Grief as an emotionally personal experience of loss. Surviving grief: grief psychotherapy

Grief reactions.

Stages of grief.

Tactics of medical personnel with patients in a state of grief.

Death and dying.

Stages of approaching death.

Psychological characteristics of incurable patients, mental changes.

Rules of conduct with a dying patient and his relatives.

The themes of death, dying and afterlife are extremely relevant for everyone living. This is fair, if only because sooner or later we will all have to leave this world and go beyond the boundaries of earthly existence.

Elisabeth Kübler-Ross was one of the first to trace the path of dying people from the moment they learned of their impending end until they breathed their last.

Approaching death

Life leaves the earthly shell in which it long years occurred gradually in several stages.

I. Social death.

It is characterized by the need of the dying person to isolate himself from society, to withdraw into himself and move further and further away from living people.

II. Mental death.

Corresponds to a person's awareness of an obvious end.

III. Brain death means the complete cessation of brain activity and its control over various body functions.

IV. Physiological death corresponds to the extinction of the last functions of the body that ensured the activity of its vital organs.

Death and subsequent cell death do not mean, however, that all processes in the body stop. At the atomic level they continue their endless dizzying run elementary particles, driven by energy that has existed since the beginning of all time. “Nothing is created anew and nothing disappears forever, everything is only transformed...”

Emotional stages of grief

Often there is a terminal patient in the department. A person who finds out that he is hopelessly ill, that medicine is powerless and he will die, experiences various

psychological reactions, the so-called emotional stages of grief. It is very important to recognize what stage a person is currently in in order to provide him with appropriate help.

Stage 1 – denial.

Words: “No, not me!” - the most common and normal reaction of a person to the announcement of a fatal diagnosis. For a number of patients, the denial stage is shocking and protective in nature. They have a conflict between the desire to know the truth and to avoid anxiety. Depending on how much a person is able to take control of events and how much support others give him, he overcomes this stage easier or harder.

Stage 2 – aggression, anger.

As soon as the patient realizes the reality of what is happening, his denial gives way to anger. “Why me?” - the patient is irritable, demanding, his anger is often transferred to the family or medical staff.

It is important that the dying person has the opportunity to express his feelings.

Stage 3 – bargaining, request for deferment

The patient tries to make a deal with himself or others, enters into negotiations to prolong his life, promising, for example, to be an obedient patient or an exemplary believer.

The three phases listed above constitute a period of crisis and develop in the order described or with frequent relapses. When the meaning of the disease is fully realized, the stage of depression begins.

4th stage – depression.

Signs of depression are:

Constantly bad mood;

Loss of interest in the environment;

Feelings of guilt and inferiority;

Hopelessness and despair;

Suicide attempts or persistent thoughts of suicide.

The patient withdraws into himself and often feels the need to cry at the thought of those whom he is forced to leave. He doesn't ask any more questions.

5th stage – acceptance of death.

The emotional and psychological state of the patient undergoes fundamental changes at the acceptance stage. A person prepares himself for death and accepts it as a fact. As a rule, he humbly awaits his end. At this stage, intense spiritual work occurs: repentance, assessment of one’s life and the measure of good and evil by which one can evaluate one’s life. The patient begins to experience a state of peace and tranquility.

Most Popular modern systems psychotherapies are known to be built on early trauma. Often all subsequent personality formation occurs under the influence of psychogeny experienced in the early stages of development. These therapeutic schools provide diagnosis and treatment of early mental trauma. This type of injury can be very diverse. And for psychotherapy, what is especially important is not its objective severity, but the subjective expression of a person’s experiences. However, mental trauma we experience throughout our lives. And the very fact of ending our life is a trauma for our family and friends.

Death loved one- the most difficult loss, difficult to compensate. There are other losses that bring pain and suffering: divorce, loss of work, restrictions related to age, health, severe material damage, change of place of residence. Finally, the loss of a beloved animal. Of course, they are different in nature, but they evoke similar feelings of loss, grief and loss.

Living with grief, the “work of grief” is a long process. However, it has some certain patterns. Here are five characteristic stages of grief.

