Explainer

Creed

Mental Health

Trauma

17 May 2023

5 min read

Lamenting the losses in life

There are paths through the thicket of loss that mental illness causes. Rachael Newham explores lament.

Rachael Newham

Rachael is an author and theology of mental health specialist.

A Victorian fisherwoman sits on a beached boat, shoulder slumped.

But O For the Touch of a Vanished Hand, 1888, Walter Langley. The title is taken from the Tennyson poem 'Break Break Break'.

Photo by Birmingham Museums Trust on Unsplash.

I am lost. I feel utterly bewildered by my surroundings and my head is beginning to spin under the strip lighting. There are people all around me, but I can’t find my bearings. This place should be familiar, it’s somewhere I’ve been a hundred times before, but I feel the panic rise as I try to find my way.

Before I had known exactly where things were, how to navigate the aisles and reach the things I needed with ease, but in the months I’ve been away, things have changed and I cannot face the thought of finding my way around the new arrangement, so I turn on my heel and leave empty-handed.

I haven’t been away on holiday or gone on a work trip, I’ve been locked inside my own head doing battle with my own mind in the shadowlands of mental illness. Stable now, with the crisis averted, I am trying to rebuild and yet the Co-op rearranging my local store has served as a stark reminder that things have changed in me and around me.

And there is no funeral to grieve what you’ve lost, no ‘closure’ as you’re still living it.

This is the where the conversation about mental health awareness falls silent; the reality of the losses mental illness stacks up like Jenga blocks while you aren’t looking. Serious mental illness doesn’t just take your mind; it takes your ability to enjoy the people you love, the work you find fulfilling, the gloriously mundane school run and the life you once almost took for granted.

And there is no funeral to grieve what you’ve lost, no ‘closure’ as you’re still living it, no five-step process to ‘get over it’. There is simply the loss and the life you’re trying to rebuild.

This loss must be grieved. I would argue that all losses must be grieved if we are to learn to live with them. It is as Michael Rosen’s childhood classic “We’re Going on a Bear Hunt” reminds us as the family go on their adventure and encounter the winds and sticky mud: “You can’t go under it, you can’t go over it, oh no! You’ve got to go through it”.

We simply have to let it have its way with us until the raw pain has faded into an ache we can tolerate.

It’s perhaps something the ancient faiths and traditions understood better than we do where there are rituals for grief; whether it be Jewish communities sitting Shi’vah or the Irish keening their songs of mourning, they acknowledge the enormity of grief and the need for communities to come together to process it.

Where the loss is more personal, we can seem to lose access to the healing found in community traditions. When the loss is because of illnesses still so misunderstood and stigmatised, these processes and traditions can feel even further away, still.

And yet.

There are paths through the thicket of loss. William Worden, a Fellow of the American Psychological Association speaks of four tasks of mourning which include accepting the reality of the loss, processing the pain of grief, adjusting to the world afresh and finally finding enduring connection. These tasks were designed with bereavement in mind, but they seem to me to speak to losses in the broadest sense and I have found them to be true in mental illness.

In the Bible we find this prophet Nehemiah, who is tasked with rebuilding the walls of Jerusalem after the Israelites exile in Babylon. They’ve returned home, but home doesn’t look like they imagined to, the place they longed for no longer exists, and they have to accept before they can begin to grieve what has passed. Author Marya Hornbacher writes that

“managing mental illness is mostly about acceptance- of the things you can’t do, and the things you must”

and I see it every day - perhaps you do too - as I take the medication and get the sleep that’s required for some kind of equilibrium to be maintained

Nehemiah grieves and weeps over the city for an estimated four months; but there is no set timescale for such things, we simply have to let it have its way with us until the raw pain has faded into an ache we can tolerate. In the Christian tradition this is called lament; it’s grief directed at God, bringing the pain before him in a way that acknowledges the twin realities of God’s goodness and our grief’s greatness. It is undoubtedly uncomfortable, but it is the gift of honesty. We do not need to put on our Sunday best for God, but can come in our brokenness and mess knowing that we will not be abandoned to it.

And then we begin to adjust to the new normal we find ourselves in. We test the boundaries of what we can do as anyone in recovery does. There is a slow almost imperceptible move towards more of life; a trip to the local shop much like I did during that disorientating visit to the co-op, a visit from a friend or a phone call answered, long avoided. Nehemiah returns to his work for the King - but even then the King asks him why he’s looking so sad. We need not rush in with fake smiles before grief has finished with us, but be honest with those around us - and with God.

We cannot lament our losses without finding a community to be a part of; whether that’s your friends, your local community group or your local church.

The fourth task is that of finding connection. For some it will be found in their friendships, others in their faith communities or peer-led community groups. Whichever way it happens it’s how life grows again around and alongside the loss. Worden I think meant it as a way to continue the connection with a lost loved one, but in the story of Nehemiah we see it as the Israelites first come together to rebuild the wall and then to celebrate it. We cannot lament our losses without finding a community to be a part of; whether that’s your friends, your local community group or your local church, we have to find spaces where we can share ourselves, our stories and know we are not alone. It is perhaps one of our most fundamental needs - it is certainly been mine - to know that I am not alone in my loss and I’m not alone as I survey the wreckage and tentatively begin to rebuild.

