BEREAVEMENT COUNSELLING

Although grief is an intensely personal emotion, overall patterns in the process of grieving have been identified. S A key element in coping with death is finding an appropriate person with whom to share the grief in order that it may eventually lessen. Bereavement counselling in its barest elements consists of a readiness to listen, often at length, while bereaved people impart often overwhelming feelings so that they can resume the threads of their lives. Help may often be needed with practical tasks until the person can regain control for himself. In many cases, of course, this help is provided by families or close friends, and counselling by professionals is needed only when this fails.

Families whose children have died of the sudden infant death syndrome may need particular help. The unexpectedness of the death leaves parents unprepared and exposed to endless feelings of guilt as they search for an explanation. Neighbors and relatives are similarly bewildered, and if the coroner's officer (a police officer) is called in this can lead to hostile comments from neighbors. The parents are often young with no experience of death. In a society where infant mortality is low they are unlikely to be able to draw on the experience of family or friends and may need outside support. So intense were the emotional and physical reactions of several young mothers that they confessed to us that they believed that they were going in sane. The death of a baby bereaves many people; the mother and father are most severely affected, but the grandparents and surviving siblings also suffer. When everyone in a family circle is devastated they are likely to find it particularly difficult to help one another. Fathers and mothers often have different ways of expressing their grief, which can cause marital stress.

Positive support should be offered to all families with babies that have died suddenly. Social workers in hospitals are well placed to link parents with local support groups, health visitors, general practitioners, and a pediatrician in the hospital. We have little doubt that an interview with a sympathetic, informed doctor is an important step for many parents in coming to terms with their loss. The health visitor was often in an ideal position, but regular support depended on whether a good relationship already existed. The work can be quite stressful, and, as Watson pointed out, not everyone is temperamentally suited to it. The sudden infant death syndrome is still fairly rare, so perhaps health visitors interested in working with bereaved couples should be identified and receive extra training and support. Bereavement counselling for trainee general practitioners could include specific guidance on the sudden infant death syndrome. For doctors, health visitors, and social workers the success of any help given is likely to depend on the helper's confidence that parents will value the support offered.