Grief and time

When Lynne came to see me, she was in great distress. Her story was heartbreaking. At six in the evening her 10-month-old baby had a fever and seemed very sick. Over the telephone, after a few quick, specific questions, the paediatrician reassured her, ‘It doesn’t sound very serious. A little paracetamol tonight and we’ll see tomorrow morning.’

At 11pm the baby was no better and Lynne was having trouble getting him to open his eyes. Despite the late hour, she decided to call the paediatrician at home. Clearly irritated at this intrusion, he answered curtly that nothing major seemed to have changed. He told her to give the child a little more paracetamol and bring him into his office the next morning at 9am. Lynne was still worried. She decided not to go to bed and settled down in an armchair in the living room to keep an eye on her son. Holding him to her breast while she rubbed his back, she felt his breath – too warm – against her neck.

At 5am she woke up with a start, furious with herself for dozing off. The child she held in her arms was dead.

Since then, Lynne had been virtually sleepless. What little sleep she’d had was troubled by nightmares. During the day, the scenes of that last night with her son would flash through her mind, and her throat and stomach would tighten. She blamed herself for being a bad mother. Why hadn’t she disregarded the paediatrician’s advice and taken the baby to hospital? She didn’t think she could go on living with her pain. Sometimes she could feel her son’s hand in hers or his breath on her cheek. She wondered if she was going mad.

Finally, Lynne went to see a therapist. The diagnosis was easy: she was experiencing a traumatic bereavement. If Lynne had suffered that way for a while, say two years, nobody would hesitate to offer treatment to help her work through her grief. If it had lasted six months, some people would ask, ‘Has she mourned long enough?’ In Lynne’s case, only three weeks had gone by. Should she be sent home with her suffering? ‘Sorry. Your pain is a reaction to the loss of a loved one and it must follow its normal course. You haven’t suffered long enough to get help right now. Come back and see me when your grief has lasted at least six months.’ Who's to decide how long someone else’s suffering should go on?

Today we know that fewer than eight sessions of grief-focused therapy are needed to relieve the symptoms of traumatic bereavement in more than 80 per cent of cases. What benefit is there in depriving a grieving person of potential relief? Does a therapist have the moral right to refuse treatment to someone who asks for help? Patients who have lost a loved one often feel that their grief is a way of honouring the memory of the departed. But, after several weeks, what would Lynne’s son have wished for his mother?

By the end of the sessions, Lynne herself had found the answer to this question: ‘I no longer feel blocked by the horrible scenes of that last night with him. I can now see again the sweet and tender moments we shared. I’m grateful for everything that he meant to me.’ Then she put her hand on her chest. ‘He’s at peace now, and I feel him in my heart. I will never forget him and he will always be with me. My life can go on.’ Should she have had to wait six months to achieve this state of acceptance?