, birthdays and all the rest. They have begun to develop new ways of doing things and so a pattern is being established for the rest of their lives. Smith and Segal ( 2012) point out that Kubler – Ross , in 2004, stated that these stages were the response that many people experience , but ‘there is not a typical response to loss, as there is no typical loss.’ They describe how the Hospice Foundation of America sees grief as not so much definite stages, but rather as a roller coaster experience full of both ups and downs, often unexpected. It is this which distinguishes grief from depression, in which low feelings are constant , the person becomes unable to function and slows down in both speech and in their physical movements. The stages vary in their length and sometimes the bereaved person seems to ‘get stuck’ i.e. they seem unable to move on from one stage to the next, as when someone is still deeply grieving several years after their original bereavement, so much so that they are unable to carry on with normal activities. The death of a parent and the loss of a spouse produce rather different types of grief. Kimberly ( 2008) describes other factors that affect the type and amount of grief felt - Was the relationship a loving one? Are other loved ones feeling their own deep pain? The author points out how the type of personal relationship dictates, at least in part , both the degree of grief and the coping mechanisms that will be used. Some want to talk in a positive way ‘to remember the good days’ – looking through old photographs can help with that. Talking about the person and the emotions someone is experiencing generally have a positive effect. Others however may turn to chemical help – alcohol, drugs, a way of masking emotions, but not of preventing them from having to be dealt with ultimately. Each person learns to cope in their own way, but the better their support system, the better they are likely to cope. Supporters can for instance encourage the person to look after themselves physically, to eat and drink, but to avoid the excessive use of medications and alcohol. Another coping mechanism described by Kimberly ( 2008) is physical exercise - whether digging the garden, going for a long walk, or deciding to repaper the lounge. Again these would be more effective if they were shared experiences. Ireland ( 2011) suggests that doing something creative may be helpful – writing down a bereavement diary or creating a work of art. She also suggests that different people need to grieve for differing amounts of time. If people understand this they are more likely to give themselves the time they need – not perhaps feelings that after 12 months things should be back to normal. This helps them to move forward to a time when sorrow isn’t always their dominant emotion. Some people try to cope by putting up defences. They seem to be detached from the situation, but will the barriers will eventually break down and this results in intense grief sometime after the events. If in early life there was a lack of responsiveness on the part of a person’s attachment figures this means that the person continues to seek for this missing attachment for very extended periods when bereavement occurs.(Smith and Segal 2012) The same authors also describe ‘complicated grief’ stating that this involves such things as an extremely intense yearning for the person who is no longer with them. They may be unable to continue with normal activities because of intruding thoughts, perhaps even images or visions, of the person. They imagine the person as still being alive and may search for him in places he would often have been found in. On the other hand they may avoid activities and places which might remind them of the lost person. This of course leads to increased social isolation. They may demonstrate how angry the situation is making them and feel that there is no point in continuing to live. Bereavement has physical effects. ( BBC 2012). As well as causing digestive problems and feelings of exhaustion, the emotions of grief can result in crying, sleep disturbance, hair loss and disruption of the menstrual cycle. They can also exacerbate chronic conditions already in place such as eczema, asthma. This is in part because the body’s stress response has a negative effect upon the immune system, as both of these conditions are due to excessive reactions to certain allergens. Bereavement causes a fall in activity of the T-lymphocytes, cells that are very important in fighting infection The steroids which are produced as a natural consequence of grief, together with the response of the autonomic nervous system, mean that the heart begins to work harder and more quickly , and the person may be aware of palpitations . This is part of the body’s ‘fight or flight’ reaction, which its natural response to danger. Grief can even cause and can even result in both audio and visual disturbances. These physical effects are a direct result of the emotional response. Among the bereaved there are higher than normal rates of both mental and physical illnesses and. Salter-Pedneault (2010) described how those people with personality