Chronic Pain and the Experience of Loss in Relation to Dying, Grief and Bereavement

Introduction

Life and death are directly related. Every person living is consciously aware of the imminent death at the destiny of life. The certainty of death is brings fear and anxiety which if not conquered leads to panic attacks and confusion. Chronic pain and experiences of loss further increase the miseries of life towards the ultimate destiny for everyone; death (Corr, Nabe, Corr, 2008). People suffer losses and subsequent suffering in life which demands that one learns how to accept and adapt to the unfortunate circumstances rationally. Chronic pain is experienced when is sick, dispossessed, abused or bereaved. The manner in which an individual responds to situations of chronic pain or loss determines whether he/ she recovers from the situation and moves on with life. This paper shall investigate the contribution of chronic pains and the experience of losses in relation to dying, grief and bereavement.

Background

There are different perceptions to life, pain, suffering and death. Generally, people’s beliefs direct their actions and perceptions to chronic pain and experiences of loss. Experience of loss could be perceived as part of nature and normal dimension in life. On the other, other people could perceive life mixed with pain and suffering as unnatural and abnormal occurrence which should have been avoided (Sherman& Matzo, 2005). Death, pain and loss of property or life are unavoidable circumstances in life which befall all mankind unexpectedly. Medical Care givers and counselors need to note their patient’s beliefs and perceptions regarding a chronic illness or terminal disease in order to promote their quick recovery and relief. Care givers and counselors also need to develop a solid foundation in their perceptions to the end of life, chronic pain and experience of loss.

Successful therapeutic interventions and counseling sessions are a product of the professional understanding regarding different experiences of life. There is also need to know the patient’s cultural background in order to adapt appropriate interventions for their sustainable recovery (Russell, Hannon& Backer, 2007). In essence, reflection develops clinical practice and strategies for developing personal growth and health in difficult times. Through reflective practice, health workers are empowered to understand the difficult times that patients experience when in pain or suffering from terminal illness. Since reflection enables people to take stock of their life experiences, it forms the basis for self-evaluation and demystifying suffering. It also develops their capacity to make wise decisions even when confronted with painful situations such as death. Through reflection, health workers are capable appreciating different life experiences which is necessary in assisting patients overcome the challenges brought about by chronic pain and losses. The process of internalizing the current experiences from the context of the past occurrences enables one to deal with painful feelings rationally (Silverman& Berzoff, 2004).

Feelings of despair and disenchantment confront patients in chronic pain and persons experiencing losses since they may not have encountered similar circumstances before. An experienced health worker is capable of assisting their patients overcome self-guilt and diminished self esteem by providing counsel during therapy. This entails orienting them with the realities of life in general and their diseases in particular. This is beneficial in eliminating misconceptions regarding their conditions and the fate of life. Death is regarded as “the ultimate disease in life” that confronts all creatures including human beings (Dickinson& Leming, 2009).The problem of dealing with the dying during sickness and chronic pain can be effectively resolved through a proper understanding of the underlying issues. Health workers such as nurses are therefore expected to receive adequate professional and individual training on how to deal with patients experiencing chronic pain or terminal disease.

Care givers should adequately appreciate the physical, emotional, social and spiritual underpinnings related to experiences of loss and chronic pain (White, 2000). Health workers need to reflect at personal level life experiences especially those revolving around pain, suffering and death. Their professional understanding of the numerous factors that contribute towards chronic pain and loss is crucial in discharging their duties. The interval between life and death occurrences is so narrow that the uncertain events confront patients with confusion and bewilderment. Patients experiencing terminal illness and chronic pain require an optimistic interpretation of life and mysteries surrounding their situation demystified. Care givers are privileged to restore the health of their patients towards greater wholeness. The dying process and the circumstances that accompany their painful conditions may have devastating effects on patients if they dwell on what they unable to do in that state.

The experience of loss

The attachment that people have with a bereaved friend or relative is important in understanding the consequences that may follow the loss. The shock and disbelief that accompanies the loss of a loved one such as death of a parent to a child could frustrate the recovery of the dependants if they do not receive adequate moral and material support in order to revive their lives once again (Gallagher-Allred, 2009). The loss of important assets and resources in life is another painful situation that could lead to despair and disorganization in a person’s life. The challenge in mourning lies in accepting the reality of the loss, to withstand the grief and adjusting to a life without the deceased. The bereaved families need to emotionally displace the deceased out of their life in order to progress optimistically.

There is a tendency for victims of death and losses to prolong the grief after mourning due to the strong relationship and attachment they had with their deceased friends. This is often manifested through periodic recollection of the previous precious moments that the deceased and the surviving people had. It is therefore important old attachments with close friends and relatives are relinquished in order to assist them adjust and adjust into the reality of their present life. The moral support from relatives and friends is crucial in helping patients and friends are crucial in helping patients experiencing grief and loss of a loved to recuperate. Their presence around buddies in difficult moment fosters readjustment through physical attachment which serves to harmonize the body and the soul together. Physical stress is thus eliminated through mutual interaction between intimate persons around the bereaved.