Stages of grief:

1.Shock and numbness

2. Denial and withdrawal.

3. Recognition and pain

4.Acceptance and rebirth.

5. Life after the end of grief.

These are the classic stages of grief, which are used in psychotherapeutic work in many schools of psychotherapy.

Types of grief.

A) – temporary (separation)

Permanent (death)

B) – real

Imaginary

The reaction of loss occurs at its own speed; this process cannot be accelerated. The grieving process can normally last from two months to two years. The grief of parents who have lost their children can last 4 - 5 years.

Physical manifestations of the reaction of loss:

Emotional shock, even if it is an expected death. Intestinal disorders: nausea, stomach pain, feelings of tension, compression, flatulence. Tension in the neck, spine, throat. Increased sensitivity to noise. A feeling of unreality of what is happening. Lack of air, suffocation, desire to breathe frequently, accompanied by fear of suffocation (hyperventilation). Muscle weakness, lack of energy, general weakness. Dry mouth. Headache, heart pain, increase blood pressure, tachycardia. Sleep disturbance. Loss of appetite (refusing food or overeating). Other physical manifestations.

Such symptoms can be observed for two to three weeks.

Emotional manifestations of the reaction of loss:

Sadness, tears. Motor reactions. Irritation, anger, auto-aggression (that is, aggression towards oneself). Aggression in particular can be expressed in accusations of doctors, relatives, funeral directors and other people. Feelings of guilt and self-blame. Anxiety, restlessness. For example, a person may feel various fears, feelings of fragility of himself and the world, and threat. Experience of loneliness, especially if communication was frequent. Feelings like the world has collapsed. To the point of refusing to leave the house. Feeling helpless. Yearning. Fatigue and tiredness, apathy or numbness. Shock. Numbness in the shock phase. If feelings for the lost person were contradictory (ambivalent), then there may be a feeling of liberation.

Intellectual disabilities:

Thoughts are scattered. He doesn’t believe what happened, it’s just a dream. Confusion of thoughts and forgetfulness. Obsessive thoughts in the head. For example, about the circumstances of death, about what could be changed or somehow returned. Feeling the presence of the deceased. The person thinks that he sees the deceased, hallucinations. Dreams about the deceased.

Changes in behavior:

Unaccountable actions. For example, he automatically bought what the deceased liked to eat. Social avoidance soon after loss. This is a normal reaction even for people leading an active lifestyle. But if this does not go away for several months, then we can talk about depression. Protecting the belongings of the deceased. When a person withdraws internally, he avoids these things. Avoiding anything that reminds you of the deceased. Search and call to the deceased. Tireless activity, a person does something and cannot stop. Frequent visits to memorable places, taking care of the grave.

Critical periods.

1) The first 48 hours after the loss: shock stage, denial, fear of losing other family members, fear of losing oneself in a physical and psychological sense.

2) 1st week after the loss: organizing a funeral, maybe the first exhaustion, the first suicidal attempts.

3) 2nd – 5th weeks: depressive stage, apathy, loss of strength, confusion, feeling of abandonment, lack of prospects. During this period, a person can already return to his usual activities (continue studying, return to work).

4) 6th - 12th weeks: awareness of the reality of the loss; by this point, shock reactions should pass. Typical manifestations: sleep disturbances, fears, crying spells, physical fatigue, emotional lability, decreased cognitive function (difficulty concentrating), changes in sexual activity, desire for solitude or an irresistible desire to talk about the deceased. If during this period the denial of the fact of loss continues, the development of pathological grief is possible.

5) 3rd – 4th month: alternation of “good” and “bad” days (periods of irritation are replaced by a feeling of calm), sensitivity to various kinds of frustrations, possible outbursts of anger, development of immunosuppression (somatic complaints, exacerbation of chronic diseases).

Stages 1 to 5 – acute grief. The characteristics of these stages depend on personal characteristics the person grieving, age, characteristics of the living environment, etc.

Normal reactions during this period are: physical suffering, preoccupation with the image of the deceased, feelings of guilt, hostile reactions towards others (or avoidance of contacts), loss of habitual patterns of behavior (inability to engage in purposeful activities).

