Explainer
Creed
Mental Health
Trauma
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 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
Care
Creed
Easter
Trauma
1 min read

Understanding the power of blood

From hospitals to hymn books, it's significant for a reason.

Helen is a registered nurse and freelance writer, writing for audiences ranging from the general public to practitioners and scientists.

A bag of blood connected to a drip.
Give blood.
Aman Chaturvedi on Unsplash.

With one billion molecules of oxygen packed into each of your 30 trillion red blood cells, blood is sometimes known as the red river of life. Countless lives have been saved through blood transfusion, but why, throughout history, across continents and cultures, has there been a special interest in the blood of one man crucified 2,000 years ago, believing it alone to have “wonder-working power”?  

Whether you are a newborn baby with half a pint of blood, or an adult with nearer nine pints, “what is certain is that you are suffused with the stuff”, writes author Bill Bryson in his book, The Body.  

Once thought to ebb and flow in waves like the sea, from the liver to other organs, having been heated in the heart, blood in fact flows in a network of vessels measuring some 60,000 miles, with the heart acting as pump, not heater. Cleverly conserved through a complex system of blood-clotting in the case of injury, blood is a precious resource that needs replacing if lost in large amounts. Victims of road traffic accidents can require up to fifty units of blood; significant amounts are needed for organ transplantation, severe burns or heart surgery. 

The first human blood transfusion in Britain, using blood from a lamb, was performed by Dr Richard Lower in 1667, given not to replace blood loss but to change character: could the old be made young, the shy be made sociable through blood transfusion? Apparently not.  

Safe transfusion awaited the discovery of blood types by Dr Karl Landsteiner in the early 20th century. Today, NHS Blood and Transplant deliver 1.4 million units of red cells to 260 hospitals each year for transfusion; about 85 million units are transfused worldwide, given to replace blood loss after accident, surgery, ulcer, ectopic pregnancy or for anaemia in cancer. Also used to boost blood cell numbers in malaria, sepsis, HIV, leukaemia and sickle cell anaemia, blood transfusion is now amazingly safe. Fatal reactions are extremely rare, “occurring only in one out of nearly two million transfusions”, writes physician Dr Seth Lotterman. “For comparison, the lifetime odds of dying from a lightning strike are about 1 in 161,000,” he adds. The risk of HIV infection has dropped dramatically, to less than one in seven million. 

History tells though of the danger of transmitting disease from the blood donor during transfusion. The World Health Organization recognises risk of infection with HIV, hepatitis, syphilis, malaria, and Chagas disease. The Contaminated Blood Scandal saw an estimated 30,000 people in the UK given blood transfusions and blood products infected with hepatitis C, hepatitis B and HIV. More than 3,000 people died as a result, and thousands more live with on-going health complications. For my final Christmas article for Readers Digest, I wrote on Stephen Christmas, a tireless campaigner for blood safety who lived with haemophilia and died in 1993, having contracted HIV through contaminated blood. 

I was a blood donor. However, I am now unable to donate blood or organs for the rest of my life since there is a possibility that my blood is ‘stained’, possibly with prion disease, after adopting embryos. The Blood Transfusion Service will not accept donations from women who have had various fertility treatments. 

And there’s another uncomfortable truth about blood donation – the NHS does not have enough blood, organs, tissues, platelets, plasma or stem cells to treat everyone who needs it. As a nurse, I remember caring for a man dying of liver cancer. Suffering from sudden, massive melaena (blood loss in black, tarry stools as a result of internal bleeding), he received emergency blood transfusion, with bag after bag of blood being infused, until the consultant called for the treatment to stop, because the bleed was too big – and blood supplies too scarce.  

Struggling to accept the stark reality of stained blood and dangerous shortages, I kept coming back to an old Sunday School song about blood, where absolute abundance and ultimate cleansing are instead promised. 

There is a fountain filled with blood 
   Drawn from Immanuel’s veins; 
And sinners, plunged beneath that flood, 
   Lose all their guilty stains. 

Gruesome and graphic in its imagery, but full of deeper meaning. And as a nurse, I’m accustomed to blood, sometimes lots of it. I’ve seen that man bleed out on the ward that night; I’ve attended a road accident, where a boy lost his leg – but not his life, because towels stemmed the massive flow of blood. I’ve raced a patient to the operating theatre after her aortic aneurysm burst within; I’ve stemmed arterial bleeding from the groin by applying prolonged pressure to the site punctured by a catheter during cardiac stenting. According to the World Health Organization, severe bleeding after childbirth is the leading cause of maternal mortality world-wide. Each year, about 14 million women experience postpartum haemorrhage resulting in about 70,000 maternal deaths globally.  

In the Bible, and in hymns of praise like this one, there is also no getting away from blood. “Like it or not, the Bible is a bloody book,” writes  Kyle Winkler. It runs through the book like a crimson thread. There’s a story of a woman bleeding for twelve years, until she touched the hem of Jesus’ garment and was healed.    

Elsewhere the Bible keeps returning to the idea of blood, shed in sacrifice, used to cleanse, save, and heal in a spiritual sense. In the Old Testament, animal blood was painted on doorposts at Passover as a sign of protection from judgment, and sprinkled ritually on the altar as a sacrifice for human sin, restoring relationship with God.  

On Good Friday, Jesus himself shed (and sweat) his blood, sacrificing his life on the cross to “wash our souls” once and for all. Millions of Christians across the world take a sip of communion wine each Sunday in commemoration of this act. It’s a beautiful gift, coming with a promise that the shed blood will “preserve thy body and soul unto everlasting life”, through the forgiveness of sins. It’s no wonder then that churches love to sing about this blood. “Would you be free from the burden of sin? There's pow'r in the blood, pow'r in the blood,” goes one hymn, while another simply says, “Your blood has washed away my sin, Jesus, thank you”.  

“God’s intention for blood isn’t gory—it’s beautiful! And I’m certainly not offended or scared by it,” writes Kyle. “Rather than question how little blood I can get by with, I’d rather stand under the cross to be covered in all that I can get!” Thank God for the fountain of forgiveness that flows from Good Friday. 

  

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