Bereavement and addiction

Julia Samuel, Psychotherapist, writes for us on bereavement and addiction. Also included is a review of Julia's best-selling book "Grief Works", by Elsa Browne.

This is an extended article from the small section on Grief and Addiction in my book.

Every year 500,000 people die in the England, and since at least 5 people are affected by a single death, that is a great deal of grief. Yet as much as we each know we are going to die, and cannot live life without being bereaved, grief and death is the last taboo. The difficulty with grieving the death of someone we love, is that it is an invisible process, and since it is profoundly misunderstood, people do not know what to expect, or get the support they need. The key understanding is that pain is the agent of change, it is the pain that forces us to face the reality - that we absolutely don’t want to be true - that the person we love has died. We need to find ways of supporting ourselves to endure this pain, (see below) but often old defence mechanisms kick into action. These can be harmful, like drinking too much, or taking drugs.

It is very common for those who are bereaved to increase their consumption of alcohol and drugs in order to anaesthetize the pain of grief. In my book ‘Grief Works’ many of the people whose stories I tell found themselves turning to the bottle or drugs for ‘comfort’ - for a break from the pain. They knew, as we all do, how bad a habit is, but we do it any way. Maybe we haven’t fully taken on board the fact that alcohol itself is a depressive; nor that when we are bereaved we’re particularly vulnerable to addiction as the pain can feel unbearable. Drugs and/or alcohol taken to medicate depression only exacerbate it. Those who experience anxiety and depression are twice as likely to be heavy or problem drinkers. A third of the people who are depressed in the UK also have a drug and/or alcohol addiction, and often unresolved loss is at the root of this habit. Some research shows 15% of all psychological disorders come from unresolved grief.

The line between a heavy drinker and a dependent drinker is a difficult one to draw, but their respective attitudes towards the drink and/or drugs are what usually differentiate the two. An addicted person’s central relationship is with their drug of choice, and they use the alcohol/drug because they believe they are unable to function without it. It controls them. Whereas a heavy drinker that binges or regularly drinks too much, could become dependent, but as yet believe they have control. Addiction often runs in families, and there can be a genetic predisposition, while some believe it is a personality type; but the most likely factor in its transmission down the generations is conditioning: children learn from their parents that drinking or taking drugs is an acceptable way to deal with difficulty.

Whatever the reason for their misuse, drugs and alcohol increase the risk of bad outcomes for the bereaved, and, as a consequence, their children, sometimes even many generations of their children. For our children learn how to grieve by observing the adults around them. When addiction prevents people from accepting the reality of their situation, not wanting to believe that the person has actually died (as if accepting it, is giving up on the person), it is this absolute determination not to surrender to reality, that prevents people from moving beyond their grief, and living their life to the full. It often becomes a very sad twilight life, full of regret, rage and bitterness.

Recovering from addiction to alcohol and/or other drugs for someone who is grieving is an important part of moving on. It is also important that when someone is in recovery that the grieving process is taken very slowly, as they are at this point vulnerable to relapse. It is equally important that they find a system of support like AA and the 12 step programme, as well as a therapist. If someone does find a way of dealing with their addiction to alcohol and/or other drugs it may mean, that they will also grieve the years they have ‘lost’ - the relationships that have been damaged, for their lack of ‘presence’ in their own life.

On my website there is a section called What Helps with links to bereavement organisations and psychotherapy, as well as the 8 Pillars of Strength that I have designed for people to help them identify ways they can support themselves through the grieving process.

Julia Samuel, psychotherapist and author

Book Review: "Grief Works – Stories of Life, Death and Surviving"

Julia Samuel is a grief psychotherapist who works in private practice and with the NHS. She has written an illuminating, important book about the subject of death, bereavement and grieving. Pertinent to our sector is the truth that people who are in the midst of grief and grieving will frequently turn to the use of alcohol and other drugs to take the edges off the pain of their experience. For some this may be a transient phase in the process, but for others it is the start of a tilt into dependence and addiction. But in our human experience, grief cannot be avoided by hiding the pain of grief.

Substance misuse as an escape can continue for years and affect all with whom the person comes into contact, until perhaps the grieving process is complete and a “new normal” is found.

In "Grief Works" Julia describes case studies where people who have lost their partners, children, or parents have generously agreed to have their stories told so that we may all study how grief can be made to work so that we can “live and learn” from great loss. The book includes a section on people facing their own death.

Despite the difficult subject matter, it is a book that exudes hope, as we work through the process with each person in the case study and sense their pain lifting, or inner peace achieved. Each section has an end chapter on reflections.

Whilst reading, I too could not help but reflect – with drug related deaths at its highest recorded level ever in the UK – on how many people currently in treatment will also be affected by the death of a friend, peer or family member. The book provides suggestions for practical support (the “8 pillars of strength”) to aid the work that needs to be done to help people to grieve – and ultimately survive - the loss of a loved one. A highly readable book, suitable for practitioners as well as lay people, it encourages making work of grief, and making grief work.

Elsa Browne, SMMGP