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】
【2.Accept reality】
【3.Talk to someone you trust】
【4.Find someone to support you】
【5.Other useful things to know】
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”.
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.
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.
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.
https://saigai-kokoro.ncnp.go.jp/
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】
【Other matters】
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.