According to psychological literature, the dying process reduces the quality of life through insecurities and fears that surround anxieties that grief brings. The confusion about what the after-life entails and the pain of living without the departed soul, render the bereaved vulnerable to despair (Boyd, 2007). The primary loss in life is death. Apart from death, material loss of properties and wealth could also drastically reduce the quality of life since it creates anxious moments in life, panic and confusion which could further increase pain and suffering. The loss of material things is regarded as secondary and may also include relationship loss where people in love get separated resulting in emotional and psychological stress. Another secondary loss involves the functional defeat of cognitive capacities leading to some terminal illness or impairment.

Primary and secondary losses may occur together or independent. The primary loss of a patient on terminal illness or health could lead to secondary losses such as inability to work, loss of income and material things which add value to life. Suffering accompanies these losses since it impacts on the victim’s faculties, body, mind and soul (Moore, Davis& Kuebler, 2005). Suffering entails the pain of enduring distress. The body, the mind or the soul could experience the pain of suffering differently depending on how the whole person is experienced in dealing with moments of suffering. The level of preparedness of the person on handling stress and suffering that accompanies grief and bereavement matters in overcoming the underlying challenges. Grief particularly creates mental anguish upon the bereaved. Idealization of the deceased could lead to the patient adopting behavior of the departed person in order to impersonate him/her.

End of life literature review

Loss can be defined as the disappearance of an important person or property. Loss is a common occurrence in life which does not discriminate against religion, gender, culture or socio-economic status. According to Boyd (2007), people experience some form of loss in the journey of life. The ultimate loss occurs when death strikes. Grief refers to the bereaved person’s response to the loss of a cherished person or possession. In essence, bereavement is associated with the loss of a cherished person. Although grief is a disturbing experience in life, it is a common response that people can overcome in life once properly acquainted with the situation.

People cope with different losses in different ways. Buttaro (2008) further explains that education is one of the best ways of managing grief and major losses that emerge in life. When people have prior knowledge on how to cope with difficult situations in life, they are better placed to respond properly to grief, bereavement and losses. Different types of losses are experienced in life apart from death whose manifestation is a mystery. Grief is the common response in each of these losses. There are losses that occur as a consequence of physical impairment of the body’s cognitive faculties related to vision, communication, hearing or mobility among others. There is also loss of the body image as a result of therapeutic surgery; accidents and the aging process that wholly or partly transform the physical appearance of the body. The change in appearance leads to substantial loss of self esteem in addition to diminished personality.

According to Dickinson and Leming (2009), loss of control is occasioned by prolonged hospitalization of a loved companion, relationship failures and accidents which could be either natural or a result of human incompetence. The pain of losing a loved one to a terminal disease is both frustrating and sickening taking into account the nature of intimacy that exists between people in a relationship. The loss of the social bond between people sharing important lines of kinship further interferes with growth and development of dependants. This could happen due to loss of material support and financial resources necessary for proper upbringing of children in a family. The loss of health due to some illness or disability interferes with the quality of life as a result of the chronic pains and psychological trauma.

Freedom and independence are important qualities in life. However loss of freedom could arise from circumstances such as political instability, incarceration or culture erosion among other social disasters. For instance individual independence could be lost to some retrogressive culture that discourages conventional medical treatment rendering patients vulnerable to health complications, terminal illness and death. Significant material loss occurs when people lose their jobs, homes and other properties that hinge on their survival and wellbeing. The resultant stigma that accompanies a financial downturn situation lowers people’s self esteem and confidence which is also important in developing character and leadership in the society.

According to Mallon (2008), the loss of identity is associated with retirements, relocation, and change in career which destabilize relationships, freedoms and independence. Love and belonging are important parameters during the growth and development of a person in accordance with the available social institutions and attachments that support people in the society. Consequently, the loss of health could trigger a chain of reaction that results in loss of finances, careers and identity which is meant to sustain the social fabric of a people. The response to such losses is always linked to feelings of despair and grief since job losses results in depreciated incomes, poverty and misery which in overall reduce the quality of life. The loss of innocence is caused by premature sexual encounters which expose children to obscene and graphic material through the media. Children being young and inexperienced get hooked on pornographic content and sexual perversions that deprive them of their innocence and proper development.

As a consequence of one losing as job, despair could set in and motivate people to take up their lives. Loss of life could therefore occur unexpectedly or through suicide where someone succumbs to painful circumstances in life. A child whose innocence was lost early in life is likely to suffer from psychological pain in subsequent years resulting in deviant behavior and substance abuse. Women also experience loss during miscarriage, abortion, stillbirth and painful mysteries such as infertility which could eventually lead to loss of marriage or valuable relationships. Loss of employment and career kills people’s hopes and dreams in life leaving people empty, worthless and confused in life. The dying process is initiated by painful circumstances in life which graduate into death itself.