6) 6th month: the severity of what happened was experienced (normally); during this period, holidays and anniversaries aggravate depressive disorders.

7) 1 year: first anniversary.

8) From 18 to 24 months: period of adaptation, building a new life without a loved one.

If, after 6 months, acute grief reactions persist, such as severe depression, psychosomatic disorders, hypochondriacal symptoms associated with the deceased, hyperactivity instead of grief, increased hostility towards others, a complete change in lifestyle, suicidal thoughts, apathy, inactivity, then we can talk about the presence of pathological grief.

Statistics.

Only 7% of those grieving need psychotherapeutic help (people who have experienced multiple losses, prone to self-destructive behavior, prone to depressive states, emotionally labile).

30% of those grieving need psychological counseling.

1% - in drug treatment.

Conditions requiring psychotherapy.

Signs of depression (apathy, loss of interest in what is happening, etc.)

A life based solely on memories

Sleep disturbance (restless sleep, insomnia, frequent awakenings, etc.)

Eating disorder (lack of appetite or overeating)

Sense of anxiety

Feelings of sadness, thoughts of suicide

(If at least three signs are observed - depressive disorder requiring therapy).

Pathological grief.

Prolonged grief experience

Delayed or suppressed grief reactions

Exaggerated grief reactions ( panic attacks, fear of death)

Disguised grief reaction (a person experiences certain experiences, but does not associate them with the event: behavioral problems, psychosomatics, a series of minor failures and losses)

Lazarus identifies the following signs of pathological grief:

A person cannot talk about the deceased, but there is no reaction of grief and the person died a long time ago

Experiences in similar events

Man talks about fatalism, fate, death

Preservation of the deceased's belongings (fetishism)

Similarity of somatic symptoms with those of the deceased

Imitation of the deceased in something

Use of alcohol, drugs, tranquilizers, drug dependence

Seasonal mood disorders, provided that they appeared only after a trauma

ACUTE REACTION OF LOSS OR Grief

TYPICAL COMPLAINTS

Acute grief is a normal and understandable reaction to the loss of a loved one. Patient

Depressed due to loss;

Fixed on the loss of a loved one;

Bouts of tearfulness are expressed;

Somatic complaints may dominate.

Grief can be experienced both with the loss of a loved one and with other significant losses (for example, work, usual way of life, breakup of a relationship). The reaction may provoke or intensify other psychopathological disorders, may be complicated, delayed or incomplete, and lead to long-term problems with mental and physical health.

DIAGNOSTIC SIGNS

Normal grief includes feelings related to loss, but is accompanied by symptoms resembling depression, including:

Depressed mood;

Loss of previous interests;

Feelings of guilt towards the deceased;

Periods of anxiety;

Tearfulness;

Desire to join the deceased;

Limiting contacts and social activity;

Difficulties in planning for the future;

Sleep disturbances (usually in the form of difficulty falling asleep and waking up at night);

Deceptions of perception are possible, often in a drowsy state (for example, the voice of a deceased person).

The pathological reaction of grief includes the following symptoms:

Feeling of longing for the deceased;

Search for the deceased;

Constant thoughts of loss;

Disbelief in the death of a loved one;

Lack of recognition of loss.

DIFFERENTIAL DIAGNOSIS

The experience of grief is a mental process with the necessary solution of the following tasks:

Recognizing the reality of the loss;

Awareness of loss;

Adaptation to life without a deceased person;

A diagnosis of depression should be considered if.

The reaction of loss to the death of a loved one can manifest itself as emotional shock with numbness and “petrification” or anxiety, crying, sleep disturbance, appetite, narrowing of consciousness due to traumatic experiences, constant memories of the deceased, mental anguish, etc. With such symptoms, patients often turn to psychiatrists and psychotherapists in connection with the death of loved ones.

The reaction to the loss of a significant object is a specific mental process that develops according to its own laws. This period life, accompanied by mourning, special attributes and rituals, has a very important task - the adaptation of the subject who has suffered a loss to a “new” life, life without the deceased person.

To date, there are no theories of grief (loss, bereavement) that adequately explain how people cope with losses, why they experience varying degrees and types of distress differently, and how and after what time they adapt to life without significant deceased people.

