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悲嘆（グリーフ）とは
Mental issues emerging after a disaster

Disasters cause two problems in people’s minds at the same time: “trauma” and “loss”. The issue of “trauma” comes from the impact of unacceptable events, such as the fear of earthquakes and anxiety over their reoccurrence. On the other hand, the issue of “loss” comes from the grief of losing loved ones and things that are irreplaceable, such as families, homes, jobs, household goods as well as familiar streets and neighbors.

 

The following summarizes the mental problems that occur when someone loses a loved one in a disaster.

 

【Emotions after disasters】

  •  The emotions may seem overwhelmingly threatening. You may have a strong feeling of guilt over what is happening to you. You may not even be able to control yourself, feeling you might have become insane.
  •  The scene of disaster may stay in your mind, repeatedly coming back to you (flashbacks), and causing nightmares. Every time that happens, you may feel fear and sadness.
  •  Sometimes you feel numb, with no feeling, no reality, and no tears. At other times, you may not be able to think straight and get confused. These happen unconsciously in order to protect yourself from bitterness and fear.
  •  On the other hand, you may excessively cry or vent uncontrollable frustration and anger. Anger is a very natural reaction to an unreasonable event.

 

【Other matters】

  •  Traumatic experience may cause severe fatigue, insomnia, a loss of appetite, headaches and abdominal pain, and increased blood pressure and heart rate.
  •  It can affect relationships with family members and friends. Sometimes, disasters become an opportunity to unite , but other times it becomes difficult to support each other because of tension. Sometimes you want someone to be with you, and sometimes you want to be alone.

 

 

Disasters threaten people’s lives. There is no rhyme or reason for which state you fall into. It is not because you’re too weak to control the condition or you are responsible to the condition.

 

Whether the issue is about “trauma” or “loss”, each person is impacted in different ways and has different methods of responding to it. There is no such thing as the “right” way of reacting and coping “to do”. For everyone, grief is unique. Also, the grief process takes time. Some people may get better in a few months, others may take years to cope. It’s important to get better at your own pace, little by little.  Do not compare your progress to others’.

 

However, if you are overwhelmed and feel hindered in your daily life for many months, or if you continue to have any strong concerns, you might want to consult a mental health specialist (psychiatrist, psychosomatic physician, psychotherapist, counselor, etc.) or a support group.

How to deal with difficult times

What the bereaved can do (addressing trauma and sadness)

It takes time to accept the reality you are facing. It can be difficult to get used to the situation. You may feel as if you have lost a part of yourself.

It is important to do what you can little by little every day. Everyone addresses grief and loss in their own way. The following items may help you after experiencing loss, though you don’t have to do all of them. Please look for the ones that you can do.

 

【1．Taking care of yourself】

  • Go easy on yourself. Don’t expect too much from yourself and keep in mind that it will take time for you to start feeling better.
  • Try to sleep well and eat three meals a day. Also, spend time with people you feel are helpful to be with. When asking for help from a person, do not think that might be a burden on him/her. If you want specific help, tell the person about it.
  • Don’t be ashamed to cry. If you want to cry, don’t hold it in, but let the tears flow.
  • If you cannot help being anxious about the future, try to think only about the current day. Just think about and spend each day at a time for a while.
  • Sometimes, little daily routines can take your mind off things. If you have to decide something, start with a small matter with a realistic goal. It is better to make a big decision after your life and feelings have settled.
  • Avoid the following acts which are known to cause long-term health problems.
    • Consuming excessive amount of alcohol and drugs.
    • Doing excessive activities. Imposing big responsibilities and roles that cause you being restless.
    • Taking actions you had never taken, such as shutting yourself away from others and retreating into yourself for long periods of time.

 

【2．Accept reality】

  • If you can handle the emotional strain, it may help you to visit the place where the disaster occurred, including locations you are familiar with, attend memorial service ceremonies, or talk to a trusted person about the event and your experiences.
  • Mental and physical changes that occur after a disaster are different for everyone. Some people settle down in a short period of time, while others take years. Also, emotions that have subsided over time may come back. You might think “Why now?” People adapt to new lives while their consciousness goes back and forth. There is no need to compare the duration or degree of suffering with others. It is very important to accept things at your own pace.

 

【3．Talk to someone you trust】

  • Memories of lost people may bring you grief now, but they are also important and can never be forgotten. It is said that when one experiences bereavement, you feel easier to talk about your feelings and memories in a way without burdening yourself, rather than locking them into your mind. You don’t have to talk about these memories if you don’t want to talk about them, but talking with someone you trust may help you sort out your feelings and change the way you react toward these hard memories.
  • After a disaster, many people cannot shake off the shocking scenes they experiences. When you talk about it, say what you want to say little by little at your own pace. Even if you recall a dreadfully fearful image, it can help you feel better to talk about whatever you can bear to talk about. Those images won’t go away from your memory, but you will eventually be able to adjust your mind in order to get used to them. If you become nervous while talking about them, take a slow, deep breath when you speak.

 

【4．Find someone to support you】

  • Find others who you want to be with and can help you recover from the shock, such as family members, friends, colleagues, support groups. Ask for help to do something too difficult to do by yourself. Many people are willing to help you in difficult times.
  • There is a group called “Sharing Groups (Groups for the bereaved family)” where people with similar experiences can talk and share their feelings. Letting others listen to your feelings may be a big help.

