The Grieving Couple

By Father John Chalmers, Chaplain, Mater Mothers Hospital, Brisbane.

Amid all the finery and romance of the wedding day, couples promise 'to be true to each other, for better or worse, for richer or poorer', till death. They say 'for better or worse' but most presume it will be mainly a matter of being 'better' and 'richer'.

Eventually, usually sooner rather than later, the romance fades, the ordinary demands of life take precedence over gifts and flowers and adulation, and couples begin in earnest the gradual and demanding task of building and nourishing an intimate relationship.

Before they married, they thought they knew each other so well; they imagined they were able to talk about anything together, and they perhaps believed that they had something special between themselves. In the early months of marriage, they realise the truth in those early assessments of their relationship but in the new way they see themselves and each other, they realise how far they have yet to go. In those first few crucial months of marriage, husband and wife, now relaxed with each other - the frantic activities of wedding preparations behind them - unconsciously test out each other, as a swimmer tests out the chill of a pool with a foot before diving in. Many couples, no longer needing to 'impress' or 'humour' or 'caress' each other, say things to each other that they'd never have been able to say before their marriage. And one of two things happens; either the barrier goes up and that issue isn't mentioned again; or a whole new area opens up in the relationship. The result of this 'testing out of the water' by both partners is that after the first twelve months or so of marriage, most couples know quite well whether or not they can talk about everything - or whether, more likely there are some things better not spoken about. Perhaps these things - worries or anxieties - are 'better understood' by a mother or by a friend or by a mate. It's seldom appreciated that no issue or topic is 'touchy': rather It's me or you who is 'touchy' about this particular issue. Looking at 'why I'm touchy about this issue' can lead to some healthy learning about myself, and if shared with one's partner can develop a closer intimacy.

One of the most significant things in any marriage is the process of preparing for a baby. Perhaps it's a first child (and maybe a first grandchild for one or both sides); perhaps it's a second or third child (and the parents feel 'old hands' at it). Preparing for a baby doesn't belong to the husband and wife alone - it calls forth great anticipation and excitement within both families, with friends, work mates even the local butcher and postman!

For most couples the 40 weeks of pregnancy is a very precious time - of heightened closeness; of shared anticipation; of future plans. It's a time filled with life and hope and all that's good.

Perhaps more people are aware today of problems that can occur in pregnancy, but most couples doubt that they will encounter those problems. Pregnancy is a special time of choosing names, of planning the nursery, of fantasising with the expanded role from being husband and wife to also being mother and father.

Then, out of the blue - word that there are serious problems. Perhaps the foetal heart beat is unable to be detected; and then scans confirm the unthinkable. Perhaps these serious problems with the child are detected only after birth .

No matter what stage parents receive the bad news about their baby, they are, for the moment knocked off kilt. Many parents say that, on hearing that their baby was dead, they felt empty inside - as though their stomach had dropped and fallen away. Many speak of feeling weak all over, or of feeling dazed - almost apart and floating away from people around them. Over the days that lie ahead their feelings will change, often dramatically and in swift succession. The initial shock will wear off; various arrangements will keep the couple somewhat occupied; family and friends may swamp them (or perhaps keep away, because they don't know what to say). However, once the initial shock has gone, (and the funeral rites have been held), it can't be presumed that the time has arrived for the bereaved couple to 'pull themselves together' and to 'get over' their baby's death .

Once the initial shock has passed, the couple are in a position to get on with the hard work of grieving. Their baby's death has many unthought-of connections with the rest of their lives: only gradually in the months ahead will those different perspectives be encountered, one by one. There will be those chance meetings with people who haven't heard about the baby's death, and ask whether it was a boy or a girl. There will be the pain and agony of putting away the cot and layette and all the things waiting for the baby's coming home. There will be the happy births of friends children. These, and so many other happenings, so innocuous in themselves, serve to focus for bereaved parents more deeply the many facets of their loss.

For many bereaved parents, this is the closest they have ever been involved with death. For many, it is a totally new experience. Few imagine that life could deal such painful blows; that one's heart could be so completely broken. This is certainly 'the pits' - the 'for worse' side of the marriage vows.

The death of one's baby causes unimaginable heartbreak, and touches deeply the very core of the mother and father. Ironically, it can be a time of coming closer to each other than was ever imagined possible. Yet, for many it can be a time of aloneness and separation - most of all from one's own partner.

The loss of a baby often confronts a couple with the harshness of reality more intensely than they have ever previously experienced. It presents at the same time an opportunity to grow closer to or distance oneself from one's partner .

When a couple lose their baby they (each in his/her own way) are confronted by a muddle of feelings. Husband and wife can choose to do many things with those feelings - and how they handle them determines how they are going to cope with the loss.

We'll identify some of the feelings that bereaved couples commonly experience - but before doing so, it's worth being aware of the various ways those feelings can be dealt with. One way of coping with the feelings is to try to ignore them: to keep them inside: to put on a strong front (possibly thinking that this is the best way of helping one's partner). We can bury our feelings - but they are buried 'live' and will refuse to stay buried. They may re-emerge in physical signs of high blood pressure or migraine headaches or peptic ulcers. When we keep our feelings to ourselves particularly the intense sort that follow the loss of one's child - we may find ourselves married to our feelings rather than to our spouse.

Another common way of coping with those feelings is to talk to an understanding person - a friend, a family member, a minister. A bereaved mother may find herself receiving much help from another bereaved parent because her husband 'seems to have got over it', or because she 'doesn't think her husband wants to talk about it.' Fortunate indeed is the parent who has access to another bereaved parent who is willing to listen . However, when a bereaved mother or father shares her/his grief with someone other than the partner, a priceless opportunity for deepening intimacy between husband and wife is forfeited.

Holding back from each other the pain and the emptiness and the hurt that the baby's death causes deep down inside is not only counterproductive - it is a sure road to marital aloofness and disharmony. When a person is worried or upset about something, and for some reason 'keeps it in', the feelings will rise to the surface in other areas - maybe it will surface as a very short fuse, or as 'illogical' irritability with one's partner or children. There's much truth in the old saying: 'Whoever conceals his/her grief finds no remedy for it.'

What most people dread after losing a baby is that their behaviour may seem to be illogical or irrational. However, when bereaved couples talk with other parents who have lost a baby it soon becomes clear that 'they are not going crazy', but that the up and down and 'crazy' feelings they are experiencing are very common reactions to pain and confusion - and are to be expected.