There are several classifications of grief reactions. Researchers identify from 3 to 12 stages or stages. These classifications assumed that the bereaved person moves from stage to stage. However, some experts criticize this approach. They believe that the main difficulty in using these classifications lies in the absence of clear boundaries between the stages, and periodically occurring relapses of the painful condition, when the patient returns to a stage that has already passed, seemingly successfully lived through.

Another feature of the manifestation of grief, which makes it difficult to use stage classifications and diagnose the current state, is its individual and changeable nature. In addition, in certain cases, some stages are absent or poorly expressed, and then they cannot be tracked and/or taken into consideration. Therefore, some authors prefer to focus not on stages and phases, but on tasks that must be completed by a person experiencing loss during the normal course of grief.

Thus, most modern specialists identify diverse options for the course and variability of grief experiences, which differ significantly in intensity and duration among cultural groups and among different people.

In his practice, it is important for a psychiatrist (psychotherapist) to distinguish the adaptive option of coping with a tragic situation (uncomplicated grief) from the maladaptive option (complicated grief).

Subjective experiences of loss are individually different for each person, and therefore clinical manifestations can be extremely variable. However, a psychiatrist (psychotherapist) needs to form an opinion about whether a person's grief is developing adaptively or not in order to decide on intervention. A clinician who does not represent the range of grief symptoms risks interfering with and possibly disrupting the normal process.

A professional's knowledge of the boundaries of uncomplicated, adaptive grief can help them recognize complicated grief and/or depression that follows the death of a loved one.

Although uncomplicated grief is determined to some extent by time criteria and the depth of experience, they are not decisive. The diagnostic criteria for uncomplicated grief are:

1. Presence of state dynamics. Grief is not a state, but a process. A “frozen”, unchanging state should inspire concern.

2. Periodically distracting attention from the painful reality of death.

3. The emergence of positive feelings during the first 6 months after the death of a loved one.

4. Transition from acute to integrated grief. Shear M.K. and Mulhare E. distinguish two forms of grief. The first is the acute grief that occurs immediately after death. It is manifested by pronounced sadness, crying, unusual dysphoric emotions, preoccupation with thoughts and memories of the deceased person, impaired neurovegetative functions, difficulty concentrating, and a relative lack of interest in other people and activities in everyday life.

During the transition from acute to integrated grief, the intensity of psychopathological disorders decreases and the person who has experienced loss finds a way to return to a full life. The loss is integrated into autobiographical memory; thoughts and memories of the deceased no longer absorb all attention and are no longer incapacitating. Unlike acute grief, integrated grief does not constantly occupy one's thoughts or disrupt other activities. However, there may be periods when acute grief becomes active again. This often happens during significant events, such as holidays, birthdays, anniversaries, but especially on “round” dates associated with the death of a loved one.

5. The ability of the bereaved subject not only to acknowledge the death of a loved one and part with him, but also to search for new and constructive ways to continue the relationship with the deceased. Faced with the dilemma of balancing internal and external realities, mourners gradually learn to once again perceive the loved one in their lives as deceased.

Researchers have found that the presence of the above criteria is a sign of vitality for bereaved people and is associated with good long-term outcomes for them.

Complicated grief sometimes referred to as unresolved or traumatic grief, is a common term for a syndrome of prolonged and intense grief that is associated with significant impairment in work, health, and social functioning.

Complicated grief is a syndrome that occurs in approximately 40% of bereaved people and is associated with an inability to move from acute to integrated grief.

With complicated grief, the symptoms overlap with those of ordinary, uncomplicated grief, and are often not taken into account. They are perceived as "normal" with the mistaken assumption that time, a strong character and the natural support system will correct the situation and free the griever from mental suffering. Although uncomplicated grief can be extremely painful and destructive, it is usually tolerable and does not require specific treatment. At the same time, complicated grief and various mental disorders associated with it can be maladaptive and severely disabling, affecting the functioning and quality of life of the patient, leading to severe somatic illnesses or suicide. Such conditions require specific psychotherapeutic and psychiatric intervention.

