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Therapeutic rituals to overcome grief

The Bottom Line

  • Grief is the emotional pain associated with the death of a loved one.
  • Rituals play an important role in the treatment of grief in all cultures. They must be taken into account to alleviate the distress of the survivors and enable them to cope with their grief.
  • However, when death occurs in violent, unnatural, or traumatic situations, some people may not be able to cope with their grief.
  • Rituals, other than funerals, are also used in therapeutic interventions to reduce the negative effects of prolonged or traumatic bereavement. They take place in a symbolic reality that allows you to take a certain emotional distance and create a space to feel and express your emotions.

If you have lost a loved one during the COVID-19 pandemic or any other traumatic event, you may still be struggling to grieve. From one country to another, from one community to another, and from one historical period to another, funeral rites help to overcome the death of a loved one by allowing mourning to begin, and this, while being surrounded by those close to them.

Families bereaved during pandemics or violent events have more difficulty in grieving because the rites are disrupted or sometimes impossible to perform, which disrupts the grief and bereavement process. Without being able to count on the support of the community and without being able to pay homage to the deceased, these people are at risk of prolonged and complicated grief, post-traumatic stress disorder, and other mental health problems.

Can rituals used in a therapeutic setting help people overcome prolonged and complicated grief?

What research tells us

A systematic review of 22 studies examined rituals and symbolic interventions aimed at reducing the symptoms of prolonged and traumatic grief in different populations.(1) These people experienced the death of a loved one in various circumstances: the death of a loved one by homicide or following a disappearance, a perinatal death, a genocide, elderly individuals who lose their life partner, professionals who are close to death (for example, police officers or personnel in palliative-care settings).

Rituals used in therapy for prolonged grief are sensory acts performed in a structured way and using symbols. Whether conducted in groups or alone, under the benevolent guidance of a therapist or independently, at home or in public places, ritual experiences create an alternate symbolic reality that allows one to express one's emotions in a controlled and safe environment.

Different interventions are used in therapeutic rituals: meditating, communicating symbolically with the deceased or an imaginary friend, writing a letter, reading religious texts or poems, keeping objects and images to remember the deceased, lighting up candles, or holding a farewell ceremony.

The social aspect of the rituals, whether funerals or done as part of a therapeutic intervention, and the feeling of belonging to a community are one of the key functions of rituals in our society. Sharing grief is comforting and promotes cohesion and solidarity.

Almost all studies show significant positive effects of following a therapy for prolonged grief, including rituals to decrease symptoms associated with prolonged grief, such as depression, post-traumatic distress, hopelessness and panic behaviours, intrusive thoughts and loneliness. Additionally, some studies have reported improved memory, positive mood, personal growth, and integration of meaning.

The review also reveals that some immigrants and members of ethnic minority groups often exhibit persistent symptoms of grief. One possible explanation is the lack of rituals, whether because of the inability to perform culturally appropriate rituals or the disconnect between the cultural customs of the host country and their own cultural traditions.


Overcoming grief together

In the first few months after the loss of a loved one, the normal symptoms of grief gradually begin to subside. However, if these symptoms persist or worsen, you may be experiencing prolonged and complicated grief.

Signs and symptoms of prolonged and complicated grief can include:(2)

  • Intense grief and persistent pain
  • Difficulty focusing on anything other than the death of your loved one
  • Difficulty accepting death or lingering bitterness
  • A feeling of numbness or detachment
  • A feeling that life has no meaning or purpose
  • A lack of trust in others
  • Inability to enjoy life or remember positive experiences
  • Having trouble performing normal routines
  • Isolating yourself from others and withdrawing from social activities
  • Experiencing depression, deep sadness, or guilt

If you have these symptoms, or if you know someone who is going through prolonged and complicated grief, get help. Programs and services exist to support those experiencing grief. Crisis Services Canada provides a list of crisis and counselling centres across the country (including local bereavement support groups). These centres are there to help you.


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Author Details

References

  1. Wojtkowiak J, Lind J, Smid GE. Ritual in therapy for prolonged grief: A scoping review of ritual elements in evidence-informed grief interventions. Frontiers in Psychiatry. 2021 Feb 3;11:623835. doi: 10.3389/fpsyt.2020.623835. PMID: 33613334; PMCID: PMC7887294.
  2. Mayo Clinic. Complicated grief. Web resource accessed on December 1, 2021.

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