Most parents (especially mothers) feel guilty that their baby has died. They search the months of pregnancy trying to pin the cause for their child's death on something they may have done. This is a normal reaction, and healthy so long as they talk about it together, rather than hiding these feelings from each other. It's only after they have gone through the long, slow process of checking out possible causes that they will gradually come to accept that they didn't cause their baby's death.

Bereaved parents often feel neglected when friends don't mention the baby, or stay away because they don't know what to say. Some bereaved parents have found it helpful to say straight out that they understand how their friends feel, and that they will tell them when it's O.K. to talk about the baby.

Many parents, on the death of their child, experience a whole new sense of being alone more isolated than they have ever felt before. There can be a tendency to become sullen and silent, and bury oneself away from others - even one's partner.

This can result in friction and apartness from the one person who most shares the depth of the sorrow: this' hell' breaks when partners break - in tears or in each other's arms.

Having 'lost' a baby, many parents feel lost themselves with a real sense of failure: 'What kind of parent am I? I'm not even able to have a normal child?'

Sometime one partner thinks she/he has to be strong to be a good support for the other. Rather than being helpful, this approach can leave the 'supported' partner with the impression that the other 'doesn't really care about our baby'. Our society wrongly promotes the image of a tearless griever. In fact the greatest support a person can receive is to hear and understand how the death of the child really affected the other.

They may also fear the possible outcome of future pregnancies. This is quite understandable. If the baby dies from a genetic disorder, genetic counselling could put the parents' fears about recurrence of their problems in a more helpful context.

Some parents regret that their stillborn child was not baptised. They may need to be helped to an understanding of God as unconditionally loving their child and quite capable of taking care of him/her. (Limbo has never been part of the Church's official teaching)

It is quite normal for bereaved parents to feel angry/to vent their anger illogically at random targets- doctors, nurses, chaplains, their partner, God, or all of these.

Such reactions are normal and may help couples to enter the healing process of grieving. They may need to be reassured that they are losing neither their sanity nor their faith.

All of these feelings - and many others - are commonly experienced by bereaved parents. They are not 'touchy' feelings in themselves; rather one or either partner may 'feel' touchy about experiencing these feelings. Such feelings are neither unhealthy nor harmful to any marriage. This article has suggested that unbearable conflict arises over the refusal of couples to share how they feel about their child's death - or to put it another way; even a terrible situation like the death of one's baby is an occasion for growth in intimacy with one's spouse when that grief is shared.

Let Kahlil Gibran have the final word:

'We forget the people we laugh with:
but we never forget the people we cry with'.

Coping strategies after baby loss

During pregnancy

• take pregnancy one step at a time
• good antenatal care extremely important for reassurance & support i.e. good medical support
• consider issues like where to deliver
• preparation for your labour & delivery
• what emotional supports do you need to choose your support carefully
• need to discuss your concerns with professional staff & investigate your worries e.g. to 'manage your molehills before they become mountains!'
• importance of knowing your particular needs and anxieties are recognised & respected.
• Empowering to feel 'held' safely
• deal with communication problems early
• often people feel their experience of losing their baby undermines their confidence.
• Acknowledge & accept what you feel.

Coping emotionally

• recognise & acknowledge your feelings. Don't push yourself to feel better.
• express your feelings. Let yourself cry.
• obtain support from those who do understand i.e. SIDS and Kids / counsellor.
• develop the skill of inner encouragement when facing difficult situations.
• learn some relaxation techniques.
• nurture yourself- do little things every day that make you feel good about yourself.
• take care of your physical self - get gentle exercise, rest, sleep.
• give yourself enough personal time for relaxation.
• develop & enjoy your hobbies & interests.
• Plan pleasant activities/outings/talk to friends.
• don't overload your life, don't rush.
• Be aware of unreasonable expectations on yourself.

After birth

• be aware of your own feelings.
• allow yourself time to adjust.
• be gentle on yourself re your expectations.
• unrealistic expectations - 'it will all be wonderful'.
• normal parenting has its difficult times & adjustment e.g. colic, sleep problems etc.
• limit visitors for a few days if it's helpful.
• gain support i.e. SIDS and Kids members/special friends.
• allow time for new relationship to develop with your new baby.
• issues re new baby
• Not 'an identical replacement '.
• Difficulty as new baby may look similar, sex of new baby different/same.

Deborah Foster-Gaitskell
Clinical Psychologist (Phone: 61 9 2713582)

DEALING WITH DEATH

By Margaret R. Diaz, RN,C, BSN

When a Baby Dies
How you can comfort and support grieving parents.

Debbie and John Brenner, a couple in their early forties who had undergone treatment for infertility, are coming to the neonatal ICU to visit their 10-day-old daughter, Sara, for the last time. Sara was diagnosed as having inoperable complex congenital heart disease and is being taken off the ventilator this morning. As Sara's nurse, you wonder, What can I possibly do or say to ease these parents' pain?

We have a responsibility to support parents experiencing the death of a baby. Stillbirth or neonatal death is devastating for families, as is foetal loss. Unfortunately, even the most caring and well-intentioned of us may shy away from these families because we feel uncomfortable and don't know what to say or do. This only adds to their feelings of grief, helplessness, and abandonment.

You can make a big difference in how families experience the death of a baby. By offering compassion, words of comfort and support, and some remembrances of their small loved one, you can guide them through the first painful hours and days and help them begin healthy grieving. Though I'll focus here on care of the family losing a newborn, many of the steps I'll describe may help you in supporting a patient, friend, or co-worker who has a stillbirth, miscarriage, or other foetal loss.

Soul-searching on your part:

Before you can support a grieving family, you need to reflect on your own feelings about their loss. Are you blaming the mother because she has a history of smoking or drug or alcohol abuse? Do you disagree with the decision to take the baby off the ventilator or think that it should have been done sooner? It's hard not to be affected by such feelings, but sometimes you have to put them aside in order to care for the family. Acknowledging these feelings is the first step.

More often, we have compassion, not disapproval, for parents, and we struggle to hold our feelings inside. Letting your feelings show will convey this compassion and reassure the parents that it's okay for them to grieve.

Don't be afraid to ask for help in coping with your emotions. Talking with your family, friends, and co-workers can help relieve stress.

No magic words

There are no magic words you can say to make things better. But parents experiencing the death of their baby don't expect you to have any. Parents like the Brenner's aren't looking for advice or solutions but for some guidance and support. Acknowledge their loss and give them 'permission' to grieve. Saying 'I'm sorry' or 'This must be terribly difficult' can help break the ice while conveying your compassion. Let them know it's okay to cry or talk about their feelings. Listen attentively, and base what you say on what they tell you. Spend unhurried time with them. If possible, show them to a room where they can have privacy.