Chronic pain associated with some terminal illness such as cancer or HIV/AIDS is a major factor leading to death. The process of enduring excruciating pain occasioned by the diseases reduces the quality of life which if not arrested therapeutically robs the patient’s life. The dying is often anticipated from the experiences of these losses or unexpectedly due to disasters. The dying process is therefore associated with chronic pain and experience of losses. The response to such experiences is manifested through grief. Feelings of grief are expressed through crying, emotional outbursts, anger and other suicidal tendencies which initiate the dying process.

Chronic pains and panic attacks

Panic attacks occur suddenly and without warning to virtually all individuals with or without a genetic predisposition. It is a brain disorder which may affect the whole body. During its occurrence, the fight reflex is abnormally generated often accompanied with biochemical and physiological malfunctioning (Mallon, 2008). Experiences that follow a panic attack are so awful that one feels like dying or going mad from just normal stressful conditions. Notable signs that are associated with panic attacks include; cardiac palpitations, stomach upset, pain in the chest, inability to breathe properly, increased heart beat, sweating, headache, lack of sensation and confusion. However, panic attacks are treatable and whether severe or mild, their symptoms and causes can be effectively managed by health professionals and counselors.

The abrupt nature in which panic attacks strike causes a lot of shame and confusion to its victims which therefore demands that they should be helped out of the problem. The situation becomes even more serious when the condition hijacks individuals when they are alone. This is because the condition, which is occasioned by stressful circumstances, leads to mood swings and anxious moments that almost bring life to a standstill. The underlying causes of panic attacks are linked to issues that deteriorate an individual’s mental health. This may include emotional and physical abnormalities that have an origin in stress, such as, death of a loved one which then causes much grief and agony to the bereaved mourners. In this case, panic attacks may spontaneously occur during or after the funeral period. On the other hand, the pain and agony of losing a friend or family member could also be manifested through serious panic attacks later in life.

Management of such panic and fight reflex conditions should therefore take into account the life history of the patients with a view to diagnose the real issues to be dealt with in the entire problem (Leming& Dickinson, 2007). If the deceased person was a sole bread winner, the counseling sessions should be accompanied with practical interventions that seek to empower the victims financially in order to check the misery associated with economic downturn. There are also scenarios when panic attacks are experienced more often and with pronounced magnitude to an individual with a close relative with the condition. However, the real cause of panic attacks linked to genetic disorders is not properly revealed.

Anxiety is therefore a common condition linked to panic attacks normally associated with “post-traumatic stress disorder.” The state of the mind of a victim should also be maintained at peace and free of stress or psychological trauma. This requires that patients are taught through counseling sessions to manage emotions such as anger and bitterness. Anger is often accompanied by feelings of hatred and jealousy which could lead to mood swings and unnecessary outbursts. Patients also need to be helped when confronted with difficult situations in life as well as tragedies which disturb their peace in order to prevent panic attacks from occurring (Niemeyer& Wass, 1995).

It is common for panic attack victims to succumb to the fear of the unknown danger since they have developed a tendency to be anxious about everything. For instance, such a victim of stressful panic could be scared of imminent road accident while driving to the point of causing a head-on collision. This could be informed of a previous crash on the road or simply a feeling of uneasiness and fear of rampant road carnage. As a result of the anxiety, adrenalin is stimulated causing muscular contractions and increased heartbeat which progresses to general body weakness, chest pains eventually succumbing to a road accident. Panic attacks have not been reported to cause deaths but generally could create a life threatening situation to their victims since it seriously reduces patients’ wellbeing (Chigier, 2009). Patients are therefore supposed to be assisted in managing the condition through appropriate therapeutic interventions and counseling.

Conclusion

The dying process is a painful experience that confronts everyone in life. The challenge lies in accepting the realities of life and death as well as the process of relieving the accompanying chronic pains and experiencing of loss. Available literature on the causes and consequences of the painful events that lead to death are relevant in guiding heath workers on how to support their patients especially those with terminal disease. Both the patient and the care givers have to develop their understanding of different circumstances in life in order to overcome grief, pain and suffering that could frustrate the hope of recovery and therapeutic interventions altogether (White, 2000). Reflection, counseling and family support is necessary in relieving the burden of chronic pain and loss in life. The dying process is therefore the ultimate fate that befalls all people. It should be demystified in order to overcome the misfortunes and painful moments that come with the realities of death.

According to Gallagher-Allred (2009), chronic pains and other losses may frustrate people’s lives but not cause death. Patients could die out of professional negligence instead of just chronic pains and frustrating experiences of losses. Grief and bereavement accompany the all losses but the loss of a loved one results in significant pain and mourning because it results in permanent consequences. In essence, the loss of life is severe in terms of the impact of its pain and the resultant grief. The approach through which people respond to losses matters in their recovery process. Prior knowledge on painful situations in life is crucial for management of chronic pains, grief and bereavement associated with death and other losses.

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