Accepting Loss

                                                                                         

At some time in our lives we are all challenged by adversity, whether it be stress, illness, pain, disability or a mental difficulty. We have to cope with whatever life throws at us and we vary enormously in our effectiveness in coping with our situations. How we cope determines to a great extent how effectively we manage our lives and how happy we are with the result. The greater our ability to be realistic and plan our future the more likely we are to be successful.

Loss figures in many of the challenges we face and this needs to be recognised as many consequences flow from this. We accept without question when we do not have any pain and feel a loss when our bodily comfort is removed. Simple activities are affected such as doing the gardening, getting the shopping and sitting in a restaurant or cinema. As we get older many changes creep up slowly upon us and we may not be happy with these and find them hard to accept. A sudden and dramatic change in our comfort or ability is much more difficult to accept, particularly if we are young or very active.

Other losses we can suffer are loss of a relationship, death of a loved one, loss of job, loss of role in life, loss of income, loss of a part of the body and so a loss of our sense of self and self-esteem. Loss of some kind which leads to the single most disabling condition in the world, depression. When we are depressed we undergo a change in our brain chemistry which causes us to think negatively and to apply a continual negative bias to all our thinking and conclusions. This is important for its own sake in terms of our mental state but also because a high proportion of depressed people suffer a pain condition of some kind.

As we struggle to come to terms with our losses we can fall into depression and become hopeless and be unable to take the actions which would help us out of our situation and thereby alleviate our depression. This position may need cognitive therapy and/or antidepressant medication to start the process of a more realistic interpretation of our position and so begin to lift the negativity we have fallen into. If we do not become depressed we may react in another typical and natural way to our losses by fighting against them.

Pain sufferers typically say I'm not going to let my condition beat me, making the situation a competitive one which they are going to win against the pain. This approach is a common one as sufferers try hard to keep control in adverse conditions, fighting to maintain their activity in getting things done such as their day to day chores and things they feel they should be able to do. This approach can however have a real disadvantage as the continual struggle against the pain can lead to a deterioration in pain, reduced activity and depression.

Conflict is one of the most important concepts here. The conflict exists between what we think we should be able to do and what we can. We can feel aggressive towards the pain and towards the world which demands things we cannot supply. We can thereby develop a relationship of conflict with others and within ourselves which can obstruct us from generating alternative approaches to our problems and gets us stuck in a rigid behaviour. These problems are all related to not accepting the reality of our situation and we cannot move forward as those actions are not acceptable.

Resignation should not be taken as the same idea as acceptance. When we are resigned to something we accept it passively exactly as it is and feel there is no point in taking any actions to change anything as this will have no effect. We have a negative slant on the situation, rating it as permanent as it is, making us more likely to suffer some depression as a result with the consequences that we won't feel like taking the actions to improve things. Resignation is not a helpful state of mind and working hard to achieve some realistic level of acceptance is much more likely to be functionally useful.

About the author:
Jonathan Blood Smyth, editor of the Physiotherapy Site, writes articles about Physiotherapy, back pain, orthopaedic conditions, neck pain, injury management and physiotherapists in Glasgow. Jonathan is a superintendant physiotherapist at an NHS hospital in the South-West of the UK.

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