Keep in mind that every parent and every situation is different. Remember that the degree of loss or pain felt by the family isn't proportional to the size or age of the baby. Parents losing a day-old infant don't feel lucky because he died sooner rather than later.

What can you say?

Sometimes, the best response to parents' expressions of grief is silence. You can reassure them that whatever feelings they're expressing are normal. This will help them to recognise and come to terms with their anger, guilt, or anxiety.

You can show empathy by speaking of the child as a person, not as 'it' or, in the case of a stillbirth or miscarriage, 'the foetus.' If the baby has been given a name, use it. Even if the baby wasn't perfectly formed, help the parents identify some positive attributes. Comments such as 'He has beautiful hair,' 'Her lashes are so long,' or 'His skin is so soft' can focus the parents' attention on what's special about their baby and show them that you see their baby as special, too.

What shouldn't you say? Certain clichés, though well intentioned, can hurt by trivialising parents' loss. Avoid the following:

• 'It was meant to be,' 'It was God's will,' or 'It's better this way.' These statements give no comfort and may arouse feelings of anger over why things 'had to be this way.' Don't try to explain the child's death.
• 'At least you're young and you can have other children,' or 'At least you have other children at home.' While this may be true, no child can ever replace or make up for the loss of another. Similarly, telling a woman who's had a miscarriage, 'You can get pregnant again,' tends to trivialise her emotional investment in the pregnancy.
• 'At least it happened when he was young,' or 'It would have been so much worse if he'd been older.' The death of a child is always painful, and parents may feel robbed and cheated that they didn't have more time with their baby, more memories of him, more opportunities to get to know him and watch him grow.
• 'You need to put this behind you so you can get on with your life.' The parents need to work through the grieving process and carry on with their lives, but they should never be made to feel that their baby should be forgotten. Their child can never be 'put behind'-- he was and always will be a part of their lives.

Helping parents say goodbye

Depending on the situation, you may be present when the baby is dying or when the parents first see him after he has died. If so, remember that it's their only opportunity to spend time with their baby, to be a parent to him, to create memories. Helping them say goodbye will make a big difference in how they remember their child's death and can help them begin a healthy grieving process.

Whenever possible, encourage the parents to see, touch, and hold their baby. This can be done in the case of a newborn who is dying or has died or one who was stillborn or miscarried intact. The baby can be clothed or swaddled to conceal any imperfections you think may be upsetting. However, many parents may want or even need to see these imperfections - often their imagination can paint a picture far worse than reality.

At first, parents may be reluctant to see or hold their infant. Encourage them to do so, even if only for a few minutes. I've never known a parent who has held his dead or dying baby and later regretted it. But I have known parents who didn't and later wished they had - this can be a great source of guilt and grief in the future.

When the situation permits, as with the Brenner's, you can also encourage parents to care for their baby. You could suggest to the Brenner's that they bathe Sara, comb her hair, and dress her. It will give them a sense of having been able to care for their baby, to nurture her, to be a parent.

When there's time, as in the Brenner's' case, it's best to give the parents some private moments with their dying baby, so they can cuddle or rock her or sing to her. Stay with the Brenner's and talk for a little while about their baby and what they're feeling. Make sure they seem comfortable with the situation before you give them some time alone, then go back and check on them in five or 10 minutes. They may want more time alone with the baby, or they may want to include some family members and friends. Offer them something to drink, a comfortable chair, and a pillow. Have tissues nearby.

The gift of memories

Mementoes of the baby can also help the parents as they grieve. Usually, you can give parents a footprint sheet including the date and the baby's name (if he was named), weight, and other information. This can be done with the smallest of babies--even those lost in miscarriage--and is greatly treasured. When a footprint sheet can't be done because the hands and feet aren't intact, a 'certificate of life' with the same information can be prepared.

Take pictures of the baby - as many as you can. Photograph the baby clothed and unclothed. Take full-length shots and close-ups of the face. Show him being bathed or baptised. Take photographs of him alone and with the parents. The idea of photographs sounds strange to many parents at first, but most will accept them. Others who don't can be encouraged to take the photos home and put them in a safe place. Chances are, one day they'll want to look at them, and they'll be very grateful to have them. For parents who adamantly refuse the photos, a special file can be created. Often parents will call in a month, six months, or even a year to ask whether you still have the pictures.

Also give parents the baby's identification bands, crib card, hat, blanket, comb, bath soap, lotion, pacifier, and any other such items from the hospital stay. Since smells most strongly stimulate memory, a swaddling blanket, hat, and other items that carry the baby's scent (or that of a lotion or cream used on her) may prove to be particularly cherished mementoes.

The months and years ahead

An important part of caring for parents who have lost their baby is helping them prepare for the months and years ahead. Let them know that over the next several months they'll be experiencing many different emotions, perhaps unlike anything they've ever felt before. They may feel intense hurt, sorrow, anger, and feelings of being cheated. They may think of their baby often and cry.

But also caution parents about the risk of unhealthy denial. Parents may try to bury themselves in work or other activities, trying not to think of the baby. Suppressing their thoughts and feelings, they fail to confront and work through them. They don't move through the grieving process and so can't move on in their lives. Friends and family members who avoid the subject of the loss or become tense when it's brought up can unknowingly contribute to this problem.

Differences in the way men and women grieve can cause serious problems for couples. Men may be more silent, believing that they must be strong for their wives and children. Women are usually more open in expressing their grief, and a woman may interpret her husband's stoicism as meaning he didn't love the baby as much as she did or that he doesn't understand what she's going through. The husband, on the other hand, may feel that his wife is too involved in grieving and can't move on. Many relationships don't survive the loss of a child and end in separation or divorce.

No timetable for grieving

To help the couple avoid such problems, stress the importance of getting in touch with their feelings and communicating with each other and with family members or friends who are willing to listen. Let them know that everyone works through grief at his own pace and that they don't have to follow some sort of timetable. Encourage them to seek professional help if their relationship begins to suffer.

If there are other children in the family, it's important that they be allowed to express their feelings and fears. Remind the parents that their children will need a lot of support and reassurance. Books for children, such as No New Baby, by Marilyn Gryte (Centering Corporation, Omaha, NE, 1988), and Where's Jess?, by Joy and Marv Johnson (Centering Corporation, 1992), can help parents in talking to their children about the baby's death.