Article

Assisted dying

Care

Creed

Death & life

19 November 2024

5 min read

“Shortening death” sidesteps the real battle

We need to do more than protest bad deaths, we need to protest death itself, it's more than biological.

Tom Dove

Tom is a physician and completing a theology doctorate.

A hand drapes over the side of an object out of shot.

Michael Schaffler on Unsplash.

What is “death”? It’s surprising the term has received little attention in the assisted dying discussion so far, because more hangs on the answer than one might expect. At a press briefing, Kim Leadbeater MP stated that the assisted dying bill she is proposing is about “shortening death, not ending life.”

But what meaning does “death” have here?

The current bill defines neither “death” nor “dying.” Granted, it implies a biological definition. The bill speaks of administering approved substances to “cause that person’s death” and of capacity and decision-making around “ending life.” These fit the understanding of death with which the medical profession operates—death is the point in time when the combined functions required for human life cease. It is a one-time event, the end of physiology, and so is recognised by a combination of physical signs.

Death, then, is a diagnosis.

So, too, “dying”—though here the waters are murkier. Setting aside sudden deaths, medical talk of dying takes us out of binary territory. Dying speaks of a process, of the “terminal phase.” Within medicine a diagnosis of dying heralds the expectation that a person’s death will occur within hours or days. And so, the focus shifts. The task of care is no longer the coordinated work of investigation, preserving life, and treating symptoms. Now attention is on bringing relief to the process of dying.

The bill seems wise to much of this. Though definitions of death and dying are absent, the bill does define terminal illness—“an inevitably progressive condition which cannot be reversed by treatment” and from which the event of death “can reasonably be expected within 6 months.” And so, it clearly distinguishes terminal illness from biological death and, implicitly, from dying.

Of course, terminal illness and biological death are related. Terminal illness is irreversible, and where terminal illness leads is death. Or, you might say, it leads to the end of life. Apart from the timescale of six months, the same may be said of ageing: ageing is irreversible, and where ageing leads is death. This is why Kim Leadbeater’s comment was puzzling to me. I suspect what she really meant was “shortening terminal illness.” If so, this is confusing because, within the framework of the bill, “shortening terminal illness” and “ending life” are identical. It seems she was getting at something else.

“It seems odd that in the name of eliminating suffering, we eliminate the sufferer.”

Stanley Hauerwas

I suspect Kim Leadbeater was echoing a conviction at home in the Christian faith. That is, try as we might to keep death at a distance and restrict it to a faraway frontier, the life of human beings involves death. I don’t simply mean the biological death we witness—the deaths of friends, relatives, or even strangers. I mean death intrudes upon the way we experience life. Death is more than simply biological.

The fear of death belongs in this category. For some, the impending loss of relationships and joys casts a shadow over life, giving birth to apprehension. Death is not simply a factual matter but something that exerts power and influence. Or take disease and illness. Built into the notion of terminal illness is the idea that the sickness borne by a human body will ultimately bring about that body’s death. That body already speaks of its death. Death is making itself felt in advance.

And so, death is more than a biological event. Even living things can bear the marks of death.

This is no novel claim. The creation account recorded in the Bible says that in the beginning, there was good. But an intruder appears. In the wake of humanity’s choice to go its own way rather than the way of its Maker, death arrives on the scene. And death is an imposter—not simply a physiological fact at the end of the road, but a destructive and alien presence in God’s good world.

Understood in this way, death is not something that God intends humans simply submit to. Death is something to protest. This is why Kim Leadbeater’s comment gets at something important: this kind of death should be protested. The marks of death should not be accommodated, because they do not belong to the goodness of what God has made.

At the heart of the Christian faith is God’s own ultimate protest against the force of death. Christians celebrate that God himself came in the man Jesus to “destroy death.” This is plainly more than biological. Jesus came to free humanity from the entirety of death’s grip. Hence why, when Jesus speaks of “eternal life” he means more than endless biological existence. He means liberation from all the havoc that death brings to bear within God’s world. To the Christian imagination, the power of death must be protested because God protested it first.

The question is how to protest death. Within the framework of the bill, shortening death or terminal illness is identical with ending life. This is the only form protesting death can take.

But the Christian faith makes a far more radical claim: God alone overcame death by dying. This is the point: Jesus was the one—the only one—who emerged resurrected victor in the contest with the power of death. In seeing his death and resurrection, an unshakeable hope emerges. Death is not the victor. And this hope stands above our present experience of death—in whatever form—and, at the same time, calls us to join the protest.

Ethicist Stanley Hauerwas once wrote: “it seems odd that in the name of eliminating suffering, we eliminate the sufferer.” I have deliberately avoided discussing suffering, not least because it would take me too far afield. Yet Hauerwas has put his finger on what I’m getting at. Protesting death—in the big sense—belongs to the Christian faith. Protesting suffering and pain, economic and racial injustice, fractured relationships and broken societies, are all part of this protest. But can eliminating those who live within the shadow of death be part of this protest? I think not. The Christian faith believes there is only one who can overcome death in this way, and that is God himself—who has already done it.