People with complicated grief are characterized by specific psychological attitudes associated with difficulties in accepting the death of a loved one. They perceive joy for themselves as something unacceptable and shameful, they believe that their life is also over and that strong pain the pain they endure will never go away. These people do not want the grief to end because they feel that this is all they have left of their relationship with their loved ones. Some of them idealize the deceased or try to self-identify with him, adopting some of his character traits and even symptoms of the disease.

Subjects with complicated grief sometimes show over-involvement in activities related to the deceased, on the one hand, and excessive avoidance of other activities. Often these people feel alienated from others, including those previously close to them.

Human He loses a lot and many people in his life. Loss is the loss of something or someone very significant to the individual.

The most difficult loss is the death of a loved one. This is one of the most severe psychological traumas that a person experiences during his life. Psychological trauma diverse in their degree negative impact psychological, and in some cases, physical health person. The psychophysiological states experienced after the death of a loved one are called bereavement syndrome or acute grief syndrome (E. Lindeman).
Man is mortal - this is clear to everyone mentally healthy person, but a person wants to prolong life, not only his own, but also that of close, personally significant people. Death is perceived by a person as evil, a huge misfortune, a tragedy in the life of the person himself and his loved ones. It becomes the moment of parting with everything that was in his earthly life - people, affairs, pleasures, joys and worries and fears, troubles, illnesses, grievances and insults, losses and suffering.
About death in our Russian culture under the influence of other world cultures, a tradition of silence has developed - people try not to talk about it, not think about it, avoid it life situations associated with death. And a person who has adopted such a cultural tradition finds himself defenseless and unprepared for a situation where he himself is faced with the death of a loved one or the possibility of his own death, as a rule, due to a sudden diagnosis of an incurable disease that quickly leads to death.

Death of a loved one

Among the many losses that befall a person in his life, death of a loved one, a loved one – the most powerful, affecting all aspects of life, the most painful and long-lasting trauma.
The experience of the death of a loved one is always associated with the fact that this is not one’s own death, but another person’s; this is an area of ​​life in which intervention is limited by the characteristics of the relationship with him. In what cases can a person do something to prevent death that threatens a person against his will, without his consent? There are many situations when this can and should be done. In some cases, inaction is assessed as a crime.
These are not idle questions; everyone who has lost a loved one or loved one faces them - “What could I have done? ...and he (she) would be alive!...".
The severity of the experience of loss depends on several very important reasons:
relationship with the deceased, cause and circumstances of death.
Features of relationships with a deceased person during his lifetime influence the strength and content of experiences in connection with his death. The strongest, deepest feelings of grief, suffering, and despair are experienced by people who had a close, trusting relationship with the deceased, based on feelings of love. In this case, a person loses the source of human love for himself, the opportunity to reveal his thoughts, feelings, etc. in trusting, understanding communication.
In conflicting, unstable, problematic relationships, the experience of loss is dominated by feelings of guilt, powerlessness from the inability to change something in the relationship, which are combined with a feeling of grief.
The death of relatives is most calmly experienced in the case of a formal, alienated relationship with him.
Cause of death of a loved one is a significant factor determining the complex of a person’s experiences in connection with this event. The disease and the characteristics of its course, suicide, violent death (murder), sudden due to emergency circumstances (transport accidents, natural disasters, military operations, etc.) - these causes and circumstances of death largely determine the attitude towards the very fact of death, towards to a deceased person, to life, the answer to the main question for a bereaved loved one: “Why? Why did he/she die?
Death that occurs as a result of a serious, incurable, long-term illness is perceived by loved ones as inevitable, and even liberation from the torment that is more or less present at the dying stage of life.
The death of a patient, whose condition is not assessed by relatives, and in some cases by doctors, as life-threatening, is often considered by the patient’s relatives as a consequence of dishonesty and incompetence of medical workers.