While parents may receive a great deal of support from family and professional care givers immediately after a baby's death, they may feel isolated a couple of weeks or so later as the impact of their loss sets in and family and friends return to their routines. This is an ideal time for a follow-up letter or, even better, a phone call. Ask them how they're doing and listen to them relate their feelings and concerns. Don't rush them. This enables them to vocalise their feelings and allows you to see where they are in the grieving process. If appropriate, refer them to a support group. If possible, make additional calls over the next year, with a one-year follow-up call on the anniversary of the baby's birth or death.

At Babies' and Children's Hospital, we hold a memorial service each year for the babies who have died in our NICU. Nurses, physicians, and social workers attend, as well as parents, siblings, and other family members. A short service in the chapel is followed by a dedication in the hospital's garden, with the planting of a tree or bulbs, and a reception. Parents and staff alike have responded positively to the event.

Because of these parents' great loss, we may feel powerless to help them. Yet with kind and thoughtful words, compassionate support, and precious memories, you can guide parents through this heartbreaking experience and influence how they look back on it for the rest of their lives.

-------------

Margaret R. Diaz is a clinical nurse in the neonatal ICU of Babies' and Children's Hospital at Columbia-Presbyterian Medical Centre in New York.
Copyright: 1995 American Journal of Nursing Co.
All rights reserved. Produced in USA.
Permission sought to reproduce article.
AJN Editors (ajn.editorial@ajn.org)

THE TRUTH IS.....

The truth ISN'T that you will feel 'all better' in a couple of days, or weeks, or even months.

The truth IS that the days will be filled with an unending ache and the nights will feel one million sad years long for a while. Healing is attained only after the slow necessary progression through the stages of grief and mourning.

The truth ISN'T that a new pregnancy will help you forget.

The truth is that, while thoughts of a new pregnancy soon may provide hope, a lost infant deserves to be mourned just as you would have with anyone you loved. Grieving takes a lot of energy and can be both emotionally and physically draining. This could have an impact upon your health during another pregnancy. While the decision to try again is a very individualised one, being pregnant while still actively grieving is very difficult.

The truth ISN'T that pills or alcohol will dull the pain.

The truth is that they will merely postpone the reality you must eventually face in order to begin healing. However, if your doctor feels that medication is necessary to help maintain your health, use it intelligently and according to his/her instructions.

The truth ISN'T that once this is over your life will be the same.

The truth is that your upside down world will slowly settle down, hopefully leaving you a more sensitive, compassionate person, better prepared to handle the hard times that everyone must deal with sooner or later. When you consider that you have just experienced one of the worst things that can happen to a family, as you heal you will become aware of how strong you are.

The truth ISN'T that grieving is morbid, or a sign of weakness or mental instability.

The truth is that grieving is work that must be done. Now is the appropriate time. Allow yourself the time. Feel it, flow with it. Try not to fight it too often. It will get easier if you expect that it is variable, that some days are better than others. Be patient with yourself. There are no short cuts to healing. The active grieving will be over when all the work is done.

The truth ISN'T that grief is all consuming.

The truth is that in the midst of the most agonising time of your life, there will be laughter. Don't feel guilty. Laugh if you want to. Just as you must allow yourself the time to grieve, you must also allow yourself the time to laugh. Viewing laughter as part of the healing process, just as overwhelming sadness is now, will make the pain more bearable.

The truth ISN'T that one person can bear this alone.

The truth is that while only you can make the choices necessary to return to the mainstream of life a healed person, others in your life are also grieving and are feeling very helpless. As unfair as it may seem, the burden of remaining in contact with family and friends often falls on you. They are afraid to 'butt in', or they may be fearful of saying or doing the wrong thing. This makes them feel even more helpless. They need to be told honestly what they can do to help. They don't need to be told, 'I'm doing fine' when you're really NOT doing fine. By allowing others to share in your pain and assist you with your needs, you will be comforted and they will feel less helpless.

The truth ISN'T that God must be punishing you for something.

The truth is that sometimes these things just happen. They have happened to many people before you, and they will happen to many people after you. This was not an act of any God - it was an act of Nature. It isn't fair to blame God, or yourself, or anyone else. Try to understand that it is human nature to look for a place to put the blame, especially when there are so few answers to the question, 'Why?' Sometimes there are answers. Most times there are not. Believing that you are being punished will only get in the way of your healing.

The truth ISN'T that you will be unable to make any choices or decisions during this time.

The truth is that while major decisions, such as moving or changing jobs, are better off being postponed for now, life goes on. It will be difficult, but decisions dealing with the death of your baby (seeing and naming the baby, arranging and/or attending a religious ritual, taking care of the nursery items you have acquired) are all choices you can make for yourself. Well meaning people will try to shelter you from the pain of this. However, many of us who have suffered similar losses agree that these first decisions are very important. They help to make the loss real. Our brains filter out much of the pain early on as a way to protect us. Very soon after that, we find ourselves reliving the events over and over, trying to remember everything. This is another way that we acknowledge the loss. Until the loss is real, grieving cannot begin. Being involved at this early time will be a painful experience, but it will help you deal with your grief better as you progress by providing comforting memories of having performed loving, caring acts for your baby.

The truth ISN'T that you will be delighted to hear that a friend or other loved one has just given birth to a healthy baby.

The truth is that you may find it very difficult to be around mothers with young babies. You may be hurt, or angry, or jealous. You may wonder why you couldn't have had that joy. You may be resentful, or refuse to see friends with new babies. You may even secretly wish that the same thing would happen to someone else. You want someone to understand how it feels. You may also feel very ashamed that you could wish such things on people you love or care about, or think that you must be a dreadful person. You aren't. You're human, and even the most loving people can react this way when they are actively grieving. If the situations were reversed, your friends would be feeling and thinking the same things you are. Forgive yourself. It's OK. These feelings will eventually go away.

The truth ISN'T that all marriages survive this difficult time.

The truth is that sometimes you might blame one another, resent one another, or dislike being with one another. If you find this happening, get help. There are self help groups available or grief counsellors who can help. Don't ignore it or tuck it away assuming it will get better. It won't. Actively grieving people cannot help one another. It is unrealistic, like having two people who were blinded at the same time teach each other Braille. Talking it out with others may help. It might even save your marriage.

The truth ISN'T that eventually you will accept the loss of your baby and forget all about this awful time.

The truth is that acceptance is a word reserved for the understanding you come to when you've successfully grieved the loss of a parent, or a grandparent, or a beloved older relative. When you lose a child, your whole future has been affected, not your past. No one can really accept that. But there is resolution in the form of healing and learning how to cope. You will survive. Many of us who have gone through this type of grief are afraid we might forget about our babies once we begin to heal. This won't happen. You will always remember your precious baby because successful grieving carves a place in your heart where he or she will live forever.