 

【5．Other useful things to know】

  • Stresses such as fear and sadness can result in strong physical responses. If you continue to have physical problems, ask for medical assistance. Also, try to come up with your own ways to relax, such as exercising, doing yoga, having a massage, listening to music, singing, and walking in the park.
  • Establish your own daily schedule of everyday life including the times to get up, go out, and go to bed. This is also helpful for children. By repeating the same routine, you can more or less give your mind a safe feeling.
  • Sometimes, you may direct an angry outburst at others. Angry is natural feeling after a loss, and expressing it in a safe manner is better than blaming yourself. When you suffer from uncontrollable anger, ask a trusted person to listen to your feelings. Talking about your feelings can help you control your anger a little easier.
  • Relationships with others can change significantly after suffering from a disaster. Try not to shut out your friends, family, colleagues, and neighbors too much. When you want to be alone, tell them about it and talk about securing each other’s time and space.
For families missing a loved one

Immediately after a disaster, many people find themselves in the position of being unable to confirm the fate of someone important to them. The Great East Japan Earthquake (2011) was just such a situation. Not being able to confirm a loved one’s condition can be very stressful for family and friends. They may become unstable due to anxiety from thinking about the missing person or being depressed by the thought that the person may be gone or possibly still alive. In addition, you may feel hurt by  people who say “Forget about it,” or “Let it go”.

 

The state of mind of such family members and friends who are missing a loved one is called “ambiguous loss”. This is the concept proposed by Dr. Pauline Boss of the University of Minnesota in the United States. Ambiguous loss has two meanings. One is a situation in which a loved one’s life or death cannot be confirmed (Type 1). The other is when a loved one is present but they are psychologically lost because of changed conditions (Type 2). The state of the life or death of the loved one cannot be confirmed (=Missing) corresponds to Type 1. The condition in which one cannot return home even though their house exists, such as in Fukushima after the Great East Japan Earthquake, falls under Type 2.

 

Ambiguous loss has no answer. No one definitely can say whether the person is alive or deceased (Type 1). Thus, the family will continue to wait for him/her, not knowing how to consider the missing condition, how to spend everyday life, how to live their own life, and how to think about the missing person. This is a very unstable condition that makes it difficult to know what to think. Also, each family member may have different perceptions and feelings. Even if the missing person is believed to be dead, people may hope and keep waiting unless death is confirmed.

 

What should family members do in such cases? In many cases, they think they have to let it go on their own, while others are pressed by surrounding people to do so. It is very hard to determine.

Dr. Boss recommends the following: “There is no need to decide,” because in those cases, “I can’t decide” is the most reasonable position. Though it is difficult to live in “unclear” condition, it is necessary for family members to cope.

 

Therefore, those who are still struggling with not knowing the fate of their loved ones do not have to “decide an answer”. If you do not want to attend mourning ceremonies for the deceased, you don’t have to attend, and you don’t have to force yourself to hold a funeral to confirm the person’s death. However, it is important to do things that remind you of the loved one to maintain a feeling of attachment. For example, talking about the person with the family, displaying his/her photos, or displaying his/her favorite flowers can help maintaining a connection with the person.

 

Sometimes it is good to talk a little about your current thoughts to people in the same position, your family, and those who understand your thoughts. Even if the other person feels differently than you, that does not mean you are wrong. Because the situation is ambiguous and uncertain, thoughts and ideas vary from person to person. Coping with ambiguous loss starts with the concept that each person can have a different mindset. People around you and yourself can support each other when they become aware of it. When you feel that your thoughts have been respected, you can take the next step.

 

* If you’d like to know more information of ambiguous loss, please refer to “Ambiguous Lost Information Website”.

When deep grief persists

Bereavement caused by a disaster is also a major traumatic experience. The goal of such post-traumatic recovery involves neither forgetting the bereavement event nor ensuring you will not have such pain again. Sadness may return for many years and you will never forget the loved one.

 

However, long-lasting grief has been shown to cause various health problems. The state of prolonged intense grief is called “complicated grief”

(see “What is grief?” On the “Complicated grief and depression” page).

 

Please consult either a psychiatrist or psychosomatic physician, a counselor, a public health nurse, a psychotheapist, a public health center, or other support groups if your daily life is affected through experiencing any of the following for months at a time.

 

  • Cannot find the meaning of life
  • Feeling you should have died with your loved one
  • Strongly feeling that the death/missing of the loved one is your fault and often blaming yourself.
  • Cannot have a normal daily life
  • Feeling numb, as if all emotion has disappeared
  • Cannot trust anybody after bereavement
  • Excessively avoiding meeting and interacting with other people
  • Long term mental and physical dysfunction
  • Excessive smoking, drinking and medicinal intake        etc.
Procedures after bereavement

Since this page in the Japanese-version website is about procedures after bereavement in Japan (notification of death, inheritance, etc.), this page is omitted in the English language website.

Information on memorial services for the Great East Japan Earthquake

This page from the Japanese-version website contains information about the annual memorial services held in each city/town for victims of the Great East Japan Earthquake (2011.3.11).

These are abbreviated in the English language website.