problems , such as those with borderline personality disorder, may be even more adversely affected than most because of the feelings of abandonment and separation from the loved person who has died. She does however point out how little research has been done on this subject. Clute ( 2007) discusses the way in which social scientists have long tried to explain and to predict the implications of bereavement in the general population. She then goes on to discuss the effects of bereavement upon people with limited intellectual abilities. She points out that it is obvious that such people observe life in a rather different way to the majority population. This she claims makes it untenable that they are treated with a same interventions, and also points out a dearth of research on this topic. Also social networks are not necessarily in place, especially if the person was living with an only parent, who then dies. Clute claims that it is not the loss and its finality, but the lack of planning and preparation, that causes real problems. The social experience of having developmental difficulties can means that the person is excluded from a very sick person, or is not involved in decisions. This lack of involvement meant that the person with developmental difficulties might have problems with the reality of their loss, so they are asking ‘When are they coming back?’ ( Clute, 2007, page 6). The people concerned found themselves unable to cope with the strong emotions they were experiencing. When this is taken together with the fact that such people have few resources and lack control over decisions affecting their own lives Clute goes as far as describing this as dehumanising. (Clute, 2007, Page 2). Conclusion In earlier times people tended to experience death and bereavement more often, and perhaps at an earlier chronological age, than in present day western society. A hundred years ago for instance a parent could expect that at least some of their children were unlikely to reach adulthood due to conditions which are rarely seen today. Many conditions now considered to be curable had no viable treatment. This does not mean that people in those days experienced less grief, but that it was a common and normal part of society, more generally understood, and so there were many coping mechanisms in place, such as special mourning clothing which told society at large what stage of their mourning the person had reached. Today many people reach middle life before they experience the death of someone close to them, most commonly a parent, although as their age increases death of those they care about becomes commoner. This relative rarity of the grieving experience in earlier life means that not only do people, especially younger people not know how to cope, in part because they have seen no one else having to do so , but nor do those around them necessarily feel able to offer the amount of support required. They may be so overcome with their own inability to cope that they actively avoid the bereaved person. Although death comes to everyone eventually, and touches every family, people often act as if they are immune. This way of behaving means that bereavement, when it does come, is a bigger shock with greater and longer term effects. As is shown above, what these effects are, and how deeply the person will be affected depends upon a variety of factors. It is also clear that social support is the greatest positive help that can be given, whether the person has an average intellect or has a disorder of their development. The fact that each family is eventually affected means that wider society must develop strategies to help people to cope – setting up of bereavement counselling or support groups such as ‘Cruse’ for instance which offers support, advice and information to people of all ages when someone dies. Their aim is ‘to enhance societys care of bereaved people’. However it seems there will always be shortcomings in the way wider society deals with the bereaved person. References Avelim,N., Comforting the Bereaved, Chabad.Ord, Death and Mourning, 2011, 3rd March 2012, < http://www.chabad.org/library/article_cdo/aid/281611/jewish/Comforting-the- Bereaved.htm> BBC , The Physical Effects of Bereavement, 2012, 12th March 2012, BBC, Victoria, 1819-1901, History, 2012, 13th March 2012, Cruse Bereavement Care, undated, 13th March 2012< http://www.crusebereavementcare.org.uk/> Clute, M., A Grounded Theory Study of the Bereavement Experience for Adults with Developmental Disabilities Following the Death of a Parent of Loved One : Perceptions of Bereavement Counsellors. 19th Symposium on Doctoral Research in Social Work 2007, 13th March 2012 Ireland, J., Five Coping Mechanisms for the Stages of Grief, Livestrong.com, March 31st 2011, 13th March 2012< http://www.livestrong.com/article/155978-five-coping-mechanisms-for-the- stages-of-grief/> Kimberley,S., Bereavement: Definitions and Coping Mechanisms, November 13th 2008, 13th March 2012, Mind, 2012, Understanding Anxiety, 7th March 2012, National Cancer Institute , Grief, bereavement and coping with loss, 23rd September 2011, 12th March 2012 Read More