Mark Perloe <mperloe@ivf.com>
http://www.ivf.com/misc.html

Dealing With Anniversaries

Anniversaries are always there; just to remind us.

'TIS THE SEASON TO BE JOLLY

By long tradition the Christmas season is the best of times: excitement, reunion, sharing and gratitude. To the people struggling with grief, Christmas can be the worst of times, casting a harsh spotlight on pain and loss. The flood of memories triggered by the season's familiar sights and sounds can create an overwhelming yearning for the return of the absent loved ones.

Bereaved parents struggle to balance their personal grief and loneliness against the pressures of 'joyful' social obligation. They feel they must at least appear to share the merriment of their family, friends, co-workers and neighbours. The increased frequency of social contact during the season, and the general assumption of 'a spirit of goodwill' only accentuates their pain!

If anyone bothered to ask, bereaved parents would likely say that they have an emotional 'wish list' that would be especially helpful in getting through this most stressful season.

I wish that....

• 
  I could be alone, or with others, only when I choose.
• 
  Others would know instinctively when I wanted or did not want to talk about my feelings.
• 
  They would know how to show their caring for my situation without awkwardness, uneasiness or embarrassment (for them or for me).
• 
  There would be acceptance of me just as I am, without criticism or judgement - including and understanding of my feelings, my struggles and my current outlook on life.
• 
  No one would assume that enough time had passed for me to be 'over my loss'.
• 
  They would not assume they know what's best for me.

Instead bereaved parents generally experience quite opposite reactions, and their grief is accordingly complicated. The anticipated dread of the Christmas season is largely because most grieving people believe they will probably be hurt again in direct proportion the the 'high spirits' of those around them.

Christmas is certainly a time when there is and emphasis on nostalgia. One expects a feeling of warmth and richness. All of the media emphasise these qualities and it often appears as if everyone else in the world has joy and completeness. No wonder, then, that the pain experience by the bereaved is intensified, and the yearning for absent loved ones may reach agonising proportion.

There are two major question that are commonly asked:

Q: Can anything be done during the Christmas season to ease my pain and sense of loss?

A: Probably not. However, some Christmas seasons will definitely be easier for you than others. The first season is not always the hardest, although this is often the assumption. There is a general trend for thins to become more tolerable over time, but it is not uncommon to hear of difficulties with the second, third or even subsequent years following the death of a loved one.

Q: What specific things can be done to make the Christmas season easier?

A: Plan ahead! Those people who are able to plan their events as much as possible rather than letting things 'just happen', tend to do relatively well. It's getting caught off-guard that may add to the sense of devastation.

There are two simple general guidelines which may help in coping effectively:

1. Do what feels right to you.

2. As you become aware of your needs, tell family members and friends about them.

Don't be afraid to try changing traditional routines. Perhaps you have always had a Christmas feast. This year you may decide to try a much simpler dinner, and you may want to have it at an altogether different time. You may want to dine out instead of eating at home.

Gift opening can be a traumatic time too. If your custom has been to open gifts on Christmas morning, consider making a deliberate decision to change that to Christmas Eve, or vice-versa.

Is it necessary to put up and decorate a tree in order to make the holiday 'official'? Not at all. Do what feels right for you and your family. If you would like a tree, but lack the energy to decorate it, there are probably others near you who would be delighted to be able to help you in that way. Ask.

Perhaps you could choose an ornament for your special baby/babies to hand on the tree. If you have other children, they would like to do. Children in some families make a special star for their dead baby brother or sister and every year they gently place them on the tree before all the other ornaments, as their way of remembering.

If you choose not to have a tree, perhaps you could have a table centrepiece. You may like to burn a candle for your baby/babies. You could buy a white 24 hour candle and light it on Christmas morning.

Sometimes bereaved parents don't realise how frustrated their families and friends may be. The care givers often stand by helplessly, wringing their hands, loving and caring, but not knowing what to do that is genuinely helpful. If they could wrap gifts, bake, address cards, shop, chauffeur, decorate, even clean they would feel better. Give them a chance, and it's likely everybody will benefit.

Then there are the inevitable invitation for social events which can make you feel very uneasy during the Christmas period. Most people will be understanding if the acceptance is made conditional on emotions a the time of the event.

If this is the first Christmas following the death of your baby/babies, try to keep in mind that it will be far from perfect, but it can be a learning experience where you will discover the kinds of activities, events and situations which will work best for you. For most people the anticipation is worse that the event. Share with others around you what is helpful and what is not. Be kind to yourself, but remember to be kind to others, too.

Adapted by Anne-Marie Robinson (SANDS WA) from ''tis the season to be Jolly' by Dr William D Alexy - Bereavement - Nov/Dec 1987 Vol. 1 No 1.

GRIEVING - A TIME TO GROW

Everyone who loves is vulnerable to the pain of grief, for love means attachment and all human attachments are subject to loss. But, grief should not and need not be a destructive emotion.

Knowledge cannot erase the emotions accompanying grief but knowledge can help us guide ourselves and others toward recovery.  The feelings that come with grief can be used creatively - to bind individuals more closely together and to strengthen their sense of purpose.

Bernadine Kreis

They who have lost an infant are never, as it were, without an infant child. Their other children grow up to manhood and womanhood, and suffer all the changes of mortality; but this one is rendered an immortal child, for death has arrested it with his kindly harshness, and blessed it into an eternal image of youth and innocence.

Leigh Hunt

Christmas

It's Christmas again and I still feel much the same as last year like I've got a large gaping hole in my heart that nothing except Emily could ever fill.

You know everyone says that time heals but I'm finding each passing year harder to accept that my baby was taken for a reason. Yes that horrible line people use. Why as time goes on do peoples attitudes towards our babies get worse I didn't think they could. Why can't they understand that our love for our babies isn't going to go away and why should it.

Since I lost my precious little girl last year I have been blessed with the most beautiful baby girl, Holly, she is loved so much but it hasn't dulled the pain of losing Emily. It has highlighted to me what I missed out on and I've missed so many wonderful things especially that first smile. I just wish I could have all my children with me. My other children often say they wish Emily didn't have to die, funny how we all wish the same things. Holly will know of her big sister and love her the way we do. I feel better in knowing we all have the same wishes about our beautiful babies and someday we'll meet them again.

We are missing you Em more than ever.