The violent death (murder) of a loved one adds to the overall complex of a person’s experiences and an acute sense of the injustice of life, people, and the world. The actions of other people that resulted in the premature death of a loved one give rise to a feeling of resentment, a perception of people and the world as hostile and unfair, and in some cases, a desire to take revenge on those responsible for the death of a loved one.
In each case of loss, a person always decides for himself the question of the degree of his own guilt in what happened, about his responsibility for the death of a loved one. The dynamics and quality characteristics the process of experiencing loss syndrome.
Death and the loss of loved ones stimulate a person to rethink his views and beliefs, becoming a factor in the psychological maturity of the individual, deepening self-awareness and reflection. If this does not happen, then various disturbances in the experience of grief arise, leading to a violation social adaptation personality, its relationship with reality.

Grief of loss

Loss is an experience, a human experience associated with the death of a loved one, which is accompanied by a feeling of grief. The experience of grief, like the entire emotional experience of an individual, is very individual and unique. This experience reflects social experience, features of personal culture, psychological characteristics personality. Everyone's grief is unique, inimitable and can lead to psychological crises.

Psychological causes of grief are associated with feelings of affection and love for loved ones. Grief in this case, it is experienced as a feeling of loss of the source and/or object of love, well-being, and security. The experience of grief is combined with emotions and feelings such as suffering, fear, anger, guilt, shame and ends psychological state calming down, increasing efficiency, activity, etc. The experience of loss affects all spheres of human life and becomes a period of one of the psychological crises in a person’s life (crisis of formation).
This syndrome may occur immediately after a psychological crisis, may be delayed, may not be clearly manifested, or, conversely, may appear in an overly emphasized manner. Instead of a typical syndrome, distorted pictures may be observed, each of which represents some aspect of the grief syndrome.

Signs of acute grief syndrome

In one of the first works by E. Lindemann (1944), devoted to the acute grief syndrome that occurs after the loss of a loved one, a number of features of this feeling were highlighted. Acute grief is a specific syndrome with specific psychological and somatic symptoms.
E. Lindemann identified five signs of grief:
1) physical suffering,
2) absorption in the image of the deceased,
3) wine,
4) hostile reactions,
5) loss of behavior patterns.

In 1943, in the work of E. Lindeman “Symptomatology and the work of acute grief,” the concept of “work of grief” was first introduced. In modern psychotherapy, it is generally accepted that whatever the loss, at the first time of loss he experiences acute mental pain and experiences an unbearable painful feeling of grief. Experiencing grief and coming to terms with loss is a gradual, extremely painful process during which the image of the deceased is formed and an attitude towards him is developed.
The work of grief is to psychologically separate from the irretrievably lost loved one and learn to live without them.
Feelings of guilt for the death of a loved one can be experienced in relation to oneself (self-blame), towards other people ( medical workers, relatives, people who caused violent death, etc.), to supernatural forces (fate, God).
Self-blame manifests itself in the fact that people blame themselves for any omissions, considering themselves to blame for the death of a loved one due to the fact that they did not notice something in time, did not insist on something, or did not do something.
Accusations against doctors, nurses and other health workers most often remain at the level of interpersonal communication in the immediate circle of people experiencing acute grief syndrome, but in some cases they are translated into complaints and statements to official authorities and legal proceedings. Relatives may claim that the patient did not receive the necessary treatment, died as a result of the negligence of medical staff, a poorly performed operation, etc.
Accusations against people who caused violent death, death in road and other accidents, during military operations are often accompanied by a feeling of injustice and, in some cases, a struggle for fair punishment for the perpetrator of death. In these cases, the relatives of the deceased person seek a more severe punishment for the perpetrator.
Accusations against other people and taking some actions to restore justice are usually accompanied by the motive “so that others do not get hurt” and a feeling of revenge, although this feeling may not be realized or covered up by reasoning about fair retribution.
Accusations against God are found among people of little faith, when much is still unknown in the professed religion, not understood or understood erroneously. In Orthodoxy, this takes the form of murmuring against God, when a person resists and does not want to accept what is happening according to His will.
Late manifestations of the mourning reaction are expressed in the suppression of all feelings, complete emotional muteness of a person. This reaction of inhibition occurs much later than the mourning event.