Love from Your Mummy

First Day of School

On Wednesday I waited patiently to be served by the assistant in the shoe shop. A little girl was being measured for school shoes. Her mother watched closely. I was there for shoes for my toddler but I would have liked to have bought Ellen her first pair of school shoes, just like that other mother and daughter. I would have marvelled at the large black shoes on the end of such skinny legs. How could she be old enough for school already?

I would have sewn her uniform out of green gingham. Later in the year, she would have a band of brighter coloured material around the hem, reminding us how tall she had grown and how much the material faded. I would have covered all her school books. Does Women's Weekly still print those pictures of horses and puppies? You know, the ones you can stick on the front of brown covered exercise books? I would have carefully printed Ellen Hemy Year 1 in the space they leave for name and class.

Against my better judgement, I might have bought her the Barbie pencil case she desperately wanted, rather than a sensible one with little pockets for the letters ELLEN.

I would have carefully shaved a piece of wood off each pencil for her name.

I would have done all those things with a feeling of pride and sadness; proud that my little girl was starting school, sad that she was leaving me. Instead I will try not to notice the other mothers walking the children to school that first day. I will try not to listen to the radio DJ's cheerfully reminding drivers to watch out for children. I will avoid the evening TV news with visions of skinny kids running home with their new friends, carrying oversized bags.

My Ellen won't be one of those children. She didn't live to skip with her friends. She will never be excited about joining the big children at school. She won't wake early to put on her uniform and those large black shoes. Her bright eyes will never look into mine with a mixture of excitement and trepidation on that first day.

I won't be able to comfort her with an extra big hug as she walks into the classroom, I will not be joining the other mothers for 'tea and tissues' where they talk about how quickly their children have grown up. These mothers will cry and so will I. But I will cry at home. I will kiss my other children. I will be grateful to watch them laugh and play but I will miss Ellen.

Melanie Hemy 18-1-97

Reprinted from SANDS (QLD) Newsletter February 1997
Editor's Note: Melanie is an ex-committee member of SANDS (W.A.).

SANDS had the pleasure of listening to Alan Keye speak at our Christmas service 1998 about how he came to write and compose music of a song dedicated to Ashton Keegan. Jenny and Mark Keegan and his family were all present at the service. SANDS would like to thank Alan for his performance and Jenny and Mark for letting us share in the Song for Ashton. Below is printed the talk he gave to introduce the Song for Ashton, also printed is the words are belong to the song.

Song for Ashton.

Our special friends Jenny and Mark Keegan, and their son Callan, were so much looking forward to the birth of their long awaited little girl "Ashton". Her life was not to be, as she was born at 22 weeks, and slowly her little life ebbed away in the arms of her loving family here at KEMH on the 22nd of December 1995. "So close and yet so far"

This image touched me deeply, and I felt strangely inspired to write a song especially for them.

At this time I was really concerned that by doing such a thing I might inadvertently be adding to their grief, but nevertheless I felt compelled to write.

So, on Christmas eve, just two days after Ashton's passing, I commenced jotting down a few words. By late evening I had written down quite a few thoughts, concepts and key words but seemed to have a mental blank as to how to thread them all together. I went to bed with it resting heavily on my mind, praying that I'd be given the right words so that I could complete it.

I awoke very early on Christmas day with a head full of words, and jumped out of bed and went to the music room and put it all together including the basis of a musical composition.

After that, I felt much more confident that it was the right thing. Jenny's sister Lyn was able to take the printed words to Ashton's funeral in Manjimup where they were read out as part of the service. Consequently I felt very humbly blessed when Jenny and Mark expressed their personal thanks to me.

A short time later the song was recorded onto tape especially for Jenny and Mark, with a friend Taya, who sung the song.

The loss of a child is dreadfully sad, no matter what time of year.

As many of you know, whatever stage of pregnancy, and even after birth, if you lose your longed for baby; the pain is never easy to bear.

I guess that for me, amongst other things, I find it hard not to focus on the loss of potential. The fact that you had already had it mapped out in your mind how you were going to shower your child with love and care as it grew up. There'll be no first steps no first tooth, no 1st day at school.

It's about this time of year that a lot of focus is put on Christmas, and indeed tonight's service is also a celebration of that.

For me, Christmas means far more than presents, and Santa, and all the unfortunate commercial hype that tends to crowd out the true meaning.

No Christmas is a time to also remember that little baby boy that was born in a humble stable in Bethlehem nearly 2000 years ago.

Fortunately God's plan was far bigger than we could ever imagine, and as you know Jesus rose victorious over death. Because he did it gives us assurance of one day being able to have the joy of holding our lost little loved ones again at a time when there'll be no more sickness, pain and death.

It seems to be a universal part of the human spirit, that at times of loss and grief, we tend to think about God a bit more than usual.

Sometimes to question why???

Sometimes to take hold of his hand and ask him to carry us through

Sometimes a bit of both.

I may not be able to give you all the answers, but I know he cares, and he's always there to listen never forget that.

For my special friends Jenny and Mark and Callan, and their families, I remember the time my heart ached upon being informed of their loss back at Christmas 95. The ongoing memories, but at the same time I have felt so absolutely blessed and privileged that inspiration came to enable me to write a few words and a bit of music that has not only helped them along the way, but also others who have suffered a similar loss.

Ashton's passing was not in vain and we can all look forward to a brighter day.

Alan Keye.

Dedicated to the precious memory of

Ashton Olivia Keegan 22nd December 1995

Fathers' Grief

Learning to live with the loss of a child
by Kim McClure

Within hours of our daughter Jade's death it became most obvious that my wife and I would be taking different paths on our way to coping with this living nightmare. Firstly, because we are both individuals, but secondly because we belong to the opposite sex.

From the very outset, the environment seems particularly hostile to the grieving father as it challenges his every image about how he should be coping. Tears may flow in abundance but aren't shed easily. Whilst everybody considers it acceptable for a father to cry up until the funeral if may not be acceptable to himself. Not only does he have a real fear of crying but he may feel that he is not providing the moral support needed by his wife and children at this crisis point. He may well feel a sense of failure in his role of 'protector' that a child so young could die whilst under his care. Most of all, he must cope with the barrage of insensitive platitudes from well meaning friends, relatives and work mates as he assumes the role of family spokesman during the mourning period and for some months after.

In addition to this, the family must learn how to deal with its grief both individually and as a unit. The mother may choose to stay in bed all day where the father may seek constant companionship. She may wish to talk about the events in detail, he may prefer to shut them out. He may wish to sell the house or go on a trip, she may want to stay home and not go out. These are fundamental differences that probably relate more to personal individuality than to sex but nonetheless they go towards forging a gap between husband and wife. Add to these the pressures of a wife mistaking the absence of tears for the absence of pain, or interpreting the emotional armour for a lack of compassion and you have a recipe for disaster.

I firmly believe that grief is an emotion of finite proportions and like most laws of energy what goes in must eventually 'come out'. Put more simply the energy or emotion that is created with the loss of a child must eventually be released and it is the manner in which this is allowed to happen which will determine the speed and extent of a person's road to recovery. It is in this area that I believe the male is at a distinct disadvantage.

In a typical scenario, the mother spends the first few months surrounded in memories and is allowed plenty of time to immerse herself in her grief. Whilst this is indeed distressing for her at the time, she is nevertheless giving herself the best chance of working her way through the grieving process by letting go her emotions. The father on the other hand usually returns to work after a week or so and after the first contact with work mates the subject is rarely raised again. Whilst he may appreciate this in the short-term, the long-term effects are much more harmful.

I recall in my own case, I was grateful for the distraction but found myself frequently needing to talk. Despite this desire I usually avoided the subject because I felt sure I would break down and cry in front of these people something that I was determined would never happen. I began to feel immense pain as the months went by and I didn't seem to feel any better. I was constantly hurt by people/s enquiry of my wife's welfare, but never my own and in the end I began to capitalise on my 'stronger' moments by opening up to complete strangers. This of course offered me the opportunity of speaking to people who were totally non-judgemental and less likely to assume I was doing 'just fine'.

Most of the reactions to grief usually surface within the first six months but with people who are slow to release their emotions the effects can be much more subtle, and surface in unexpected ways. Because of their emotional makeup, most men are therefore prime candidates for this delayed reaction effect.

For me, this phenomenon was particularly devastating and undetected for some twelve months. My business was at that time undergoing enormously complex problems but in my line of work that was nothing unusual. I always prided myself with the ability to turn problems into opportunities, but ever so slowly things started to get more difficult. Answers seemed more and more elusive and options seemed to be reducing. Eventually I reached a point where all I could see was dead-ends and I was in despair. My peers were beginning to doubt my abilities and I had reached a point where I could no longer steer my company effectively.

It was significant that at that time my wife and I had decided to have a night out without children, and it was then that the real value of talking was highlighted. For the first time I approached the subject of my work and we began to discuss how I felt that I had reached the limits of my ability as a businessman. For a person who once knew no limitations, I had finally accepted that I was not capable of operating at this level and should return to something less demanding. Strangely enough, she relayed a story to me that she had heard at the Brisbane SIDS Conference a month earlier that was amazingly similar.

The apparent loss of problem-solving skills is, as it turns out, quite common amongst men and often surfaces in the work environment as a by-product of the grieving process. Whilst it all makes good sense in hindsight it is nonetheless perplexing for the victims who are often totally unaware of its connection to the death of their child.

The opportunity to share this problem had created a solution for me and the change in my outlook and performance from that point on was quite dramatic. For once, I understood what was happening, I could relax and begin to believe in myself once again.

Despite the many differences in the way men and women approach the grieving process, there are still a number of hurdles which must be cleared together, hurdles which have an equally devastating effect on both parties. The most obvious of these are anniversaries. My wife had, it seemed to me, built the significance of the first anniversary out of all proportion and was quite a 'mess' for weeks beforehand. I, on the other hand, had profoundly stated that time goes in a straight line, not cycles, whereby it was going to be just 'another day'. When the day finally arrived, my wife coped admirably. I cried all day.

Two years have now passed since our daughter Jade died, and whilst some of the 'sharp edges' have now disappeared our grief continues to be deep and painful. Our family unit seems to be fairly well synchronised in our grief, but we all still have our moments. I am aware of my emotions and do everything possible to help us along the way. Happily, I am once again able to solve my problems and operate my business confidently - but the tears are never far away and I still wake up at 3 am with the same thoughts every day.

Such is the way of learning how to live with the loss of a child.

Reprinted from the SIDS Foundation

Grief - A Man's View

Men, since childhood, have been exposed to a social conditioning process that establishes roles, expectations and conventions which often serve as barriers. These often subtle barriers rob them of the opportunity to grieve in an open public way - an opportunity traditionally given to women. Whether they are also effective in hindering men's grieving privately is difficult to determine.

A brief look at these roles may indicate how most men have been hindered in their capacity to grieve openly. These comments are general and may apply to individuals in varying ways and varying degrees.

STRONG MAN ROLE -

Typified by such comments as 'big boys don't cry', 'don't be a sissy', 'be brave' heard during childhood. Television and movies reinforce these comments in adolescence and adulthood. Women who are also subjected to the same conditioning hold similar expectations of their men. When the bereaved father feels sad what outlets does he have? Does he surrender to the lump in his throat, or the tears in his eyes? Probably not, unless he is by himself in a private place. Society accepts men crying at the time of the death and at the funeral, but not long afterwards. Friends 'helped' the father to maintain this strong man role, by comments like 'you are doing well', 'someone has to be strong enough through this whole thing'.

PROTECTOR ROLE -

Said to be the 'natural' role of the father. Because his child has died the man feels he is a failure in this role. His sense of failure is further reinforced when he can't protect the rest of his family from the pain of grief nor shield them from the effects of his own grief. He is regularly reminded of his protector role by comments such as 'how's the wife doing?'.

SELF SUFFICIENT MAN ROLE -

A well established role that serves to prevent men from reaching out to others. 'If only my husband would get some help, he would feel better' is a comment made by many distraught wives. During his lifetime, he has probably been urged to 'stand on your own feet', 'learn to do it by yourself', which reinforces his need to be seen as self-sufficient. Men generally resist seeking professional help and are often reluctant to come to meetings with other bereaved fathers where feelings may be shared. He is left to struggle through with his own feelings and emotions, and how to express them. He has had little experience in sharing them with his wife and has learned that you don't share feelings with other men. The result is that men are often barred, not only from openly displaying their emotions, but are also denied the opportunity to explore their own feelings.

PROVIDER ROLE -

the death of the child has occurred, someone has to provide, so father returns to work. He finds that his work mates treat him differently. They often avoid him, protect him from the normal stress and challenge of the work which tends to reinforce his sense of failure and his low self-worth. He feels isolated. He may throw himself into his work, but each evening he returns home where there is the reality of death and grief. At this time, he may start working overtime, drinking at the club or pub, becoming more involved in service club activities. Such behaviours are judged as the man trying to forget his grief-filled reality of home, to avoid the pain of grief.