Stages of bereavement

Experiencing the loss of another person involves three stages.
First stage- this is an experience of a state of psychological shock, which is accompanied by numbness, a kind of lethargy after the shock, a sharp decrease in psychological, intellectual and motor activity. Often a person is unable, unable to accept, to comprehend a terrible loss. He may even deny the fact of loss and act as if the deceased continues to live. The mourning reaction can manifest itself in the fact that a person adopts character traits and habits of the deceased, often continues his work. Such phenomena of identification can also manifest themselves in experiences of fear and anxiety that he, too, will die from the same cause as his relative. A state of “internal muteness” sets in. The person does not yet realize the loss. Everything that needs to be done, he does automatically, by inertia. Disturbances in sleep, appetite, and absent-mindedness may occur. Everything is perceived as empty and unnecessary.

At the second stage negative experiences manifest themselves in the form of such psychophysiological reactions as states of melancholy, despair, in the form of crying, sleep disturbances, appetite, attention, exacerbation of psychosomatic diseases, outbursts of anger, attacks of unaccountable anxiety and restlessness, and a depressed state. A person recognizes the event as a fait accompli that radically changes his life. External manifestations negative emotions, even very strong ones, vary according to psychological characteristics a person’s personality, his sociocultural experience and worldview characteristics.

At the third stage there is a psychological “acceptance” of knowledge about the accomplished event, an understanding that life goes on, despite the most difficult losses. At this stage, the restoration of psychological balance, the ability to think rationally and continue to live occurs.

The spiritual meaning of loss

The spiritual component of bereavement syndrome in scientific psychology it is considered to a small extent. Psychological crisis arising due to loss of identity significant person, involves the revision and resolution of many life-meaning, worldview issues. Attitude to death, its types, causes and circumstances, questions of belief in life after death, the meaning of life when death is inevitable and meaning own life after loss - these are questions that become especially relevant for a person who has experienced the grief of loss. Their decision determines the ability to cope with feelings of resentment, anger, despair, the desire for revenge on the “culprits” of death, and the ability to live on without the deceased person.
To the greatest extent, the spiritual meaning of a person’s death is revealed with a religious, Orthodox understanding of human life and death. Many Christian preachers have spoken and written about this. Surprisingly simply and clearly, recalling incidents from life, the Athonite man close to us in the time of his earthly life spoke about the meaning of the death of loved ones (children, spouses, parents) Elder, Saint Paisius the Svyatogorets.

“Of course, a person experiences pain because of the death of a loved one, however, death must be treated spiritually.”
“If people have comprehended the deepest meaning of life, then they find the strength to treat death correctly. After all, having comprehended the meaning of life, they relate to life spiritually.”
The spiritual meaning of death is that it is the moment of transition to another world, the world of eternity, where a person can no longer change anything either in himself, or in relations with other people, or in relation to God.
“No one has ever signed a contract with God about when to die. God takes each person at the most appropriate moment of his life, takes him in a special way, suitable only for him - so as to save his soul. If God sees that a person will become better, He lets him live. However, seeing that the person will become worse, He takes him away in order to save him.”
The unexpected tragic death of a beloved child. How to survive this?!
“ - Geronda, one mother comes here and grieves inconsolably because she sent her child on business, and he was hit by a car to death.
- Tell her: “Did the driver hit your child out of spite? No. You sent him on business just to get hit by a car? No. So say: “Glory to Thee, God,” because if the car had not hit him, he could have walked along a crooked path. And now God took him at the most opportune moment. Now he is in Heaven and does not risk losing it. Why are you crying? Don't you know that you are torturing your child with your crying? What do you want: for your child to suffer or for him to be happy? Take care to help your other children who live far from God. You should cry for them, and not for the one who was killed.”
Recognizing that the death of a loved one occurred by the will of God and for the good of both the person himself and other people is extremely difficult, since this requires abandoning the logic of earthly man, the logic of self-will and the recognition of any other justice other than the justice of God. But this is the only way that gives strength to a person and the meaning of life as a phenomenon that is not limited to the existence of a biological body.

Literature
1. Saint Paisius the Svyatogorets. Words. T. IY. Family life/ Translation from Greek by Hieromonk Dorimedont (Sukhinin). – M.: Publishing House “Holy Mountain”, 2010.