But is he really avoiding his grief? He has been told (directly or indirectly) that this is not the best way to deal with things. On the other hand, when the mother spends all her time weeding the garden or is not able to do more than physically keep the rest of the family going, people are understanding - 'it's quite a common reaction'. Her behaviour is not labelled as avoiding grief, but her husband's is.

This double standard may hinder the man in his particular grief. People do not see the man's behaviour as a common, natural reaction too. He is said to be selfish and that he doesn't care because he doesn't talk about his child. With such negative value placed on this behaviour the man often comes to feel 'not OK' about himself and about what he is doing. He feels isolated and misunderstood.

Open displays of grief may be helpful and necessary for some people but to expect such behaviour of all or even any men may be counterproductive to their own way of grieving.

Such unrecognised differences exist in the way men and women grieve that neither parent is able to fully comfort or support the other. Apart from being 'empty' themselves, they do not understand the way each needs to grieve. Both may become angry and frustrated with the other, putting strain on the marital relationship during this traumatic period.

We can be supportive by being available to encourage the man to experience and explore his own feelings in a way that feels comfortable for him. We need not reinforce social role expectations, but be honest and direct in our contact with him. We also need to be careful not to burden him with the message that his way is second best. Our understanding, physical presence and listening are what we can offer so that his grief is given time and space to progress in its own individual way.

Peter Dunn for the Sudden Infant Death Research Foundation, Melbourne Australia -
first published in SIDRF Newsletter No. 18 Winter 1983.

LAPLESS FATHERS STILL CAN LOVE

When the good Lord was creating fathers, He started with a tall frame. And a female angel nearby said, "What kind of a father is that? If You're going to make children close to the ground, why have You put fathers so high? He won't be able to shoot marbles without kneeling, tuck a child in bed without bending, or kiss a child without a lot of stooping."

And God smiled and said, "Yes, but if I make him child size who would children have to look up to?"

And when God made a father's hands, they were large and sinewy.

And the angel shook her head sadly and said, "Do You know what You're doing? Large hands are clumsy. And they can't manage diaper pins, small buttons, rubber bands on pony tails or even remove splinters caused by baseball bats."

And God smiled and said, "I know, but they're large enough to hold everything a small boy empties from his pockets at the end of the day ... yet small enough to cup a child's face."

And then God moulded long, slim legs and broad shoulders.

And the angel nearby nearly had a heart attack. "Boy, this is the end of the week all right," she clicked. "Do you realise You just made a father without a lap? How is he going to pull a child close to him without the kid falling between his legs?"

And God smiled and said, "Mothers need a lap. A father needs strong shoulders to pull a sled, balance a boy on a bicycle or hold a sleepy head on the way home from the circus."

God was in the middle of creating two of the largest feet anyone had ever seen when the angel could contain herself no longer.

"That's not fair. Do you honestly think those large boots are going to dig out of bed early in the morning when the baby cries? Or walk through a small birthday party without crushing at least three of the guests?"

And God smiled and said, "They'll work. You'll see. They'll support a small child who wants to 'ride a horse to Banbury Cross' or scare off mice at the summer cabin, or display shoes that will be a challenge to fill."

God worked through the night, giving the father few words, but a firm authoritative voice; eyes that saw everything, but remained calm and tolerant.

Finally, almost as an afterthought, He added tears! Then he turned to the angel and said, "Now are you satisfied he can love as much, as a mother?"

The angel shutteth up.

ERMA BOMBECK

About Men

It has been said that a man would rather suffer a heart attack than let his emotions show. Yet, experts say that tears are a healthy outlet and may account for why women outlive men, in part. Most men fear the loss of their masculine identity if they openly display any signs of distress and often mask their feelings, hiding them from view. Fearful of being considered weak or unmanly, they suffer in the lonely pew of repressed grief. Not only must they endure the psychological impact of their loss, they must also brace themselves to meet the ever-present eye of public opinion.

In building an image to fit what our society expects, a man who reveals his emotions during a time of tragedy believes he is looked down upon by others. After all, have we not been taught that a "real" man will be strong in time of crisis...strong in time of war...strong under fire?

But bereavement doesn't rank side by side with other stress factors. The loss of a loved one transcends the barriers of emotional behaviour. The honest gut emotion of crying is similar to lancing a wound to drain the infection - and a man or a woman is entitled to the right of diminishing the pain of sorrow.

For example, it is a natural response for a man to experience the same devastating upheaval in grieving the death of a child that a woman does. In suffering a loss of such magnitude, it is also natural for a man to deal with feelings of anger, guilt, anxiety, depression, frustration and other real and gnawing thoughts. Grieving is a period of adjustment for men as well as women.

A primary fear of men who hold in their grief and painful thoughts is losing control if they "let go". They also fear emotional involvement - in the sense that if they start to talk, they will become vulnerable. For these reasons, a lot of men do their crying in private, preferring to be alone when they are hurting. But, in doing so, they may commit a great injustice to themselves as well as to their loved ones.

Most men cannot grieve because they do not know how other men feel. This cannot be emphasised strongly enough. Men who believe they must contain their emotions also believe that other men know how to handle those feelings. So, their reasoning is: "I have to be as stoic and strong as they are. Surely they must not be feeling the way I am. See how unemotional they are - there must be something wrong with me for feeling this way."

Often, men are simply unaware that other men are really suffering the same way, struggling with the same inner pain and the same conflicts of guilt and anger. They can't conceive that this is "normal" behaviour for a man who is grief stricken.

When a man hears another man speak of a parallel tragedy, he then becomes aware that other men do indeed feel as he does. Suddenly it hits him: "I am not the only man who feels like this!"

It is so important for men to be in touch with their feelings and experiences - and no matter what these are, to know they are valid and okay. Not every man has similar reactions, but it is hoped each will permit himself a healthy grief process without the chains of the macho roles imposed upon him.

Sometimes it is difficult for a man to understand just what is going on inside himself. He may have trouble identifying feelings of grief and may not know how to deal with them.

Counsellors can help if they are aware that many times they need to give men permission to express pain, usually in the form of tears. But it is equally important that counsellors indicate that tears are not the only signs of grief.

It is imperative for men to realise grief is a process that must be gone through. As one bereaved father said, "We grow according to how we experience this process....There is no healthy way around it - only through it."

Thanatos Journal Vol. 10, N°3 (Fall, 1985)